HomeMy WebLinkAbout1010 POPPY CIR - Building PermitsApplicant to fill in all spaces except those within heavy border lines andsign all appropriate declarations
CI,%tTF COSTA MESA e CONSTRUCTION PERMIT .- _
Project Address /0/0 I 41CM4i 4f&.'M P1fS4
PER 1 N0.
TRACT NO.
LOT NO.
UNIT N6.
_
2$52 10/22/85
• '. 11a06 i
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION _ OF WORK/USE OF BLDG.
. IAppIicant's Mailing Address - .,/ �� �ayy%..7 (�:�j�(s
Keiltti flLsdiJMaNi PhoneL
Owner's Name /9a�:+
Address %0/0 FvPP� Ci'cr.E Cdr -$%%i t'1EY% 7.�.
A.P. # Zone
S
Main Building: - Accessory Building:
.Arch/Eng. License NO.
' Address
TYPE OF PERMIT ❑'GRADING ❑ FOUNDATION El STRUCTURAL
1-1 ElTENANT- ❑ ELECTRICAL -❑ PLUMBING E] MECHANICAL
THERA
PROJECT DESCRIPTION SO. FT. OCCUPANCY
CONSTRUCTION TYPE VALUATION $
ZONE GRADING'CU.YDS. ACRES-
'
E
T
Front
'
2
O
B
Rear - - - '•
N
I,
Contractor's Nam Phone
Address (mailing)
City License No. _ -
'LICENSED CONTRACTOR DECLARATION
;C
Right
-
N
G
K.
:s
Left _
R
Ping. Ref. # Parking Req./Provided
E
Remarks - ��r
FH n1 F C F �.
-
.Planning NOre$:
-
M
I hereby affirm that I.am licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect.
License Class License No.
C, _ Q — W t
- E
T
S
PLUMBING
FEES
'Date Signature
Bar Sink
Showers-
ELECTRICAL
FEES
WORKERS'COMPENSATION DECLARATION
1 hereby affirm that 1 have a certificate of consent to self -insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section
3800, Lab. C.)
Backflow Prevent¢r
Service Sink
Automatic Washer
Transformer ❑ 15-50 KW
"
Backflow Irrigation
Sewer Cap-
Policy No. Company
eCertified,copy is hereby furnished.
Certified copy is filed with the city Building Division.
Construction Pole Sub.
❑ 50+ KW
Bathtubs
Sewer Connection
Cooking Unit
Meter ❑up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
Clarifiers
Solar Collectors
Dishwasher
Meter Dover 100 amps
-
(Thissection need not be completed if the permit is for one hundred ($100) or
less).
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Workers' Com pe�nsajion� Laws of Californ
Datel �.!) ?5-' f—rpx.,.t �
NOTICE: If, after making this declarati n, you should come su lett to the
Dishwasher
Solar Piping
Dryers ❑❑
Gas Electric
-
Sub Panel
lDrinking Fountains Solar Tank
-Fan Motors ❑0-1 HP ❑1'/x - 8
Floor Drains Swimming Pool w/Spa
F.A.U. Inc. Solar 09-15 HP ❑16-15+
Floor Sinks
Urinal
Fixtures
Microwave
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed- revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
.� Gas Service Outlets
Water Closet
Device Boxes -
POIe Light
9
Interceptors
Water Heater
Outlets
Range
of the work for which this permit is issued (Section 3097 Civ. C.)
Lender's Name
Kitchen Sink
Water Service
-
Switches
Sign
Lender's Address -
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's,License Law for the
following reason (Section 7031.5 Business and Professional Code: Any city or
Lavatories _
Auto -Wash
Garbage Disposal
Standing Sections
P_Trap
Laundry Trays
Generator ❑0-5 KW 05-15 KW Trash Compactor
county which requires a permit to construct, alter, improve, demolish or repair
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
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
Roof Drains
-
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to a civil
enalty of not more than five hundred dollars ($500).
owner of the property - '!1 �� '^^ ^ •^'e
`-certrpens'aLrbi, will do the work, and the structure is not intended or offered
for sale (Section 7044, Business and , Professional- Code: The Contractor's-
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
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of com-
pletion, the owner will have the burden of proving he/she did not build or Inn-
1TVO for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed con-
tractors to construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who
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
proof of their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section B. & P. C. for this reason
_
'
Reinspection. Fee $15 Issue Fee - $ 3
Reinspection Fee
$15 Issue Fee $ 3
- MECHANICAL
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date
Building Approved By Date
Application Issued By net. Z0 —..1-8S
Boiler
..
Hood or Type I ❑
Canopy Type 11 C1_
Duct - Under Ground
Duct - Structural
Refrigeration System
00-100,0()OBTU ❑100,0.00 BTU
'
)
Duct- Ventilating
BUILDING PERMIT
PLAN CHECK
PLAN CHECK 25%
ELECTRICAL
CHECK 50%
MECHANICAL .
PLAN CHECK 25%
$
$
$
$
$
$ ,
$
$ ;
SUMMARY OF FEES
SMIP $
PERMIT
04 ISSUANCE $
! ENERGY P.C. $
GRADING $,
MICROFILM' $,
TOTALFEE $
1
I
Exhaust System ❑ Multiple ❑
_
System Repair/Alteration
Firepl/Fact. Bit. ICBG #
Fire DampersPLUMBING
ate /O 2,7
1 hereby certify that I have res this applicatl n antl state that the above
information is correct. I agree to comply with all city and county ordinances,
and state laws relating to building construction, and hereby authorize repre-PLAN
entatives of this city to enter upon the above-mentioned property for
sispecp
gup poses.
Signature bate 17 R
`Drivers' License or SS's —
Heating System & Ducting
❑0.100,000BTU ❑100,000 BT
Registers
- -- - -
I
•.
-
Reinspection Fee $15 Issue Fee $ 3
CMF 0865-46, rev. 10/84 White - Building: Canary - Applicant; Pink - Accounting;
Goldenrod - Assessor
r
CC,NSTRUCTION AND PLANNING
APPROVALS Permit#
Date
Inspector
POOL & SPA
N` -
APPROVALS Permit#
'Date
"
Inspector
1. Temporary Electrical Service or Pole
52. Pool &Equipment Location
'
2.' Soil Pipe-Undrgrnd.
:J
53. Steel Reinforcement
3.. Electrical Conduit Utility-Undrgrnd.
54. Forms
,4i'Ele6tr.lcal-Conduit-Undrgrnd.
-
55. Electrical Bonding
' 5.• Steel,Relnforcement
56. Rough Plumbing & Pressure Test
.��
6.^Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
/
•n
' y"r
�
7 ^Footings
✓
58. Electrical Conduit-Undrgrnd.
B.�Foundation
59. Gas Pipe, ❑ Undrgrndi,'.Test
19:4ater Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, 0-Undrgrnd,
10. Structural Floor System
2
61. APPROVAL TO DECK -
-
11. Propert`y:.Sewer Line &House Connection
j�
62. Backwash &Receptor Final
ti
12. SewerS Cap
f
63. Heater &Vent -Final '
it
13.''Roof-Drains
-
64. Plumbing System - Final
-
14.'FIN; Plumbing
65. Electrical -Final i
�•�
15. Rough Electrical -Conduit
66. Solar System -Final
-
16. Rough Electric Wiring_
B9 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
APPROVALS Permit#
-
20. Rough'Factory Fireplace ^
. 21. Ducts, in Structure �,.
