HomeMy WebLinkAbout652 CENTER ST - Building Permits,1
�r � ��31
� SA BUILDING DEPARTMENT
P. O. BO% 31�
� 'TA MESA, CALIFORNIA
PPLICANT TO FILL IN
Center Street C( , �
-OSTA MESA. CALIFORNIA
Braeburn Construction Corp.
o"�ooRess 3404 i�ia Lido
c�rv Newport Beach
' �EB19-SBPOnesaAfi42a ****64.5�
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
flCCEIPT rvo, pEFMIT NC
Tno:OR 3-1240 qooRe�ss
ARCHITEGT ��c. COSTA MESA. CALIFORNIA
OR ENGINEER Ray Levanas NO. C�4%
1d49 V1�. (1..�..f.. TT...�.�.....4 II......1. FIRE .A
CONTRACTOR Lido Constr, GITY N�o; 157915
nooRess 3404 Via Lido TNo: OR 3-12�
EscwirrioH NO? 13 BLOCK TRP.CT32H�I
A.P. NO.
sae 50 x 125
OF LOT
USE OF
E%ISTING BLDG.
$EiBACK LINE FPOM 45'
CENTER OF STflEET
rvo; oF a�ocs. 0
���P
REAR VA
SIDEYARO FIGHT �j� LEFT �� "jll
DESCRIPTION OF WORK
NEW � ALTERATION AD�ITION
REPAIR MOVING DEMOLISH
5 ZIE DING 3124 $ . lt. ROOMS 1> STORIES L
EXTERIOR WALL WOOCI ROOF �yOOd shinv le
COVERING SY71CC� COVERING b
BUEL�FNGEW Multiple Dwelling
ar
CORRECTIONS
703 s. ft. attached ara e& car ort .� — /��
��f_e_ / 6 � -
1 MEREBY 4CNNOWL[0�4E iHwt I VE RESD RPP�IC�TION �NO ��/
ST�TE TMRT TNE �BOVE IS CORRECT 4N0 AGREE TO COMPLY WITX tLl � �
CITV OR�IN�NCE$ �Np ST�TE L�WS REGUL�TING BUILDING CONSTflUC�
iwN. n n 1 ypLUATION
SIGNATURE OF � I/�� �� PERMIT FEE $ 3• O
� PERMITTEE �� i
� �i �� � PLNN CHECK S ��. S
S /
AUTHORIZED AGENT TOTAL FEE S tp��� O vsrr
� f� � ��
COSYA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 317 . COSTA MESA. CALIFORNIA
FOR APPUCANT TO f/[L /N COMPLETfIY
TYPE OR PRINT
eui�oiNc 52 �C �`i-f�'? ST%lG�T
ADDRE55
COSTA MESA, CALIFORNIA
6Sz Cc—��Z sT
O ST A��S t�i TEL.1,,,I•
NO.
LIC.
=R NO.
CCONTRAGTOR
�LEGAL ILOT
SIZE Ho. oc e�oc
OF LOT �O X � YS Now oH Lo'
USE OF � F���
EXISTINGBLOG. Y .DMI�'c1-�-�Nf�
SETBRCK LINE FNOM
CENTEfl OF STREEf �X� REAR YARD
SIDE YARD ILEFT IRIGHT
DESCRIPTION OF WORK
NEW I II ALTERATION I II AOOITION
BUILDWC�O_ NO.OF
SIZE � ROOMS
UILDING AND WORK TO BE PERFORMED
LfiGT�G RoeG OJEQ YORTION
I HENEOY ACI(NOWLEUGE TXAT 1 MAV6 READ TX19 APPLICATION
BUILDING CONpf�Til' UCTIONO� CORflECT � O �OHE� CO�
PLY WITH ALL CI Y OPOINA 8 AND 6TATE�:iB HE6 LATING
Y�IUTHORIZED AGENT
e�E� ,.�CEIlIED ,
D �1PR 2 2 I959 y��
fINANCE DEPT.
