HomeMy WebLinkAbout2233 CANYON DR - Building Permits�»a� �sa-sz�s • FaX f�ia� �ea-aess • www.ci.costa•mesa.cgpyILDING PERMIT
Job Address: 2233 CANYON DR
Suite:
Viciniry: REROOF APT BLDG A
Primary Occ: R-1 Hotels/Apts/Res >10 Occ Type of Construction: V-N
Parcel Number: 42207119 Zoning: '
Applicant: LEMUS, RAFAEL
Address: 2016 WALLACE AVE
UNITB . � -Phone: 949-642-7057
COSTA MESA, CA - - � � Zip: � 92627�- � .
Owner: PACIFIC DIVERSIFIED
Address INVESTMENTS
WOODLAND HILLS, CA Phone: ,
20545 OXNARD ST Zip: 91367 �
Comracror: , LEMUS ROOFING
Address: - 2016 WALLACE AVE �
UNIT B � � Phone: 949-642-7057
CO$TA MESA,�CA
� ' Zip: 92627 -, License: 8268'13
Arch : � Eng:
Address: Address:
77 FAIR DfiIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 10/03/2005
Issued: 10/03/2005
- � � Phone: Phane: �
� Zip: � License: `. � � License: . � �
SCOPE OF PERMIT
REROOF APT BLDG A: � -
FLAT ROOF: T/0 EXISTIN ROCK ROOF, REPAIR/REPLACE SHTG AS NEEDED, INSTALL BASE SHEET AND A.P.P TORCH.
PITCHED ROOF: T/O EXISTING ROCK ROOF, REPAIR/REPIACE SHTG AS NEEDED, 2 LAYER 15# FELT, APPLY "30-YEAR.COMP SHINGLES."
2200 SQ FT - . . . . . ' . . � . :
- FEE SUMMARY
Plan Check: $0.00 Calc Valuation: Sa,000.00
Permit $97.25 fi. �, Claim Valuation: ga,000,00
SMIP Res: $0.50
� SMIP Com: $0.00 ' =� . � � � �
Other: $0.00
Inspection: ' $0.00 `
Total: $97.75
PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0 �Rear 0-0 Lefl 0-0 Right 0-0
ACCESSORY Front 0- 0 ,, Rear 0- 0 Lefl 0- 0� � Right 0- 0
PARKING Existina: 0 Reauired: 0 Pronosed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days. -
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetiona and tinel epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545826
2N&4B (BNO)
,
�
WORKERS' COMPENSATION DECLARATION: �
1 hereby aflirm urMer penalry of perjury one ol tha followirg declaratlons:
❑ I heve entl will malntain e ceNficate of consent to selt-Insure tor workers' compensetlon, es provitleA tor by sectian 3700 0l ihe Lebor Cade, for ihe pertortnence of ihe
work tor wMch this permlt is Issuetl.
�I�ave arM will mainWn vrorkore' compensetlon Insurence, es required by sectim 3700 oi the Le6or Coda, for the peAormence of Ne work fw whiU Ws pertnil is Issuetl.
My wwkers' pensetlon Insure rrier e7Q pollcy number ere: n-7(� �-7 �7 / c-
Cartie? ��� P �c9 n c5 PWry�Numb�r. —4 1 Ll "l L_� l7 �' d>
('mis secrim neetl rm� ae canpleter Ir (ne perMr �s vsn,ea e� one nuneree ew�ars (atool or �ess.)
❑ I ceNty Uet in Ne peAormance oi t�e work br whic� ihis pertnit I5 L95ued, I shall rwt employ eny peroon in eny manner so es to Decwne suD�ect to tha workers'
canpensatlm laws of Celifoml , end egree Ihet It I hould become sub�ecl ro Ihe wwkers' compensetion provlslana ot Sectlon 3700 of the Lebor CaAe, I shall lorthwflh
mmpy wlth Nese p���g�
n�rt s� n re: `�SB � G� �-- oa�- -7 l G-- 3- o S
WAFiMNG: FMURE TO SEWRE WORKFAS' CDMPENSATIIXJ MGE IS UNUWFUL AND SMALL SUBIECi AN EMPLOYER TO CRIMINFL GENnLT1E5 AND CM� FlNES UP TO ONE HUNDRED
TYIOUS4ND OOLLME (5100,OW), W RDDITION TO THE COST OF COMPENSPTION, OAMAGES 0.S PRONDED WR IN SEGTON 31080F THE IABOR COOE, IMERE5i, FND ATTORNENS FEES.
