HomeMy WebLinkAbout2131 ELDEN AVE - Building Permits 14928 . FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT JUL 181981 .
•
P. O. BOX 917 COSTA MESA. CALIFORNIA �. NANCE DEPT.
For Applicant to Fill In Completely -� PPLICA�(;;I�71t�TTyyNU n ROMiSA
n /TYPE ORPRINT
BUILDING
BUILDING o�-/ C,/1 ` iDe-AZ.-------
ADDRESS
COSTA MESA.,CALIFORNIA For Office Use Only
OWNER /fin ‘ r ,,VA-,e D I RECEIPT No. I 7 No.
ve
MAIL y 1 EY DATE AB 1 /DATE l U-
ADDRESS J �0 3�sr S ' ` I K-J 17 °f4i
,// I TE�Lyy�� BUILDING
CITY /“ZIa.)�,e 2:7c4 NO(/2 3 V 7l ADDRESS
OR`" EER�"'tinerrh'f Z/— NO.��en/y�4. COSTA MESA. 'C/ALIFORNIA
ADDRESS 24/`- a- tLLr 2.. 1.. ll FIRE
ZONE TYPE V GROUP
-1 HJ (/p
CONTRACTOR 61L'1. � APPROVEDCl.) ATE�p "/
BY' /I ///111
if
ADDRESS ZONING 10 LAA.
-�. ZO NO.or ^ / USE OP NEW l
CITY _ I PLANS V II.{/'B�m'1L/Ow/D �. A
STATE TEL. _ eBCRLIPTION PO n 6I O(ii ( kg Igiul h
SIZE
LIC.NO. �/ NO. t �j .9
N
iaint
OF LOT S (-- l�7�I NOW ON LOT / A.P.NO. I I ,u.) I�2
USE OF - YARDS EVES
EXISTING BLDG. ip'.- O . APPROVED ALLOWED
SETBACK LINE FROM ' / (CENTER LINE RJ cb
CENTER OP STREET L7 G REAR YARD /S FRONT (�.FT. 6 IN.
SIDE YARD I LEFT ' /77RIGHT 2-c, R.SIDE ( �Q/ FT. /i.-.a± IN.
DESCRIPTION/ OF WORK FT. n IN.
III ALTERATION I V ADDITION I L.SIDE 7) e
NEV REAR 7 U FT. IN.
REPAIR I II MOVING I II DEMOLISH APPROVED
BYl c nDATE 9,/Q -./ I
BUILDING el /� m 'SZ �Yxe ROOMS STORIES
EXTERIOR WALL
ROOF
COVERING COVER INC//Ql4/11CB � Al- 24 a
USE OF BUILDING AND WORK TO BE PE FORM
` oIr?.G»IA-A /�.�e lz� Qaee-rn.1 3 SM.47- I
•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY O RANGES AND STA LAWS rtqOULATING
BUILDING CONSTR On )/ VALUATION //
SIGNATURE OF // R1 PERMIT FEE S -j N
PERMITTEE • 1 $ "-7 01/4 ° PLAN CHECK $ OLD ea y'
AUTHORIZED AGENT // ‘ Y/% 0
TOTAL FEE 5 L
9951.°/
•
'COSTA MESA BUILDING-SAFETY DEPARTMENT V
ei P.O.BOX SIT COSTA MESA.CALIFORNIA CJFEE RECEIVED E C E I"V E D
For Applicant to Fill In Completely APP;LICA1TIaON ,fQR PERMIT
TYPE OR PR/NT
e)......4. / F SIA ArL2•n 17Tpal
BUILDING Z / 3/ vAl CITY
tlX01FDF(l�rl�t�TUfY(�BAIr(�] y J(�
ADDRESSRcISAI N MESA yr.',V
COSTA MESA, CALIFORNIA 11 59