APPLICATIONM'FOR PERMIT
BUILDING
fOR Off/CE USE ONU'
I PCCEIPT NO. I PEHMIT NO.
� a� Y%zEz�s 9 � o.'.za � s`
�v y 2 � �s,✓.-e�
C
COSTA MESA, CALIFORNIA
type gs'°uP � nH ��
' ��� .� 9 v� �
DATE
ZONING
L I NO. OF I USE OF NEW
PLANS BUILOING
1`.■
�%/i�ii�� �(�i �.�r 1�_C1a.
4—
1 N� , �o � .• �n(' .
J�
�TNE AMOUNT BMOWN UNOER VALIIATION �8 FOR THE
PURPOSE OF ESTABLI6HING A PEHMIT F8E ONLY.
VALUATION
PERMIT FEE S Z
$( Ei lf � PLAN CHECK S/
/
TOTAL FEE S Z�
^ — , � " CITY OF COSTA MESA �' �
�pMfq BUILDING DIYISION '
Ft�� 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
a"'°"°"°� PERMIT NUMBER: 610-00118
PERMIT TYPE B_ROOF2
APN: 42421235
JOB ADDRESS: 652 CENTER ST CM
Vicinity: HOUSE ROOF ONLY
Squares: 2800
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
05/04/2010
RMD
$5,800.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL 1 LAYER OF 75# FELT AND 1 LAYER OF 30# FELT ON A
4:12 PITCEHD ROOF, REROOF WITH 30 YEAR COMP SHINGLES ON HOUSE ONLY, APPROX 28 SQUARES. REPAIR
AND REPLACE SHEATHING AS NEEqED. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. -
OWNER: HENNINGER, LESLIE ' . Address: 470 MAGNOLIA ST � Unit:
PHONE: . City/State/Zip: COSTA MESA, CA � .�
APPLICANT: JONES, JAY Address: 220 VICTORIA PL Unit: :UNIT A
PHONE: 714394-6494 City/State/Zip: COSTA MESA, CA
CON7RACTOR: ARIES ROOFING COMPANY
Address: 220 VICTORIA PLUnit:
City/StatelZip: COSTA MESA, CA 92626
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspedion Fee:
Bidg Std Admin Fund
$0:00 ,.
$125.25
$0.00
$1.00
UNIT A
License No.
License No.
License No. 868990
PHONE: 949-548-2056
CELL:
PHONE:.
PHONE:
HOURS FOR CONS7RUCTION ACTIVITY; EFFECTIVE 3/18/2070 - PER CMMC Sec. 13-279
Monday thru Fritlay - 7:00 am thru 7;00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federel
New Years DaV. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksoivina Dav and Christmas Dav
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-g2)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
LODE1. INSPECTIONTYPE DRTE INi1TIRL5 LODE� INSPECTIONTYPE �AIE INPTIALS
1616 Fixetl System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final c- Y� � �. .�. �/d.. 208 Final Plumbing
200 Final Re-Root J—i r/D �Y�� `) 210 Final Electncal
20t Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Faclory Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Buil�inyOccupancy
WORKERS' COMPENSATION DECLqRAT10N:
I pereby a(frm under penalry of perjury one of the following tleclarations:
❑ I have and will maintain a certificate of consent to sel(-Insure for workers'
compensation, as providetl for by Eection 3700 of Ihe Labor Code, tor Ihe
pertormance of the work for which ihis permit is issued.
❑ I have and will maintain workerg' compensation insurance, as requiretl by
section 3700 ot the Labor Code, (or the peAortnance o( the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
�er'' � (,�7Z� F'� �,.. p
(i�is seci.on neetl raf Oe crom��eLd atn(eipAenn/n i�s valued at one n�ntlretl ddlars (Si�) or�essJ
Polc� v.Number: �S�/ S?Y/iSV7
C:�
❑ I certify that in Ihe pedormance of [he work for which this permit is
issued, I shall not employ any person in any manner so as to hecome subjecl
to the workers' compensation laws of California, and agree that if I should
become subject [o [he workers' compensation provisions ot Section 3700 of
t e Labor Code, I shall forthwith comply wilh these provisions.
