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Home My WebLink About337 COSTA MESA ST - Building PermitsThe residence at 337 Costa Mesa Street is in substantial compliance with building codes wi[h the following exceptions: 1. Water pressure at some outlets is low. 2, Waste piping under sink must be tigid pipe, not flexible. 3. The flexible gas connector to the gas dryer may not_ pass through a wall. The through the wall protion must be replaced with ir�n pipe. 4. There is no trap on the washer waste line. Provide a trap at the bottom of the standpipe. �A�f,�-�cct�(J� RIC}IA12D HANkIART Building Safety Director March 30, 1976 1t}I/ar AVV�icant 10 fi11 in all sDaces exceD� ihose within hear)' boraer Iines an0 sign all aDvropriata aeclantions. R'tv oF cOS7a M Sn C NSTRUCTION��QPE,RMIT Project Address �� 1 ' � • ApplicanYs Mailing Address � < t �.. :..<T 1,'•�.. _ :.� Owner's Nary�Q ' •'u' �'� � � Phone Address jJ 1 `i. r.,- .• �� c' �_�. Arch/Eng. License No. Address Contractor'sNama 1 � i' " � ' ^`�Phone�'��'"''^�� Addreulmailin9) "S�V " �-1, � . City License No. - � � � �� LICENSED CONTRACTOR DECLARATION I ne�eby alli�m �M1at I am licensetl untlor provi5ion5 01 C�a�ter 9(Commen[Ing with sec[lon ]000) of Divislon 3 0� tne Bu5ine55 antl Pratesslons Cotle, an0 . my license is In IN1lorca antl nflect. � �� . LJcense d55 _S�� ICBf158N0. 1�'.��v�� Date'��" Si9nature ��' �" WORKERS' COMPENSATION DECLARATION ' he�eby aHirm t�at I nave a cer�ilitale Of cOnsenl to Seli�niure o� a certHlcala 1 Workers' ComOensation Iniurance, or a certiiletl copy thereot (Sectlon ' l800, Lab. C.) , . � , Policy No. Company 8 Certifietl copy Is �ereby (umishotl. CertifieU copy Is flletl witn the clty Bulltling Dlvislon. Dale AppliCdnl EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -' � (This section neetl nol ba compintetl II t�e Oarmit is for one nuntlratl (5100� or less). I terti�y thal in lhe pa�fOrmance o� the wo�k for whlGh ihis pGrm�t is lssuatl I shall not emplOy dny pe�so� In any mann¢r; az tO�become subjaCl t0 t�e Workers; Compensatlon Laws of California. .,_.-� Dale i' '�� $I9nature �� • l �' ' 'NOTICE: 11, aller making this tloclarallon, you ShOultl become subject to lhe Workers' Compenidtlon provislons of IhG Ldbor COCe, You muit for[hwith comply wilh such 0/ovision5 or lhis pe�mlt shall be tleamatl /evoketl. CONSTRUCTION IENDING AGENCV � I hereGy allirm tnat tnere is a constructlon lentling a9on<y for tha pertormance of the work for whic� Ihis parmlt� is I55ueU (Sactlon 3097 Civ. C.) LenOer's Namn , Lenae�'S Atldress OWNER BUILDEH �EGLARATION ' � I hereby affirm ihat I am exempl (rom the Con(rac[or's Licanse Law for the following reason (Sectlon 7031.5 Business antl Professional Cotle: Any city or counly whic� requires a permit to con5truct, alter, ImprOvl, tlemollsh or repair �efrom antl t�e bazis for the allegetl ezemplion. Any v!o�ation ot 5ecuon 13.5 by any appliwnt fOr a porml[ subjec�s Iha apP��anl to a Clvll alty o( not more lhan five nuntlred tlollars (5500).