HomeMy WebLinkAbout1733 FULLERTON AVE - Building Permits - I �XApplicant to fir in all spaces except those within heavy border,lie5 and sign all appropriate declarations.
CITY OF" STA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. I�LOT NO'. UNIT NO. .^
( ' 456E 7/2D/64 n,It
Pr act Address /73V FN LG fin fnN I ('l-•I� -• � G a�.
Applicant's MailingAddress SA 7y'! ' • TYPE OF CONSTRUCTION `1.++ NEWTS ADD LJ ALTERATION H REPAIR
Jq �+ /, ❑ CONVERSION ❑ DEMOLISH E OTHER A,P•# ' - - Zone
Owner's Name L'3 L �y J M iI Ty Phone%/d(�7.3a� DESCRIPTION OF WORK/USE OF BLDG.
Address .5-Aric -' - S Main Building: '- 'r Accessory Building:
Arch/Eng. I - License No. - TVPE.OF PERMIT�1 E GRADING ❑ FOUNDATION ❑ STRUCTURAL ' T Front • ' . ' - O
Address i - r ❑ TENANT I ELECTRICAL ❑ PLUMBING ❑,MECHANICAL B Rear . . - N
Contractor's Name 0�� Phone - ❑ OTHER - F` • _ -
PROJECT DESCRIPTION SQ. FT. )OCCUPANCY' C Right , r N
Address(mailing) CONSTRUCTION TYPE • :VALUATION$ ' S Left G
' R
City License No. i ' ZONE GRADING CU.YDS. ACRES Ping. Ref.# ' Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION - - O
I'hereby'af firm that I am licensed under provisions of Charter 9 (commencing Remarks: - ' Planning Notes: _ ' ' M
with section 7000) of Division 3 of the Business and Professions Code, and -
my license is in full force and a .Kt. Q 1- _ T
License Class ' `J\ /l License No. , - • S.
Date I - Signature YY---�� . PLUMBING FEES '
'ORKERS'COMPENSATION DECLARATION .' Bar Sink Showers ' ,
ereby affirm that I have a certificate of consent to self-insure or a certificate _ - ELECTRICAL FEES
• Workers' Compensation Insurance, or a certified copy thereof (Section_ - Backflow Preventer _. . Service Sink
3800, Lab. Cr) - - -i - - Automatic Washer - -- - Transformer 0 15-50 KW ••
Policy No. P Company Backflow Irrigation ' - $ewer Ca i -^ Construction Pale Sub.' - 0 SO+KW , •
8 Certified copy is hereby furnished.' ,
Certified copy is filed withth the city.Builtling Division. •
• Bathtubs Sewer Connection ��'� Cooking Unit Meter ilieto 100 amps c
Date Applicant."' - `�
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors i- _ Dishwasher I Meter Dover 100 amps, ,
(This section need not'be completed if the permit is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric , 'Sub Panel ,
I certify that in the performance of the work for which this permit is issued, I - - '
shall not employ any person in any ma so s to bacon a sub'ect to the Drinking Fountains Solar Tank Fan Motors❑0.1 HP ❑1%-8
Worker CgqgrRrggggnvi Laws of Califor H. /
-
Date "./•V" Jr 7 ' Signature ! Floor Drains Swimming Pool w/Spar F.A.U. Inc.Solar ❑9-15 HP 016-15+
NOTICE:It,after making this declaration, y should become subject to the -
Workers' Compensation provisions_of the bor Code, you must forthwith Floor Sinks Urinal ' Fixtures
comply with such provisions or this p rmit shall be deemed revoked. _ - ,Microwave - - -
CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet • Device Boxes Pole Light
1 hereby affirm that there is a construction lending agency for the performance - • - 9
of the work for which this permit is issued (Section 3097 Civ. C.) •
Interceptors • Water Heater
Lender's,- Name ' p - - Outlets - Range
Lender's Address ' ' I Kitchen Sink Water Service Switches Sign J
OWNER BUILDER DECLARATION- -
•
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - - _ Garbage Disposal 'Standing Sections
following reason (Section 7031,5 Business and Professional Code: Any city or - -
county which requires a permit to construct,alter,improve,demolish or repair P-Tra Generator ❑O-5 KW ❑5-15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such-permit p - - P
. to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains " •
