HomeMy WebLinkAbout1953 PARSONS ST - Building Permits1
•
ADDRESS OF BUILDING: 1953 PARSONS ST. VET CITY OF COSTA MESA — BUILDING PERMIT
• OWNERSHMOIFOamm: IKE PROPERTIES PERM NO: B 077839
' 500RES51990 HARBOR BL
t' COSTA MESA, CA 92626 PERMIT NO: B 077839 PLAN CHECK NO: N GOVT: N SUPP : N
722-2014
APPL.MUIDID ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: DEM
•
ARCHRECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : DEMOLISH SINGLE FAMILY RESIDENCE SQ FT:
ARCH OR EM'S ADDRESS: DET:
CLAIM VALUE: CALC—VALUE: 1 ,000 .00 GROUP OCC : R-3 /U-1 .
CONTRACTOR'SNAME TODA CONSTRUCTION OF CAL ( 714 ) 220-3141
CONIRACTOWSMMUNG 5816 CORPORATE AV COMMENTS: DEMOLITION IN PREP FOR NEW "TOYOTA" DEALERSHIP
ADDRess,CYPRESS CA uc.NO.: 427375 *************************+E****x****************+ ***** ******** ****************
90630 mr: 160 Z ONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Slim under penalty of perjury that I am licensed under provisions of Chapter S SETBACKS
(commendng with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect.
car LIC.NO.:04583 LIC.CLASS:B /IX.NO.: 4273�7`5� EXP: 00/00 MAIN BUILDING ACCESSORY BUILDING
owe: 9,747...q q� comas«:�O�t�t Ca /��� crAJ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
I OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury thin I am exempt from the Contractors License Law for the
following reason(Section?031.5Business and Professions Code:Any cly«county which regain*a permit toc«Iswm.alter,improve, PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: .i;
demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to Be a signed statement that he or she
is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES> ((
Business and Professions Code)or that he or she is exempt therefrom end the basis for the alleged exemption.Any violation of Section > .1'
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more then fee hundred dollars(S.503)). **,**,*,*,*,*,*****,*-****************,**-*******..**,*******,*******************************
❑ I,as owner of the popeny or my employees with wages as thei sole compensation,will do the work.and the structure i not intended DEVELOPMENT SERVICES R E Q U I R E M E N T S
or offered for sale(Section 7044,Business end Professions Cade:The Contractors License Law does not apply to an owner of propertywho bolds or inproves thereon.and who does such work himself or herself or through hi or her own employees,provided that such 7
improvements are ndintended or offered for sale.If,however.the building oinprovenentissold withinoneyear ofcompletion.the ZONING APPROVED BY DATE: (,. '
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ Prof�onsCtode:TheCCa�ownseLawdoeesplicensed aaplyytoncontractors oowwneerropr constructwhoeumo drovion ameren"a®ndeao BUILDING APPROVED BY : DATE:s end 7n
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ lam exempt under semion. B.3P.c.,i«tnlsreason: APPLICATION ISSUED BY: DATE: 'Sl2tLt,
Date: owner: ************************************************ ************************ *****
LEGALIZATION:N F E E SUMMARY • STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware or end understand the requirements of California Health end Safely Code Sedans 25505,25533,and
25534,and that I or any future building occupant will/will not(drci one)need to comply with said mate codes end the requirements for
a permit for mmtructionOrmodification from the Ai 'thty eiagemenl Dimdd.Residential camnaioneppicatiosare exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 34 . 75
Date: Applicant: S M I P/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty ofperjury one of the following declarations: PLAN . 50
ISSUE FEE
❑ Ihave and will maintain a of thewdwnsenttoepetre for sued,workers'compensaton,as provided for bySecton3700ofthe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
coder«the performance of wankf«wl:cn this permit is issued.