� . I, as owner oi the property or my emploYeos with wa9es as lhelr Sole �oensation, will tlo the work, antl Ihe structure Is not Intentletl or o(}eretl sale (Section 7044, Business antl ProfeSsional Cotle: Tha Contractor's' ense Law tloes not apply lo an owner of a Oroperty who Dui1tl5 Or ImpYOves reon, antl wno aoes such work himselt/nerselt or tnrougn hB or hor own ployees, proviaea that such Improvaments are not Inteneatl or oHeretl lor �. It, �oweveq t�e bulltlin9 or improvement Is soltl within ane year ot com- tion, the owner will have lha burtlen of proving he/sne tlitl not bulla or im- va tor Ihe purpose o/ 5ale�. � 1, as ownm ol tha proper[y, am uxcluslvely ConlraCtinq with IICan50tl con- :tors to construct Ihe 0/ojecl ($ecliOn ]044, Buslnoss and Ptolessions Cotle: � Contractor's License Law doas no[ apply to an owner of property who Itls or improves lM1areon, antl who contracls lor 5uch projects wltn a con- ,tor(sl licenze pursuan[�to Ibc Contrac[or's License Law�. I am awar¢ that � iot o( tnair Worker's Compensatlon insuranca snoultl be provlEatl to me. I am exempt unaer SecHon B. 6 P. C. 1or tnis reason Date Owner I hereby certily tnal I have reaa ibis appliwtlon antl stale that thc above information is cortecL I agree to comoly with all clty antl county orainances antl State laws relating to builtling conSlru<tion, antl he�eGy dutM1orixe �epre- sentatives oi lhit city lo ¢nte� upOn the abova-menlioneE property to� Inspection pulPosas. � Signature � � �— Date `� ' � 1 • Driv¢rs' License or 55 � `� — TYPE OF CONSTRUCTION, � lJ NEW LJ ADD I..J ALTERATION IJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ p,p, � DESCRIPTION OF WORKIUSE OF BLDG. '� . S Main Building: TYPEOFPERMIT � GRAOING FOUNDATION STRUCTURAL T Front ❑ TENANT Q�ELECTRICAL ❑ PLUMBING ❑ MECHANICAI B Reaf ❑ OTHER A PRWECT DESCRIPTION 5q. FT. ' oCCUVArvCv C Right K Leh � CONSTRUCTION TVPE � VALUATION S $ ' ZONE GRADING CU. VDS. ACRES p�ng. R2f. 96`- Remark�: Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs rinking Foun[ains - loor Drains loor Sinks 25 $2fVICE �UIICtS Kitchen Sink Lavamries � P—Trap Roof Dreins Reinspection Fee � � $15 Dun - Under Ground ' Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepUFact. BIL IC80 � Heating System & Ducting ❑ o-i oo,000 eru O i oo,000 er Reinspeetion Fee � S15 CMF OQ65-46, rev. 10/84 White - Bulltling: Canary - Applican[; Plnk - Accounting; Goltlenrotl - Assaisor $ho.vers Service Sink • Sewer Cap� ' Sewer Connection Solzr Collectors Solar Piping Solar Tank Swimming Pool w/Spe Urinal Water Closet Water Heater Waler Service � Auto-Wash ' Issue Fee Hoodar Typel ❑ Canopy Typell ❑ Refriyeration System �0.700,OOOBTU ❑100,OOOBT System fiepair/Alteration Fire Dampers ' Registers Iswe Fee $ 3 FEES 5 3 � i ��} . � .�� . I�. Zone Accessory Building: Z O N I N G R Parking Req.IProvided E U M T � ELECTRICAL Automatic Washer ' Transformer ❑ 15-50 KW ConstructionPoleSub. � 050+KW Cooking Unit � Meter �yp to 100 amps Dishwesher - � Meter �over100amps Dryers OGas ❑Electric Sub Panel Fan Mators 061 HP O1'h - 8 F.A.U. ' � Ina Solar �9�15 HP �16-15+ Fixtures Microwave Device Boxes Pole Light Outlets � Range Switches ' Sign � Garbage Disposal ', Standing Sections Generator �0.5 KW �5�15 KW Trash Compacmr Fee �$15 � � Issue Fea DEVELOPMEN7SERVICESREUUIREMENTS: 2oning Approved By 8uilding Appraved By � Aooliwtion Issued Bv � �� ' FEES $ 3 � SUMMARY OF FEES BUILDING PEFMIT $ SMIP $ - PLAN CHECK $ PERMIT PLUMBING $ �SSUANCE $ PLAN CHECK 2!i% $ ENERGV P.C. $ ELECTRICAL $ �% GRADING $ PLANCHECK 50% $ MICROFILM $ .' ) MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ CONSTRUCTION AND PLANNING PO < SPA , APPROVALS Permit# Date Inspector qppROVALS 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 5. Steel Reinforcement 56. Rou9h Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Co�duit-Undrgrnd. 8. Foundation � 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Ftoor System 61. APPROVAL TO DECK 71 . Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing SVstem - 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 16. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Under9round Hydro 22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Nydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe� 28. Lathi�g & Siding 77. FIXED SYSTEM FIfVAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final Z 80. FOOD CERTIFICATE ISSUED 33. Final Electric " Notes: 34. Final Heating & Air Conditioning 35. Fi�al Gas Pipe-Test 96. Hood or Canopy 37. Final FactorY Fireplace 38. Final Plumbing , . 39. Water Service-Final A0. Gas Service-Final � 47. Solar pomestic-Final � 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. So�nd Attenuation q6. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Etectric Release to Edison 50. Gas Release to Southern California Gas (b 51. CERTIFICATE OF OCCUPANCY No Date oA f � . AOplicant to filt in all spaces excep� those within �eavY Dortler lincs anE si9n all appropriate tleclarations. CITY OF COSTA MESA CQNS RUCTION PERMIT P RMIT NO. TRAC�T�pIO. LOT NO. UNI' T NU. , . r [� � �-t�3 PrDject Address -�/� Applicant's Mailing�4ddress ��/�� Owner's NaiMe � � Phone /p.71-� Address Arch/Eng. License No. Address Contractor's Nam Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I heteby aHirm [hat I am Ilcensetl untler ptovl5ions of Charter 9(commencing wi[h section ]000) 0/ Division 3 ot Iho Busin¢55 antl ProfesSions Cotl¢, antl my license is in full force antl eftact. LICCOSC CId55 LICCOSC NO. Date Si9nature WORKE(15' COMPENSATION DECLARATION � nereby aRirm that I have a certificate oi <onsenl to selt-Insure or a certiflcate � Wo�kers' CompensaliOn Insu�ance, o� a certlii<tl COpy Ihereof ($ectlon l00. Lab. C.) Policy No. Company 8 Certifietl coOY is hereby Iumishea. Certifietl copy is lilea wlth lhe city Builtlin9 Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be complet¢tl i1 the Oe/mit is for one huntlretl ($300) or less). ' 1 certify Shal in the performanGu of the wo�k for whiCh this perm�t i5 issuetl, I shall not employ any perzon tn any �9A�ner 5y� as o beco e u ject to ihe Workers' Comp eryytJon Laws of Calit�9�a�.,,�� /� �ate � �L/=)L/ Si9nature �'Y �� NOTICE: If, a(ter making this tletlaration, you shoultl become subject to the Wo�ke�s' Compensation provisions of the Labo� Cotle, you mu5t forthwith comply with Such plOVI510f15 0� this pe�mit Shall be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV I hereby atfirm [hat there is a con5iructlon lentling agency for the pertormance ot the work fo�w�h4A this permit is issuetl (Section 309] Civ. C.) LRntler's Name T Lentler's Aaaress OWNERBUILDER dECLFRATION I nereby affirm tnal I am exompf trom tM1e Conbactor's License Law for the followin9 reason (Section 7031.5 Business antl Professional Cotle: Any clty or county whiCh reqaires a permil to conslruGt, altCr, ImO�ove, tltmolish o� repdir any�SVucture, prio� lo its issuance, alm r¢qui�es the appli<ant to� such pOrmit to file a signetl statemeni that he/She is IicrnS¢tl pursuan[ to the provislons of the Contractor's License Law (Chaoter 9(commancing with Section 7000) of Division 3 of Ihe Business antl Professloni Cotle) or thal be/she is exampt �erefrom antl tM1e basi5 for [he allegetl ¢xemOtion. Any viOlatlon of Section )31.5 Dy any appli<an[ for a permlt subjects tho applicant t0 a civil 1ca�nalty of not more than five huntlretl tlollars (y500). n I, as owner of tne property or my employees wlth wa9es as their sole compensation, will tlo Ihe work, antl [he st�ucture i5 not in[entletl