/� /� M1� RECEIVE Br D '�[' pc ye� __ A Ta...Su.195
OWNER 7 �I/- / //D //v. .�U�I .I9
BUILDING
M
IL
ADDRESS 2 i 33 eaten-- L.�4y1 77 'J ADDRESS
CITY NW/C�✓' / 6 J FIRE
ZONE TYPE ' /GROUP y I
l I( APPROVEDAR / .....AL
,//�
OPCN�INEER ( fa. NC( f P513 BY V/� /1T DATE /
L f f , ZONING
ADDNES$ d76(fG ar /_ 7:2.2 an... 'h
ZON PLANS USe OP NEW, LL
//�� � � � � get" � ( BUILDING f'..., RC 1
CONTRACTOR (pjrA/yL/�.J �/1[/.q"'( 1/}..� (�LV ,'�I ,�
ADDRESS /t3s( DESCRIPTION U 1 lei Fri 3 /Talh H " " j
airy dre, z (/(.C/+s•.� ��// 'y J A.P.NO. I I ���.J I -�In
LIC.STATE TIE&4 915 6.7 NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
N TEL // SO'TO SIDE H REAR P.L
EAVES
VE
/ t X.it
/7 I NO.OP SLOGS. ALLOWED (U.S.C.REQUIREMENT)
OR LOT 6 . 7 C NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. .//'— l / ,,�o
SETBACK LINE PROM 1// REAR YARD.Q FRONT CCat FT�) ...5/4 FT. W- .J
CENTER OP STREET n `I V'
SIDE YARDI LEFT /7 I RIGHT.2 f� R.SIDS 2-(6 Fr. Fr.
DESCRIPTION OF WORK L.SIDE 1 I FT• 0 FT. se-
Cr
Nr _ "'ALTERATION ADDITION REAR/ / 137.1-4 FT. cI
DEMOLISH DISTANCE BET. BET.MAIN H 0'
MAIN BLDGS. ACCESS.BUDGES. I,LI
REPAIR MOVING
BUILDING NO.OP
VAR2 .# DATE
SIZE - ROOMS .4 STORIES C.U. -. j APPROVED 1
EXTERIOR WALL ROOF ) APP , 1 C /Lf��` W
COVERING COVERING / A ' L ay 1�,r. NAL DATE ILI
USE OF BUILDING D WORK TO BE PERFORM.D (rlI • D.
in
Cd
I orefriteA10/42:17,€4,14,1* __„9 ig _ li S'i-___-- / ti . \ 0
N A
SQ.FT. G
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE _ 0
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. O
PLY WITH ALL CI INANCBB AND STATE LAWS RIMY VALUATION o
BUILDING CONST'
PERMIT FEE $ / O H
SIGNATURE OF ' � O
f//Iyy�yy co
PERMITTEP $�✓� 737 --. .E . - �� 1'O
AUTHORIZED AGENT (/
TOTAL FEE $ /5Cif•/fie
City of Costa Mesa •
Building Safety Department CERTIFICATE OF OCCUPANCY N?. 1918 C
P. 0. Box 317
Costa Meso, California
The Building located at 21371. Men Annecy Ilatte 1 to 8
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group 8 at Occupancy.
Use of Building '� •t Paeldeetelal giant Building vith Detached
Legal Description Amon). YJ0e3L.26
(See reverse side for Metes and Bounds) �'y�,,y.
