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Home My WebLink About2701 NEWPORT BLVD - Building Permits� �, � Aov��ant to flll in all soaces exceot those within heavy boraer Ilnes antl sign all aooropriate tleclaralions. CITY OF COSTA MESA CONSTRUCTION PERM� PERMIT NO. TRACT NO. LOT NO. UNIT NO. Proje�t,AdQress G�d' ✓ Ap1SliCan�'S Mailina Arflrlrrc< r � S L�J � 5�/"7/'fli/0'� Owner'sName �+...n�/`E lv��fC Phone�}�-�'�;?.�7 Address Arch/Eng. License No. Address Contracmr's Nam �hone �L Addreulmailingl�p/f,j�� f�✓� Ciiy License Na ��y LICENSED CONTRACTOR OECLARATION I he�eby aifirm lhat 1 am Iicensetl untle� proviSiOn50f Cha�te� 9(commencing with sectlon 7000) ot Divislon 3 0l t�e Busineu antl Profe55ions Coae, antl my license is in tull f�ce� tl y(fect. License Class U Lite Se No. '�ate/2/b 87 Signature �RKERS'COMPENSATION DECLARAT{ ireDy afilrm that I have a certiflcale of coi+cp t to selLinsure or a certificate of Worken' Compensatlon InSurance, o� a cerU(i¢tl Copy IherBot ($ectlon 3800, Lab. /Cc.) L/� Po tY No. aq7�s� 'g� ComPanY �t��1• Certitletl copy Is nereby lurnishetl. Certi(letl copy Is filed wilh the Clty� Itlin9 Dlvi.�} n. Date'T�-+A._�_� ApPlicant`�.�� 1��+ti/'•,]� - EXEMPTION FROM WORKERS' COIOIPENS1lTI�DECIARATION (This sec0on neetl not be tompletea if the permi[ is for one huntlretl (5300) or less). I certify that in the pertormance of thn wo�k (o� which this pe�m�t i5 izzuetl, I snall not employ any person in any manner so as to become subject to tne Workers' Compensatlon Laws of California. Date Si9nature NOTICE: If, after making lhi5 tl¢clatatlOn, You shoultl become Subj¢[t to th¢ Workers' Compensation provisions oi the Labor Cotle, you must forthwith compty with such p�ovl5ion5 0� IhiS permit Shall be ❑eemea �evoketl. CONST0.UCTION LENDING AGENCV 1 hereGy af(Irm lhat t�ere Is a con5truction Ientlinq agency for [be pertormance of the work for which this permlt is Issuetl (Sectlon 3097 Civ. CJ l.entler's Name LentleYs AGtlre55 OWNER BUILDEN �ECLARATION I hereby affl�m that I dm exempt trom tlte ContracloYs Ucense Law fOr the following reason (Sactlon 7031.5 Business and Professional Cotle: Any city or rnun�v wnir.n .nnmrna r oermlt [o construct. alter. Imorove. tlemolisb or r¢paii t b file a 5iqne0 Stat¢ment Inat ne/ine Is ucrnsea pursuani io me provumna m �e ConVa<tor'z License Law (Chapter 9(commencing with Sectlon 7000) ot ivision 3 of the Businass antl Protessions Cotle) or that he/she is exempt .nerefrom antl the DaSis tor the allegatl ezemptlon. Any violation of Section 7031.5 by any applicant tor a permlt subject5 the ap0licant to a civil penalty oi not more tnan five huntlretl tlollars (E500). ❑ I, as owner oi the property or my employoes with wa9es as their sole compensation wltl tlo tne work, antl the structure Is not intentlea or offeretl for sale ($ection 7044, Business antl Protezzlonal CoCe: The Gontrac[or's LitenSe Law aoes mt apv�Y to an owner ot a pro0erty who builtl5 or impmves thereon, antl who tloes such work himseli/herselt or tnrough his or her own lmployee5, provitletl Inat such improvCments are no[ int¢n0etl o� offeretl for sale. 1f, however, the builtlin9 or improvement is soltl within one year of mm- Ole(ion, the owner wlll nave ihe burtlen of provin9 he/she tlitl not builtl or im- �rova 1or the Ourpose ot 5ale). I, as Owne� of the property, am exclusively COnt�acting wlth lic¢nSeU con- t�actors to conzt�uct lhe p�oject (5¢ction ]044, Business antl Pr01l55Ions Cotle: The Contractor's LiCenSa Law tlOes not apO�Y to an owne� ot property who builtls or Improves thereon, an0 who contracts ior such projects wit� a con- Vactor(s) ii<ense oursuant to tne ConVactor's Llcense law). 