Otte Contractor's License Law (Chapter'9(commencing with Section 7000) of ' . '
' '-,vision 3 of the Business and Professions Code) or that he/she is exempt - -
';-v-refrom-and the basis for the alleged exemption. Any violation of Section - - r •
zrlta1.5 by any applicant for' a permit subjects the applicant to a civil
patty of not more than five hundred dollars($500). -
LJ I, as owner of the property or my employees with wages as their sole - Reinspection-Fee $15 Issue Fee $'3 —
compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee I $15 Issue Fee , $ 3
for sale (Section,7044, Business and Professional Code: The Contractor's • MECHANICAL FEES -
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself-or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered for Boiler 1 Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy. Type II ❑ • - ZOning,Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- ' Duct: Under Ground Building Approved By Date
ro for the purpose of sale). /-�(7, �y �/ �.�,,
I as owner of the property, am exclusively contracting with licensed con- Duct-Structural • Refrigeration System Application Issued By !!_'_Y _DatZ
tractors to construct the project (Section 7044,Business and Professions Code: - S'
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- - - -
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING'PERMIT $ ' SMTP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ ' PERMIT
0 I am exempt under Section ' B. & P.C.for this reason Firepl/Fact.Bit. ICBO'# PLUMBING $ SS UAN CE $
Date .4:FI�� Owner �il/� Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $
-I hereby certify that I-have readtothisOn and sta a that-the above • 00.100.000 BTU 0100,000 BT �,� GRADING $
information is correct. I agree to comply th n city and aountythat ordinances r ELECTRICAL $
and state laws relating . buil• ng constructs an her y authorize repre- MICROFILM $
sentatives of this o eyr-r' th ab property for PLAN CHECK 50% $
•Inspection purpos. 7^� -�� MECHANICAL "$ •
'TOTAL FEE $ e'co
Signature .� • Date
^` Drivers' License or SS# ' � Reinspection Fee $15- Issue Fee $ 3 PLAN CHECK 25% $
�\ CMF 0865-46,rev.4/84 White-Building;Canary-Applicant: Accounting;Goldenrod -Assessor \
Pink-
CONSTRUCTION AND.PLANNING PC a SPA
- . 'Date Inspector - . APPROVALS Permit# Date Inspector
i - A PROVALS Permit# - -
'.4. Temporary Electrical Service or Pole • - "52. Pool & Equipment Location
2. Soil Pipe:Undrgrnd. 53. Steel Reinforcement -
3. Electrical Conduit Utility-Undrgrnd. :
4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding , •
J- .
5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6: Electrical UFER Grnd. q1.,01 57. APPROVAL TO COVER-GUNITE i irk CQ -
7. Footings - 58. Electrical Conduit-Undrgrnd. •
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9: Water Pipe-Undrgrnd. - - 60. Backwash Lines, P-Trap, 0 Undrgrnd. ,
10. Structural Floor 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-Final- • ..
16. Rough Electric Wiring 67. Fencing & Access Approval
1.;44•:� 17. Rough Wiring Sign ' . - 68. APPROVED FOR PLASTERING
�18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
1 ,. Rough Heating & Rir-Conditioning FIRE DEPT. REQUIREMENT
20:1Rough Factory Fireplace , APPROVALS Permit# - • •
21. {`ucts, in Structure 70. Underground Hydro
22. [+acts, Ventilating 71. Product Piping 0 Gas ❑Oil
23. as Pipe-Rough & Test ,72. Underground Flush
24. I. oof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil .
2o.'Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat _ -75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
•
- 28. 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. Electrical Power Meter-Final tatjt 80. FOOD CERTIFICATE ISSUED '
