HomeMy WebLinkAbout386 16TH ST - Building PermitsAOV��cant to fill in ali spaces except t�ose wit�In �eavy Eortler lines anE tign ail appropriate Eeclaralians.
CITY OF COSTA np�S,� _ CO�TI�IJC�I�ON PlE�VI, )T
Project Address �5�`S�n l (n S/ (."Gf�l
Applicant's Mailin Ad c;�y.�_, �' � �'
Owner'sNa e �Wl/� �'��� ahone
Address � �
Arch/Eng. License No.
Address �
i ��p
Contracror'sNam P one.�Yp_�
Addrew (mailingl. ._—
City License No �� z �
LICENSED CONTRACTOR DECLARATION
1 hereby aHirm tbat I am lic¢nsetl untler Orovisions of Char[er 9(commencin9
with section 7000) oi Division 3 Of [he Bu51ne65 antl Professipns Cotle, antl
my Iicense is in ful�r�e�qetfect. � 3;Z�7
,
Licenze I L� Ce No.
Oate Signature
`�ORKERS'COMPENSATION OEC R ION
veby affirm tnat I have a[ertiticat ot nsent to self-insure or a certificat¢
Workerz' Compensation Insuranca, or a certitietl copy thereot (Sectlon
.,d00, Lab. C.) i
Po11cy No. Company
8 Certitietl copy is hereby fumishea.
Certifletl copy is filetl with the city Builtling O��Ision.
Dale Applicdnt ' �
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION �
(7his sectlon need not be wmpletetl it the Oermit is for one huntlretl (E100) or
less). �
I certity that,in th¢ performance of tM1 rk tor yyhich4hi5 pe�m�t i5 issuetl I
shall not employ an person in any an r so to become subject fo [�e
Worker Co nsa 'LSws oi Cal' .
. Date Si9nature
'NOTICE: Ii, aiter makin9 this aeclaraHo , yo shoWtl become subject to the
Workers' COmpensalion provisions ot t¢ La o� Cotle, you muzt torlhwith
comply with such provisions or tnis permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affirm that Ihere is a mnstructton lentling agency for the oerformance
of Ihe work for which [hls Oermlt is ISSuptl (Section 309� Civ. C.)
Lentler's Name
Lentler's Haaress �
OWNER BUILDER DECLARATION - �
I hereby aHirm tha[ I am exempt from the Coqtractor's Llcense Law tor [h¢
following reason (Section ]031.5 Business antl Professional Cotle: Any city or
munry which requires a permit to construct, altpr, imorove, tlemolisn or repalr
any structure, prior to its issuance, also requirei the applicant for such permlt
�n �iie a sionetl statemen[ that he/she IS licansed owsuant to the OroviSions O�
refrom antl the basis for the allegetl exempqon. Any violation of Sectlon
,31.5 by any applicant tor a Permlt Subfects the applicant [o a civil
�enalty of not more tnan five hunAretl tlollars (E500).
U I, ds owne� of the prope�ty or rny emplOyCes with wa9es as their Sole
compensation, will tlo the work, antl the slructUre is not inten0etl or offeretl
tor Shc¢ (Sec[ion 7044, BuSinesS antl Proiessirynal Cotle: The Contraclor'S
License Law tloes not appty [o an owner ot a prOperty who bwltl5 or imprOves
therGOn, antl who tloes such wo�k him5elf/he�5g1/ o� thrOugh his o� he� own
employee5, providetl that such imprOvement5 are noI Intentletl or otf¢retl 10r
sdl¢. If, howeveq the builtlin9 or Imp�ovement 15 Soltl wlMin on¢ yea� of com-
pletloq the owner will have tha burtlen ot proving he/sne tlltl not builtl or im-
prova for the pu�po5e ot sale).
❑ I, as owne� of the property, am ezUusively �ont�aCting with IicenSetl con-
VaCfO�StO COnTt�UCt th¢ P�OJ¢Ct (SECSI00 JO44. �USIfIC55 dOC PfOfE551005 COd2:
The Contractor's License Law does not apply to an owner of property who
bulltls or improves thereon, antl who contracts for such projects with a con-
tractor(i1 license pursuant to the Con[rac[or's �icense LawJ. I am aware that
proof of lheb Worker'S COTPensation inturanre Shoultl be provitletl to'me.