1 am aware that proot-o( their Worker's Compensation Insuranco snoultl be providetl to-me. ❑ I am exempt untler Section B. & P. C. for this r¢ason Date Owner I nereby certliy that I have r¢aa this application antl state lnat the above informa[ion is correct. I agree to comply with all cily antl coun[y ortlinances antl state laws relatlng to builtling constructlon ana hereby authorize repre- sentatives of t city to enter upon [he above-mentionetl Property tor inspection Du�p se `Signature ' .(v�^ E. O � � . TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR �� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p.# DESCRIPTION OF WORK/USE OF BLDG. . S Main Buildi E TVPE OF PERMIT 6RADING FOUNDATION STRVCTURAL T Front ❑ TENANT ELECTRICA� ❑ PLUMBING ❑ MECHHNICAL B Reaf ❑ OTHER . � %� PROJECT DESCRIPTION S�. F7. oCCUvnrvCv C Riqht K Left CONSTRUCTION TVPE VAIUATION $ $ ZONE GRADING CU.YDS. ACRES p�ng. Ref. # Remarki: II� r.�e n c /I^.iv .. � Planning Notes: 3ar Sink 3ack(low Preventer 3ackflow Irrigation 3athtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks GasService OuUets Interceptors Kitchen Sink � Lavatories P—Trap .. • Roof�Drains Reinspection Fee $15 Boiler Duct - Under Ground � Duct - Structural Duct - Ventilating Exhaust System � Multiple Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑0.100.000 BTU �100.000 Rainspection Fee � $15 CMF 0865-46, rev. 10/B4 White - Builtlinq; Canary - Applicanh Pink - Accountinq; Goldenrotl - Asse55or Showers . Service S(nk Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Pool w/Spa Urinal Water Closet Water Heater Water Service Auto�Wash laue Fee Hood or Type I ❑ Canopy Type II ❑ efrigeration System ]0�00,000 BTU ❑ 100,000 a tystem Repair/Alteration Fire Dampers Registers laue Fee FEES $ 3 $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan 8612 10/29/87 Zone Accessory Building: Parking Req./Provided ELECTRICAL Transfarmer ❑ 15-50 KW ❑ 50+KW ' F.A.U. Fixtures Oevice Baxes Outlets Switches — Garbage Disposal ' Generator 00.5 KW 05�15 KW Meter Llup to 100 amps Meter �over100amps Sub Panel Motors �0�1 HP � 1%- 8 InaSolar �9-15 HP �16-75+ Microwave Pole Light Range Swnding Sections Trash Compactor I Reinspection Fee I$15 I I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approvad By Building Approved By C Appliption laued By / e( � �" BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ �5�� PLAN CHECK 50% $ MECHANICAL $ PtAN CHECK 25% $ Z O N I N G R E Q M T 5 FEES $ 3 SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ 'Q ^ TOTALFEE $ � `CONSTRUCTION AND PLANNING � . POOL & SPA � ' APPROVALS Permit # � Date Inspector' AppROVALS Permit # Date Inspector � 1'Temporary Electrical $ervice or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgmd.' " � 53. Steel Reinforcement - ' � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. "� 55. Electrical Bonding ' 5. Steel Reinforcement . � 56. Rough Plumbing & Pressure Test - ' 6. Electrical UFER Grnd. ; 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. � , 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd.f 60. Backwash Lines, P-Trap, O 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 Electriral-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 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 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 O Gas ❑ Oil . 25. Roof Sheathing 74. Overhead Hydro " 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe � � �_ I 26. Lathing & Siding 77. FIXED SYSTEM FINAL � �� 29. Insulation 78. FIRE PREV. FINAL '-� � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ,. . � � 37. Plaster Brown Coat 79. FINAL INSPECTION ,' � ` 32. Electrical Power Meter-Final ��, 7 80. FOOD CERTIFICATE ISSUED � 33. Final Electric � �,�� tes: . � { 34. Final Heating & Air Conditioning ,, ' I 35. Final Gas Pipe�Test - ' 36. Hood or Canopy '" �7. Final Factory Fireplace , . � �� '�y I" fv C 38. Final Plumbing • C " <� " ' . �, . 