70. Underground Hydro
-
22. Ducts, Ventilating l
71. Product Piping O Gas 0Oil
" 23. Gas Pipe -Rough & Test'72:
Underground Flush
"
24. Roof Framing i"
73. Undergrnd. Storage Tank OGas ❑Oil
- -
25. Roof Sheathing
74. Overhead Hydro - -
26. T -Bar Ceiling (Structural) & Mongcoat
75. Dry Chemical
27. Frame and FlashingV
-
-
76. Dry Standpipe
28. 'Lathing & Siding f
77. FIXED SYSTEM FINAL
29. Insulation - •� h
78. FIRE PREV. FINAL
30. Drywall Nailing t,
HEALTH DEPT. REQUIREMENT
' 31. Plaster Brown Coat t V
79., FINAL INSPECTION -
-
32. Electrical Power Meter -Final a
80., FOOD CERTIFICATE ISSUED
33. Final Electric '�
Notes: j,)/Z-3/45/ ha MEOFW RE<."rZE,CJ.t.V '
•'34. Final Heating & Air'Conditioning
- -"-
35. Final Gas Pipe -Test
=Z3
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
"
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
51: CERTIFICATE OF. OCCUPANCY
No. Date
- -
'-
\.✓
Applicant to fill in all spaces except those within heavy border lines and Sign all appropriate declarations.
- - -
STA MESA 'Plan •3 ELEV B
-Pea IT NO.
TRACT NO:
LOT NU.
BLDG.
PERMIT r Lot: 3
5 % 3
/LO
11
3
5I EF 3/O I /64 6h4. Q T[:UCTION
-_
Project Address 1010 Poppy CirrleTYPE
OF CONSTRUCTION
NEW 71 ADD LJ ALTERATION REPAIR
Applicant's Mailing Address, -1565 W MacArthur BIVd.
❑CONVERSION ❑DEMOLIS
H ❑ OTHER.
.A;p-# �' -_
Zone
'
T F F411•
ner's Nae STANnARn PAC.C:f O�P—Phone Fi-
Owm 6I
-DESCRIPTION OF WORK
- -
S
Main Building. _
Accessory Building: .-
2
_ �
Address •` SamP - - `-.
T
r
_ _
Front - Zr b/ /
_
t s '1 C
O
N
TYPE OF PERMIT- GRADING--E1FOUNDATION ❑-STRUCTURAL 1 -
Arch/Eng.' .AfIBmz/Stre Ptar License No. 75083
❑TENANT ❑'ELECTRICAL
❑PLUMBING ❑_MECHANICIALI -
B.
_
Rear ,,
- 1
Address' m 1Z9R 1- Sky Park Pirr1P 'Tryine I -
❑'OTHER. -•
- - '
C
2-
N
-SPP'
RI ht '. + -
' -
G
Con tractor's.Nam•• Owner Phone'
: PROJECT DESCRIPTION SO. FT.
2604 OCCUPANCY-A=1
K
' _ _
R +
- '" - I' ' -
Address (mailing) - -p
- CON STRUCTION TYPE
-
'VALUATION$ lAA FZN
--`;4,520—
S
Left -/
-
- - _ `- -
-
E
p`
City License No. �dd 7a' '-
- _
1 ZONE GRADING
CU.YDS. ,ACRES
Ping. Ref.# DO{
ZE S3- 05,
Park. Fees $. s- 1 ..
O
LICENSED, CONTRACTOR _DECLARATION = I
Remarks: - L
,
Parking Req./Provided
D
I hereby affirm that I. am licensed under provisions Uf'Charter:9 (commencing
H
with section 7000) of Division 3 of the Busineis'and Professions Code, and
+
Use of Building: - SI !� I
_ - ( i '
E
my license is in full f -rc and, effect.
-+ - 248042
Planning Notes:
,
-
M
Licen{e Class q p;p,
+
PLUMBING FEES
_
E
Date 12 Signature -
I.
Bar Sink
Showers '
jIJ1.D FOR SPI (,JAI
pCllinn nn..,. -0.
N
WORKERS' COMPENSATION DECLARATION,.
-
uaaasa
T
I hereby affirm that I have a certificate of consent to Self-insure or a certificate
Backflow Prevenier
Service Slnk -
l
S
of Workers' Compensation Insurance,-or a certifletl:•copy thereof (Section
3800, Lab: C i
ppgpy No. 4iP-84'-225-856.Dompany 'Fremont Indemnity
Backflow Irrgation
-'
Sewer Cap i-" = -Z h"-'_ j
- -
' - ELECTRICAL - ' FEES
i
BCertified copy is hereby furnisneA: +
Bathtubs
_ -
Sewer' Connection {:• ' _
Automatic Washer
Transformer' ❑ 15,-50 KW -
Certif'e c f'letl with the city ilding Dlvlyiopp.
pp p �y
Clarifiers
i -y',-• -
Collectors
Construction
; ,
❑50+.KW
Date Applicant_-It
-r O YaClf1C
Solar _-
-
Po_I_e Sub.
'I
EXEMPTION FROM WORKERS' COMPENSATIONDECLARATION - -
(Thissection need not be completed if the permit is for one hundred ($100) or -
- Dishwasher -' - --
SOlar'Piping ' - - _
'Cooking Unit -' -
- _
-Meter yup to-100'amps - -
less) - +
1 cert ify;that in the performance of the work for which this permit is issueiJ, I
Drinking Fountains
-, -
Solar Tank ' ; �'
,Dishwasher j
Meter ❑over 100 amps,
shall, not employ any person in any manner so as to become subject to the
Workers', Compensation. Laws of California.' t I
-
Floor Drainsi
- -- ,
Swimming Pool w•/Spa
-
Dryers 11G as❑Electric
Sub Panel �1 .
Date Signature
NOTICE: If, after making this declaration, you should become Subject to the
Floor Sinks
UrinalFan
Motors ❑0-1 HP ❑1 % -8
Workers' Compensation-provisions of .the Labor Code, you must forthwith
, - - - -
comply with such provisions or .this, permit f shall be; tleemetl revoked.
-
_ Gas Service 'Outlets
Water Closet -
F.A.U. ''
'
'Inc. Solar 09-15 HP 016-15+
CONSTRUCTION LENDING.AGENCY .,I -
;
I hereby affirm that there is a construction lending agency for the performance
Interceptors i
Water Heater '
Fixtures
Microwave
of the work for which this permit, is issued; (Section 3097 Civ. CJ•
" --
-
Lender's Name _ - - '-
_
- Kitchen Sink .-
Water Service - -
_
Device Boxes
'Pole Light '
Lender's Address;
OWNER BUILDER DECLARATION _ -
Lavatories
Outlets
Range
I hereby affirm that 1 am exempt from the Contractor's License law for the
following reason (Section 7031.5 Business and Professional Code: Any city or
p _
—Tra P r�
1 r •'
Switches' -(
-
Sign
county which requires a permit to construct alter, Improve, demolish or repair i
'
any structure, prior to its. issuance, also requires the applicant for such permit ..
i- Roof Drains
- ."1
_
Garbage Disposal '
Standing Sections
to file a,signed statement:that he/she is licensed pursuant to the provisions of
Y
'
the Contractor's License taw (Chapter 9 (commencing with'Section 7000) of
Division 3-of the.Business and Professions Code) or that he/she is,exempt !
Generator 110.5 KW ❑5-15 KW
Trash Compactor
therefrom and the basis for ,the alleged exemption: Any; violation:of Section
-
-
7031.5 by, any applicant for-a- permit, sUbjects-the; applicant-to a civil
enalty of not more than five hundred dollars ($500). ' :
wa9e5
- i
-Reinspection F,ee
F$25
Issue Fee f - $ .3
t
'
Reinspection Fee $25
'Issue Fee - $'3
1,; as; owner of the property Or.my employees with as their sole
compensation will do the work, and the structure is not intended or offered
' -
MECHANICAL -- FEES
for sale (Secilon 7044, Business and Professional Cotle:, The: Contractor's
License Law does not apply to an owner Of 4 property who, builds or improves
thereon, does
Roller I
HOOd Of Typ¢ I ❑
PUBLIC SERVICES REGUI RRR�EE �t
�,/�
I
and who such work-himself/herself-or through his or her own
employees, provided that such improvements intended or for
-
Canopy Type II, ❑
Zoning Approved By --T
-DetO11
are not offered
sale. If, however, the building or improvement is sold within one year of com-
Duct , Under Ground ,
'
Application Approved By
Date
pletion, the owner will have the burden Of•proving he/She did not build or im-
for the purpose of sale). !