TOTALS----> 35 . 25 0 . 00 0 . 00 35 . 25 35 . 25 . 00
❑ I have and wit maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.My waiters'compensation insurance tamer end policy number are:
. Carder • REVENUE DIVISION TOTALS--> COLLECTED : 35 . 25 OVER/SHORT: . 00
Polry Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed I rhe Fermi is for one hundred dollars(SIM or less) 34 . 75 . 50
❑ I certify that in the performance of the work for which this penny is issued.I shall riot employ any person in any manner so as to
became subject to the workers'comperomion laws o Cslfomia.and that a ec
I should b «ne subject to the wakens' *******************************************************************************
compensators of on 3700 of the Labor Code.I shall fp��n comply with noose
Dale pr2-9 9G APP&si*o/ '( IND I V IDUAL FEE BREAKDOWN
Warning:Fallurs to Deere workers'compensation coverage M unlawful, ed Ilsctpct ansmployert cit Ipenaltlu and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil Ams up to one hundred thousand dollars($100,000),M addition to t of compensation,dame ea provided for In
Section 3706 of the Labor Cods,Interest,and attorney's feet NO FEES WERE SELECTED FOR THIS PERMIT
• CONSTRUCTION LENDING AGENCY:I hereby affirm under WSWof perjury Theis that ea Wrist/WIN,footling
p agency for the ''n
performance of the work for which this permit is issued(Section 3097.CN.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application end state that the above information is correct.I agree to comply with all city end county ordinances
and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property
for inspection purposes.
KATSUYA AMASUGA
01 nr .
PnirN' In//J/(%J /J • I-t .-,__
Date:
J Sig :ure of Owner/ t/Applcant/Co
(5151 d6.WP) White-Buidkp&Safety:Green-Fle:Ceary-Appirant;Pink-Revenue:Goldenrod-Assessor
A•.
•
CONSTRUCTION AND PLANNING Pout. &SPA
•.APPROVALS Permit# Date Inspector APPROVALS 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.E •
lectrical Conduit-Undrgrnd. - 55. Electrical Bonding
cl 51Ste`el Reinforcement ' 56. Rough Plumbing& Pressure Test -
-6. Electrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE :1
.=r7�Footines _'Q 58. Electrical Conduit-Undrgrnd. .�
8.. Foundation T i •
59. Gas Pipe, 0 Undrgrnd.,Test' a
- 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
' 10. Structural Floor System n . - 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 Electricat-Con-duit . . 66. Solar System-Final •
16. 'flough Electric Wiring: _ 67. Fencing & Access Approval
• r
17. Rough Wiring Sign ". 68. APPROVED FOR PLASTERING
18. Rough ElectricalT Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL '
:19.'Rough Heating,& P,ie,Conditioning, e to ct.z • FtR€�DEPT,eREQUIREMENT
. - " -� _ ,h 1 "i :t
•
.. - >
20. Roue Factory. Fiteplace i:1T �,_ " ,- c-t t APPf OVg{Lt1^ Peijnit# , t.•
`' 21. tu", inStructure=„ r- c - r 70.rllndergroui tl Hydro a
-22. Duct`s, Vehtilating ! - �' - 71. Produ 'rPiping CGas COI! .,.
rr= i' Y .- 7 r.,a' •. , . --fit,...i �• '
,23. Gas Pipe-tough&Test .r a t- <-. . 72. Undergreund Flush-1.
f• i24 Root Lrraming T ^ - . ' 73, Undergrnd.Stobie Tanl(0 Gas 0 Oil •
. ...p . ,Roof_$hething ,;r '� ra ' , 74. Overhead Hydrat,,
_
I-
' 26: i -Bar•Ceiling (Structural) & Mo-lid-Coat • - •= • 75, pry Chemical EC -
27."Flame a 'Flashing..-
.-.
D� • rs r. Z z
d, rn3,. -rr:; 7 76. Dry Standpipe<., r
-.**28. Lathing Bi.Siding �: _� r - !x 77; FIXEDSVSTEMMFINg_`"
.tL229. Insulatio; r r. -. , r
.2 -.-a > ,z i ! 'r 7Ri FIRE PREY. FifaL ;+
30. Drywall Nailing "r , S '+iEALTH DEPT..- REQUIREMENT
-, 31. Plaster BEown.Coaf,. ::- , F i ,- J 79. FINAL iJ PECTdON ; -. jr
32. Electrical:- Meter-Final rf a 80. FOOD CERTIFICATE ISSUED- r
A- 33. Fina&&'Electric_ _ _ - r ' j, Mates: a T�;, ,
• t 34. ,i<inaL}ieating$� Air Conditioning' ' �- rl ,` - r-t' k• -
:: -, -,c * .