Building Permit No. 19F+Q Electrical Permit No., ''`2 5 Plumbing Permit No. *POO
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments _ and/or guest rooms
ISSUED TO: Building Official�
third ITLVe81 dE0 by t„" 'ci�y// C/!/�
• 4 ,
Date RU'Ch AT) 1964
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Foca BU34-1M-11-63--.sB r
ADDRESS OF MUM 2131 ELDEN AV UMT: CITY OF COSTA MESA - BUILDING PERMIT
ONNEnSNAMEn1Dmm: ASHLEY, ROBERT TR PERM NO: B 072807
ADDRESS p 0 BOX 10224
COSTA MESA,CA •92627 PERMIT NO: B 072807 PLAN CHECK NO: 01988-95 L GOVT: N SUPP : N
APPL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STA PURPOSE: OTH
ARCIInECTOBowwi, ALBERT KAMKAR & ASSOC DCND: C38311 JOB DESCRIPTION : REPLACE WOOD STAIRWAY INTO STEEL/CONCRET SQ FT: 8, 131
ARCM.OR EMI ADDRESS: 1510 FRANKLIN ST WIT:
SANTA MONICA CA 90404 CLAIM VALUE: 8 , 131 . 00 CALL-VALUE: 8, 131 . 00 GROUP OCC: R-1 /
CONTRACTOITSKMC: ROYAL DECK AND STAIR ( 310 ) 820-2725
Ca4BACTORSYNIl1012021 WILSHIRE BL COMMENTS: REPLACE STAIRWAY INTO STEEL W/CONCRETE LANDINGS
ADDRESS: L.A. CA NC NO.: 579874 *SEBEBt******+ESE*******BE******BEBE*NBEBE*x***BEBE****+Ear*x********* BEBEBEBE*BEBE***BE*****AE**BE*SE
90025 ural: 822 Z ONING REQUIREMENTS
110ENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACK S
(commencing with Section 7000)a Derision 3 a the Business and Profusions Code,and my Rowse is in full force and ended.
CmuC. Contractor:
LA
LIC.CSS: C-15 LW.NO.: 579874 EXP: MAIN BUILDING ACCESSORY BUILDING
G/<Z FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN
DaleContractor: � LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby dins under penally of perjury that I am exempt from the Caeredon License Law for the
following reason(Section Tots Business and Professions Code:Any city a cavy Mich requires a permit to=rrid,alter,improve, PARKING REQ: PROV: PARCEL: 42612110 ZNE: REF NO:
demolish,lcersedpuu°suremtothee:tura prior pr sdme'e�w.tors°i;:,»v(C°°aperrt 9(commmenci"awgwito thSe°signed ed i statement
3ain PLANNING NOTES> ,
()ninon and Professions Code;or lbs he or she is exempt therefrom and the basis for the alleged exemption.Any violalon a Section >
7031.5 by anyappicanl for a permit subjects the applicant to aawl penalty of not more than free hundred defter*[S5001). *******************************************************************************
o
n° fvetwitn d as at� cell sdoeand °` ature is pr°AeDEVELOPMENT SERVICES R E Q U I R E M E Nr1Sor end ors (Section ranProfessionsC�e The Contractors the
not applyto an Owner of property
who buids or improves thereon,and who does such work Knoell or herself or through his or her own employees,provided that such
improvements ere not intended or offered for sale.If,however,the building Of inprovernem is sold within one year of completion.the ZONING APPROVED BY (1,6E- DATE: CP 11,31 q.
owner'builder will have the burden a proving he or she did no build or improve for the purpose of sale).
❑ I."owner a the pmyerty,em exdavely contractig with"flied
canlrs rs fo mmtrl the pops(Sectio"44.
BusineBusiness and
Professions Code:The Coltman License th
Law dose nor appy to an owner of properly who builds or improvesereon and who BUILDING APPROVED BY : DATE: -1.
contracts for such projects with a mniractor(s)D:ensed pursuant to the Contractors license Law).
❑ Iamexempt under Section: B.AP.C.,for this reason: APPLICATION ISSUED BY: DATE : k �� C
********************************************* ******W"*7FWW********.** * *******
Date: Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware a erd understand the requirements of California Health end Safety Code Seaona 25505,25533,end
25534,and that I or any future building occupant will/wil not(circle one)need to comply with said stale=lea and the requirements for
a permit lamutnxtion or recordation from the Air-Oryratgemenl District.ResidemmlmMndion applications are exemptions these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
Provisions. PERMIT 108 . 00 . 81
Dale: Applicant: PLAN 70 . 20 SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: ISSUE FEE
o Ihave and wiimimed acertificate amnentlosef'lneure for workers'compersaon,asprovdedfor bySection 3703of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code.f«the p.dmaw
« s.aln.wakl«wNah lni.permit is issued.
