HomeMy WebLinkAbout2286 CANYON DR - Building PermitsAVGlicant to till in all spaces ezcep[ those within heavy bortler lines antl sign all aoP�oDriata tleclarations.
CITYpFCOSrA'MESA C NSTRUCTI PERMIT
Project h,ddress #
= Applicant's Mail.inyg� Addreu
Owner'sName�.l�m�-�CS�Bp..✓����,T_��)�y�A//C',�hone �.
Address e.2 oZ J�J `=^�'e'/✓,/N-«/ /-J�- ���,�._
r
Arch/Eng. License No.
Address �
Conttactor's Nam Phone ��
Address Im� �"��� �CiS�T{ 1�-TPI'T �l (/d •
City License No. ���� `
�LICENSED CONTRACTOR DECLARATION �
� 1 M1ereby atfirm [hat 1 am licensetl untler provi5ions of Chart¢r 9(commenGing
wifh section 7000) of Division 3 of the Busine55 antl Prof¢SSions Cotl¢, antl
my license is in full torce effect.
I License q 5 ce� e No. /S� 439
� Date Signature
.� ORKERS' COMPENSATION DECIARATION ,
w� � iereDy atiirm that 1 have a certificate of consent to self-insure or a ceriificate
' o Workers' com0ensation Insurance, or a certitied copy thereof (Section
' -J800, Lab. C.)�} / �>/7 �^
PolicY No. d �' �✓� ComPanY s� ` �/
�Cerlifietl copy is hereby tumiSheC.
Ce�titi cop i5 le with the city�ltling �ivision. �7''
Daie___� APPlicant �� G.fA-� _LN.STG ��
EXEMPTION FROM WORKERS' COM�NSATION DECLARATION �
(This section neetl not be completetl it the permit i5 for One huntlrEtl ($100) or
less). . ,
I certiry that in the pe�formance of the�work tOr which thiz p¢rmk i5 i55uetl, I
shall not employ any person�in any manner so as to become subject to the
Workers' Compensation Lzws ot California. '
Date Si9nature -
NOTICE: If, aiter making this tleclaration, you shoultl become subject to the '
Wo�kers' Compensation pvovisions ot the Labor Cotle, y0u mu5t iorthwith
comply with such provisions or thls permit shall be tleemetl revoketl.
CONSTRUCTION LENOING AGENCV •
I hereby affirm that there is a const�uction lentling agency for the pe�Po�mance
of the work tor � whicn this permit i5 issuetl (Section 309T Civ. C.)
Lender's Name �
Lentler's Aatlress
OWNER BUILDEH �ECLARATION
I hereby afiirm that I am ezempt from the Contractor's License Law for the
followmg,reason (Section 7031.5 Business antl Pwfessional Cotle: Any city or
county which requires a.permit to construct, alter, improve, tlemolisb or repair
any stru[[ure, prio� to its issuance, also require5 the apD�icant (o� Suth pe�mit
to file a signetl statement that he/she is licensetl pu�suant to th¢ p�Ovisions o(
the Contractor's License Law (Chapter 9(commencing with Sectlon 7000) of
�i�ision 3 of the Busine55 antl Professions Cotle) or that he/She is exempt
�refrom anC the basi5 for the alleged exemp[ion. Any violation o( Section
31.5 by any applicaut fo� a permit SUbjects the aOP�icant to a civil
c-,nalty ot noi more than five�huntlretl tlollars ($500).
LJ I, as owner of the p�operty or my emplOye¢5 witlt wages as Iheir sole
rompensation, will tlo the work, antl the structure is not intentletl or otferetl
for sale (Section �044, Business antl Professional Cotle: The Contrattor'S
License Law tloez not apply to an owner of a properry who builtlsor improves
thereon, antl who does such work himself/herselt or through his or her own
employees, p�ovitletl that such imp�ovementz are not in[entletl o� offe�etl for
Sa1e. If, however, the builain9 or improvement Is soltl within one year ol mm-
pletion, the owner will have the burtlen of provin9 he/she tlitl not builtl or im-
p�ove for the purpose of sale).
❑ I, as owner of the Oroperty, am exclu5ively cont�aGting with licensetl con-
tractors co wnstruct the project (Section ]044, Business antl Professions Cotle:
The Contractor's License Law tloes not appty to an owner oi property who
builtls or improves thereon, antl who mntracts for such projects with a con-
tractor(s) btense pursuant to the ConVactor4 License Law�. I, am aware thaf
proof ot tM1ei� Wo�ker'S Compensation insurance shoultl be provitletl [o me.