39. Water Service-Final ' �� i �;� � . 40. Gas Service-Final �' • ' � � J 41. Solar pomestic-Final � i' ' l , 42. Backflow Preventer i � .r - �� 43:'Backflow Irrigation ' '- � " r• �� ' �� '�44. -Landscape Irrigation System `'• � , �� n' � � 45."Sound Attenuation 1 � �^ ' � .... �. �46. liandicap Regulations •� .- tS � rt � �� 47. FINAL STRUCTURE & BUILDING - � �:, 1 •� t-y 48„Special Requirements Completed .i;.. ' !' 49. Electric Release to Edison �, �. � � � ^. �; 50. Gas Release to Southern California Gas Co =� � � '� i ),_ 51. CERTIFICATE OF OCCUPANCY . . - No. Date ` � � � �� \� ADDlicant to fill In all sDaees except those witnin heavy Doraar Iines ana si9n a11 approo/�ate tleclarations. �ITY OF COS,%'� €jSP �C ��N �RM� � Pro'e; F, dress Q Applican['�ailingAddress 7%d S�D �RR�O'Y� %�Rw`� ow�e�•sName PGSiA w!�'S.4 1/!4/{S'�,(/��phone 7�'/-7��/ Address �g �� %�%iWNs CV�/� �U�{R%AJ Arch/Eng. License No. Address Contractor'sNemeE�FC—,, rce�•Syzrsns phone�%S7SS°J Addresslmailingl-%%D 5. /�QR��'� �IPNY �� CityLicenseNo. � 0`i�f�%/ LICENSED CONTRACTOR DECLARATION . I hereby alli�m [hat I am licensetl untltr provi510n5 0l C�arter 9(commencing wit� seclion 7000) of Divlslon 3 ot lhe Business antl Protessions Coae, ana my Ilcense is in full1o�ce tl effect. ' �`` / Licensf Ciass L ice� No.� DateL ��- % 519 t /J � WORKERS'COMVENSATION �ECLAR ION ereby altirm that I have a tertiticate ot tonsent to Salf-Insure or a certHlcate Workers' Compen5ation Insurance, o� a ce�U(ietl copy thereof (SectlOn .,aoo, �o. c.� w� �/�%�T %a:}iF/1(C/�/`' Policy No. � ��/��7 Company 8 Certifietl copy is hereDy tvmishetl. � Certiti �Q py I tl wi[h th< ci[y uilCing i51 Da[e �-'�L •�� APplicant EXEMPTION FROM WORKERS' C PENS ION DECLARATION (This z¢Ction naetl nol be comple[e0 i the permit ii tor One huntlr<tl (E300) Or less). I certity Mat In th¢ performance of [he work IOr which this permR i5 i55u¢tl, I shall not employ any person in any manne� so as to become subjec[ to [he Workers' Comoensalion Laws of California. Date Si9nature NOTICE: If, a/ter makin9 this Ceclaratlon, you shoultl become tubject to tha Workers' ComOa�sal�on Provlsions ot lbe Labo� Code, y0u muzt to�Nwith comply with suc� provision5 or thi5 parmit Snall Ee tleemaC revoketl. CONSTRUCTION LENDING AGENCV I here�y a�fltm that tnere i5 a construGtlOn lentling agency for the Oerformance ot tne work for whith thiz p¢rmit is ISSuetl (SectlOn 3097 Civ. C.� Lentler's Name Lentler's Atltlress OWNERBUILDEN UECLARATION • I nereby alflrm that I am exempt Irom tho Contractor's Llcense Law for tno following reason (Sectlon �031.5 Buslness antl Prote55ional Cotle: Any clty or county whiGh reQuires a permit to con5[ruGt, dlter improve, demolish or ropdir any SlrucW�o, prlor to Its Issuan[C, alm rcqWres t�e ap0��cant ior Su<h parmlt to tiie a signatl ztatement tnat he/sne is Iicensetl pursuant lo tho provisions of �he Contractor'S Ucense Law (Chapter 9(commoncing wlth Sectlon 7000) of 'vision 3 0l [ho �Bu5ina55 antl ProfCSSioni Cotle) Or lhat be/sha is exampt :rafrom anE tM10 bailzdor the allegetl exemplion. Any dOlation Ot SeGtlon 131.5 by dny applicant 1or d Pe�mll suD�eGts the apP�� to a civll �enalty ol nol more than fiva huntlretl tlollars (ES00). 1, as ownor ol the Oroperty or my omO�oY¢es witb wages as theh solo com0ensatlon, will tlo lhe wark, ane tne structuro Is nol inlentletl or ottered tor sale (Section 7044, Businesz antl Professional Cotle: Tho Contrattor's License Law tloas not applY to an owner ol a property who builtls or ImOroves thereon, antl wno tla¢s such work himself/narselt or through his or her own emplOyees, p�ovltletl Inal zucb ImprovCmCnIS are nOl Intentletl o� otiCrCC for sa10. If, how0veq tha builtlin9 or improvement is Sold wilhin ona yCar ot com- o�etlon, thc ownar wlll have tne burtlen ol