35. final Gae�Pipe=Te y* `.,r, - mac; 0- :� � r -
36. Hood or Canopy : - 1, . c
37. Final'Fadtory Fireplace " -' , a r r ' , '
s 38. Final Plumbing ma' r. - ' _ t I. - `- r _
- -.» _ i rr,
44 39. Water SerJice=Finall'h Z •* t`. I n'
•
40. Gas Service-Filialr
LC,34' ��' , ' '4 - v • - J r
H t- [T. i- . .-`�_- 1
-
41. Solar Domestic-Final F ' - - . �. 1
t - - - -.
42. Backflow Preventer r v, = _ _ . .. :;, -� r �-
43. Backflow Irrigation �, -. , j
Y ',
44. Landscape Irrigatiory,System.- - - r a = . v-'-� - F^
-
45. Sound Attenuation - ' - ' '
46. Handicap Regulations ..
47. FINAL STRUCTURE & BUILDING /„•3`':QL) ca*,-,- ,t, t-
48. FINAL PLANNING. L' ( T1' - e;
.
49. Electric Release to Edison ,-
50. Gas Release t6 Southern California-Gas CoC -
- I-
51. CERTIFICATE OF OCCUPANCY
No. Date
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ADDRESSOFBUtLN : 1953 PARSONS ST WIT: CITY OF COSTA MESA — BUILDING PERMIT
ow7E"SNANEIFMc*N:IKE PROPERTIES _ PERM NO: P 077840
ADD" °1990 HARBOR BL
COSTA MESA, CA 92626 PERMIT NO: P 077840 PLAN CHECK NO: N GOVT: N SUPP : N
722-2014
APPL.NUImGADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT OR ENGINEER: ANO' JOB DESCRIPTION : DEMOLISH SINGLE FAMILY RESIDENCE SQ FT:
ARCW OR END'S ADDRESS: WU:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /U-1
CONTRACTCIRSNAME'TODA CONSTRUCTION OF CAL ( 714 ) 220-3141
CONNRACTO"S/MUM 5816 CORPORATE AV COMMENTS : SEWER CAP IN PREP FOR NEW "TOYOTA" DEALERSHIP, RE: #877839
ADORESS:CYPRESS CA sacra: 427375 x*SEx SESESE�Fx+E+ESESESESriEiESF****�Fx*** **St*�Ex�ESF**�FSFx*******R *******Sr*Sr*�tSFSFSE+E AESEx*******SE*
90630 WIT: 160 Z ONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby dim under penalty of perjury Wet I em licensed alder pwWons of Chapter 9 SETBACKS
(commencing with Section 7003)d Division 3 of the Business and Professions Code,end my license is in fa force end enact.
CIYUO.NO.0458 3 UC.CLASS:B UC.NO.: 427375 EXP: 00/00 MAIN BUILDING ACCESSORY BUILDING
Dec 5-16-1 �ql, coeee« -7-63).4- /pr1��'j (JA/ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under mealy of perjury that I em exempt from the Contractors License Law for the
reasonCederequiresconstruct,tad PARKING REQ. PROV: PARCEL: 00000000 ZNE: REF NO:
wink drpuuepay rsuant i tthe r prior ane Connce,also requires oco Contracted,LicenseLaw(Chapter 9(oma e°ermit�ng twithh Section 7file a signed 000)of Minhe or the PLANNING N TES>
anew end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >
7031.5 by any applicant for a pens subjects the apdpart to a end penalty of not more than fire hundred dollen($500)). *******************************************************************************
❑ I.asowwdtheprmertyamyrnpgmswthwagesateiedecompensation:willdothewokadteet ebnahurded DEVELOPMENT SERVICES REQUIREMENTS
Of offered for sale(Section 7044.Business end Professions Cade:The Contractor.Limine Law does not apply to an owner of property
who Wide or inpmes thereon.and who does such work loose or herself or through his or her own employees.provided that such
improvements are rot intended or offered for sale.D.however.the building or Inproveneni Is sold within one fee'of completion,the ZONING APPROVED BY •
DATE:
ownrtiilr wit have the burden el proving he or the did not build or improve for the purpose of sale). •
❑ Pw wirier c hethe"°°"wr L,.nseLaam exclusively wdo:.n°oh we°yo°°mow°d"'apoo construct ywroad""Naa provsaSalim dneeonarid a BUILDING APPROVED BY : DATE:
contracts for such protects with a caveola(.)teensed pursuant to the Contractors Lune Law).