TOTALS----> 108 . 81 0 . 00 70 . 20 179 . 01 179 . 01 . 00
o I have and tel merman wakes'compensation insurance,as requited by Section 3700 of the labor Code,for the performance of the
work for whit's this permit is Sued.My wakes'compensation insurance caner and policy number are:
STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 108 , 81 OVER/SHORT: 00
Policy 1358 /58-94 09 /01 /95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
n ,This section need not to completed a the patine isfor one hundred dollen 15100)abs.) 108 . 00 . 81
❑ I certify that in the performance of the work for which the permit is Sued,I shall not employ any person in any manner so as to
become subject Io IM workers'mrwereaton lows of Caliomie, end spree that i *Mullm
I sd becoe subjed to the wakes' *******************************************************************************
compensation n previsionsof Sedan 3700 a or the LabCafe.I shall forthwith complywith these provisions. INDIVIDUAL F E E BR EAKDOWN
Done: 4-7—An — QS Applicant
Warning Failure to secure workers'compensatoncovxageis unlawful,and shall utMcr anerrployet to crlMrw/deanship and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
doll lines up to one htdred thousand dollars(51x[{000),In addition to the cost of compensation.damages as provided for In
Section 3106 of this Labor Coad Interest and atfornOra fees. SFR 8131 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 8, 131 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury lbs there is a mrutndion lending agency for the END OF FEES
pedonnanoa of the work for with this permit is issued(Section 3097,Civ.C).
LENDER'S NAME
LENDER'S ADDRESS:
I certify that I have read this application end data that the above information is correct.I agree to comply with all city and maty ordnance*
and state feats rotting to building construction and hereby authorize representatives of thtsahyto amerupon theabore'namoned property 01 00184104-00184105 TOT 108.81
for inspection pcpoen.
MAGALY MORATAYA DATE: 06/13/45 TIME: 14:36
Pke Neo
Date: C / 3 -7<"
� da
(5151.4e.WP) White-Buildig A Safely;Green-Fie;Canary-Appiranl:Pink-Revenue:Goldenrod-Assessor
I ,
' CONSTRUCTION AND PLANNING • POO JPA
Z:APP.R OVA LS Permit # Date Inspector APPROVALS Permit # -Bate- Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • - - - -
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
. •3
• . . ;Electrical Conduit;Utility-Undrgrnd. 54. Forms ' ,
• 4..:ElectricaLCondult;Undrgrnd. .. I 55. Electrical Bonding
. 5. Steel Reinforcem_Ent 56. Rough Plumbing & Pressure test _
6. Electrical UFER.Grnd. 57. APPROVAL TO COVER-GUNITE (
- 7. footings . �r.cr+= ?Leg-15 4 4,9-- 58. Electrical Conduit:Undrgrnd.
8. Foundation ' ' 59. Gas Pipe,0 Undrgrnd.,Test
r 9. Water Pipe,undrgrnd.L 60. Backwash Lines;P-Trap, 0 Undrgrnd.
10. Structural:Flod, System . 61. APPROVAL TO,DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final'
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains _ - 64. Plumbing System - Final '
14. Rough Plumbing 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Frinal ,
16. Rough Electric Wiring: 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED F!R PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
• 19. Rough Heating & Air Conditioning FIRE DEPT.,REOUIREMENT
20..Rough Factory Fireplace ' - C: �'• r" APPROVALS: L• Permit# r
21.-Ducts, in-Structure - - - : ^-' : - 70..Underground Hydro
22. Ducts, Ventilating.-. 'i� ; .. " 71. Product,PipingD Gas ❑Oil
23. Gas Pipe-Rough & Test 4. - _ - _Jrc
P ,_ � 72. Underground Flu"sh=
24. Roof Framing' -- ;. r , � 73. Undergrnd.Storage Tank D Gas 0 Oil
•
25. Rodf Sheathing i. • .--; Y - 74. Overhead Hydro
26.•T-Bar Ceiling (Structural) & Mono_coat - - • . `,•-, 75. Dry Chemical - -7
27. Frame and Flashing, - I-r,, . t- - 76. Dry Standpipe- -
28. Lathing&.Siding-.^ . - ,. r .-L; * :4 •' 77., FIXED`SYSTEM FINAL- -
29. Insulation <• _ T •r 78• FIRE PREV. FINAL ' -
. • 30. Drywall Nailing y : - Y r , HEALTH DEPT. REQUIREMENT
✓ 31. Plaster Brown Coat •- .--- + ^ 79. FINAL INSPECTION
32..Electrical Power Metier-Final � ; ' SO;. FOOD CERTIFICATE ISSUED
33._Final•Electrie 11'?' - i _ . Notes: •
• 34..inal'Heating & ATr�Conditioninii . g-- : . -; -
35.:Final Gas Pipe:Tet ,, - :- ,_ ;r _ - . - -- I-1` :