proving he/she tlia not bulltl or Im- p�ove io� lhe purpo50.ot sale). ❑ I, as owner ol the properry, am excluslvery contracting with IlcenseC ton- Iractors to construcl the project �Section 7044, Business antl Professlons Coao: The Contractor's LI<ense Law oes not apply to an owner o( property who bu1105 or improvas l�ereon, an0 who conVaCtS fOr SUCh projects wrth a Con- Vatior(s1 bcense pmsuant to tne Contractor's �icense Law). I am aware that proof of [halr Worker's Compensa[ion insurance 5houltl be provltletl to me. ❑ I am exempt untler Seccion B. & P. C. for thls reason Date I �ereby tertlly that intarmalion is torrect. antl state laws relating se�eau�es or mis aey inspectlon p po5e5. Signature 1 Drivers' L nse or 55 � ,CMF o865-46, rev. 10/B4 owner have rea tate that [na above tl county oralnances eby authorii¢ repre- ionetl/ property Gfor Datt(r �� a � TYPE OFCONSTRUCTION LJ NEW L1ADD LIALTERATION IJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Ap yµ, DE CRIPTION OF WOR /USE BLOG. y� ,. S Main Buildi TVPEOF RMIT GRADIN FpUNDATION STRVCTURAL T FrOnt ❑ TENANT ELECTRICAL VMBING ❑ MECHANICAL g flear ❑ OTHER A PR0.IECT DESCRIPTION 5�. FT. OCCUPANCv C Right CONSTRUCTION TVPE VALUATION S S Left ZONE GRADING CU. VOS. ACRES Ping. Ref. # Remarki: �� RM w e it K 4 �i %i'!N �% Planning Notes: Bar Sink Backftow Preventer Sackflow Irrigation � Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Seivice . Outlets InrerteptOrS. Kitchen Sink Lavatories" P—Trap . Roof Dra Y Reinspection Feo $75 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating ExhauscSys[em ❑ MW[iple Firepl/FacL BIL ICBO # Heating System & Ducting ❑0.100,000 BTU �10� Fae � $15 Whi[e - Bulltling; Canary - Applicanq Pink - Accounting; Goltlenrotl - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimm' Pool w/Spa Water Cioset Water Heater Wa[er Service Auto-Wash laue Fee 1ANICAL Hood ar Tyyel ❑ Canopy Typell ❑ Refrigeretion Sys[em ❑0-100,000 BT � System air/Atterati ire Dampers Regiseers laue Fee S 3 FEES $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Eleci Fan F A,U. Fixtures Device Boxes Outlet5 Switches Garbage Disposal Generatar �0-5 KW � I Reinspection Fee �� DEVELOPMENTSER 2oning Approved By_ Building Approved By Aoolintion Issued 9v. 018E 6/B?/ 7 � � „�• zone �-- Accessory Builtlirig: Z + O N I N G R Parking Req./Provided E Q M T S ELECTRICAL . Transformer ❑ 15-50 KW ❑ SO+KW Meter up to 100 amps Meter ❑overlDOamps Sub Panel Motors �0.1 HP �1'r5 � 8 Inc.Solar �9-15 HP �16-15+ MicrO�vdve Pole Light Range Standing Sections 5 KW Trash Compactor $15 Issue Fee FEES S 3 . . SUMMARV OF FEES �Of�/� . BUILDING PERMIT $ �—++� SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE S PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ �%„) • �D GRADING 5 PLANCHECK 50% $ MICROFILM S MECHANICAL S TOTALPEE S _.�1•0� PLAN CHECK 25% $ . CONSTRUCTION AND PLANNING _ POOL & 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 ,�.y_� J C 5. Steel Reinforcement 56. Rough Plumbing & Pressure Tesi 6�Iectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation , • 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. , 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural Floor System - 61. APPROVAL TO DFCK 11. Property Sewer Line & Wouse Connection 62. Backwash & Receptor-Final 72. 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. POOUSPA SYSi'EMS FINAL 19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # _ 21. pucts, in Structure 70. Underground Hydro {_ 22. 4ucts, Ventilating 71. Product Piping OGas ❑Oil. 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathin9 74. Overhead Hydro _ 26. 7-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. Orywall Nailing - � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION ' - 32. Electriral Power Meter-Final ��,�� G 80. FOOD CERTIFICATE ISSUED 33. Final Electric � C. Notes: . ,� v� 34. Kinal 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 pomesticFinal � ' 42. Backflow Preventer . . 