❑ Iemexempt under Raskin: B.AP.C..tor this reason: APPLICATION ISSUED BY: DATE: • 2 Ic‘
************************************************ **************** **
Date °" " LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N
I do hereby certify that I am aware of ed understand the requirements of Gallants Health and Safely Code Sections 25505.25533.arid
25534,and that I or any future building occupant will/we not(race one)need to coney with said mate codes end the requirements for
apermit for canwdionor modification!menthe AsQaMyManagement Di na.Reserewmanppf
nnlonemllonreexemptfrom these PERMIT BLDG PMT PLUMBINGNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions.
Dale: Appy: 25% 1.4%. SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally al perjury one d the following declarations: PLAN
dvNmeusaineunlreeofmnmlton se faworkers'c satin.asprwfdedfobySeeun37ODdtheLabor ISSUE FEE 20 .00
❑ Ihavea
cos..1«1Mmdomra.dMworkl«wNuw.pema . n.e. BUILDING—DIV > PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ Ihave and wDma:aalowaken' n
insurance, of
edbySection3700m ra
elabCods. theperfomd
performance TOTALS----> 7 . 00 20 . 00 0 . 00 27. 00 27 . 00 . 00
work for which this permit is Sued.My waken'compensation insurance Uglier arid policy number we:
Cartier: REVENUE DIVISION TOTALS--> COLLECTED: 27. 00 OVER/SHORT: . 00
Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be compered if the perms is for one hundred dorm Manor fess.) 27 . 00
❑ I amity that in the performance ol the work or which this pants is issued.I shell rd employ any per lo any manner so an to
become gabled to the workers'canperurton laws d Catania.and • that d I ahoud •.... subject to the waken' *******************************************************************************
compensation sans Section 3700 d the Labor Code.I shall 1 • • ply well thew .
��29��� p,pb/ /' I N D I V I D U A L FEE BREAKDOWN
Due: FT/ APO' .
—l7 WamLp:FSDunbsecure workea'co pen..doncoverageisunlwM. • .pnanemployrto�, 1 penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines te to WO hundred thousand dollars(S'OR00VA In addition to of compereate/L . es provided for In
Section 3,o6ofthe Labor Code,interest and.nmk.fsea. PLU 1 SEWER CAP / DEMOLITION EACH 7 . 00 7 . 00
• CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there e e construction lending agency ler the END OF FEES
performance of the work for which the pent a issued(Section 3097.Civ.C),
LENDER'S NAME: •
LENDER'S ADDRESS:
1
I certify that I have read this application and state Mel the above information is coned.I agree to comply with a city end county ordinances
and state laws rotating to buidig construction and hereby authorize representatives of this city to enter upon the above-manlbned property
for inspection purposes.
KATSUYA AMASUGA G: `u"L- -•?"''a'•. Cc' ...t_u
Name / / DATE!! - . ; K,1•.� Ti:?,:.!: 1.'-
S'enature ofr ../ApenifA••- rector ((( 'a
,l (5151'46.WP) White-Building&Soley:Green-file:Canary-Appicent;Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING PO0 SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
• 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location , . ,
2. Soil Pipe-Undrgrnd. r- 53. Steel Reinforcement
^37Electrical Conduit.Utllity•Undrgrnd. 54. Forms
c4 Electrical Conduii.Undrgrnd. 55. Electrical Bonding
54Sieel Reinforcergeot- - 56. Rough Plumbing & Pressure Test
6�; lectricalUFER-Ggnd. 57. APPROVAL TO COVE R-GUNITE -
-. 7,u Footings 77:: 58. Electrical Conduit-Undrgrnd. _
'8.'Froundation --. c 59. Gas Pipe, 0 Undrgrnd.,Test . ,
9. Water Pipe•Undrjr . - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10, Structural Floor System _ , 61. APPROVAL TO DECK _ -
11, Property Sewer Line;& House Connection 62. Backwash & Receptor-Final ••
Q Sewer Cap t-
b X7e)n�
,97 ` 1 63. Heater & Vent-Final
13. Roof Drains -- 64. Plumbing System - Final •
14. Rough Plumbing;; ,. 65. Electrical-Final '
•
15, Rough Electrical-Conduit �.