�nl55ignalure q le
���.
WARNING F ILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLqRqTION:
I hereby affirm that I am licensed under provisions o� Chapter 9(commencing
with Section 7000) ot Division 3 of the Business and Professions Code, and
my license is in full force and eRect.
Lic. #.- • �� � Gess_#- "— 9
r:= �
Co G s'Signalure L - .
CO TRUCTION LENDING AGENCY:
❑ I hereby affirtn that lhere is a cons[ructbn lending agency for the
per(ormance o( the v.ork fa wfiich this permit is issued. (Sec 3097, Civil Code).
Lender's Name:
Lender's Address:
Date
OWNER•BUILDER DECLAR4TION5:
I hereby aKrm Ihat untler penalty o( perjury [hat I am EXEMP7 FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or counry which requires a permit to
construct, alter, improve, demolish, or repair any strucWre, prior to its
issuance, also requires the applicant for such pertnit to Ne a signetl statement
that he or she is licensed pursuant to Ihe provisions of the Contractors
License Law (Chap[er 9(commencing with Section 7000) of Division 3 of [he
Business antl Pmfessions Code) or that he or she is exempt �herefrom and
the basis for �he alleged exemption. Any viola[ion o( Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penally of not more than
fve hundred dollars ($500).):
❑ I, as owner of ihe property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and Ihe structure is not intended or
offered tor sale (Sec. 7044, Business and Pmfessions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
Ihereon, and who does such vrork himself or hersel( or through his or her own
employees, provided that such improvements are not intended or oRered for
sale. If, however, the building or improvement is sold within one year of
completion, ihe owner-bu�lder will have the burden of proving ihat he or she
did not build or improve for purpose of sale.). .
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTWG WITH
LICENSED CONTRACTORS to tonBtruct the prqed (Sec. 7044, Business and
Pmfessbns Code: The contractws License Law dces not apply to an ovmer of
propetly who builds or improves ihereon, and who contracts for such project with
a contracta(s) license pursuant to the Contractors License Laws.�.
❑ I am exempt under sec.
Business and Protessions Code for this reason:
Signatore
]OSl-a6 �3ro]�
Owner ID venfied by drive� � license. ❑ Yes .� No ,
Driver's License No. Expires:
Verifica[ion of Ovmership by (type o( document, i.e. - property lax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceAify that no excavation fve (5) or more feet in depth into which a
person is required [o descentl, will be made in connection with vrork authodzed
by this permit, and that no building structure, scaFfdding, falsework, or demolition
or dismanHing [hereof, will be more than thirty-six (36) (eel high. (Chap. 3.2, Grp
2, Atl 2, Sec. 341, T�le 8, Cali(omia AdministraWe Code).
❑ As ovmer-builder, I will not employ anyone to do work which would
require a permit (rom ihe Division of Industrial Sa(ety, as no�ed above, unless
such person has a permit to do such work (rom the division.
Applicanl's SignaWre Oate
Division o( IntlusMal Safety Permil Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or presenl or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health antl Satety Cotle requires, with some
exceplions, lhat a Business Plan be fletl with the Costa Mesa Fire
Depahment by every business which has at any one time during a reported
yeai a quanlity of hazardous materials equal to or greater than a weigM of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at stantlard temperature and pressure).
2. Does or will the appticant or present or future baiiding occupant need to (le
a registration form (or acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 ot the Califomia Healih and Safety Code, with some
ezceptions, requires registration with ihe Cos[a Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazartlous materials equal to or greater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
tempereture and pressure).
3. Does or will the applicant or present or futuie building occupant need ro
prepare an RMPP (Risk Managemen[ and Prevention Program for awtely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 ot the California Health and Safery Code provides that the
Cosla Mesa Fire Department may require the preparelion, ceAification and
fting with the Fire Department of an RMPP by businesses which are required
to register acutety hazartlous materials with the Fire Departmen[.