LICENSED CONTPACTORS DECLARATION:
I hereby aKrm that I am lice under proNsions of Chapter 9(commencing wilh Section 7000) of �Ivislon 3 of Ihe Business enA Professions Cade, antl my Ilcense is in full
torce and ettecL ' c. x . _ _ �1 �_ _ _ ___. _ Gese�N� i� — .� � �� � � .
CONSTRUCTION LENDING AGENCV:
❑ I �ereby aHirtn that there is e construction lending egency for the peAortnance of iha wark lor which this pertnit is Issued. (Sec. 3097, Civil CoCe).
Landers Name: LentleYs Adtlress:
Signatura: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirm thet under penelry oi per�ury thel I em E%EMPT FROM THE CONTRACTORS LICENSE LAW lor the tollowing reeson (Sec. 7031.5, Buslnass entl Prolessions
Catla: Any ciry or counry which requlres e permit lo conslrucL elter, improve, tlemolis�, or repair eny stmcWre, prior lo Its issuance, elso raqulres the eppllcaN for suth pertnit
ta tile e signed atetement thet �e or s�e Is IlcenseA pursuant ro t�e proNsions ol t�e Cantrectors Llcense Lew (Chepter 8(commencing with SecUon 7000) 01 DlWsion 3 of t�e
Busineu entl Protessians Cade) or thet he or she is e:ampt Iherotrom end Ihe besia for the ellegetl exemption. Any violation of Sectlon 7031.5 Cy eny epplicant for e pertnit
su6Jects the eppllcant to a clvll penalry of no� more ihen five huntlretl tlWlere ($500).): . .
❑ I, es owner ol Ne property, or my employees with wepes es their sala compensation, WILL DO THE WORK, end Ihe structure Is rrot IntenOetl or aflered Por sele (Sec.
7044, Business antl Professions Cotle: The Contractors License Law does not apply to an owner of pmperry who builds or impmves thereon, anO who does such work
himself or �erself or ihrough his or her own employaes, provided Ihat such impravements are not intentled or oflered tor sale. If, however, the Duilding or improvement is
wld wit�in one year ot completion, the owner-builder will have the burdan ol proving Ihat he or she did not builtl or improve for purposa ot sele.). '
❑ I, as owner of the propeM, am E%CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to cansiruct Ne praJect (Sec. 7044, Business entl Professions
Cade: The contrectors Licensa Lew tloes not appy ro en owner oi pmperry wfw �uilds ar imprwes t�ereon, and who wntracis for such pmject wlth e cnntractar(s)
license pursuant to the Contrectors License Lews.).
❑ I em e:empt under sec. _
Signature:
Owner ID verified by drivefs Ilcense.
Veriticetlon o1 Oanership by (rype of
Business entl Protessions Code for Ihis reason:
� NO DriveY9 Licen58 No.
propeM �ez CIII or tle90):
Date:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certily that no excavetlon Ilve (5) or more feet In deplh Into which e person is requiratl to Oescentl, wlll ba maEe In connection wlih work authorizetl Dy this
pertnit, end that no building sWcture, sceNolding, lalsework, or dBmWilion or dismantlinq thereoi, will Oe more than Ihirty-six (38) leet hiph. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomla A�mInLqlretive Code).
❑ As owner-builtler, 1 will not employ enyone to do work wNch would require e pertnil from Ihe Divisian oi Industnel Setery, es notetl ebove, unless such person �es e
permit to do such work trom Ihe tlivision.