❑ I am exempt under Section B. & P. 0.�or this reason
Date � Owner � � �
I hereby certity that I have reatl this applicat�on antl state that tne above
iMormation rrecL I agree to comply wltn all city antl countY ortlinances
antl stdt ws re In9 to builtlinq con5tructlon� antl hereby autho�iie reore-
s¢nfa[iv s OI Ihis city enter up00 the ahove-mentionetl' Proparty for
insoectl r s. d � - p`
Si9natu�a � II �C If-�'��. Date `'3 O l
Drivers' Licen or 5 �
CMF 0865-46, rev. 0/84 White -
[; P�nk - ACtounting; Goltlenrotl - Assessor
$hOwers
Servite Sink
Sewer Cap
Sewer Connec[ion
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w(Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Isue Fee I
iANICAL
Hood or Typel ❑
CanoPY TYPe I I ❑ �
Fiefrigeration System .
❑aioo,000aTu ❑ioo,000sTu
Sys[em Repair/Alteration
Fire Dampers
Registers � i
Issue Fee
A.P. qf`-
S Main Build
E
T Front •
B Rear
A
� Right
K Left
S
Ping. Ref. # 1
Planning Notes:
Automatic Washer
Construction Pole Sub.
Caoking Unit
Dishwasher '
Dryers ❑Gas ❑Elec
Fan
F.A.U.
k Zone'
Accessory Building: '
Z
�J O
�, N
I
� N
G
R
Parking Req./Provided E
Q
� M
T
S
ELECTRICAL
Transformer � � 15-50�KW
❑ 50 + KW
Device Boxes
Outle[s
Switches
Garbage Disposal
Generator 00.5 KW �5-15 KW
Meter LJup ro 100 amps
Meter ❑over100amps
Sub Panel
Motors �G7 HP 01 %- 8
InaSolar �9-15 HP �16-15+
Microwave . —
Pole Light
Range
; Standing Sections
Trash Compactor
$ 3 I
�- - Reinspection Fee $15 I�ue Fee
FEES
DEVELOPMENTSERVICESREQUIREMEN7S:
ZoninB APP�ovad By
8uilding Approved By _�
. Aouliwtion Issued Bv
$ 3
FEES
$ 3
• SUMMARV OF FEES � , .
: BUILDING PERMIT $ � ' SMIP ' $
PLAN CHECK $ PERMIT ,
PLUMBING $ 'r'�•<�i ISSUANCE $ -
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ � GRADING $ �
PLANCHECK 50% $ MICFOFILM $ � �
. MECHANICAL $ TOTALFEE ' $ 5-�%h
� PLAN CHECK 25% 5
CONSTRUCTION AND PLANNING �� PO( SPA .
CAPPROVALS Permit# Date Inspector p�ppROVALS 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
A., Electrical Conduit�Undrgrnd. � � 55. Electrical Bonding 1. ,
5. Steel Reinforcement � � � 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVALTO COVER�GUNITE �� �'
�
-7. Footings ' ' - , ! � - 58. Electrical ConduifUndrgrnd. . .
8. Foundation - . � �-• 59. Gas Pipe, � Undrgrnd., Test ,
9: Water Pipe-Undrgrnd. � , 60. Backwash Lines, P-Trep, O Undrgrnd.
,
. 10: Structural Floor System ' 61. APPROVAL TO DECK
17. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
12: Sewer Cap i . ' 63. Heater & Vent-Final '
.
13. Roof Drains • 64. Plumbing System - Final �
14. Rough Plumbing` �. � 65. Electrical-Final .
15. Rough Electrical-Conduit 66. Solar System-Final �
16. Rough Electric Wiring 67. fencing & Access Approval
17.. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning 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.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
37. Plaster'Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final Heating & Air Conditioning / � � � - -
i�
35. Final Gas Pipe�Tesi . � tJ �� ��
' - .. ' v�
36. Hood or Canopy
37. Final Factory Fireplace
�
38. Final Plumbing � �S/�
39. Water Service-Final d� � 4% � � -
40. Gas Service�Final �
41. Solar pomestic-Final
42. Backflow Preventer '
43. Backflow Irrigation. _ ' � ,
44. �Landscape Irrigation System � �
45. Sound Attenuaiion � -
46. Handicap Regulations '
47. FINA�STRUCTURE&BUILDING
48. Special Requirements Completed .
49. Electrie Release to Edison � �
50. Gas Release fo Southern Glifornia Gas Co
51. CERTIFICATE OF OCCUPANCY _ .
No. Date