4. If an RMPP is presently required, has Section 25534 of lhe California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applican[ or present or future building occupant require for
Ihe vrork which is the subject of Ihis application a permit for such constmclion
or motlifcation from the South Coast Air Quality Management DisMct or from
any other air pollu[ion control dislrict or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Code requires lhat the requestetl
in(ortnation be fumished on applications fa noo-resitlential Duiltling pertnits).
6. Will any part of the faciliy to be constructed under Ihis permit be wi�hin
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
Qf "yes", the facility must meet the requirement of Sections 25534 and 42303
of lhe California Health and Safety Code).
7. If a permit from the South Coast Air Qualiry Management Disirict or other
air polWtion contml disMcl or agency is required for the vrork which is the
subjecl of this application, have all of the disclosures prescribed by California
Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certificate of compliance fmm the appropnate air polWtion
control offcer).
CERTIFICA7E OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correct I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaNre Date
CERTIFICA7E OF COMPLIANCE AND AUTHORIZATION OF EN7RY: I
certify under penalty of perjury that 1 have read this application and state that
the information given is correct I agree to comply with all state laws and city
ortlinances relating to building cons[ruciion, and authorize representatives o(
the Ciry of Costa Mesa to enter upon the above-tlescribed property for
inspection purposes. I agree not m occupy or allow occupancy of any building
authorizetl by lhis permit until final inspection.
///J Signature oi Legal /Oj/� �er(s� . 0 te j
�rl _'/'�`"�.'.'t:t�% = /IAA�� _ (J
An4lo�AWhw 0 O�Lcanl (
wonessaewinw: 652 CENTER ST
OIMERSIUV'�FqlvMN: HE23NIt3GER, LESLIE
� -'�iooeEss TRAVIOLI, CLIFFORD DOZT
470 MAG130LIA ST
COSTA MESA,CA 92626
� ��o�x SAME
WCNITECT OfiF/M�1[�FA:
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CONIN1C70A8YM�lIi
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LICENSED CONTXACTONS DECLAfl�T10N; I heroW Mkm uMer Po�eW d perjury tMt I em fpmea uMx prwi�bm d Cheqm B
I�mmananp wilh Sectbn �OW) d Divi+ion � d Ihe B��einea md Ptalmuona Coda. erd my 1'van» e m IW bcs end e11eC.
cm uc. Ho.: uc. cuss: uc. No.: EXP ;
Oma: CanvpCa:
NNER BUILDEN OECIAN�TON: I IweEy dfirm uMa panely d perjury �hel I em eRamq Iron iM COMrer}as lkenea Lew lor Uw
,ilowiq rsnaon (Satlion ]W t.5 Bueross entl Pro/eaima Coda: AnY cYY a mun1Y xMidi iaVuire� s Germil io crostrW. Mer. imWws.
demd'o�, or repei arry a�unuro, pia ro h e�uenca, aho npuves iM epplimm la wrJi Pamt t0 fil� e eqnsd ewarront tlul M p�M
u ficamed pu�wwenl to the pw'mions d tlr GwNrmare Limnae lew �Cheqm B(�me��q x+lh Seuion ]UW) d Ureion 9 0/ lle
Bwinm e�k Proleoiwu Codef w ihn M a sha b exemq ihrehdn uk IM bvu /a IM �bpeE ssemqion. My videtion d Saabn
T03�.S ty em/ appFreot la a pwml aAyG+tM appliwLL b a dvi pwWly M mt maa Nen fwa Neqnd ddlen �SSWU-
n I. m owrer dihe pooeM a�m' omOMwe xih wN� m ihei eob mmror�aetbn. will do 1M wA. W Ihe svuelure 6 m1 inteedeE
n' aaRveEtareeb1��701I.8uvroa�endPmlauoneCada:TMCamratlonlloenealerEoeemtepplytoenow�wdpvpny
wla Wide a inpwes iMroon. W Ma Eom euth xak h'vnaetl a hM+N a Ovap� h's a her oxn amplV/ar. qwided Ihel wch
impim+meMf ua rol inlerded a dised �a eeb. H, howewr, iM buikiiq w inpovemenl ie eoN within one yeer A mmplelbn. the
axrorWitler will heve ihe bukan at pwinp M or eAs d'd nd buik a impqe la iM purpw� d eebl.