Signature: Date:
Division of IntlusMal Satery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EMRV: I certity unGer penelty oi perjury Ihal I have reaa this epplicafion and stete thet tha Intortneilon given is
correc�. I egree to comply wilh ell stete lews entl clty or0lnenCe9 relating to bulltling constructlon, entl euthodze represeNatives ol the Ciry of Coste Mesa to emer upon the
ebove-descnbetl Droperty tor Inspectlon purposes. I egree not to occupy ar ellow occupancy of eny building euthorized by this permit until final inspection.
COOE �. INSVECTIONTYPE
1616 Fiaetl System Final Fire P�evention
1266 Pool Spa Final
200 Final Re-Rooi
201 FIna1 Block/FleWining Wall
202 Finel Factory Fire Place
203 FinelSign
204 Final Demolition
QA7F 1[�ELS
l� OO C/i�
Date c
� � � � � � v
�Dete.I
CO�E I INSPEGTION TYPE
206 Finel Mechanical
208 Final Plumbing
210 Flnal Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Sile
250 Final Builtling/Otapency
PLIF 1t�dL@
(714) 754-5273 • Fex (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DfiIVE, COSTA MESA, CA 92626
1ob Address: 2233 CANYON DR
Suite No
Vicinity: FRONT OF PROPERTY
Parcel Nunmber: 42207119
Applicant: PATRICK ANTHONY
Address: 1556 S ANAHEIM BLVD
ANAHEIM, CA.
Owner: PACIFIC DIVERSIFIED
Address INVESTMENTS �
WOODLAND HILLS, CA
20545 OXNARD ST
PLUMBING PERMIT
Phone: (714) 75&7725 �
Zip: 92805
Phone:
Zip: 91367
Contractor: PACIFIC COAST COPPER REPIPE
Address: 1556 S ANAHEIM BLVD
ANAHEIM, CA
Phone: (714) 758-7725
Zip: 92805
License: 661428
SCOPE OF PERMIT
REPLACE MAIN LINE, HOSE BIB AND PRESSURE REGULATOR.
Status: ISSUED
Applied: 04/19/2005
Issued: 04/79I200�
ISSUED BY:
PLUMBING TO INCLUDE: 1 PRESSURE REGULATOR, 1 VACUUM Bf2KR BKFLOW (1-4), AND 2 WATER
SERVICES. • -
FEESUMMARY
AMT aTY AMT QTY , AMT QTY
ISSUE FEE $23.50 Laundry Tub I Washer. $0.00 0 ' Sump Pump 50.00 0
BackFlow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap � $0:00 . 0 Trap Primer $0.00 0
Bathtub 50.00 0 Pressure Regulator $9.80 7 „_ Urinal � 50.00 0
Clarifier System 50.00 0 Process Piping (per 10 ft) $0.00 0 � Vacuum Brkr 8kflow(1-4) 512.30 1
Connect (Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bktlow(5+) $0.00 0
Dental Units 50.00 0� Septic Tank $0.00 0 Wash Basin 50.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 ' Wash Basin Set , $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 � Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 � � Water Closet (Toilet) 50.00 0
Drain, Roof � 50.00 0' Shower $0.00 0 Water Heater / vent $0.00 0
Dnnkinq Fountain 50.00 0, Sink, bar $0.00 0 Water Piping (Inst or RepJ 50.00 0
Expansion Tank $0.00 0 Sink, wmmercial $0.00 .0 Water Re-pipe 50.00 0
Gas Earthquake Valve $0.00 0= Sink, Floor $0.00 0 Water Service 59.80 1
Gas (1-0 outlets) $0.00 0 . Sink, kitchen � 50.00 0 Water Softener 50.00 0
Gas (Over a outlets) 50.00 0 Sink, service/mop 50.00 0 . OTHER 50.00
Gas Repipe $0.00 0 Spa (private) -$0.00 0 VIOLATION 50.00
Gas Service 50.00 0 Spa (public) $0.00 0 PLAN CHECK 50.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1247-92)
EXPIRATION: This permit shall automatically expire end become void if work is not commenced within 180 days, or If work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all
requlred inepeetlone and flnel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
zsa�ae (a�oo)
WORKERS'COMPENSAnON DECLARAnON:
I herehy ettirm under penalty ot perjury one of the lollawing decleretlon9:
❑ I heve end will meintein e certiticata o� ��senl ro self�lnsure br workers' compensaUon, as prwldad tor by section 3700 0l the Lnbor Code, for the peAortnance of the
wOrk fOr whiCh Ihis pemiii i5 is5uetl.
ve end will meintain vrorkers compensetlon Insurence, es required by 5ecfion 3700 oi the Lebor Cotle, lor Ihe pertortnance of the work for which this pertnit is issueC.