43.�Backflow Irrigation � � 44. Landscape Irrigation System � '; '- 45. $ound Attenuation � , ' � 46. Handirap Regulations . 47. FINALSTRUCTURE&BUILDING � � 48. Special Requirements Completed ( - 49. Electric Release to Edison • � • 50. Gas Release to Southern California Gas Co . � 51. CERTIPICATE OF OCCUPANCY - No. Date .. AVG�icant to /ill in ali soaces exceo� those witnin neavy bortler lines anC sign all apprapriate aeelarations. c�TY cOSTA MESA CO�VSTRUCTION PERMIT Prolect Address a.7o I ucw FD2t Eilu O ' - Applicant'sMailingAddress , ��5 �.CYJC .CYN � Owner'sName �-�} �' ��A�+��.�'�Phone Address �• �� 6• � SP.r.7 f�6 E�O Cq �-�1 Arch/Eng, � License No. Address Contractor� Phone �'1- i0� Addreu Imailingl C[ �� ,,/ . Ciry License No. 7 �S (L� LICENSED CONTRACTOR DECLARATION ' � I hereby aftirm that I am licensetl untler provislons ot Charter 9(commencing wltn sectton �000) of Division 3 of [he Business ane Professions Coae, antl my Iicense is in full forc ettect. 343 6 S� Licens lass �' � N � oatc� U c'ooar .o �- I �s1rV�� WORKERS' COMPENSATION OECLARATIO� � ' hmeby affirm thaTl have a certificata of consent to se i-Insure or a certiflcate ,f Workers' Compensation Insurance, or a cortlfietl copy thereof (Section 3800, Lab. CJ � - ' Policy No. Company BCertifietl copy is hereby turnishetl. � Certlfiea copy is tilea with the city Builtling Division. Oate Applicanl � E%EMPTION FROM WORKERS' COM7ENSATIOfY DECIARATION (Thls section neetl not be com0�efetl if the permit is for one huntlrotl (y100) or less�. I ce�tify tbat In the performanG¢ of the work fOr which th{5 p¢rm�t i5 ISSuetl I shall not employ any person in any m ner so as [o become subject to [�e WOrkpc.c� �)�� tion Laws ot Califo DatC ! , ^""' �"— $i9nature - NOTICE: If, at[e� making this tleClara[ion, y0u Shoul beco e Subj¢Cl (O lha . Workers' COmp¢nsation .provisiOns of the Lzbor Cotle, y u mu5l fOrthwilh comply with such provisions or this permit s�all be tleemeE revoketl. CONSTRUCTION LENOING AGENCV 1 hereby aflirm tnat t�ere is a construction lentling agency tor tne performance of lho work for.which thi5 permii is issuetl (Sectlon 3097 Civ. C.) Lentler•s �Name LCntler'S AUCfe55 . OWNE0. BUIL�ER DECLARATION - ' I hereby afflrm that I am ezemo< Trom the Contractor's Licenso Law for the followina reason (Sectfon 7031.5 Business antl Professional Cotle: Any ci[y or C[or'S LicenSe Law (Chapte� 9(commenCing wifh Sectlon ]000) ot o� Ihe Bu5ine55 antl ProtesSions.Cotle) or tM1at he/she Is exempt anC the basis for the allegetl exemptlon. Any violatlon of'Sectlon anY applicant fol a permit Subjec[s tbe applicant to, a clvil ❑ I, as owner ot the properry or my employees with wages as their sole compensaUon, wlll tlo the work, antl the structure Is not Intenaetl or oiteretl lor sale (Sectlon ]044, Business antl Professional Cotle: The Coniractor's License Law tloes no[ apply [o an owner ot a property who builtls or improves lhereon, antl who tloes such work himself/herselt or throu9h his or h¢t own employee5, prOvlOetl that such Improvement5 are nOt In[entletl or ot}eretl fo� sale. If, however; the builtling or improvement Is soltl wlthin one year of com- pletion, the-owner will have the Gurtlen oi proWng he/she tlitl not bulltl or Im- �rove torthe purpose of sale). I, as owner of [he pro0er[y, am exclusively contracting with Ilcensetl con- tractorsto construct[he pro�ec[ (Section 7044, Business antl Professions Cotle: Tha Con[ractor'S License Law tloes no[ apply to an owner of property who bulltls or improves'th¢reon, antl who contracts tor zuch vrqects witn a con- tractor(5) iicense pursuant to t�e Contractor's Litense Law). I am awara that p�oot o( Inel� Work¢r'S CompBnsation insurance ihoultl Da o�ov�aea �o me. ❑� I xm exem0� untler 5¢ction _ 8. & P. C. for thi5 reaSon Oate Owner I hereby certity :that 1 have reatl this apo��atlon antl state that the abov¢ information I5 correct. 