•
33. Final Electric //!3t/� e.g._ •Notes:
34. Final Heating & Air Conditioning / •
35. Final Gas Pipe-Test
36. Hood or Canopy . ,
37. Final Factory Fireplace •
38. Final Plumbing .
39. Water Service-Final
40. Gas Service-Final -
41. Solar Domestic-Final •
42. Backflow Preventer
43. Backflow Irrigation •
44. Landscape Irrigation System - '
r
. 45. Sound Attenuation '
46. Handicap Regulations -
• 47. FINAL STRUCTURE & BUILDING '
48. Special Requirements Completed -
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co 4 '
51. CERTIFICATE OF OCCUP.ANCY - -
No. 'Date
\I
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ,
OF COSTA Mta$A CONSTRUCTION PERMIT Zit NO. TRACT NO. LOT NO. UNIT NO. A.P # Zone
t Address/733.rota-sited �f« Pr*`(as--ii//- 3 7-sa rr I S Main Building: ,Accessory Building:
•
'nt's Mailing Address
TYPE OF CONSTRUCTION jIU NEW a ADD U ALTERATION REPAIR '.E Z
�i#9 "' I` 'tG/J, Phone 41 WW46S3 ❑ CONVERSION ➢SI DEMOLISH El OTHER 6 Front • N
s Name DESCRIPTION OF WORK/USE OF BLDG. Rear
ess�T707��c.'2PS3r 'i1/2.�CA-F�U�+9 �ar 1, 7'a'�o5`� • A I
ch/Eng. _ License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL K Right - N
Address ❑ TENANT 111 ELECTRICAL El PLUMBING ❑ MECHANICAL S • Left - . R
Contractor's Name Phone ❑ OTHER Ping. Ref.# . ,Parking Req./Provided E
PROJECT DESCRIPTION SQ. FT. OCCUPANCY Pla nnin Q
Address(mailing) �/� oo _ g Notes: M
LARCONSTRUCTION TVPEVALUATION$ �/9c-iJ •City License No. ZONEGRADING GU.YDS. ACRES TLICENSED CONTRACTOR Dj. ..,
CLARATION 'A sf1 S-
Ihereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: rI�G�T/Oy
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. ELECTRICAL FEES
License Class License No.
Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
cIRKERS'COMPENSATION DECLARATION Construction Pole Sub. 0 50+ KW •
"r,reby affirm that I have a certificate of consent to self-insure or a Certificate Bar Sink Showers •
.3CWorkers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter Cup to 100 amps
r ii - • Backf low Preventer •- - Service Sink -. • - .
`°b00, Lab. C.) -
Policy No. Company - Backflow Irrigation I Sewer Cap 5 DQ Dishwasher Meter Dover 100 amps '
Certified copy is hereby furnished. Dryers ❑Gas ❑Electric $ub Panel
Certified copy,{ flied with the city II "n ivisidn. Bathtubs Sewer Connection
Date.4./.-71 F-r Applicant V7/141 Fan Motors❑0-1 HP 0.11-B
EXEMPTION FROM WORKERS'COMPENSATION DELL RATION Clarifiers Solar Collectors -
-(This section need not be completed if the permit is for one hundred ($100) or .
less). Inc.Solar ❑9-15 HP 016-15+
less). Dishwasher - Solar Piping
I certify that in the performance of the work for which this permit Is issued, I - Fixtures �%
shall not employ any person in any manner so to to become comect to the Drinking Fountains Solar Tank - Microwave
Worke Cppyr�penpp{1on Laws of Califowta. - __ '// '
Date/'-/7- tr 7 Signature /Cie- Floor Drains Swimming Pool w/Spa - •' ' , Device Boxes •
Pole Light
NOTICE: If,after making this declara ion, you should become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - - 9
comply with such provisions or this permit shall be deemed revoked. - '
CONSTRUCTION LENDING AGENCY - Gas Service -Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance .
Disposal
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9 p Standing Sections
Lender's Name '
.' Lender's Address - Kitchen Sink Water Service Generator 00-5 KW ❑5.15 KW Trash Compactor
OWNER BUILDER DECLARATION • `
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or -
county which requires a permit to construct,alter,improve,demolish or repair • . P-Trap Laundry-Trays
any structure, prior to its-issuance, also requires the applicant for such permit
-
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
"be Contractor's License Law(Chapter'9 (commencing with Section 7000) of .