' 36. Hood or Canopy t • - `•t
I •I
37. Final Factory Fireplace - : ..•
38. Final Plumbing F ' ' ` •: ` ' -
• . r
39. Wet&Service-Final ; - C . -
t • 40. Gas Service.Final- . . - - _. v
'' 41. Solar Domestic-Final = a -
42. Backflow Preventer i .
43. Backflow Irrkgationy. � '- r } ...
-44. Landscape Irrigation System!: ' r' - 1 c -
:45.•Sound Attenuation:
. .. - r r.. f F r- +
46.1 Handicap Regulations , s C. I_ -
47.•FINAL STRUCTURE & BUILDING Q Z8 d(,I/ - `
48.:F,INAL PLANNING - a * -
49. Electric Release to Edison - r -
50. Gas Release to Southern California Gas CO - - •
51. CERTIFICATE OF OCCUPANCY -
No. Date
APPLICANT DO NOT FILL IN SHADED AREAS:
CITY OF COSTA MESA CONSTRUCTION/ // PERMIT PERMIT 7_7,>--7, UNIT MODEL A.P.# Zone -
•Project Address: (-3) .z 4 ..��t-- A V'c. Unit: i- g SO — - S Main Building • Accessory Build'.: Z
Owner's Nam of r✓*- A.(4_ PURPOSE: 0 NEW 0 ADDITION ALTERATION ❑ REPAIR • T Front N
Adreu: kin 1:4ev io ? Ch. /'iJPr •. CZ - B Left 1
-71.4', get -c}'aZ� ❑ CONVERSION 0 DEMOLITION ❑ OTHER - - C Right • N
ArehJEnglneer: Reg.No.: - K Cx
Address: Unit DESCRIPTION OF WORK/ se-or-ettDt]: '1 F I O 1Lr CC1-A'S J \CSC S Rear • R
. - Ping. Ref. # Parking Req./Provided E
- O
PenniD': • Planning Notes: • M
Address: - TYPE OF PERMIT: 0 GRADING 0 FIRE 0 STRUCTURAL ❑ SIGN T
. S.
LICENSED CONTRACTOR DECLARATION: I hereby affirm that lam licensed under prmtiois of Chapter 9(commencingj] ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ REINSPECTION
with Section 7000)of Dilsion 3 of to Business and Professions Cade,and my license is in full face and effect.
, ELECTRICAL FEES
CITY UC.: STATE UC.: CLASS: JOB,DESCRIPTION:•❑ SO. FT. OCCUPANCY GROUP 2- ' 1 Automatic Washer Motor 0 0-1 HP 0 1.10 HP
Date: Signature: - `1
WORKERS'COMPENSATION OECtARMICA: I hereby affirm that I have V a certificate of consent to self-insure CONSTRUCTION TYPE ' Li VALUATION $ 0 GRADING CU.YDS. Christmas Tree Lot 0 10-50 HP ❑ 54100 HP:• •
or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Section 3000,Lab.C). - Construction Pole ❑ over 100
POUCY NB: EXP.BRE: CATEGORY: ❑ MINOR CONSTRUCTION 0 MAJOR CONSTRUCTION(Under 200100 soft) Sub Pole Outlet . • • .
• . 'MAMMY: - .- ..