❑ 1 am exempi untler Section . B. & P. C. for [hi5 r¢asan'
Date Owner _
I hereby certify that I have read this
Information is correcL I agree to comp
antl state laws relatin9 to buil 'ng
Sentatives of this ci y to poi
inspection purp �
Signature
Drivers' License or 55 � �� _�.� �
the aDove
�rtlinances
rize repre-
ip¢�fy (O�
I� �-°! S�f "1 � � �
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
' ❑ CONVERSION ❑ DEMOLISH 0 OTHER '
,DESCRIPTIONOFWORK%USEOFBIDG. ,
TVPEOFPERMIT LIGRADING �yLI,FOUNDATIOIV LJSTRVCTURAL
❑ TENANT ❑ ELECTRICAL II/J PLUMBING ❑ MECHANICAL
'Q OTHER '
PROJECT�DESCRIPTION �Sq.�FT. � OCCUvnrvcv—
CON�9TRUCTIONTVVE � � � VALUATION;$
20NE GRA�ING CU. VDS. ACRES—
Remarks`:� � �
��
Bar Sink r. _
Backflow Preventer -
Backflow Irrigation �
Bathtubs '
. Clarifier's � -. , _ _
Drinking Fountains
Ftoor Drains
Floor Sinks .
Gas Service
Interceptors � -
Kitchen Sink.
Lavatories
P-Trap �
Roof Droins '
Reinspectian Fee
; Outlets .
$15
Boiler
Duct - Under Ground
Duct - Structurel
Duct-Ventilating -
Exhaust System ❑ Multiple ❑
Firepl/Fact.8lt: ICBO #
Heating System & Ductin
❑0-100,000 BTU O ip ,000 BT
peinspection Fee . � $15
CMF 0865-46, rev. 30/84 White - Building; Canary - Applicant Pink - Accounting; Goldanrotl - Assessor
Showers ,
Service Sink � �
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinai '
Water Closet
Water Heater
Water Service
Auto-Wash .
laue Fee
Hood or Type I ❑
Canopy Type I I ❑
4e�igeration System
�0-700,OOOBTU ❑100,OOOBTU
System Repair/Alteration
Fire Dampers �
Registers
laue Fee
FE
A.P. �
S Main Building:
E
T Front `
ARear
C Pight- - -- � '-
SLeft
Ping. Ref. #,
Planning Notes: ,
Automatic Washer
Construction Pole Sul
Cooking Unit '
Dishwasher e.
Dryers•�Gas ❑Ele
Fan
F.A.U.
Pixtures '
Device Boxes .
0
Switches . . .
Garbage Disposal
Generator �0-5 K 5-15
$ 3
$ 3
0
0
Parking Req./Provided
ZOne '
Z
• O
N
I
.. ' " 'N
G
R
E
�
M
� �
ELECTRICAL .
Transformer ❑ 15-50 KW
❑ 50+KW
Meter Oup to 100 amps
. Meter, �over 100 amps ,
Sub Panel ,
Motors 00�1 HP �1'h �
I nc. Solar � 9-15 16-7 5+
Standing Sections
Trash Compactor
� Reinspection Fee '$75 � � Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2anin9 APProved By .
Building Approved By
Appliption Issued By
FEES
$ 3
SUMMARV OF FEES .
BUILDING PERMIT $ SMIP $
PLAN CHECK $_ O C) PERMIT - �
PLUMBING $ �SSUANCE S
PLAN CHECK 25% $� ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50°,6 $ MICROFILM $
MECHANICAL $ TOTALFEE $ r� O�S'
PLAN CHECK - 25% $
CONSTRUC ITION AND PLANNING . POOL & SPA � � �
APPROVALS Permit# Date Inspector qpPROVALS Permit# �Date Inspector
1.�Temporary Electrical Service or Pole 52. Pool & Equipment Loc9iipn
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 & Pressucg Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�G�JNITE
7. Footings � 58. Electrrcal Conduit-Undrgcrid.
8. Foundationl 59. Gas Pipe, � Undrgrnd., T�st .
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Flloor System 61. APPROVAL TO DECK �
17. PropertY Sewer Line & House'Connection 62. Backwash & RecAptoT=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. Raugh Wiring Sign � 68. APPROVED FOR PLASTERING ��
18. Rough Elect�rical-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 Stiucture 70. Underground Hydro �
i
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
i
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
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation I 78. FIRE PREV. FINAL
i
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes:(2�887 G��T'�p�j• [�,f,a� '
34. Final Heating & Air Conditioning (••t•j•�aG�A'�'lG�. � Pu •�s Va. L. �
35. Final Gas Pipe-Test
36. Hood or Canopy
i
37. Final Factory Fireplace �
38.-Final Plumb�ing .
i
39. Water Service-Final . -
i
40. Gas Service-Final
41. Solar pomestic-Final , ' •
i
42. Backflow Preventer � � ' � •
� 43. Backflow Iriigation '
�
44. Landscape Irrigation System . �
45. Sound Attenuation , '
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING �
48. Special Req'uirements Completed �
49. Electric Release to Edison
50. Gas Releaselto Southem California Gas Co y�
51. CERTIFICATE OF OCCUPANCY �
No. Date 1 � �
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