� I, u owrrer W I�e puPoM. em a�duen*N aontreG�q vm� fiomfad wninclon ro wMrW Ms PN� (Seclun �M. Bwinme end
Pro/epiom Gode: Tha ConlMae licenM lew Eroe nq eVD�/ b an oxner d popeny xfio buiN! w M�Pp'�M tlwWn end Who
mnveeU lor wM prqeee wiN e oomeaqor(e) Icemed pusueM b �tp Contm2m limme faxj.
�I em azemp uMm SecOon:^ '. B. 8 P.C., for Mrc �n: \ �/ `
1 Eo ha�eby canEy Ihtl I%m aware d ard wEseWk tWs� We M CdYamie Hsellh end SeletY CoAe 9eKau 25505. P".r.�3. utl
25531, enA tlW I u ury Mws Wildirp omqenl will / (�6 one) nseE �o canpy w1� uN qets wde� bd iM npuiromaW b
eMmmfaomevuCionamodi&ationhomiMArsi iiery7i+ropn�wYOitlnd.R�rfrumla�m�udionappimiamana*amqhomihua
.,.: �wa�m: ,� , ,
IOIfKEF'9 COMPENS�TION DKL�H�TON: I Mrdy netly W pwpvy aa d tM blbw'up Eedvefnro:
7 IAeuaeMxilmainldnece�Niuledaoroentloeatli lawhse'amps�mYian,npoYiMdinEySatl'on3)OOdMeleEor
�coe.. �« ina o.eoim�c. a u...w �« wlicn inm w� u w�.d. •
� �nnr.m�ewmanaei�.ohen•m�,w�:N�,�.no..anpuirtaMsoaunsroadmeleborcoe..betnaw�«menma�n.
wwk Ia which Ihie pmmil ie inueE. My waken' mmperuetion imurerce mMx end pofiry number era:
cem..:
Pd'cyNumbsr.
�e«xiar n..d mr e. cxmaiaw r w osmr! u la. ars nunmed ddw. /Stool a wu./
' I oenly Nm m tlro pMameix.ro d�M wdk br xhcA �hie pemL ia beued. I slWl rM amqq airy qnm in xry menrar w e io
�\pecwne wpjea to the wken' compeneetion lewa d CelNpnia, erd�Y'se Np R I kwN beconr aEjw to iM Mvkre'
'%compa wbn P�s9^� d Swbn 9TW d lhe laba Code. I e1WI ionjy6� mmpy wuh Moprpro}Sions. ,�
W�ml�pjFiNun�acunwortr�'ronpw�utlon I mG�Ivllsup��nMnylqwroWnFiYlpwftlpuW
GHI l/ns ,p b om h�ndrb tlpu�vd eo/bn (SIOO,OWI, tlon b N� cwt ol tompawfbn, Wm�p� �� poHdb b� In
S�etlon J]06 0� IM LNm CoM, Inlx�a4 ��d �tbmry'a
CONSTii11CIlON LENqNO AOENCY: I Mreby elfirtn uMar penelry d perlNry Ihet �Mm Is e canel�udion �ip epe�wy M iM
peAormenca d Iha woA M whiM ih'e MmiY u e+uad (Sadbn �09). CN. CI.