9 66. Solar System-Final .
16. Rough Electric Wiring; 67. Fencing & Access Approval -
17. Rough Wiring Sight C" - G
68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating}& Aic.Conditioning * , -i- n: y FIRE D€P.T,r$EQUIREMENS
• 20. EiougftFactors Fic'rpiace - XC .y r.APPROVA'.I[S
' Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. .
• CIT.-Y-c F COSTA MESA: '- f • f • - I t PER4yT N TRACT NO. ' • LOT NO. BLDG.NO. t - • - •
CONSTRUCTION PERMIT , . ; •n , c. 1 _ , r 1 . .F: , 1 3' ci • . 12; ! 1 1 Y' , ' --• : C -. n; i '" vl l 1 + j
ApplicanYe Mailing Addddr Q IL— !; a ° TYPE OF CONSTRUCTION � •U NEW .L ADD- LIALTERATION•
:YJ•REPAIR ' - _ ;?.„,;2;11.-13.
�` ?a�Q' TL
Project Address- \ 7 1,' •• Pa.5'0 V s _ •5 El CONVERSION 4❑ DEMOLISH ❑ OTHER - 1 -(^� s�� �//O r _ ✓ " t
Owner's Name l G\\ P L.�W\ S •Phon 'DESCRIPTION'OF WORK •���, —c)S. �M� S
• ,`�j� ��- �� - I r - r • \ �'� - I " - ZONING REGULATIONS'
Address \ 4 cc. FAP. R Sae. 3L. U 0 - - I - - - - i - i
• ' TYPE OF PERMIT • U•
GRADING: 'FOUNDATION' ❑STRUCTURAL A.P.vW. ZONE
• Arch/Eng ' I • I - -y License No, I ' ' - •❑.TENANT ❑ ELECTRICAL' PLUMBING-• ❑ M•ECHANICAL { pLNG.REF els-. ; ; :-BUILDING ' , I r ' - •
Address) `. i - • , 1 SwTgnrr rn S-r
�� 4 _❑,OTHER TO BUILDING .
�'�` •S' p..q • I i PROPERTY LINE _REAR YARD (TO P/L) • I - j c > '•
Contractor's Near _ Phone 1D_--l�L'•'U PROJECT DESCRIPTION SQ.FT.' ' - •-- DCCUPANCY 7 '
- • - CONSTRUCTION TYPE !• VALUATION§ LEFT SIDE YARD I RIGHT SIDE YARD, �' . 'P
Address:lmailing) - -- - -
i - , ' ZONE " ' • GRADING Cu.YDS. ACRES ' - - PKG.SPACEiREG. • , . • PROVIDED j
License No. • I -
I i i .. . .- , '• i,..
LICENSED CONTRACTOR DECLARATION I Remarks: , ` - STREET WIDTH - ,PARK FEE$ ' ? •
-
1-hereby affirm that I am licensed under provisions of Charter9 (commencing - �' , I I .., ' "
with section 7000) of Division 3.of the Business and Professions Code, and ! • - I SPECIAL CONDITIONS: ,
•
my Ilcense'Is In full force and effect, i • '- - i - ,
; License Class - '• • License No.' c , I � 1 PLUMBING I i. I • ! •t I _ }
Dale _ Signature I : f. 1 . , •, : . . -
WORKERS'COMPENSATION DECLARATION : I ' e ' j { Bar•Sink � I • Sewer Cap- I ' i I i ELECTRICAL 1 -
I hereby affirm that I have a certificate of consent to self-Insure or a certificate ; - Automatic Washer I :Meter Dover 100 amps i
( -of Workers' Compensation-lnsura`nce;,or a-certified:Copy theieof'(Sectiod-� "'(' Bac•
kfiow.Preventer _ .. _Sewer Connection:. _ I ( j_.- ... - .. .
3600, Lab. C.) : •i I I i 1 { Backflow Irrigation 1 Soler Collectors 1 I .« I •- ' •
• Construction Pole 1 ;Sub Panel I j i
•
Policy No. ' Company - ' - { - . - Cookin Unit I -
certified-copy IS hereby furnished. I ; ; I , Bathtubs t , 1 , Solar Piping I ' j 9 ! Sub Pole _ , 1 i.