Duct -Structural
Refrigeration System '
Application Issued By
• /�� / Date
grove i :
Tye
as owner of the property am exclusively contracting with licensed con-
,
,
tractors to construct the project (Section 7044, Business and Professions Code:
Duct - Ventilating
❑0-100,000 BTU (]100,000 BTU
'SUMMARY OF FEES '
The .Contractor's License, Law. of oes-notapply to an owner of property-who
builds or improves thereon,'and who contracts for such projects with a con-
Exhaust System ❑ Multiple El
System Repair/Alteration----P—
BUILDING PERMIT $ 545
Fn SMIP $ _ 12
tractor(s) license pursuant to the Contractors License Law).
❑'I
PLAN CHECK$ gg
64 ' PERMIT
am exempt under Section e. & P. C. for this reason
Firepl/Fact. Blt. ICBO #
ISSUANCE $
PLUMBING $
Date Owner
Heating System & Ducting
PLAN CHECK $
ENERGY P.C. $
I hereby certify that 1 have read this application and state that the above
00-100,000 BTU ❑100,000BT
ELECTRICAL $
GRADING $
information is correct. I agree to complywithall city-and county ordinances
-
-
and state laws relating,to building construction, and hereby authorize repre-
PLAN CHECK $
MICROFILM $
sentatives qg�j,�,�J,,his ty o'e ter upon the above-mentioned r petty .for
InspectionLl/Q e
_
r
MECHANICAL $
- ,
FEE $ 'Fad
ISlgnature �- Date X
-
.
TOTAL 9Fi
,Drivers' License or. SS =j- -
Reinspection Fee
$25
Issue Fee $ 3
PLAN CHECK $
.
JF 0865-46 rev. 7/83 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor
CONSTRUCTION AND PLANNING•-
APPROVALS Permit
•.
Date
Inspector
, - POOL& SPA -"
�
APPROVALS � Permit
.Date
Inspector
Temporary Electrical Service or Pole
_
52. Pool & Equipment Location_
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3." Electrical Conduit Utility-Undrgrnd.
-
54..Forms-
Electrical Conduit-Undrgrnd.
-
55.. Electrical Bonding -
5: Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd `
! Z
'�
57. APPROVAL TO COVER-GUNITE
7: Footings
-
, 58.' Electrical Conduit-Undrgrnd.
-
8. Foqndation: 6
59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undigrnd.
60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System
, 61. APPROVAL TO DECK -
11. Property Sewer *Line & House Connection
62. Backwash•&-Recapt or-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
.18. Rough Electrical-T Bar Ceiling
69: POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure ;j
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas ❑ Oil
23. Gas Pipe :Rough &Test.
.-72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank ❑Gas ❑Oil
25. Roof Sheathing
n/
74. Overhead Hydro
26. T-Bar Ceiling (Structural) &,Monocoat
75. -Dry Chemical
27. Frame and Flashing -.•_
fi
L/t•/
76. Dry Standpipe
28. Lathing,& Siding-
C/t�
77. FIXED SYSTEM FINAL.
29, Insulation
L g
ve--
78. ,FIRE PREV. FINAL
30. Drywall Nailing
Y
�c�
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
6
���
79. FINAL INSPECTION
32. Electrical Power Meter-Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
w
38. Final Pliu nbing
-
I
39. Water Service-Final
1 i
-
-
40. Gas Service-Final
41. Solar Domestic-Final` I
42. Backflow Preventer - -
'•
'43. Backflow Irrigation
44. ,Landscape Irrigation System
-
- 45. Sound Attenuation
'
46. Handicap Regulations -
-
47. FINAL STRUCTURE & BUILDING
48. Special.Requirements Completed
/�/916Y4-
GG
'
49. Electric Release to Edison
- - -
50. Gas-Release to Southern California Gas Co
51. CERTIFICATE,OF OCCUPANCY
No. Date
- '
n
1
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA M A CO STRUlitC 0� ERMIT,
Project Address O '�
Applicant's Mailin s
Owner's Nam
aTfi
Address
Arch/Eng. License No.
Address
Contractor's Name / Phone
Address (mailing)
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing
with sect) n 000 of Division 3 f he Business antl essions C� antl
my Ilcens n i f (1 roftD vis effect. J .
Licensee (�(J is c o. rL•/f
Date Signature
WORKERS' COMPENSATION DECLARATION
Hereby affirm that I have a certificate of consent t self -insure or a certificate
of Workers' Compen anon I surance, or a cert'fi d copy ther9of (Section
3800, Lab. j vvys�tta
Policy No, l0 Company 1111.E
eCertifi tl c py a ereby furnished.
Car iletl with the city Bs
Date Applicant r
EXEMPTIO ROM WORKERS' COMPENSATION DECLARATION
(Thissection need not be completed if the permit is f r one hundred ($100) or
less),
I certify that in the performance of the work for which this permit is issued, I
shall -not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California.
Date Signature
NOTICE: If, after making this declaration, you should become subject to the
Workers', Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LEND NG AGENCY -
I hereby affirm that in ine, is a construction lending agency for the performance
of the work for rm it is issued (Section, 3097 Civ. C.)
Lender's Name
Lender's Address
OWNER BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License ,Law for.the
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct, alter, improve, demolish or repair
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
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section ,
7031.5 by any applicant for a permit subjects the applicant to a civil
f1nalty, of not more than five hundred dollars ($500).
- I, assaowner of the property•or my employees with wages as their sole
compention, will do the work, and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's
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
employees, provided that such Improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of com-
pletion, the owner will have the burden of proving he/she did not build or im-
7 Lve for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Con-
tractorsto construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who
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
proof of their Worker's Compensation insurance should be provided to me.
❑ �I am exempt under Section B. & P. C. for this reason
Date Owner
I hereby certify that I have read this application and State that the above
information is corrEct. I agree to comply with all city and cmmty ordinances
gnature
ni vers"License r 55
PERMIT NO. TR CTNO.—' LOTylQ. uN1TNo:
TYPE OF CONSTRUCTION NEW ADD ALTERATION -REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER- A.P. #
DESCRIPTION OF WORK/USE OF BLDG.
S Main Building:
❑ FOUNATION -TFront'
TYPE OF PERMIT ❑ GRADING DRUCTURAL T
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING L4<EcHANICAL B Rear.
❑ OTHER A
C Right
PROJECT DESCRIPTION. SQ. FT. OCCUPANCY K.
CONSTRUCTION TYPE VALUATION $ S Left
ZONE GRADING CU.YDS. ACRES Ping. Ref.+
3599 7/06/84
Zone
Accessory Building:
-
-
Parking Req./Provided
8.00 TI
Z
0
N
I
N
G
R
E
Q
Remarks:
Planning.Notes:
M
T
S.
PLUMBING -
FEES
f
Bar Sink
Showers-'
ELECTRICAL
FEES
Backflow Preventer _
Service Sink. ..
Automatic Washer
Construction Pole Sub.
- Transformer ❑ 15-50 KW.
❑ 50+ KW
Backflow Irri at_ion
9
Sewer Ca p
Bathtubs`
r �
Sewer Connection
.,- Cooking Unit '
.Meter 11up to 100 amps
Clarifiers
Solar Collectors
Dishwasher -
Meter Dover 100 amps
Dishwasher
Solar Piping
Dryers ❑Gas' ❑Electric
Sub Panel
Drinking Fountains
Solar Tank
Fan
Motors ❑0-1 HP D 1 X -'a
Floor Drains
Swimming Pool w/Spa
F.A.U.
- Inc. Solar 119-15 HP El 16-15+
Floor Sinks
Urinal
Fixtures _ '
Microwave
Gas Service, -Outlets
Water Closet -
Device Boxes .