�' My workers' {.rompenSellon Insyrence certier anA pollcy number ere:
ynrrs secrron neen nor ne c�mp�erea u me perm�r is vemea e� one
❑ I cenify that in the pertormance ot the woAc for y�M i e
compensetion lews ol Celifo�+ en egree 1 8t II I s [
compty wit� these P�sio S.
Applicant Signeture:
LICENSED CONTRACTORS DECLARATPN:
�POI1cylJumber: � y�7 /
ar less 1 L..,�,,,,r^'�'
ill 19 Is9ued, I shall noI employ eny persOn In eny manner 90 as to bemme suD�en to the worken'
:ome sub�eCl lo Ihe workers' compBnseNon prwi91on9 0� Section 3700 oi Ihe Lebor Code, I shell torthwith
��6-"�� $�- �9'o s
IS UMAW FUL AND 5lULL SU&IECT rW E PIOYEF TO CHIMINAL PENaLTIES r1ND GML FlNES W TOONE MWDRED
�t10N, DP.MApES RS PROVIpED FOR IN SECTIqJ 3108 OF THE LABOR CODE. INiEFEST, rWD ATTORNEYS FEES.
I hareb at I xm licensed%�n er prov�slpons ol Chepter 9(com cin Seclion 7000) ol Divislon 3 o ILi9��usiness tl Prof/e�sions Code, antl my Iicense is in full
,.r...'sXeol{ic!Ny.'a"�^ti (.��v�0 � / j�junaJl.��'� �-�V
�`�`�gnaWre:-- Onte' �-��'C7 ,r
'�..-�.r. -7 r__�. _ ._�..
�
CONSTRUCTON LENDING AGENCY:
� I hereby eftirtn thet there is a construd�o� �ending egancy lor Iha pedormance ol lhe work lor whic� this permit is issuetl. (Sec. 3097, Civil Cotle).
LenEers Neme: Lender's Atldress:
Signetura:
OWNER•BUILDER DECLARATIONS:
Dete:
I hereby aXirm t�et unCer penaly of pe�ury thet I em E%EMPT FROM THE COMRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Professlons
Cade: Any dry or couny which requires e pertn�� to construc6 eller, impmvo, tlemolisn, or repair any slmcWm, prbr to Its issuance, also requires Ne applitant for surh pertnit
to file e signeE sfetement that he or she is Ifcensetl Dursuant to the proNsions af tha Contrectors Ucense Lew (CheD�er 9(cammencing with Section 7000) of DlvLsim 3 of the
Busineu anA Professions Cotle) or t�et he or she is e:empt Iheretrom en0 tha besis tor Ihe ellegetl exomption. Any vlolation ol Sectbn 7037.5 by any a00���� �ar a pertnit
subject9lhe eppliceN Io e Gvil penalry oi na� more �hen Ilve hundred dWlars ($500).):
❑ 1, es owner ol Ihe property, or my emp�oye9s wlih weges es ihelr sole tompensatlon, WILL DO THE WORK, end the 9lructure is not in�entletl or offereA for Sale (Sec.
7044, Business and Professions COEe: The Contractors License Lew tloes not apply to en ownor ol property who builds or improves thereon, anC w�0 does such work
himself or herself or through his or �e� own employees, providad Ihat such improvements are not intended or oHeretl lor sale. II, however, che building w improvement is
so10 within one year ot completion, t�e ownervbuilder will heve the �urtlen of pmving ihat ha or she did not build or improve lor purpose of sale.).