B Certified copy is fiend with the city Building Division. i , •
Dishwasher j - Motors 001 HP 01X$ i 1
Date • ' Applicant 1 : f f Clarifiers 1 Sour Tank !
EXEMPTIONIFROM'WORKERS•;COMPENSATION DECLARATION' Dryers 0005 -DElectnc- •
- •jlnc.Solar^09'15 HP 016-15+• "'^
Djshvvasher i 1 _Swimming Pool w/Spa - `
less).(Thissection need not be completed if the permit is for one hundred($100)or i _ ' '
less): t i i I ! , 1 - - - - - -- - Fan, . II ' t
' I certify that In the performance of the work for which this ermit Is issued I t Drinking Fountains I I Urtnat . I I 1 t ' f i
' shall,not eingi any person Ina eon as to beco subject e .- - • ' ' - 1
Workers' ns .Laws of Ifortla.: : Floor Drains: i F.A:U. a i :Pole Light i I t
Date' 1 .e. 519natu x""r ' �`^�"r�^'^ `•`- ' i Water Closet• ; 1 {
NOTICE:If,after making this declaration,you should become the •' Floor Sinks :__ j -s_ _I _Water Heater _ _I • ! Fixtures i I i IRange !
, Workers' Compensation provisions of the Labor Code, you must forthwith ! - - -` •
comply with- such provisions. or this .permit Shall be•deemed revoked.. Gas Services ' 'Outlets- f.' ' WaterService •„ 1 2 Device Bozos Sign l
CONSTRUCTION',LENDING^AGENCY•' I I. ` I ' . • - - ' i- ' ' . . •
I hereby affirm that there is a'construction lending agency for the performance i Interceptors - ! _s 1 _ f, _ , { Outlets i Standing Sections
of the work for,.which'this; Permit 'Is ;issued ,(Section -3097 Civ CJ ' - - -
Lenders; Name ' - - A) 4 I =p Kitchen:Sink I - j - .: Switches ! Trash Compactor ; { f
Lender's Address' 'v�� ' _ - - I y I
{ 'G • Lavatories t,,,- Garbage Disposal I i
OWNER BUILDER DECLARATION. i 7 .-` t ' y ! _ , I- I
I herebyjaffirm that I am'exemptifrom the,Contractor•s License Law for the' P Tre i Generator t❑o-5 KW ❑5-15 KW ' -
' following reason (Section-7031:5 Business and-Professional;Code: Any city or I p, , _ - ' I j
county which'requires a permit.to construct;alter Improve,tlemolishlor repair _ - : '� . Transformer 015-50 KW r - 1
'any structure, prior to itsissuance, also requires the'applicant for such permit , , ' Roof,Drains p. I - I i / j ' - + ; I
to file a signed statement that he/she is licensed pursuant to the'provisions of - - - I - i
the Contractor's'License Law,(Chapter 9(commencinglwith Section,7000)of - s' T I. ' `' i - I 05U+KW: , 'Reinspection Fee 1 $15'
+»Ivision:3r of the:Business and,Professions'Code)-or.that)he/sheas;exempt ' „ • Showers : `5: _ .. I • Reinspect - '
•'t*'aerefrom and the basis for the alleged exemption. Any,violation of Section i - Meter ❑up to 100,amps • Issue Fee: I ' .$ 3
/031:5 by, any applicant for t a I permit• subjects the applicant•to a.civil i - I i 3 i ' I ' I -? __ _ -
s(_erylty of not more than five•hundred dollars($500). i • , : 1 Service Sink ! a I. Issue Fee = .$ 3 - -- • I
in the[property or,my employees with wages;as their sole Zoning Approved By Date •
I, a5;owner of, i i i , +
I compensation' wllbdo the work,and-the structure Is not intended or offered ! • MECHANICAL 1 ! , , - ; Application Approved By ( • 'Date
'• for sale{Section 7044, Business.and•Professional 'Code:'Thel Contractor's , '
License Law does not apply to an owner of a property who builds or improves t • { ; - Refrigeration System ! I I j j I 7 - i
• thereon es, who does Such.work hlms¢IT/herself or through his or her own , Boiler • - , •� i -[ Application Issued By ' Date '• / /��
' employees, provided that such Improvements is
intended or offered for ' Duct ,Under Ground r ❑0.100,000 BTU ❑100,000 BTU •
sale, If, however, the building or improvement Is sold within onot of com- r - 6 ' t i i I SUMMARY OF FEES • - j '
' pletion, the ow l have the burden of proving he/she did not build or Im- - , - - ' I ) t • ;
; grove for the purpose property,
Duct-Structural System Repair/Alteration j :BUILDING PERMIT $ SMIP { l $ i
U I,as owner of the property,am exclusively contractInglwithessiosed con- ' I • j I I ,
tractorsto construct oject(Section 7044,Business and Professions Code: i : Duct-Ventilating r 1 I - ., PLAN CHECK ' '
,-•The'Contractor's License.Law-does not apply to an owner of.property-who + • . - ' ; i• I $t ' PERMITISSUANCE T $ I '
build r improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple ' • 'PLUMBING • $ S.00 '
• tra� ��r(os) license pursuant to the Contractor's License Law). I y p' I i r -PLAN CHECK $ •
GRADING $ ' !