or Ofteretl for sale (Section ]044, Business antl Professional Cotle: The Cont�acto�'S LiCenSe Law tloes not apply [o an Owne� of a property who builtl5 or improves thereon, antl wno tloes such work nlmseli/herself or tnrough his or her own employee5, provitletl tM1at such Imp�ovements are not Intentletl o� ofte�etl for sale. It, howaveq [he builtlin9 or improvement I5 solG wilnin ono year o1 com- pletlon, the owner will have lba burtlen of prOving ne/she tlltl no[ builtl o� Im- prova tot tite purpose ot sale). ❑ I, as owner of the property, am excluslvely Contracting with lic¢n5etl con- tractors to construct the proiect (Sectlon ]044, Business antl Professians Cotle: The ConVaclOr's License Law does nOt apply to an owner of property who builds or improves thereon, antl who conlracts tor such orojects witn a com tractor(51 �icense pursuant [o Ihe Contracfo�'s Llcense Law�. I am aware [hat proof of [hei� Worker'S Compensatlon insu�ance Shoultl be provitletl [o me. ❑ I am exempt untler Section B. & P. C. tor this reason Date Owner I hereby <ertity that I have reatl tnls appiicatlon antl state that the above information is correcL I agree t0 comply with all cily antl coun[y ortlinances ana state laws relating to builtling tonstru<tlon, anC hereby authorize repre- sentatfves, ql this city to ent¢r upon �the abov¢-menUonetl Otpperty fy� �„vr«�o� �,°�i:i� �.»�'� �� .—laz• / Siqnature [ Date Drivers' Licenze or 55 � ,, �� —T �3 S 1 9 TVPE OF CONSTRUCTION NEW AOD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIONOFWORK/USEOFBLDG. �IL�� t�'� �✓� TVPE OAPERMN�� LJ GRADING LJ FOUNDATION L�15TRVCTURAL ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL '❑ OTHER PROJECT DESCRIPTION 5a. F7. � oCCuaArvCv� i CONSTRUCTION TVPF � r' VA�UATION $ . ZONE GRADINGCU.YDS. ACRES_ Remarks: �� J � ,.., ! � PL Bar Sink Backflow Preventer Backflow Irrigation Dishwasher Drinking Fountains Floor Drains� ' Floor Sinks GasServiie ��. Outlets Interceptors Kitchen Sink .n Lavatories ' Roof:Drains -'.: i Reinspection Fee Showers Service Sink Sewer Cap Sewer Connection $010f COIICCLOlS $olar Piping Solar Tank Swilnming Pool w/Spa Water Closet Water Hearer Water Service �' Auto�Wash Laundry Trays � . . $15 Issue Fee Boiler Duct - Under Ground Duct - Strucmral Duct - Ventilating Exhaust System ❑ Multiple Firepl/FacLBIt.IC60# � Heating System & Ducting ❑ ai oo,000 sru O i oa,000 Reinspection Fee � $15 Hoodor Typel ❑ Canopy Type I I ❑ 3efri ration System 700,OOOBTU Ot00,0008TU System Repair/Alteration Fire Dampers Registers Issue Fee CMF OB65-46, rev. 10/84 White � Builtling; Canary - Applicant; Plnk - Accounting; Goltlenrotl - Azsessor I $ 3 $ 3 A.P. # � S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit OIShWd5h2! Dryers OGas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0-5 KW �5-15 � Rainspection Fee I $15 DEVELOPMENTSERVICESREQI 2oning Approved By � Building Approvod By � 2993 iii.2iae Zone Accessory Building: � ��/�ii .f.p �i_iSJ 3' Parking Req./Provided � — r'nn _ ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter over 100 amps Sub Panel Motors �0-1 HP � 1 h- B Inc.Solar 09-15 HP �16-15+ Microwave Pole Light Range ' Standing Secnons Trash Compacmr luue Fee REMENTS: SUMMARV OF FEES" BUILDING PEftM1T $ Tf� 8•� SMIP PLAN CHECK $ �V '7-b PERMIT PLUMBING $ 1 �SSUANCE PLAN CHECK 25% $ ENERGV P.C. ELECTRICAL $ � GRADING PLAN CHECK 50% $ '�s' S�S MICROFILM MECHANICAL ff �� TOTAL FEE PLAN CHECK 25% $ G 271041 TI_ 2 O N I N G R E � M T S FEES e !'L/ ' d X�( e l��'i^'�pOp e � "` �2`Y]A $ rV p $ $ 3 $ Z�I• CONSTRUf,TION AND PLANNING ' + �'; POOL & SPA � I APPROVALS .Permit# - �_� Date ��I.nspector qppROVALS Permit# Date Inspector . „ 7� Temporary Electrical Service or Pole 52. Pool & Equipment Location - . 