Pole Light
I nterceptors
-
Water Heater
Outlets -
Range
Kitchen Sink
Water Service
Switches
Sign
Lavatories
-
Garbage Disposal
Standing Sections
P—Trap
'
Generator 00.5 KW 115.15 KW
' Trash Compactor
Roof Drains
Reinspection Fee
$15
Issue Fee-
S 3
Reinspection Fee
$15
i Issue Fee j
$ 3
-
MECHANICAL
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Approved By Date
Building Approved By Date
Building
Application Issued By cldb Date—
BoilerHood
or Typal ❑
Canopy Type 11 El
Duct - Under Ground
Duct -Structural
Refrigeration System
❑0-100,000 BTU 0100,000BTU
Duct - Ventilating
S MARY OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
ENERGY P.C. $
ELECTRICAL 25% $ GRADING $
ELECTRICAL $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL 7t$00TOTAL FEE $
- PLAN CHECK 25% $ (�-J
Exhaust System ❑ Multiple D
System Repair/Alteration
Firepl/Fact. Bit. ICBG#
Heating System &D�u, ctln�
❑0-100,000 BTU ILJ ,000 BT
'
Reinspection Fee
$15
Issue Fee
$ 3
rev. 4/84 - Applicant;Pink - Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING
APPROVALS Permit#
Date
!
Inspector
POOL & SPA -
APPROVALS Permit
;Date
Inspector
1. Temporary Electrical Service or Pole
- :
T'
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical, Conduit Utility-Undrgrnd.
-
54. Forms
4. Electrical.Conduit-Undrgrnd.
557Electrical Bonding
5. Steel Reinforcement.`_
56. 'Rough Plumbing & Pressure Test '
_6. Electrical LIFER Grna. --
57. APPROVAL TO COVER-GUNITE
7. Footings - �- - -
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, ❑ Undrgrnd., Test
9. Water Pipe-Undrgrnd. - -
-60. Backwash -L.ines, P -Trap, ❑-Undrgrnd.
10. Structural Floor System
61. APPROVAL'TO DECK
11. Property Sewer Line & House Connection.
62. Backwash & Receptor -Final
12. Sewer Cap i
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
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19.- Rough Heating & Air Conditioning
7
(,�/�
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70, Underground Hydro
22. Ducts, Ventilating
71. Product Piping C3 Gas ❑Oil
23. Gas Pipe -Rough & Test --
72. Underground Flush i �
-'
24: Roof Framing
73. Undergrnd. Storage Tank 0Gas ❑Oil
25. Roof Sheathing
-
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monoc oat
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
80. FOOD CERTIFICATE ISSUED
33. Final Electric
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 Prevebter
43. Backflow Irrigation ..
-
44. Landscape Irrigation System'
_
45. Sound -Attenuation
46. Handicap Regulations.
47. FINAL STRUCTURE,& BVILDING
48. Special Requirements Completed
49. Electric Reli;ase to Edison
50. Gas Release to Southern California Gas CD
.'
51. CERTIFICATE OF OCCUPANCY
No. 'Date
(('
W
Applicant to fill in all spaces excepnose v1it1hf1eavYlbortlei li�n'tl sign III appropriate declarations.
CITY OF COSTA/1/)�E NST UCTI QNB' SPE/j��M IT PERMIT.NO. TRACT NO. LOT NO. UNIT NO.
Project Address, /, 7,, �!M•CNv/ -
TYPE OF CONSTRUCTION L^EW LJ ADD U ALTERATION Li REPAIR .
Applicant s Mar{' ddra�s - El OTHER
._..rp r_ ❑ CONVERSION '❑ DEM LUSH
Owner's N//'h,(Oam/ %// /, y"
PYIGv/
, DESCRIPTION OF WORK/USE OF BLDG.'
- f. •�'�-+
Address(-.i� 'ui�il
- Transformer ❑ 15-50 KW
Construction Pole Su
Sold.
Arch/Eng. License No.
TYPE OF PERMIT El GRADING 13 FOUNDATION STRUCTURAL
Meter ❑up to 100 amps
❑ TENANT ELECTRICAL
XPLUMBING ❑ MECH'ANICAL
Address
'
:❑
Garbage Disposal
Contractor's Na Pho i
+ '❑,'OTHER
Trash Compactor
% d
PROJECT DESCRIPTION' SO. FT.
'OCCUPANCY—
•VALUATION$
Address (mailing) -
CON STRUCTION TYPE
'
City License No.
ZONE GRADING
CU. YDS. 'ACRES_
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing
Remarks: ,
with section 7000) of Division 3 of the Business antl ProfessionsCode, and
my license is in full f flaw 'e fect.
L'iceryse, Mass Cense No�Q���
Date'/1��/��%{% Signature (J
PLUMBING
WORKER5' COMPENSATION DECLAIRATION - - •
I hereby affirm that I have a certificate of consent to self -insure or a certificate
Bar Sink
$nOWe�S I
of Workers' gompensation Insurance, or a cern fie copy thereof (Section
Backflow Preventer -
Service Sink
3800, Lab,
Iv , ,iyx
Policy No Company
Backflow Irrigation
Sewer Cap
Certified copy is hereby furnished.
/
er '� etl) y r it d with the ildi9 non.
Bathtubs
Sewer Connection
Da[e_;L APplican Y[ n
-EXEMPTION FROM WORKERS' COMPENSATION DECLARA ION
Clarifiers
_ Solar Collectors
-"
(This section need not be completed if the permit is for one hundred ($100) or
Dishwasher
-
Solar Piping
less).
certify that in the performance of the work for which this permit isoissued, I
shall not employ any person in any manner so as to become subject to the
Drinking Fountains
Solar Tank
Workers' Compensation Laws of California.
Date Signature
Floor Drains
Swimming Pool w/Spa
NOTICE: If, after making this declaration, you should become subject to the
Workers' Compensation provisions of 'the Labor Code,you must forthwith
Floor Sinks
Urinal - '
-Urinal
comply with such provisions or this permit, Shallbe deemed revoked.
CONSTRUCTION LENDING AGENCY 1
Gas Service Outlets
Water Closet --"
I hereby affirm that there i5 a construction lending agency for the performance
of the work for which this permit - is: issued .(Section -3097 Civ. C.)
Interceptors i
Water Heater
-
Lender's Name'. [
_
_
Lender's Address ' - �.
Kitchen Sink
Water Service
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
Lavatories
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
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
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
-
Division 3 of the Business and Professions Code). or that he/she is exempt
and the basis for the alleged exemption. Any violation of Section
!therefrom
7031.5 by any applicant for a permit subjects the applicant to.a civil'
enalty of not more than five hundred dollars,($500).
1, as owner of the property or my employees with wages as their sole
Reinspection Fee
$15
Issue Fee,,
compensation, will do the work, and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's
MECHANICAL
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
- -
Boiler
Hood or Type I ❑
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of com-
Canopy Type 11 1:1pletion„the
owner will have the burden of proving he/she did not build or im-
Duct - Under Ground
'
far the purpose of sale).
Me
I, as owner of the property, am exclusively contracting with licensed con-
-
Duct -Structural
Refrigeration System
tractors to construct the project (Section 7044, Business and Professions Code:
'
The Contractor's License Law does not apply to an owner of property who
Duct - Ventilating _
❑0-100,000 BTU 0100,000BTU
builds or improves thereon; and who contracts for such projects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that
Exhaust System ❑ Multiple ❑
System Repair/Alteration
proof of their Worker's Compensation insurance should be provided to me.
❑ 1'am exempt under Section B. & P. C. for this reason
Fimpl/Fact. Bit. ICBG #
Date - Owner
Heating System & Ducting
I hereby certify that I have read this application and state that the above
110.100,000 BTU 0100,000 BT
information is correct. I agree to.comply with all city and county ordinances
sentatives of t rs ty to enter up me ove entione op rty-nor
inspection pun I> a^'
Signature _ ✓rte ,✓ Date
Drivers' License or SS # ( �. — Reinspection Fee
CMF 0865-46, rev. 4/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod -Assessor
9
$ 3 -
FEES
$15 1 '1 Issue Fee 1 '$ 3
A.P. # Zone'
S Main Building:' Accessory Building:
E
T Front
Ek A Rear
N
C Right '
K
S Left
Ping. Ref. # Parking Req./Provided
Planning Notes: _
Z
O
N
I
N
G
R
E-
Q
M
T
S.