her
am exempt untler Section ' B.8, P,C.for 1L s r n , j Firepl/Fact.BIL ICBG# - I I $
•'� ' r6 ` r� HeatinDucting • ,ELECTRICAL: $
Date' : Owner,)\ r/ T ` g:System& r -
• I hereby',certify that Ir have read this application and.state that tbe:above. ' - ❑0100,000 BTU 0100,000BTLJ_._ jPLAN CHECKI $ t MICROFILM : $ I
Information is correct.-1 agree to comply with•all city. nd county ordinances r • -, . I , ' ' i' - . . TOTAL FEE. $ .
and state laws relating to building construction,and h eby thorize repro- ( - MECHANICAL $• ,
sentatives this to en er;upon the above- property for Hood or Type I ❑• i.
P p P Y 1 Reinspection Fee; $75 LESS
Inspectlo p ses. l Canopy -Type II 0. : PLAN CHECK, $ - i
Signature'\�:.1. • �TMr]PA , Date,�ZT� - i ADVANCED PC $ "
Drivers' License or 5S#, \/ . ' Registers i Issue Fee , $ 3 •
i aSOo
FINAL FEE: , $ •
CMF'0865A6'rev:12/82 White t Building;-Canary=Applicant;Pink-Accounting;Goldenrod=Assessor - -- - - --- '" - •.. - - • _ - � - - --- -�-- - -
' G CONSTRUCTION AND PLANNING ' + ''n. t-'. -o r' POO, .SPA_ - --.21
., O ' r. � - ii r 21.71: - 40&3- • : Date - Irispeetor ,APPROVALS 7 Permit# - • . -Date' Inspector -
,• �APPROVACSr Permit# f- -
R.ITempOrary Electrical Service.or Pole - - - -- ' a° i i r ;4,':: '52.Wool &Equipment Location - - - I t-
- -
(2.i Soil Pipe-l)ndrgrnd: _- ' s :`5 i 00 ' 53: Steel Reinforcement ,
(3 Elerical Conduit Utility=Undrgrnd. ": ' " • -' 54 Forms;- - - _ . :*,`i :
C4.IElectrical,Gondtit-Undrgrnd r' is m ; c I • r ' . 55. Electrical Bonding ,. - _ •:'.
•
.5.,Steel Fteinforcerrient j _2 ' ,; a; - 56.:Rough Plumbing& Pressure Test_ - ,�. '�
16.cFJectricaltUFER.Grnd c ` -, , 57: APPROVAL TO COVER-GUNITE '. "�'•'
7;1Fooppgs ' I I ., i r, . ,:!i ' 58.'Electrical Conduit-Undrarnr-
8.';F'oundation I 1 i 'C _i '1 ' r - - 59. Gas Pipe;O Undrgrnd.,Test ty
9.AWaterPipe-Undrgrnd. _ ` :-z •'t ,60. Backwash'Lines,P-Trap, 0 Undrgrnd. •`• 1' ''
10.'Structural:FloorSystem 1 i c 1 7 • ! -I: ,'• t . 61..APPROVALTO DECK - �.'