Certified-copy a hereby furnished. 0 Certified copy is filed with the city, Building 0Msion. 0 MAJOR/HIGH RISE(Over 200ATq sq.ff.)' Cooking Unit • Pole Light
Poo-w,
Dishwasher Sign Outlet
Date: _ - Applicant: Remarks: JtlO1) G�.� Sr�v 1 c-6 CGP1t5.F1 i cs2_!4 LT�� Dryer 0 Gas 0 Electric••:, Square Footage .
•
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION:'(This section need not be completed if the permit I PWMBING FEES .FA.U. • Standin. ::pion
is for one hundred($100)or less).I certify that in the performance of the work for which this permit is issued, -
Ishallrotehhmployaany person b any manner so as to Deco^ subjedd�to the Workers'Compensation Laws of California. Backflow Prevention Repine - Fireworks Stand ' S • •:nal
Date: P✓' 7-70 - Signature: /C `r�Y Al�� Backflow Irrigation Roof Drain 'Fixture :- Swimming Pool/Spa
MOTU:II.alter malutg oris declaration,you should become subject to the11 Congers tion pawl- Bar Sink • Service Sink •Garbage Dis '+,
sats ce the labor Cade,yw must forthwith comply with such prov5na a dis slat be dxmed ended. 9 Posei ' Switch O• .
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perlor. Bathtub Sewer Cap 1 , - Generator: Size ' Temporary Work With Pk-
, mance of the work for which this permit is issued(Section 3097.Civ.C).. i Clarifier Sewer Connection ' Meter 0 up to 200 pop'4'' Transformer
LENDER: ._ _ __ _ _ _. _ '
ADDRESS: • Dishwasher Shower - Meter ❑ over v r amps • Size'
OWNER BUILDER DECLARATION:-I hereby afflrni that Lam exempt from the Contractors'State License Law Drinking •Fountain - ! Solar Collector Microwav'
for the following reason(Section 7031.5 Business and Professional Code: .Any city of county which requires a ' Trash Compactor •
permit to construct,alter.improve,demolish,or repair any structure,prior to Its Issuance,also requires the atoll- . Floor Drain - ' t ' ' Solar Piping . , .
i cant for such permit to file a signed statement that he/she'is licensed pursuant to the provisions of the Contras• • - - - '
La
tors'State License w(Chapter 9lcommeicing with Section 7000j o1 Division 3 of the Business and Professions Floor Sink' •' Solar Tank t '
Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 'Ou Reinapedlon Fee 1 ,530 Issue Fee •
$15 •
by any applicant for a permit subjects the applicant to a civil penalty of not more than Irv¢hundred dollars($500). , g+ Gas Service 7.: - i Swimming Pool w/Spa ; 1 8 �- '
i- ❑ I.as owner of the property or my employees with wages as their sole compensation;win do the work,and ' - _ - DEVELOPMENT SERVICES REQUIREMENTS:
the structure is not intended or offered for sale(Section 7044,Business and Professional Code:. The Con- lies System _ Outlet _ •Toilet -
. tractors'State License Law does not apply to an owner of a properly who builds or Improves thereon,and Interceptor - '.Urinal
who does such work himsellMerself or through his or her own employees,provided that such improvements - •_ Zoning Approved By Date
are not intended or offered for sale.If,however the building or improvement is sold within orie year of corn- Kitchen Sink,_ . 'Wash Basin
lletion,the owner will have the burden of proving he/she did not build or Improve for the purpose of sale). BuildingApproved i .r;as owner of the property,am exclusively contracting with licensed contractors to constmct'the project laundry Tray ' Washing Machine • PP By • Date py
(Section 7044,Business and Professions Code: The Contractors'State License Law does not apply to an P—Trap - ` Water Heater Application Is ZU� `(✓
r owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) - •_ PP Date
license pursuant to the Contractors'State License Law).I am aware that pp)roof of their Worker's Compensa- • . Water Service - '
non insurance should be provided to me. I- . •
g 1" iD ivii SUMMARY OF FEES
. I am exempt under .)0 :y • IR.&P.C Reinspection Fee S30 Issue Fee , $3
•
for this reason: /Y T 0r K "a.:✓- _ - : _ BUILDING PERMIT $ MECHANICAL $
• MECHANICAL FEES •'
��_rf� 90 Boiler Heatin S tem&Ductin . • PLAN CHECK $ -- PLAN CHECK 25%'$
Date: Owner: U Ys 9
I do hereby certify that I am ware of and understand the requirements of California Health a Safety Code Sec- Duct—Underground 0• 4100,000 BTU + 0 1W,0008fU + ems.