Fan
ELECTRICAL FEES
Automatic Washer
- Transformer ❑ 15-50 KW
Construction Pole Su
Sold.
D5 +KW
�
Cooking Unit ,
Meter ❑up to 100 amps
Dishwasher.
Meter ❑over 100 amps
Z
O
N
I
N
G
R
E-
Q
M
T
S.
Fan
Motors ❑0-1HP❑1%-8
F.A.U.
Inc. Solar; ❑9-15 HP 016-15+
Fixtures - I
Microwave -. - --
Device Boxes
Pole Light
Outlets -
Range
Switches [
Sign
Garbage Disposal
'Standing Sections
Generator 130-5 KW ❑5-15 KW
Trash Compactor
on
on
Reinspection Fee I $15 I' I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By .
SUMMARY OF FEES
BUILDING PERMIT $ SMIP $
PLANCH $ PERMIT
PLUEpj
MB
PLAN HE
'E GV
ELECTRICAL $ GRADING $'
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $
PLAN CHECK 25% $
$ 3
-` CONSTRUCTION AND PLANNING
.APPROVALS Permit # -
! •
Date
Inspector
- POOL & SPA
APPROVALS Permit #
- Date •.
Inspector
1. Temporary Electrical Service of Pole
52. Pool & Equipment Location
_
2. Soi('Pipe-Undrgrnd.
r '
-%
53. Steel Reinforcement "
3�Elearical,Conduif-Utility-Undrgr,nd.
54. Forms
4:1Elecf_ncal Conduit-Undrgrnd. _
55. Electrical Bonding
i
5. 'Steel -Reinforceme'
• nts
�•
56. Rough Plumbing &Pressure Test
6�Electrical)UFER Grnd--
;.
_
57. APPROVAL TO COVER-GUNITE
7 Footings„ ,�
'%
58. Electrical Conduit-Undrgrnd.
-
B. Foundation
�•
•
59. Gas Pipe, 0 Undrgrnd., Test
.A
9 ;Water Pipe-Undrgrnd., ^i
•"!
60. Backwash Lines, P -Trap, 0 Undrgrnd:�-
10."Struct6ral Floor System
r�
61. APPROVAL TO DECK
11.�Property.8ewer Line & House Connection
, '
62. Backwash & Receptor -Final
-
12. SeweF•Cap r;
63. Heater & Vent -Final
13. Roof.Drains
64. Plumbing System -Final
14. Rough Plumbing•
65. Electrical -Final
15. Rough Electrical -Conduit f
66. Sola�System-Final'
16. 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
APPROVALS Permit #
'
20. Rough Factory Fireplace
21. Ducts, in Structure .
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping EJ Gas 0Oil
23. Gas Pipe -Rough & Test /
/
72' Underground Flush -
'24. Roof Framing I
73. Undergrnd. Storage Tank ❑ 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
,HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
-
79. FINAL INSPECTION
32. Electrical Power Meter-Final-�
��.
80; FOOD CERTIFICATE ISSUED
33. Final Electric it
Notes:) /J n
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
'
37. Final Factory Fireplace
,
38. Final Plumbing
i A_21ij
LSU
39, Water Service -Final
40. Gas Service -Final
-
41. Solar Domestic -Final
42. Backflow Preventer
43.. Backflow. _Irrigation- .., :... ..
.. _
44. ,Landscape Irrigation System
. .
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
-
51. CERTIFICATE OF OCCUPANCY
No. Date
.Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations..
),.CITY OF COSTA MESA' 'BLD
PER MI -NO.
TRACT
NO. .•
LOT NO.
NSTFiUCTION PERMIT 1
3 j'
5767 3/0/84
IL
' r
40.50
Vowdreks, ''
TYPE OF CONSTRUCTION - N NEW LJ AOL), Ll ALTERATION L
REPAIR
-
Applicant'sMellingAd ass
❑CONVERSION ❑DEMO ISH
El OTHER
A•p-#' -
- Zona,
Owners Name oneS4
DESCRIPTION OF WORK
S
Main Building: --
Accessory Building: "J _
_
2
-
Address 5b
-
- --
O
_
TYPE OF PERMIT GRADING
FOUNDATION STRUCTURAL
T
Front -
N
Arch/Eng.License No.
❑ TENANT ❑ ELECTRICAL
PLUMBING ❑ MECHANICAL,
B
Address
. _❑ OTHER -
A
Rear
-
N
41
C
Right
=
G
Contractor's Name'Aione
PROJECT DESCRIPTION 54. FT.
OCC UPANCV
R
Atldress;(msiling)
CONSTRUCTION TYPE
VALUATION $
S'
Left -
E
City License No.
ZONE GRADING
CU.YDS. ACRES
Ping. Ref. #
Park. Fees $
.Q
'
U
LICENSED CONTRACTOR DECLARATION
Remarks:
'�3
Parking Req./Provided
I
I
1 hereby affirm that I am licensed under provisions of Charter 9 (commencing
'-
-
_
R
with section 7000) of Division 3 of the Business a, Professions Code, and
-
Use of Building:
-
E
my license Is In fulI for a d effeC .
M
License"Class C— Lice I No..-
PLUMBING -
FEES
Planning Notes:
E
Date Signs ure
WORKERS' COMPENSATION DECLARATION
Bar Sink
Showers
N
T
I hereby affirm that 1 have a certificate of consent to self -Insure -or a certificate
- -- - - -
Preventer
- --+ - -
Service Sink
- - -
-•- - T -
-
S
of Workers' Compensation Insurance, or a certlfied. Copy ieof (Section -
--
3800,
3800, Lab.,9 ��0
Backflow Irrigation
Sewer Cap
ELECTRICAL
FEES
Policy No. W Company _ dY� ';
copy is hereby furnished. ;;
•: �'
Bathtubs
Sewer Connection
C�
o
'--_
Automatic Washer„
Transformer ❑ 15-50 KW
Cert Ie cop 01 d with the city Bu g
ElCertlfled
to Applicant
Clarifiers
Solar Collectors
Construction Pole.Sub..
❑50+KW
EXEMPTIMPTI N�RKERS' COMPENSATION DECLARATION .3
(This section need not be completed if the permit Is for one hundred ($100) qr
Dishwasher +
Solar Piping
P g
Cooking Unit
Meter Cup to 100 amps
less). , - I. ,,
I certify that In the performance of the work for -which this permit Is Issued b
Drinking Fountains
Solar Tank
Dishwasher
Meter Cover 100 amps r
shall not employ any person In any manner so as to become subject to the
Workers', Compensation Laws of California.
, Floor Drains
Swimming Pool w/Spa
Dryers ❑Gas ❑Electric
Sub Panel '
Date Signature
'-
'NOTICE: If,iafter making this declaration, you should become subject to the
Floor Sinks --
'
-Urinal
Fan
- Motors 110-1 HP ❑1:-8 `
Workers' Compensation provisions of the Labor Cotle,•you must forthwith
comply with. such provisions or this permit shall be deemed revoked.
"`
7 Gas Service• I i--
Water Closet
-
'-'
.Outlets
F.A.U.
Ina $olar❑9-15 HP❑16.15+
CONSTRUCTION LENDING AGENCY'
1 hereby affirm that there is a construction lending agency for the performance
_ Interceptors' -
''`
Water Heater, -
�1
O� 100
Fixtures
Microwave
of the work for which' this permit Is Issued, (Section ,3087_ Clv. CJ
Lender's Name
_
Kitchen Sink'
Water,Service
Device Boxes
Pole Light
Lentler's Atldress•
OWNER BUILDER OEC CA RATION S ,
Lavatories
ava'a '
- '
Outlets
-
;Range
,
I hereby affirm'. that I am exempt from the Contractor'{ License Law for the
following
p—Trap ' "
- -
reason. (Sectlon-,7031.5 Business and Professional Code: Any city or
p -
Switches
Sign
county which requires a permit to construct, alter Improve, demolish or.repair
any structure, prior to Its Issuance,' also requires t6 applicant for such permit
Roof Drains '
Garbage Disposal
_'
Standing Sections
j
to file a signed statement'that he/she is licensed pursuant to theLprovislons of
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or. that he //sheds exempt
Generator 00-5 KW 115-15
KW Trash Compactor
therefrom and the basis for.the alleged exem cation: An- vl Ola4i on of, Section
7031.5 by,any applicant for a permit subjects the applicant to a civil
Reins Paction Fee
$251
Issue Fee
$ 3
penalty of not more than five hundred dollars ($500).