❑ I, es ownor of the pmperry, em EXCLUSIVELV CONTRACTNG WRM UCENSED CONTRACTORS to constmct Ihe project (SecJ044, 8usiness and Professions
Cotle: The contractors License Lew tl0es not epply to an owner ol property who builtls or improves thereon, antl who wntracts for such proieci with a contractor(s)
license pursuant to the Contractors LiGense Lews.).
❑ I em exempt un0er sea Business antl Profossions Code br ihis roason:
SigneWre: Data:
Owner ID venfietl Dy dnvefs license. ❑ Ves � No Drivers License Na.
Venfication of Owners�iD by (rype of tlocuma�t, i.e. - D�operry tex blll or tleed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATON:
❑ I �ereby certify t�et no eawvation iive (5) or more teet in deplh imo which a person is required to descene, will Ge made in connection with work euNonzed Dy Nis
permi6 entl t�at no building structure, sceflMtling, telsewod, or Oemolition w tlismantling ihereot, will be more ihan t�irty-six (36) tee� high. (Chap. 32. Grp 2, Art 2. Sec.
301, TIIIB 8, Celifomie Adminislrelive Gade).
❑ As owneo-builder, I will not employ enywie to do wark which woultl reqNre e permit tmm the Division ol Intlusiriel Saley, es noted above, unlesa such person has a
permil Io tlo such work trom t�e divisi0�.
SigneWre: Date:
Division of Intlustrial Selery Pertnit Number:
CERTIFlCATE OF CAMPLIANCE AND AUfNORRATION OF ENTRY: I canity untler penalry of perjury ihat I have roed I�is application antl slate ihat t�e information given is
corred. I agree to wmply with ell state IawB end ciry ortllnances rQleting to hullding consiructlon, entl eulhodze represemelives at Ihe Ciry of Cwta Mesa ro enter upOn Ihe
above-tlescribed property tor inspection Durposes. I egree n�.1� ulAr allow occupency of eny hullding eut�odzotl by thb permit unlil linal inspection.
COOE I, INSPECTIONiYPE
1878 Flxed System Final Fire Preventian
1268 Pool Spe Final
200 finel qe�Roat
201 Flnel Black/Retelning Well
202 Flnel Fectory Fire Place
203 Final Slgn
20e Flnel Domdition
Date
Qdjj �$ �Qj� IN9PECTIONTYVE
206 Flnel Mochanlcal
�E �
20B Finel Plumbing �`i—%-�'��
210 Finel Eloclricel
2t2 FIneIFlrePmvontion
220 Finel Planning Approval
222 Finel Si�a
250 Finel Builtling/Occupancy
' Applicanl to fi11 in all soaees ezcevt those wlMin heavy borae� Ilnes'ana sign all aDoraD��ate Oeclaratlons.
'CITY Or COSTA MESA CONST UCTION PE/R�MIT P�FRMIT NO. �, � TRACT NO. LOT NO. UNIT NO.
ProjectAdA+ess �2���- �.W��( r' _
ApD����t's Maif �� ddress
� __
Owner'snlame ..t�,��NG Phone�y��4
Address , � � �G �►iw�sn at r — G�C �
�Arch/Eng. License No.
Address '
Contractor's Name � Phone
Address ( mai I i ng)
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affi�m that I am litensetl untllr provi5ion5 of Cha�te� 9(commencing
with section ]000) of Division 3 0( the Business antl Protessions Cotle, antl
my Iicense is in full force and efiect.
License Class License No.
Date Signature
WORKERS' COMPENSATION DECLARATION
�ereby affirm that I M1dv2 a certifiCat¢ Of tontent to zllt-in5ure o� a Certificate
Workers' Compensation Insurance, o� a c¢�tifletl copy the�eot ($ection
�aoo, �o. c.� ,
Policy No. Cbmpany
BCertifietl Capy is hereby tumishetl. ,
Certifietl copy 15 flletl with the dty Builtlin9 Division.
Date Applicant �
EXEMPTION FROM WORKERS' COMPENSA ION DECLARATION.
(This 5¢ction ne¢tl not be campletetl i/ Ihe per i5 for one huntl�etl (E100) o�
less).
I certiy that in the performance oi the w rk or this perm�t is Issuetl, 1
shdll not employ any pe�son in any m n a ub�ec o the
Workers' C pe ti ws o( CalifO .