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcemen[ 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' � 4. Electrical Conduit-Undrgmd. 55. Electrical Bonding � . 5. Steel Reinforcement' � g t% 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnd. ¢�✓ 57. APPROVAI TO COVER-GUNITE 7. Foo'tings � � � r( �. �/ � 58. Electrical Conduit-Undrgrnd. 8. Foundation � � ;�rf � 59. Gas Pipe, � Undrgrnd., Test � • 9. Waier 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 & fleceptor-Final, 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing Sys[em - Final 14. Rough Plumbing - . 65. Electrical-Final 15. Rough Electriral-Conduit 66. Solar System-Final � 16. Rough Electric Wiring Z r '� 67. Fencing & Access Approval � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �t � �, j 20. Rough FactorY Fireplace APPROVALS Permit # 21. Ducts, in Structure . . 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil i� 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing . � G, �/. 73. Undergrncl. Storage Tank O Gas ❑ Oil 25. Roof Sheathing N, � 74. Overhead Hydro •� 26. T-Bar Ceiling (Structural) & Monocoat , 75. Dry Chemical "� 27. Frame and Flashing , � 76. Dry Standpipe , 28. Lathin & Sidin � : � 9 9 ' 77. FIXED SYSTEM FINAL ` 29. Insulation 78. FIRE PREV. FINAL �': 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �� ; 31. Plaster Brown Coat a . 79. FINAL INSPECTION '_ �- 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED , 33. Final Electric otes: �� E !W o 34. Final Heating & Air Conditioning ry � O 4 �y�-• Q 35. Final Gas Pipe-Test `u � O � 36. Hood or Canopy �f.l � f�.S f "�.q, 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final � • 41. Solar pomestic-Final ' . , .�42. Backflow Preventer � 43. Backflow Irrigation � ' .44. Landscape Irrigation System � � � 45. Sound Attenuation � ' 46. Handicap Regulations 47. FINA� STRUCTURE & BUILDING 1 48.� Special Requirements Completed ' � 49. Electric Release to Edison . . 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY.� - • No. Date �W . - ACP��cant [o fill in all spaces exce0� those wit�in heavy bortler lines ana sign all aooroDriate Ceclarauons. . CITY OF GOSTA MESA CONSTRUCTION PERMIT PERMIT NO. � TRACT NO. LOT NO. , UNIT NU. - '� . 95�3 .2/ I 9IBE . � Qp{iiJ �L . ,Pr�ect Address 3�, C O�T :� MG�a�� S-r . �aaSSDS� . ' Applicant's Mailin Address _ � TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Owner's Name �pNn� ST Ew p<T y5-2 � � CONVERSION ❑ �EMOLISH ❑ OT� ER ' A p # Zone ' 2 Phone DESCFiIPTIONOF,WORK/USEOFBLDG. „�-S��NC= Address —7q5 COSTO. i�►E�lp1'-ST LM. ' '� � S Main Building: Accessory Building:' ' 2 AfCh/Eng. Lic2nse No. ' TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRVGTURAL � T Front • • � -- _ ' p Add/¢ss - ' � � . ❑ TENANT � �ELECTRICAL -O PLUMBING ❑ MECHANICAL - B R¢df �- N COntfdct0�'SN3m ��-�SLNV�.1.. Er�phone ��%��. �'OTHER ' 1 � ' A - , , - N� Address (mailing) 10 �AIC ST - PROJEC7 DESCRIPTION 5�. Fr. oCCUaANCv K Right " G 2SOy� CONSTRUCTIONTVPE VALUATION$ S Left City LiCenseNo. ZONE GRADING CU.VDS. ' ACRES R LICENSED CONT�RACTOR DECLARNTION PI�J. Ref. # ' Parkin9 REq./Provid¢d . 