LJ 1, as owner of the property or my employees with wages as their sole
Reinspection Fee
$25 Issue Fee
$'3
compensation will do the work, and the structure is not Intended or offered
Professional
i MECHANICAL
r
FEES'
for sale.(Sechon 7044, Business and Code:• The Contractor's
'
-
PUBLIC SERVICES REQUIREMENTS:
•,
License Law does not apply to an owner of a property who builds or Improves
Boiler
Hood or ; Type 1 ❑
r
thereon, and who does such work himself/herself or through his or her own
Canopy Type II Elsale,
Zoning Approved By
Date
emploes,' provided that such'Improvements are not intended or offered for
Duct - Under Ground
Jr.,/however, the building or Improvement is sold within one year of com-
I
Building Approved By
Date
pletion, the owner will have the burden of proving he/she did not build or im- -r
rove for the purpose of Sale).( - L T
LI I, as owner of the am exclusively contracting with licensed con-
Duct - Structural
Refrigeration System :'• -
Application Issued By
Data
property,
tractors to construct.the.project (Section 7044,.Business and. Professions Cotle:..
Duct -_Ventilating
9
❑0.100,000 BTU ❑106,000 BTU
SUMMARY OF FEES
-
The Contractor's License Law does not apply to an owner of property who
builds or Improves thereon, and who contracts for such projects with a con-
Exhaust System ❑ Multiple ❑
System Repair/Alteration
BUILDING PERMIT $
SMIP $
'
i
'
tractor(s) license pursuant to the Contractor's License Law).
1
❑ ram exempt under Sactlon - B. & P. C. for this reason
Fiiepl/F,act. Bit. IC80 # s
-
PLAN CHECK , $
PERMIT
�3 ISSUANCE I $
t
PLUMBING • $
Date owner` I
HeatingSystem & Ducting I
PLAN CHECK 25% ! $.
/ SU' ENERGY P.C. '$
I
that I'have read•thls application and state that -the -above -1
information
"-
❑0.100,000BTU'❑100,000 BT
t
1 - -- -,
ELECTRICAL '$
GRADING $
1 '
Information Is correct. I agree to comply with all city and county Ordinances
laws to building tructlon hereby repre-
'$
! - MICROFILM
and•state relating cons .antl authorize
sentatives of this city to enter, upon the above-mentionetl pr pertyyy forr
Inspection
'
}
PLAN CHECK 50%
- ;$
u poe t
-
MECHANICAL $
TOTAL FEE ;$
Signature Date
'
Reinspection Fee -
- •$25
. Issue Fee'
$ 3
- PLAN CHECK 25% $
Drivers' License orjSS
'CMF 0865-46 rev. 12/83 White - Building; Canary - Applicant; Pink - Accounting;
Goldenrod _- Assessor
-
r TRUCTION AND PLANNING -
-
��
-
+
- _ POOL & SPA -_ a{.
r7
' `
OVALS - Permit #
Date
Ins ector.•'
p-
'APPROVALS "- "Per mit;# ` c
-Date.�nspector
'
_
T' T mporary Electrical Service or Pole
-
' 52. Pool & Equipment'Location-
,: ;
-
-;,
m2.- Soil PiperUhdrgrnd:
L".
. 53; Steel Reinforcement
3:- Electrical Conduit Utility=Undrgrnd.
Z 1
". 54.. Forms
�4-Electrical Conduit=Undrgrnd.-_
.55_�Electri*:IBonding
ca
5'Steel Re nforcement .r��
�+-
56.- Rough Plumbing & Pressur`e.Test-
6- Electrical UFER Grnd_:.
-
57' APPROVAL TO COVER-GUNITE
-`'
; ; i'•" ,
ol
r
7. Footings_- n j t
f,.
58.' Electrical:Conduit:Uncirgrnd.; -
•A�4,
_
-
8. Foundation
59. Gas Pipe, 0 Undrgrnd., Test'-
V�
9. Water Pipe.Undrgrnd.
�
(
60. Backwash Lines, PETra p, 0Undrgrnd.-
•v,
10. Structural Floor System ~{
• -;
- .
i 61. APPROVAL TODECK '-•'-`-` ,".�
i �
`-' --
i.
11. Property'Sewer Line & House Connection
r' .LEO
62. Backwash& Receptor -Final
-
71c
12. Sewer Cap ' r_�' .•
-
63. Heater &-Vent-Final._ -
13. Roof Drains-,
-
64. Plumbing System -Final
14. Rough.Plumbing
7/2tMt
rte)
65. Electrical -Final -• -
I
'�L'
415. Rough Electrical -Conduit -
-' s
-'66..Solar-'Sysfem-Final"
1
16. Rough Electric Wiring -
-
67:' Fencin & Access A -
:17. Rough Wiring Sign68..
APPROVED FOR PLASTERING ;
+ " • ?
-
18. Rough Electrical -T Bar Ceiling
69.•POOL/SPA SYSTEMS F+INALj
r•�' `
r
X19%Rough Heating & Air Conditioning
y
FIRE DEPT. REQUIREMENT; `
APPROVALS + Peimit#
20. Rough Factory Fireplace
+
21. Ducts, in Structure Z,
70.E Underground Hydro
-
22. Ducts, Ventilating
71.1 Product Piping 0 Gas -,0 Oil +
(
I L
�-
•��'
I•1,
23. Gas Pipe-Rough&Test .--
f
_
72.1 Und&ground Flush '
f
• 24. Roof Framing ''-•,
-
' 73. Uridergrnd. Storage Tank 0 Gas 'D Oil'c
1
25. Roof Sheathing
74. Overhead Hydro
26. T-Bar.Ceiling (Structural) & Monocoat
75.•Dry.-Chemical .
t . • .
I _
• 27'.' Frame and Flashing
76.' Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
`' I
29,- Insulation
78.FIRE PREV,. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT +
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final I"'
'
807FOODCERTIFICATE ISSUED
•'
33. Final Electric
-
Notes,. -�i
A� L
34. Final Heating & Air Conditioning
35. Final'Gr as Pipe -Test
tr�l;,
_ +-
36. Hood or Canopy'
37. Final Factory.Fireplace ;
i 'l� - c •,• I
38. Final Plumbing
39. Water Service;Final
40. Gas Service -Final
41. Solar Domestic -Final
'.r l
42. Backflow Pr6enier
43. Backflow Irrigation
44. ,Landscape Irrigation Systemr-
45. Sound Attenuation
C
:c
46. Handicap Regulations
47. FI NAL STRUCTURE&BUILDING_'
48. Special,'Requirements Completed
'
.. I + l " •(i `- ' " "'
A
49. Electric Release to Edison
j I-
r
- I d+
heGas
50. Gas Release to Southern California
Co
51. CERTIFICATE OF OCCUPANCY
-
:;- :--- - -i 4-'^ -
No. ,_ , ; Date -
1 - - - - a'
Applicant
to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERMIT NO. v1 TRACT NO.. LOT NO. UNIT. NO.
A-576
1
-
0186 10/12/84 T _
5.50 TL
CITYOFCOSTA MESA CONSTRUCTION PERMIT -
Project Address 1010 POPPY Or •
41
,
, -
,
Applicant's Mailing Address -
ownei's NameStandard.PacifiDCor�_Phone 546-1161❑CONVERSION
Address 1565 W -Macjlrthr Oc a M Sa 92626
TYPE OF CONSTRUCTION 'kkNEW U ADD U ALTERATION REPAIR -
-E] DEMOLISH ❑OTHER
' DESCRIPTION OF WORK/USE OF BLDG:
- - -
-
AP,# e _ Zone
-
I
S
Main Building:. -' Accessory. Building:
Arch/Eng: _ _ License No.