1 agree to comply with all;city antl county Ortlinances antl state laws relating to builtling cons[ruction, antl hereby au[norize repre- sentatives Of thi5 City f0 enter upon Ine abave-mentionetl pro ert fpr ins0ectlan p oses. ' ,� .Id� Y /.� Si9nature Oate N Y Dri'vers' Llcense or 55 � — � E';Z�3 `f-2� ,,,..., ...,. . � ,..,. �,�� . TVPE OF CONSTRUCTION . NEW ADD ALTERl1TION REPAIR �' .,❑ CONVERSION ❑ DEMOl15H O OTHER A p�y �DESCRIPTIONOFWO K/ SEOF LDG. � ' � �n W P lr �OYt �1� _� �1� � 4 1 1�22 O S Main Buildi TYPE OF PEHMI�qDING FOUNDA7loN U STRUCTURAI T FronY. �❑ TENANT ❑ ELECTRICAL � Q PLUMBING ❑ MECHANICAL g Rear ' ❑ �oTHER . ' A PROJECT DESCRIPTION Sq. FT. oCCUanrvCv C Right ,CONSTRUGTION TVPE VALUATION $ S LEft ' "�ZONE GRAOINGCV.VDS. ACRES p�ng.,Ref.�k ;,Remarks; �c��y ��- � � �a,,,�� F�(a�C�d PlanningNotes: 0 F.loor Dreins Floor Sinks Gas Service ' Outlets Interceptors ' ' Kitchen.Sink.. _ _ lavatories..• • P-Trap ' ' Roof Drai ` Reinspection Fee $15 Duct- UnderGround Duct - Strucmral Duct - Ventilating Exhaust System � Multiple FirepUFact. Blt. IC80 �1`- ' Heating System�& Ductin po-iao,000eTu o,000 Fee � ' $15 CMF 0865-46, rev. 10/84 White - Builtlin9; Canary - qpplicant Pink - Accountin9; Goltlenrotl - Assessor Service Sink Sewer Cap Sewer Connection . ' Solar Collectors $olar Piping ' �� Solar Tank Swimm' Pool w/Spa �Water Closet Water Heater .Water Service� Auto�Wash Laundry Trays Issue Fee iANICAL Hood or Type I ❑ Canopy Type II �❑ Refrigeration Sys[em ❑aioo,000e n Syst epair/Alterati Fire Dampers Registers � laue Fee � Automatic Washer . Construction Pole Sub. Cooking Unit Dishwasher _ Oryers ❑Gas ❑Electr Fan F.A.U. ' Fixtures Device Boxes Outlets - Switches - Garbage Disposal Generator O65 KW �! N $. 3 FEES DEVELOPMENTSER �Zonin9 APProved BY_ Building Approvad By ADoliwtion laued Bv_ $ 3 7357 111/17/B6 p.�� TL � Zone � Accessory Building: _ 0 ELECTRICAL - FEES Trensformer �❑ 15�50 KW , ' ❑ 50 t KW, � Meter �upto100amps, ��' Merer ❑OVEf ��BTDS ' ' Sub Yanel . -� ' Morors �67 HP � 1 h- 8 Inc.Solar �9-15 HP �16�15+ Microwave ' Pole Light Range 5 KW Trash Compactor $15 luue Fee EQUIREMENTS: Z O N I N G R E Q M T S � � SUMMARVOF,FEES � . � BUILDING PERMIT $ SMIP $ PLAN CHECK $ �•PERMIT " PLUMBING ,q � ISSUANCE $ � _ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL _ � $� ' ��d GRADING $ - PLANCHECK 50% $ MICROFILM S - MECHANICAL $ TOTALFEE $ `�D PLAN CHECK 25%� $ ' CONSTRUCTION AND PLANNING . POOL & SPA. . Date Inspector. " Date Inspector APPROVALS Permi� # APPROVALS Permit #, 1: Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding • 5. Steel Reinforcement �. 56. Rough�Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings � 58. Electrical Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Dreins 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 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT " 20. Rough Factory Fireplace APPROVALS Permit # �, _ , 21. Duc[s, in Structure 70. Underground Hydro 22. Duc[s, 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 � 74. Overhead HYdro ' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing - 76. Dry Sta�dpipe 28.� Lathing & Siding 77. FIXED SYSTEM FINAL "' 29. Insulation 78, F�RE PREV. FINAL ' 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � , , 32. Electrical Power Meter-Final ��y5 f6 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: `'�/ F��{ �� 2 eo �,��G�,e4 34. Final Heating & Air Conditioning � ph �R S�'o ��7 (A �.,.