lions 25505,25533,and 25534 and that I orfuture buildingoccupant wNl/willM(circle one)need to comply - PLUMBING $ 2.. I SMTP $
any Duct—StructuralHood or Type 1 ❑-
mesaid state.codes and the requirements fpr a pont for construction tee modification from the Air Quality Nudger
District.Residential construction applications are exempt from these provisions. Duct—Ventilating Canopy, T • PLAN CHECK 25% $ •GRADING $
• Exhaust System ❑ Multiple ❑
Date: , Applicant:• geration System ELECTRICAL $ ,
Fan • ❑4100,000 BTU + ❑ 100,000 BTU + 11 -�
I hereby certify that I have read this application and state that the above information is correct.I agree to comply PLAN CHECK 5094 $ TOTAL FEE $ "2- l
with at city and county ordinances and state laws relating to building construction and hereby authorize represen- Fire Damper - ' System Repair/Alteration '.
utives of this city to enter upon the above-mentioned lGiaperry for ins nen gooses. -
r^k q ned ern Fireplace/Fact BI O#
Date:fu— — /Q Signature: . ' ;
— ;
Driver's liceme or Social Secunty 0: Reinspection Fee 530 Issue Fee S75 71-"�' ''"" 'i` ,�-_,r r 1
oae5-4e rev.19 White-Building;Green-Code Enforcement: 2
Canary-Applicant; Pink-Revenue; Goldenrod-Assessor DATE: i /[(i/9t
015 1)1-,E: y¢'1C
.-... ...-u .n:n.,r...:;.,if..n .. ,.. ......irpour..-cw in-ncir✓. ^:kMrir Ec _.v' Y4vA 'i'iTc!wa,i ...mil p• e. fvp.c:.iif:3.i:::;i;:'.'i:'W""l
CONSTRUCTION AND PLANNING POC "SPA
APPROVALS Permit# Date Inspector APPROVALS F.-mit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. ,Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footikgs 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water1Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System - " 61. APPROVAL TO DECK •
11. PropeLly Sewer Line & House Connection -
62. Backwash & ,leceptor-Final .
12. Sewer-Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
`r
18 Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL i
19: Rough Heating & Air Conditioning '• . - . FIRE DEPT. REQUIREMENT '
20.' Rough Factory Fireplace ' APPROVALS Permit#
... r
21 Ducts, in Structure I, 70. Underground Hydro 1
i
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23./Gas Pipe-Rough &Test L,. 72. Underground Flush
.
24;'Roof Framing _ 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing ,;; -74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat -''., 75. Dry Chemical
27. Frame and'Flashing - 76. Dry Standpipe
2B. Lathing&Siding 77. FIXED SYSTEM FINAL '
29. Insulation. 78. FIRE PREV. FINAL
30. Drywall Nailing '! HEALTH DEPT. REQUIREMENT
31. Plaster Brown'Coat 79. FINAL INSPECTION
32. ElectricalPower Meter-Final , 80. FOOD;CERTIFICATE ISSUED
33. Final Electric Notes: '`1 .
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy ."
37. Final Factory'Fireplace 'i
38.'Final Plumping / : y ;
I
. 39. Water Service-Final - i . fil
40. Gas Service-Final *Obi ti
41. Solar Domestic-Final ' It / --
•
42. Backflow Preventers ;`
.
43. Backflow Irrigation
44. Landscape Irrigation System I
45. Sound Attenuation '
46./Handicap Regulations
471 FINAL STRUCTURE & BUILDING f
48. FINAL PLANNING
49. Electric Release to Edison .....
50. Gas Release to Southern California Gas Co , )
151. CERTIFICATE OF OCCUPANCY - .
No. Date ri'