Date '____�Si9nature
NOTICE: f, alter makinq this tleGlara n, you oultl be ome Subj¢Ct to th¢
Workers' Compensation provisions of the Labor Cotl ou must torthwith
comply with such provisions or this permit shall tleemetl revoketl.
CONSTRUCTION LENDING AGENCV �
I hereby affirm t�at there is a cons[ruction lentling agency for the performance
of tne work for which this permit is issuetl (Section 3097 Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDER DECLARFTION '
I hereby affirm lhat I am exempt from the Contrdctor's License taw tor the
(ollowin9 reason (Section ]031.5 Business antl Protesslonal Cotle: Any city or
county w�ich �equires a pe�mit to CbnSbuct, altE�, ImOrov¢, tlemolisn o� �¢pdir
any struc[ure, prior to its issuance, also requires the applicant for such permit
to (ile a signetl s[atement'that he/She Is licens¢d pursuant to the p�ovislons ot
the Contractor's License Law (Cnapter 9'(mmmencing with Se<tion 7000) oi
�ivision 3 ot the Busine55 antl Professions Cotle) or that he/she,�is exempt
ierefrom-an0 the basis for the allegetl exemptlon. Any violation of Section
,'031.5 by any applicant for a permit subjecls the applicant to a civil
�enalty ot not more than five huntlretl tlollars ($500).
I, as owne� ot the property Or my employ¢es with wages as their sole
compensation will tlo the wo�k, antl the structure is not intentletl O/�o(fe�etl
tor sale (Section 7044, Business antl Professional Cotle: The Contractor's
License �aw Ooes not apply to an owner oi'a property who builtls or improves
the�eon, antl who tloes such work him5elt/he�selLor tM1wugh his or he� own
employ¢es, prOvitletl Ihat zuch imp�ov¢ments a�e not Intentletl or Offeretl /o�
sale. If, howeveq the bulltling or improvement is Soltl within one year Of com-
pletion, the owner will nave the burtlen of proving he/she tlitl not builtl or im-
�ove tor the purpose of Sale). '
L..1 I, as owner oi tne property, am exclusively contractin9 with licensetl con-
tractorsto construct the project (Section �044, Business antl Professions Cotle:
The Contractor's �icense Law does nOt apply to an Owner of prope�ty wlto
builtls or improves thereon. antl who contracis for such oroiects with a con-
[racior(s Lcense pursuam m me Contra 's Licen e Law). 1 am aware that
prooi o� tneir Worker's Compensatlon n ran s ultl be provitletl to me.
❑,I am exempt untler Section B. & P. C. for this eason
Da[e � ' Owner
I herebvi certitv hayp have �reatl this application ntl state that the above
sentatives ot t
InSp¢Ction pu�p 5
Slgnature
Orivers' Licenu or 55
OB 5-46, rev. 5/88
TVPE OF CONSTRUCTION LINEW LIADD LIALTERATION LJ REGAIR
❑ CONVERSION ❑ DEMOLISH ❑ OT
DESCRIPTION OF WORK/USE OF BLO
�;v.r,—� c L Ty—�p�,�—� Z ..
VPE OF PERMI�RADING LJ FOUNDATION �STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sq.FT. oCCUCANCv
CONSTRUCTION TVPE VALUATION $ a�Q�i. u
20NE GRADING CU. VOS. ACRES
Remarks:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains .
Floor Sinks
Gas Servic.e
Interceptors
Kitchen Sink
P—Trap
Roof Orains �
Reinspection Fae
Showers
Service Sink
Solar Collecmrs
Solac'Piping
Swimming Pool w/Spa
Urinal
�U[ICSS N/atCf C1052L
Water Heater
Water Service
Auto-Wash �
Laundry TrayS
$15
Boiler
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepUFacL BIL iCBO #
Heating System & Ducting
❑6100,000 BTU 0100,OOOBT
eoy autnonze repre- .
lonetl property for
oate/� ��•�Z- painspection Fea S75
White - Builtlin9: Canary - Appllcant; Pink - Accounting; Goltlanrotl - Assassor
Isue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
F ire Dampers
Registers
Isue Fee
fEES
$ 3
FEES
$ 3
A.P. #
S Main Building:
E
T Front
A Rear
C Right
g . Left
Ping. Ref. #
Planning Notes:
Automatic Washer
Construc[ion Pole
Cooking Unit
Dishwasher
Dryers ❑Gas ❑
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator �65 KW 05-75 K
2one
Accessory Building:
Z
O
N
I
N
G
R
Parking Req./Provitled E
Q
� M
T
S.