1 E� � I-hereby aftirm that I am licensetl untler provisions of Charter 9(commencing Remarks: � • i � � . �� ' P,lanniny NOL¢5: � ' �^ M with SecUon �]000) ot Division 3 of the Business antl Profezzions Cotle, antl , _ T my license is in full torce antl effect. � . � • . � - License C ss � ice e � � S ,� Date�� Signature ' ' ' ' PLUMBING, FEES � ' � WORKERS' COMPENSATION DECLARATION � � ' � � - I hereby atiirm thal I have a certificate ot consent to selt-insuie or a certi�lcate Bar Sink ' Showers . � ELECTRICAL . F.EES o( Workers' Compensation Insurance; -or a certifietl-wpy thereof-(Section� gackfiow Preven[er Service Sink � Automatic Washer - Transformer ❑ 15-50 KW 3800, Lab. C.) � . � ' . ' Policy No. ' � ' Company � Backflow Irrigation Sewer Ca ' - � ❑ 50+ KW eCertifietl mpy is hereby furnishetl. • � � P Construction Pole Sub. , Certifietl copy is filetl with the city Builtling Division. , . Bathtubs Sewer Connec[ion Cooking Unit Meter p to 100 amps � �ate � Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � Cl2�ifIEiS _ SOId� COil2tto�s . . � Di5hwa5hC� - - M¢t¢� ❑Ov2� 700 drt1p5- � - - (This section neetl nat be completetl if the permit is tor one huntlred ($100) or less). ' Oishwasher ' Solar Piping i ' Dryers ❑Gas ❑Electric Sub Panel � � I certi(y that in the pe�to�mance of Ihe wo�k to� which this pe�m�t is issuetl I � � . , - snail not employ any oerson in any manner so as t ecome subject to the Drinking Fountains Solar Tank Fan ' Workery�i rr,�yon �aws of C p�a \ r� Momrs �0-1 HP � 1%- 8 Date �"��Q4 Signature Floor Drains ' � I Swimmin Pool w/S a ' ' ' . � 'NOTICE: H, after inakinq this tleclaratlon, yau shoultl become subjec[ to the 9 P F.A.U. Inc. Solar �9-15 HP 016-15+ Worke�s' Compensation provisions ot'tbe Labot'COtle, you must tortnwlth" FIOOf$inks�� U�inal � � Fi%tu�¢5' MiGrow2v¢ � compry with such provisions or [hi5 pe�mit� sitall be tleemetl revoketl. ' CONSTRVCTION LENDING AGENCV ' � Gas$2rviCe OuLIEtS � W2tefCl05¢t D¢viC¢BOZBS� ' POIeLiht ' 1 hereby aftirm that there is a const�uction lentlinq agency tor [he performance 9 of the work for whith this permit is issuetl (Section 309] Civ. C.) - i— . Intercepmrs :Waffir Heater Outlets ' Ran e Lentler's Name 9 Lentler's Aatlress Kitchen Sink Water Service � ' Switches Sign � OWNER BUILDEH OECLARATION I hereby afflrm that I am exempt from the Contractor's License Law tor the � Lavatories � Auto-Wash ' foilowin9 reason (Section �031.5 Business antl Professional Cotle: Any ciry or - Garbage Disposa ', Standing Sections county which requires a permit to construct, alter, improve, tlemolish or repair P—Trap ' Laundry Trays Generator ❑ 5-1 W Trash Com actor any st�ucture, prior to its issuance, also requires the applicant fo� such permit P to /iie a signetl stalement �that he/she is licensetl pursuant to lhe provisions of ROOf Dfdi05 [he Contractor's Litense Law (Chapter 9(commencing with Sec[ion 7000) ot ' DiviSion 3 ot the Business antl Profe55ion5 Cotle) or that h¢/sne is ezempt , � . therefrom antl the basis fOr the alleqetl exemption. Any violation of Section - 7031.5 by any applicant fo� a pe�mit subjects lhe apPlicant ta a civil �nalty of not more than five huntlretl tlollars ($500). - . �3 ' LJ I, as owner o( [he praperty- or my employees with wa9e5 as their sole R¢inSpeMiOn FBe � $15 �s5ue Fee $ Wmpensation, will tlo the work, antl the structure is not intentletl or offeretl Reinspection Fe $15 luue Fee $ 3 for sale (Section,�044, eusiness antl Professional Cotle: Tne Contractor's . . . MECHANICAL FEES License' Law tloes not app1Y to an owner of a p�operty who builtls or improves � thereon, antl who tloes such work hlmself/M1erselt or tnrough nis