� .35. Final Gas Pipe-Test ' Ch�j�, d eC w �. �� 36. Hood or Canopy • 37. Final Factory Fireplace �, � , 38. Final Plumbing . � . ' � 39:�Water Service-Finai � � , 40. Gas Service-Final � ..41. Solar pomestic-Final • ,' , 42. Backflow Preventer , _ ., _ 43. Backflow Irrigation , • ' ' . 44. Landscape Irrigation System 4_ , • � �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 '' � �� r: 51. CERTIFICATE OF OCCUPANCY 4` � No. Date � G� � O Applicant to fill CITYOF�� TAry�ES O�g T UCTIONPERMIT ProiectAtl"�essCORA1�O�ME�F�IJR.lAiET^!fal� IV4 1J Rh Applicant's Mailin`g �Address .,, �- G�� C a' ' Owner's Napie� -�..7_Yi�� one�� '� - Address Q �X� � . Arch/Eng. License No. I Addres tractor-sName.s �� Phone �Off� � I' qqq Ad�lmailingl up�� -�f C�� C-�N• Ct� '• �� City Licenu No. UOOOL' _ � � LICENSED CONTRACTOR DECLARATION i1 � I bereby af(irm tnat i am licensetl untler provisions of Cnarter 9(commentlng � with section 7000) ot Division 3 Ot the Bu5ine55 antl PrOtessionz Gotll, antl my Ijeense is in full lorce ar�Q eftecL �/� p p/ �rns C1�ss �U LicenseNo39 V1O Date��v`�� 5'g t i'�"�— WORKERS' COMPENSATION DECLARATION �i hereDy affirm tnat I nave a certifiwte ot consent lo selt-insure or a certificate � of Workers' Compensation Insurance, o� a ce�tifietl cooY� tnereot (Section�. 3800, Lnb. CJ � , ' v - Policy No. Company Certitietl copy is hereby fumishe0. � ;.1 � Certifietl copy Is filetl with the city iltlin9 ' ision. ate APPlicant `� ' E%EMPTION FROM WORKERS' COMPENSATION ECLA0.ATION ' (TM1isseclion neetl not be completetl it Ihe pe�mit Is fo One hun0�etl (5100) or I¢5T). r I certify ihat in the perfo�mance of the wo�k fo� wltich this permk iz is5uetl, I� shall no emp loy any perzon in any manner so as to become subject [o tM1e WOrke ar0�i Laws of Califor _ Date �U Si9nature � � NOTICE: Ii, atter making this tleclaration, you sho beco e subject to the ' Workers' Comp¢nwtion provi5ion5 of the Labor Cotle, yo must forthwith Comply with such provizions or [hi5 permit Thall be eemetl revoketl. CONSTRUCTION LENDING AGENCV I here�y affitm that thery�a a conitruttion IenUin9 agency (or the performdnc¢ ol ihe work for w�ch tnis permit iz issuetl (Sec[lon 3097 Civ. G.) Lentler's Name � LenOer'S Adtlre55 0 OWNER BUILDEN �ECLARATION I hereby afflrm that I am exempt irom the Contractor's License Law for tne /ollowing reason (Sec[ion 7031.5 Business antl Professional Cotle: Any city or county which �equires a Oe�mit t0 Conitruct, alte�, Improve, Oemolish or r¢pair any structure, �prlor to its issuance, also requires the applicant tor such permit to file a signetl statement that he/she is IicenSetl pursuant to the provisions ot tne Contracior's License Law (Chapter 9(commencing witn Section ]000) of �Ivision- 3 of the Business antl Prolessions.Cotle) or that be/she is exempT herefrom and t�e basis for tM1e allegeG exemption. Any viola[ion bf Section /031.S�by any aOP�i<ant fo� a pe�mit 5ubject5 the aOP��ant t0 a civil �nalty ot not more Ihan five huntlretl tlollars ($500). I, as owner of the' p�operty or my employees with wages as their Sole compensation, will Co the work, antl the structure is not intentletl or otteretl ior sale (Section 7044, Business antl Professional Cotle: The Contractor's Lic¢nse, law tloes nol appty to an owner o( a property who builtls or improves thereon, antl who tloes such work himseli/herself or through his or her own ¢mployees, 0/ovltleE Ihat zuth improvements a�e not intentletl o� offer¢tl for sale. If, however, the builtling or imOrovement is soltl within one year of com- - plation, the owner will have the burtlen of p�oving h¢/She tlid not bulltl o� im- prove for the purpose of sale). ❑ I; as owne� of tlte p�o0erty, am exUusively cont�acting with IicenSetl con- bactors to construct the project (SeCtion ]044, Busine55 antl Professlons Cotle: The,Contractor's �icense Law does not apply to an owner ot property who builds or improves thereon, antl who mntracts for suth projects witn a com tractor(sl ucense pursuant ro the Contractor's License �aw). 