E�ECTRICAL
Trensformer ❑ 15-50 KW
❑ SO+KW
Meter ❑up to 100 amps
Merer ❑over100amps
- • Sub Panel .
Motors�0.7 HP�1Yh-8
Inc.Soiar �9-15 HP,�16-15+
Microwave '
Pole Light '
Range
Si9n
Standing Sections '
W Trash Comoactor �_.
Reinspection Fee �$15 � � Issue Fea
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
Building Approved By ��J g
SUMMARV OF
BUILDING PERMIT $ �
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK 25% $
FEES
$ 3
?—Date
'—Date--�—}��
'�Datg///�Q�'�
SMIP • $ �
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $
TOTAL• FEE $ 'S U
o�*�°OiiiisiE°s°ali nt: 15�6
'SJ, J�
, � • .
�
�"CONSTRUCTION ANDPLANNING PO� .SPA _ _
APPriOVALS Permit # Date Inspector qpPROVALS Permit # Date Inspector
v:
� 1. Temporary Electrical Service or Pole ! 52. Pool & Equipment Location '
� r, 'i
2. ' il Pipe-Undrgrnd. ; 53. Steel Reinforcement �� ���" .
��� 3. ElBctiical Conduit Utility-Undrgrnd. . 54. Forms '.� ._- �
.
4n,Elect"r�cal Conduit-Undrgrnd. " 55. Electrical Bonding . ' =_ .
e •
5. �Steel�Reinforcement 56. Rough Plumbing & Pressure Test �`•
6. Ele�ctYical UFER,Grnd. 57. APPROVALTOCOVER-GUNITE t- �` .r
.�
•7.`Footing5 � 58. Electrical Conduit-Undrgmd. . • �, . �
S.�,Fouridation '' r�� 59. Gas Pipe, � Undrgrnd., Test � �� •,•. ,
9�Water Pipe-Undrgrnd. �� '� 60. Backwash Lines, P-Trap, O Undrgmd, r�: ., y�
10. Structural Floor System ' a61. APPROVAL TO DECK �
11.'Property Sewer Line & House Connection - 62. Backwash & Receptor-Final
J
12..SewerCap . 63. Heater & Vent-Final ' � I �,
13. Roof Drains 64. Plumbing System - Final -
14. RougN Plumbing 65. Electrical-Final �
15. �Rough Electrical-Conduit 66. Solar System-Final -
16. Rough Electric Wiring 67. Fencing & Access Approval
1��Rough Wiring Sign 68. APPROVED FOR PLASTERING
18.' Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL � �
19� Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
i
20. Rough Factory Fireplace APPROVALS Permit #
.�
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Vehtilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe:Rough & Test 72. Underground Flush - " -
24. Roof F�afning � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing � 7 G�(/• 74, Overhead Hydro � �
26. T-Bar Ceiiing (Structural) & Monocoat 75. Dry Chemical
27. Frame��nd 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.Brpwn Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ,_ �
33. Final Electric I- 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 , �
47. Solar pomestic-Final � v �
n
42. Backflow Preventer �•/ ,'�
43. Backflow Irrigation '� `
44. .Landscape Irrigation System ' �'i,�
� 45. Sound Attenuation ' �i;
46. Handicap Regulations / /o �`p � a3
47. FINAL STRUCTURE & BUILDING �- � S' � � - "
48. Special Requirements Completed '
49! Electric Release to Edison ' �� �
%
�. .
50. Gas Release to Southern California Gas Co � a
51. CERTIFICATE OF OCCUPANCY / : '
No. Date � '