'vision 3 of the Business and Professions Code) or that he/she is exempt - - ' - Reinspection Fee $15 Issue Fee $ 3
.erefrom and the basis for,the alleged exemption. Any violation of Section -
/031.5 'by any applicant for a permit subjects the applicant to_a civil '-
enalty of not more than five hundred dollars($500).' • DEVELOPMENT SERVICES REQUIREMENTS:
Li I, as dwner of the property or myemployees with wages as their sole . Reinspection Fee $15 Issue Fee 3
$ Zoning Approved By Date
compensation will do the work,and the structure Is not intended etl pr-otferetl
for sale (Section 7044, Business and Professional Code: The Contractor's _ MECHANICAL • FEES Building Approved By ,ems Date_
License Law does not apply to an owner of a property who builds or Improves -\A`1/1�1� //
thereon, and who does such work himself/herself or through his or her own Application Issued By Dat
. employees, ever, ed that such improvements are not intended or offered for Boiler Hood or Type I' ❑
sale, If, however, the building or improvement is sold within one year of com- Canopy, Type II 0 SUMMARY OF FEES
prove , the owner will have the burden of proving he/she did not build or int- Duct-Under Ground
prove for the purpose of sale). - _ _ BUILDING PERMIT $ ez.S.DO SMTP $ . • S0
us I, as-owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - PLAN CHECK $ PERMIT •
tractors to construct the project (Section 7044,Business and Professions Code: ry
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU _ PLUMBING $ U.00 ISSUANCE $ — •
builds or improves thereon.and who contracts for such oroiects with a con- . ENERGY P.C. $ _
tractor(s) license pursuant to the Contractor's License Law). I am aware that —Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ .GRADING $ _
❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers • MICROFILM $ _
e PLAN CHECK 50% $ � _
Date /_(�-t Owner D, ,P p4e2-144 Heating System&Ducting' Registers MECHANICAL $ • TOTAL FEE $ S 3S 0
o-,l` I hereby certify that I have-read'this application 'and state that the'above ❑0-100,000 BTU ❑100,000BTL - PLAN CHECK 25%
Tinformation is correct. I agree to.comply with all city and county ordinances ' $
and state laws relating to building construction,and hereby authorize repre- ,
sentatives of: this city to enter upon the above-mentioned property sfoorrr • '
inspection l{�rpole� ' _ � Date q-j 7-�/ i
Signature �s^,7�( r+.
•
Reinspection Fee $15 Issue Fee $ 3 e
Drivars' Liceriseoc55# �� ,��� O1 00026579-110026581 TOT `5
/08fi5-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 'DATE: 02I 17/89 TICIE: 12:15
-,ION AND PLANNING PO. < SPA n
-.LS Permit# _ Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 7�, ! 52. Pool & Equipment Location
2.,Soil,Pipe-Undrgrnd. �' 53. Steel Reinforcement
( 3. Elecirical Conduit Utility-Undrgrnd. , 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding' •,.
5. Steel Reinforcement _ 56. Rough Plumbing & Pressure Testi �''
: 6. Electrical UFER Grnd.,
57. APPROVAL TO COVER-GUNITE . j. -- i
7. Footings 7 •- 58. Electrical Conduit-Undrgrnd. ,i t.
8'.Foundation :'i• 59. Gas Pipe, 0 Undrgrnd.,Test
_
9.-Water Pipe-Undrgrnd. 1 ,. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System ) 61. APPROVAL TO DECK - ,. - - 4.
'I
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 'K
12. Sewer Can
R•]- (-am,. 63. Heater & Vent-Final
13. Roof Drains '- 64. Plumbing System - Final 'i
14'. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit • 66. Solar System-Final-
4.1%4.•
ystem-Final-
c16• Rough Electric Wiring 67. Fencing & Access Approval
:17). Rough Wiring Sign .68. APPROVED FOR PLASTERING
18! Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19:' Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT •
..
20: Rough Factory Fireplace APPROVALS Permit#
ir Ducts, in Structure • 70. Underground Hydro
22.,Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test _ . . 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 •
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing ;-1 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat, 79. FINAL INSPECTION • .
32. Electrical Power Meter-Final rro 80. FOOD CERTIFICATE ISSUED
33. Final Electric rr Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test •
36. Hood or Canopy '
37. Final Factory Fireplace
38. Final Plumbing • •
39. Water Service-Final
40. Gas Service-Final .
41. Solar Domestic-Final -
r.
42. Backflow Preventer • Al.' .1,
43. Backflow Irrigation G' t
-
lr ..1
44. Landscape Irrigation System -1
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 9-7449 (�{ 7
48. Special Requirements Completed
49. Electric Release to Edison ij
• i'
50' Gas Release to Southern California Gas Co
.J
51. CERTIFICATE OF OCCUPANCY0- -,
.'
No. Date ....