11.1P{operty Sewer Line & House Connection' , _ s •;itj _62. Backwash.& Receptor•Final - j,
12. $ewer,('aP, I �, I I i' ` " 63. •Heater& Vent-Final
13.,Roof;grains i__ � � - ( _ •' il, ., • 64.:Plumbing Systein - Final a7 •
a 14.1 Rough,Plumbing - - ` - i ' 65. Electrical-Final. ' - - '�'
n •
`T _MtRRough-Electrical-Conduit -I--',-"-. 1---T-1-- --r--I-.- 66. SolarSystem-Final -' - - -i ..
i6. Rough.Electric Wiring ,, I ' l ' - 5-,74, _ " 67. Fencing'&Access Approval ' • _ -
;17.�Rot gh Wircing Sign' L° ' i :: I , : l: I .‘•-I68 APPROVED FOR PLASTERING
-18: Rough Electrical-T;Bar Ceiling ;) i! I 1= I )'- I - 69. •POOL/SPAISYSTEMS FINAL - - - '
191i Rough Heating & Air Conditioning r I.1 '' I j ^ • R I ' • I FIRE'DEPT: REQUIREMENT r
261 Rough Factory Fireplace I ! II, �' 1 I 1 APPROVALS i Permit#
21 NDucts;,in Structure' ; I I s ,i I i I 1 I 170. Underground Hydro ,
;.22.:Ducts;Ventilating,.. I r i I ,Th I, I ; 71. Product Piping 0 Gas ❑Oil -
`223.ti Gas PipeRough&Test.,``, 1 th iI ) I j ;72f Underground Flush
624.."Roof framing I ' i` ! i' c11'g �:'o• iry ' p -- I -.I. 173. Undergrnd;StorageTank-OGas 0 Oil
n t
s; .. ,
n : 25. Roo _f heathing , I I 1:9 ' I 17 .2 74. Overhead Hydro
^26., T-Bar Ceiling'(Structural)i�& Monocoat c ! ;.i r "i ''I • 175. dry Chemical j - ' ?. ' '
,'• --,27. Frame and'Flhshing - ' ' i it 1 ; - ; I i 76. Dry Standpipe . ,
0 28s Lathing&-Siding ' - j 1 11 it , ' . I ; ,77. FIXED SYSTEM FINAL.
' ` I i ,
_29JInsulation] 't , p II i 1 78. FIRE PREV. FINAL •
ii -130. Drywall Nailing n ' �� I i Notex
1
• /tarn allot
31:,Plastel Brown Coat I ' i II ', ! I I I I i _itayfr / re
'32. Electrical Power Meter-Final • II it i 4 t
1. 33.4inafElectric I It, 1; Ii )t_ 1_._J_.
34. Final iHelatirig;& Air Conditioning I i I ! 1 , ' ; - •
35. Final'Gas Pipe-Te`•stI- 1v i 1'• I r 'I 1! • '- -
, i
36: Hood piiiCano ly.LI "'I, I ,, I Y " I . H . t , ' _ - - .
37. Final,Factoiy'Fireplace; I i - (I 1' i I 1 I
38. Final'Plumbingl _I i I • ; 1 ' i i ' -' .. '
39. Water"Se'rvice-Final 1 ' 11
i I I $ I I
I .
40. Gas Service Final 1 I I I 11 1 I I I ,` ,
is I
I
41. SolarlDoI , .mestic-Final ' 1 '` , _ I-- r ;
42. Backflow PreventeFa I I I _. _- _I -
43. Backflow lenge - I i ''`?I : 1 I-, 4' ' . I • • -
44. Landscape Irrigation:System ,2L f , - I _ •
45. Sound..TAttenuaa
tion� =; 1 ' j ' .1 I. ♦ I t- t " I Yr. 1, ' I . - '
l •
46. Handicap Regulations, I : I I II �� 1 IPI '; ! , i I ^ I
47. FINAL STRUCTURE•& BUILDING 1 I 1 '
I ;
48. Special Requirements1Cornpleted 111 I.! I I i ! I •,� -
49. ElectriclRelease to;Edison I I d I__ _c_ H _ -:4,..J......4. _ - ....1. ....:... • - ' "
50. Gas Release to Southern California Gasco I ' i ' ' ' ' _ ,
51. CER TIIF,ICATE OF OCCUPANCY _1 1 _I_i«._ l _
. ' _
No ti I I Daie ! I ,' I` i ; 1 I I - , -