Address I
TYPE OF PERMIT ❑ GRADING ��II'' FOUNDATION ,STRUCTURAL _.
El TENANT 1:1 ELECTRICAL qa PLUMBINIG ❑ MECHANICAL'
❑ ,OTHER -
'. PROJECT DESCRIPTION SQ: FT. -- OCCU PANCV
-
CONSTRUCTION TYPE -'VALUATION $ 1
ZONE GRADING CU.YDS. ACRESE.
T
Front -
Z
'O
B
Rear '
N
1
Contractor's Name NPw Pl_umhi ng -Phone 529-1140
Address(Mailing) 7102�N 'FPR Ana Anaheim
City License No. 42871
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under r' isions f Charter 9 commencing
P ( 9
with section n full of Division 3 of the sines ntl Professions Code, and
my Incense is in full te ellec[. -
License Class Ir dense No: 426109
Dbtel0/10/84 � Signature LXZ
A
C
Right
- -
'
N
,
K-
S
- -
Left
G
Ping. Ref. # Parking Req./Provided
Q
Remarks: %,
57
Planning Notes: --
M
�
T
s.'
:
PLUMBING
Bar Sink
Showers
ELECTRICAL
FEES
WORKERS' COMPENSATION DECLAR TION
I hereby affirm that I have a certificateof consent to self -insure or a certificate
. of- Workers' Compensation Insurance, or a certified copy thereof.,(Sectlon
y,
3800, Lab.L-177%141 ' Home
Policy No. L Company
Certified copy is hereby furnished.
Cer ifjiLj1e(� w }� tiled with the city B ilding visi n.
bew �f Wing
- Backflow Pr¢venter - -
-Service Sink - - -
- -
Automatic Washer- -
Construction Pole Sub.
-
-Transformer ❑ 15-50KW -
❑ so+Kw
'
- -
.
Backflow Irrigation Sewer Cap
Bathtubs
Sewer Connection 1
_.
Cooking Unit � •
Meter ❑up to 100 amps
Date Applicant I
EXEMPTION FROM WORKERS"COMPENSATION DECLARATION
(This section need not be completed if the permit is for one hundred ($100) or
less). I
I certify that in the performance of the work for which this permit is issued I
shall' not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California.
Clarifiers
$Pier Collectors ,
Dishwasher ^ i
Meter ❑over 100 amps
Dishwasher Solar Piping
Dryers []Gas , Electric Sub Panel
Drinking Fountains Solar Tank
Fan 1 Motors E30-1 HP D `/: - 8
Floor Drains
Swimming Pool W/Spa,
F.A.U.
Inc. Solar ❑9-15 HP ❑16-15*
Date Signature
NOTICE: If, after making this declaration, you should become subject to the
Floor Sinks' - ` --
--Urinal - - t
-
Fixtures
Microwave '-
-
Workers' Compensation provisions of the -Labor Code, you must forthwith
h
comply witsuch .provisions, or this, permit, shall be deemed revoked.
CONSTRUCTION LENDING `AGENCY j (
I hereby affirm that there is a construction lending agency for the performance
Gas Service Outlets' Water Closet
1 6. -
_
- 2 50
Device Boxes
POI¢ Light
,
Interce tors'
p I
'Water Heater -�
r,
Outlets ,
Range
of the work for which, this permit is issued .(Section .3097 Civ. IC.)
Lender's' Name' - _
Lender's Address - I
_
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business and Professional Code: Any city or
Kitchen Sink
Water Service -; '
Switches
Sign
Lavatories, -
Garbage Disposal 'Standing Sections
P -Trap .n -
-
Generator 1305 KW 1:15-15 KW Trash Compactor
county which requires a permit to construct, alter, improve, demolish or repair
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
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
-Division 3 -of the Business !and Professions Code)orthat. he/she is exempt
therefrom and the basis for, the alleged exemption. Any violation of Section
7031.5 by. any applicant for a permit, subjects .the applicant to a civil
malty of not more than five hundred dollars ($500).
LJ I, -as owner of the property or my employees with wages as their sole
'compensation, will do the work, and the structure is not intended or offered
Roof Drains
-
..
I'
_
.
-
- ReinspeetibnyFee
-
-
$15 Issue Fee 1
$ 3
Reinspection Fee
$15 Issue Fee
$ 3
(
MECHANICAL
FEES
for sale (Section 7044, Business and Professional Code: The Contractor's
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
employees, Provided that such improvements are not intended or offered for
sale. If,'however, the building or improvement is sold within one year of com-171Canopy
pletion, the owner will have the burden of proving he/she did not build or im-
rove for the purpose of sale).
1, as. owner of'the property, am exclusively contracting with licensed con-
tractorSto construct the project (Section 7044, Business and Professions Code:
The Contractors License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such projects with a con- -
tractor(s1 license Dursuant to the Contractor's License Law). 1 am aware that
Proofo// their Worker's Compensation insurance should be provided to me.
❑ p aM.e.empt under Section _ - B. & P. C. for this reason
iiiiiii
DEVELOPMENT SERVICES REQUIREMENTS: '
Zoning Approved By Date
Building Approved By Date
T
Application Issued By Dat I v
Z
Boiler Hood Of Type I, ❑
Type II -
Duct -Under Ground
Duct -Structural ' Refrigeration System
Duct - Ventilating _ 110-100,000 BTU ❑100,000 BTU
- -I
BUILDING PERMIT
PLAN,CHECK
PLUMBING I
PLAN CHECK 125%
ELECTRICAL
PLAN CHECK 50%
MECHANICAL
SUMMARY OF FEES
$ 'SMIP $
$ PERMIT
$ 3v S0 ISSUANCE , $
$ ENERGY P.C.' $
,GRADING $ I
$
$ MICROFILM $
$ TOTAL FEE $ % I .150
Exhaui[ System ❑ Multiple ❑ System Repair/Alteration 1
Firepl/Fact. Blt. ICBG#
Date 1 owner
I hereby certify -that I have re this application and state that the above
information is correct. I agree to Imply with all city and county ordinances
and state laws relating to bu" di g construction, and hereby authorize repre-
sentatives of this' city to nt upon the above-mentioned property. for
inspection pu k
Heating System & Ducting
❑0-160,000'BTU -❑100,000BT - -,
-
Reinspection Fee ,$15
I Issue Fee $ 3
Signature i Date l
Oriver5' License or 55 ' ^
PLAN CHECK 25%,
'
$
CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting;
Goldenrod - Assessor
- CONSTRUCTION AND PLA NNING
APPROVALS-. Permit#
Date -
Inspector
POOL&SPA -
_4PPROVALS - Permit #
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 •. -
- i r
,
5. Steel Reinforcement , I
56. Rough Plumbing & Pressure Test
'6. Electrical UFER.Grnd. -
-
57. APPROVAL TO COVER-GUNITE
7. 'Footings - i�. '�
58. Electrical Conduit-Undrgrnd.
4 '•
B. Foundation
r
59. Gas Pipe, 0 Undrgrnd., Test
tr
9. Water Pipe-Undrgrnd. �%� -r
60. Backwash Lines,�P-Trap, 0 Undrgrnd.
10. Structural Floor System d
-
-
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor -Final
12. Sewer Cap
63. Heater & Vent -Final
�r -
13. Roof Drains
64: +Plumbing System - Final -
i
14. Rough Plumbing
"65: -Electrical-Final . -
%-
15. Rough Electrical -Conduit - -
66. Solar System -Final -
- -
16. Rough Electric Wiring
67-. Fencing & Access Approval17.
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
APPROVALS Permit #
...