or ner own DEVELOPMENT SERVICES FEQUIREMENTS: employees, provitletl [hat such.improvements are not intentl¢tl o� otteretl for BOiI¢� � HOOd 0� Typ¢ I ❑ ' sale. Ii, however, tne Cuilain9 or improvement is soltl within one year of mm- Canopy Type I I ❑ Zoning Approved By _ Date O�efion, [he owner will have tlte burden of proving he/she tlitl not builtl or im- Duct - Und¢� G�OUnd Building Approved By — DdtO prove for the purpose of sale). . ^� ❑ I, as owner of the property, am exclusively contractin9 with licensetl con- Duct - Structural ' Refrigeration System AppliCetion ISSued By Dat -1 tractor5to consVuct the pIOjCCL (SECBOO JO44� BUSIfIC55 dlld PIO}QSSI005 COGE: e � ' The. Contractor's License Law tloes not apply to an owner ot property who Duct � Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARV OF FEES . builtls or improves lhereon, antl who mntracts to� such projects with a con- tracmr(st license pursuant�to the �Contractor's Licenze Law). 1 am aware that Exhaust System ❑ MWtiple ❑ System Repair/AI[eration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance shoultl be provitletl to me. _ P�AN CHECK .$ PERMIT ❑ 1 am exempt untler Section e. & P. C. for this reason Firepl/Fact.8lt. ICBO # Fire Dampers PLUMBING $' ISSUANCE ' S _ Date Owner Heating System & Ducting Regiscers ' PLAN CHECK 25% S� ENERGV P.C. �$ I hereby certity tnat I have reatl this application antl state that fhe above ❑0-100,OOOBTU Ot00,0006T GRADING �$ intormation is correct. I a9ree to comply with all city antl county ortlinances • ELECTRICAL $ antl state laws relatin9 to builtling construction antl hereby authorize repre- , MICROFILM $ sentatives of� this city to enter upon the above-mentionetl property �or PLAN CHECK '50% $ p. inspectionyyyyyµjj(ppp w ��5�� F ' MECHANICAL � $ � TOTA�FEE $ D'� Si9nature �� Date�� Reinspeetion Fee �$15 luue Fea $ 3 PLAN CHECK 25% $� ' Drivers' License or SS � �__ CMF 0865-a6, rev. 30/84 White - guiltling; Canary - Applicant: Pink - Accounting; Goltlenrotl - Assessor CONSTRUCTION AND PLANNING POOL & SPA � Af'�ROVALS Permit # Date Inspector AppROVALS Permit # Date � Inspector 5. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe;Undrgrnd. � � � 53. Steel Reinforcement F 3.�ElectricalConduit.Utility-Undrgmd. � 54. Forms - ' 4: ElectriCafConduit=�Undrgrnd. 55. Electrical Bonding � 5. Steel Reihforcement,� : ' 56. Rough Plumbing & Pressure Test '' 6.'Elect�ical UFER Grnd. ' � 57. APPROVAL TO COVER-GUNITE � i 7.•Footings� . , • 58. Electrical Conduit-Undrgrnd. r 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test � 9. ;Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. � � 70. Structural Floor System � - ' 67. APPROVAi TO DECK � � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �� 12. Sewer Ca` � � 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 -- i6. 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# � 21. Ducts, in Structure , 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas .❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � � 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheatfiing � � 74. Overhead Hydro -' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' - 27. FrameandFlashing 76. DrySiandpipe 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 pomestic-Final ' � , 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation , � � 46. Handicap Regulations � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electrie Release to Edison ; .. 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY " No. Date