1 am aware that proof of [heir Worker'S Compensation insurance shoultl be provitl¢tl to me. ❑ I am exempt unEer.Section g. & P. C. for th15 reason . ipaces except those wit�in heavy EorCer Iines anE sign all approp�iate tleclarationz. TVPE OF CONSTRUCTION LJ NEW LJ A�D Ll ALTERATION lJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � �DESCRIPTION OF WORK/USE OF BLDG. ., -TVPE OF PERMIT canDirvG FOurvDarlorv STRUCTUaa� . T �❑ TEIVANT Q�ELECTRICAL ❑ PLUMBING ❑ MECHANICAL �❑ OTHER_. . ' . PROJECT DESCRIP710N 5c1. FT. oCCUaANCv y GON�STRUCTION TYPE � VALUATION $ ? �ZONE GRADINGCU.VDS. ACRES Date ' Owner � . I nereby certity that I have read tnis application antl state that the above � Info�mation is conec4 I agree [o comply with all clty antl county ortlinances' ana state.laws relating'to buildin9 construction, antl hereby authorize reore- sentatives of this city to enter upon Me above-mentionetl property tor, Insoectlon oses. � _/oU $ignature Oate u Drivers' License or 55 t ` � .� •i � Bar Sink Backflow Preventer � Backtlow Irrigation Bathtubs Clarifiers � �IShVJd5h2f � Drinking Fountains �. Floor Dreins . Floor,Sinks Gas'Service ` Outlets � Interceprors Kitchen Sink -- Lavatories � � P—Trap • Roof,Orains Reinspection' Fee- $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System � Multiple � Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ o-� oo,000 aru O i oa,000 sr Rainspection Fee � $15 CMF 0865-46, rev. 10/84 - Applicani; Pink - Accounting; Goltlenrotl - AsseSsor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 � � Solar Tank Swimmin9 Pool w/Spa Urinal Wacer Closet Water Heater Water Service Auto-Wash Issue Fee FEES $ 3 A.P. # • S Main Building: E T Fron[ A Rear . C Right g Left Ping. Ref. # Planriinq Notes: Auwmatic Washer Construction Pole Sul Cooking Unit � � Dishwasher Dryers �Gas ❑Ele Fan F.A.U. Fixtures ' Device Boxes � Outlets Switches Garbage Disposal 7094 �I I / I 2/86 ' _ _ Zone Accessory Building: Parking Req./Provided ELECTRICAL . ' Transformer �0 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter �over 100amps Sub Panel . - ' KW 1J5-15 KW ! Motors Do-l. HP �1 X- 8 Inc. Solar �9-15 HP �16- Microwave Pole Ligh[ Sign ' � Standing Sections Trash Compactor " Reinspection Fee � $15 Issue Fee IANICAL FEES Hoodor T DEVELOPMENTSEflVICESREQUIREMENTS: ypel ❑ Canopy Type II ❑ Zoning Approved By 11 _ Building Approved By y,�.,�� Refrigeration System ❑aioo,000aru ❑ioo,aoo Sysrem Repair/Alteration Fire Oampers Registers � luue Fee � � $ 3 i3.nn TL Z O N I N G F E Q M T S FEES 0 $ 3 SUMMARV OF FEES � . . - . BUILDING PERMIT $ - SMIP . �$ � PLAN CHECK � $ � PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ �� ENERGY P.C. $ ELECTRICAL $._J �.`"�' GRADING $ PLANCHECK 50°6 $ MICROFILM $-• - MECHANICAL $ � TOTALFEE $ l3.� PLAN CHECK 25% $ � CONSTRUCTION AND PLANNING POOL & 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. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. - � 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. - . 60. Backwash Lines, P-Trap, O 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 Electriral-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 Conditioni'ng FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in Structura 70. Underground 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 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:�� fr-�(� �, ��„p o- rv _c l.4 34. Final Heating & Air Conditioning '�p. Gc.. � �y C'- Osa. c�o an 35. Final Gas Pipe-Test � . 1 � / c w �Sr� / N 36. Hood or Canopy � ' �� fh 37. Final Faaory 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. 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 � � i7 (y