20. Rough Factory Fireplace
21,..Ducts, in Structure-
70. Underground Hydro
r
22. Ducts, Ventilating
�71. Product Piping L1 Gas El Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
-
24. Roof Framing
-
73. Undergrnd.Storage Tank '0Gas 0Oil.
25. Roof Sheathing
-
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
r
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation - -
'
78. FIRE PREY. FINAL -
30. Drywall Nailing
,HEALTH DEPT. REQUIREMENT
.31. Plaster Brown Coat
79. FINAL INSPECTION"
--
-
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
r
33. Final Electric
_
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
) p`q
�zO
'
36. Hood or Canopy
37. Final Factory Fireplace
-
38. Final Plumbing
�a�22(jx{
39. Water Service -Final '
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
`-
•J
43. Backflow,lrrigatiori
44. ,Landscape Irrigation System
'
45. Sound. Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
i
48. Special Requirements Completed
49. Electric Release to'Edison
,r
50. Gas Release to Southern California Gas Co
.J
51. CERTIFICATE OF OCCUPANCY
No. Date
r ,
.5
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
.' CITY OF COSTA MESA CO TRUCT ON PERMIT PERMIT NO. TRACT NO. LOT `10 UNIT NO_
Project Address •Z" e
Applicant's Mailing.Address
Owner's Name% Phone -
Address Z z ^ 1�12,9(-, 1'1 / 61
Arch/Eng. sS,4 License No.
Address
Contractor's Nam
Address (mailin /0
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that Lam licensed under provisions of •Charter,9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and '
my license is in fu0lorce effect.
License Clpss Com- *ha n sc
Date !O`
WORKERS' COMPENSATION DECLARATION r
1 hereby affirm that I have a certificate of consent to self -insure or a certificate I
of Workers' Compensation Insurance,! or a certified copy -thereof (Section
3800, Lab. C.) C
Policy No. � �Company 7-
a
-
❑ Certif tad copy is hereb furnished.
®•Lerti etl c 15 - ith the city ild' g n.
Dale -^ Applicant
EXEMPTION FROM WORKERS' COMPENSA ION DECLARATION- -
(Thissection need not be completed if the permit is for one hundred ($100) or
less).
1 certify'lhat in the performance of the work for which this permit is issued, 1
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California.
Date Signature -
NOTICE: If, after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit • shall be deemed revoked.,
CONSTRUCTION LENDING 'AGENCY - -
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permitr,is, issued (Section 3097 Civ.;C:)
Lender's Name ,
Lender's Address
OWNER BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business and Professional Code: Any city Or
county which requires a permit to construct, alt,sr, improve, demolish or repair
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
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to •a civil
malty of not more than five hundred dollars ($$00).
I, as owner of the property or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's
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
employees, provided that such improvements are not intended or offered for i
sale. If, however, the building or improvement is sold within one year of com-
pletion, the owner will have the burden of proving he/she did not build or im-
nrove for the purpose of sale). _
I, as owner of the property, am exclusively contracting with licensed con-
tractors to construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such projects with a con-
tractor( license pursuant to the Contractor's License Law). I am aware that
proof off their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section B. g, p- C. for this reason
Date Owner
I hereby certify that I have read this application and state that the above
Information is correct. I agree to comply with all city and county ordinances
and state laws relating to building const rudi and hereby authorize repre-
sentatives of this y p ter up the ove-mentioney Pryyfrty Fjorj
inspection purpose / /O /7 d'a/f
Siqnat ure Date
Drivers' License or SS
3020 6/27/84
Accessory Building:
_ I
Parking Req./Provided
83.85 TI.
Zone
'
PLUMBING
FEES
ALTERATION
TYPE OF CONSTRUCTION LJ NEW LJ ADD
LJ REPAIR
"
❑ CONVERSION .❑ DEMOLISH ❑ OTHER
-
A.P.
DESCRIPTION OF WORK/USE OF BLDG.
Hood or Type I , ❑ -
Canopy Type I I ❑
Automatic Washer
Pole Sub.
: Transformer ❑ 15-50 KIN
❑50+KW
-
3ackflow Irrigation Sewer CapConstruction
S
Main Building:
TYPE OF PERMIT ❑ GRADING FOUNDATION
STRUCTURAL
T
Front
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING
❑ MECHANICAL
B
Firepl/Fact. Bit. ICBG#
❑ OTHER
Meter @6ver 100 amps,
A
Raaf,
Solar Piping
C
Right
PROJECT DESCRIPTION SO. FT.
OCCUPANCY—
K
-
CONSTRUCTION TYPE - VALUATION
$
S
Left
ZONE GRADING CU.YDS.
ACRES
Ping. Ref. #
Remarks:
Planning Notes:
3020 6/27/84
Accessory Building:
_ I
Parking Req./Provided
83.85 TI.
Zone
'
PLUMBING
FEES
$ 3-
Bar Sink
Stiowers
MECHANICAL
ELECTRICAL
FEES
3ackflow Prev anter -
_t - Service Sink
Hood or Type I , ❑ -
Canopy Type I I ❑
Automatic Washer
Pole Sub.
: Transformer ❑ 15-50 KIN
❑50+KW
-
3ackflow Irrigation Sewer CapConstruction
Refrigeration System
E10-100.,000BTU E1100,000BTU
3athtutis I
Sewer Connection
Duct - Ventilating
Cooking Unit
Meter ❑up to 100 amps
System Repair/Alteration
Clarifiers-
'I _Solar Collectors
Firepl/Fact. Bit. ICBG#
Dishwasher
Meter @6ver 100 amps,
Dishwasher
Solar Piping
Dryers []Gas ❑Electric
Sub Panel
Drinking Fountains
Solar Tank
-
Fan
Motors ❑0-1 HP IL IS - 8
Reinspection Fee
Floor Drains
Swimming Pool w/Spa
$ 3
F.A.U.
Inc. Solar 09-15 HP 1116-15+
Floor Sinks
Urinal
Fixtures -
Microwave
Gas Service Outlets
Water Closet
-
Device Boxes '
Pole Light
Interceptors
Water Heater
Outlets
Range
�5
Kitchen Sink -
- Water Service
Switches
Sign
Lavatories
/ Garbage Disposal
Standing Sections
P -Trap
_
H
Generator 110-5 KW 1-15-15 KW
11
Trash Compactor
Roof Drains
_
-
Reinspection Fee '
$15
Issue Fee
$ 3-
Reinspection Fee $15 Issue Fee $ 3
MECHANICAL
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date
Building Approved By Date -� ��
Application Issued By � > Date_ `o
Boiler -
Hood or Type I , ❑ -
Canopy Type I I ❑
Duct - Under Ground
Duct - Structural
Refrigeration System
E10-100.,000BTU E1100,000BTU
E—
Duct - Ventilating
SUMMARY OF FEES
BUILDING PERMIT' $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
ENERGY P.C. $
PLAN CHECK 25% $ ------90 GRADING $
ELECTRICAL $ �� �'
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $
PLAN CHECK 25% $
Exhaust System ElMultiple❑
System Repair/Alteration
Firepl/Fact. Bit. ICBG#
Heating System & Ducting
00-100,000 BTU❑100,00067
Reinspection Fee
$15
Issue Fee
$ 3
CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
Z
O
N
I
N
G
R
E°
G
M
T
S.
^�- CONSTRUCTION AND PLANNING
' APPROVALS- Permit #
Date
Inspector
POOL & SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. -Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ' -
53. Steel Reinforcement
-
3.rElectrical 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. Footings
i
58. Electrical Conduit-Undrgrnd.
- 8. Foundation
r
59. Gas Pipe, 0 Undrgrnd., Test
g. -Water Pipe-Undrgrnd•.-
60. Backwash Lines, P -Trap, Undrgrnd.
10. Structural Floor System ' `
61. APPROVAL TO DECK ' _
-
11. Property Sewer Line & House Connection
I,
62. Backwash & Receptor -Final
• 12. Sewer Cap
j
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 -
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16: Rough Electric Wiring
3
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
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
f
22. Ducts, Ventilating
71. Product Piping 0Gas 0Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank []Gas 0Oil
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'
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final
/
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
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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 .
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48, Special Requirements Completed
49. Electric Release to Edison!•
i
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50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. i Date
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