LENDER'S NAYE
LENDER'S RDDpE%:
I cMM �hm I Mw reeE Uua eGO�� W aW IMt tlr ebwa "vdamNion e cortetl.l ePb to camPN x5h NI mYW �MY oAimMs�
eM etaie b�n relelnp lo Wild'n0 �^^w��db^ � �meEy eu�Aor¢a reqeeenletivee d ihle aty io amer upon the epore�meniioneE papeM
laimpedion W�Povee.
LESLIE HENNINGER
CITY OF COSTA MESA — HUILD2NG PERMIT
PERMIT NO; B 071527 PLAN CHECK NO; 00959-95 L
CONSTRUCTION TYPE; PERMIT TYPE: STR
JOH DESCRIPTION ; CONSTRUCT WOOD & PILASTER
PEAM NO: B 07152
GOVT: N SUPP: N
PUAPOSE: CON
SQ FT: 132
CLAIM VALU6: 1,000,00 CALC—VALUE; 1,320,00 GROUP OCC; R-3 l
COMMEtJTS: FENC£ ON CENT£R ST & ALLEY SZDE NOT TO EXCEED 6' HIGH
if ff if if 1E iF ik i! f! iF fE 1f 1f fk 1f M M iF fFlE if ff if 1f iE ff f! fFlf M# if fF 1f ff if 1F 1f 1F �t iF 1f i! �f ff 1f if 1f if M 1f M if M 4 iF i! if 4 it if 1f 1F if i! M it M if �f �t iE 1R if if �f M iE 1f
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S .
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN FtEAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; F'f IN RGHT; FT IN
PARKING REQ• PROV•
PLANNING N6TES> CONSTRUCT'
> OF HLOCK T
D E V E L O P M E N T
PARCEL: 42421235 ZNE: A2HD REF NO:
,F „ 6' HTGH FENCE CONSISTING OF 1-2 COURSES
W/ WOOD PANELS BTW BLOCK PILASTERS.
1f1fdFlfflil�7Fi(�1F1�'1liflfiElfiElfif1f1f1f1f1fifi('iflEffiFiEillflElfif'lEikif-''1FKikififlElfif'N"M'_ . _
S E R V I C E S R E Q U I R E M E N.T S-- `—�
ZONING APPROVED BY V���� A' DATE; �
BUILDING APPROVED HY : �/J�_ DATE;�� �^
APPLICATION ZSSUED BY: v DATE; �
iEiF�F'kif7EiFififiFif3FaFifiFififMiFlf'M1f iFMMitlfiF%i1�iFfF ffiF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GMENT:Y
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/AES GRADING
PEAMIT 33.00 � .50
SMIP/NON–AES
PLAN 21.45 �.
ISSUE FEE
BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK TOTAL PAID DUE
TOTALS----> 33,50 0,00 (-'21,45 54.95 54,95 .00
REVENUE DIVISION TOTALS--> COLLECTED; " 54,95 OVER/SHORT; ,QO
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN–CHECK
33,00 � ,50 21,45
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I N D I V I D U A L� F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O N, UNIT COST TOTAL COST
SFR 132 RES—PILASTER WZTH WOOD,ETC BET/ FT, 10.00 1,320.00
END, OF FEES
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• GATE: G3/2i/y5 T?HE: 15�45
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��ONSTRUCTfON ANO PLANNINO >: L & S�.
APPROVALS Permit # Date Inspector APPRO�/Al�S Permit #• �
+: Temporary Eiectriral Service or Pole � 52. Pool & Equipment Location ��
2. Soil Pipe•Undrgrnd. ' 53. Steel Reinforcement �
�.3� Electrical Conduit Utility•Undrgrnd. ' 54. Forms •
==4'. ,�le;tl}�cal Cond�it�Undrgrnd. ` 55. Electrical Bonding
r- _� : . _
� 5� jigel Reinforcemeot � Z`j-ag �Ct� 56. Rough Ptumbing & Pressure Test
��6.��'Electrical UFER Grnd. 57. APPAOVAL TO COVER•GUNITE
,..�7,,Footings 21 .Qt,�f 58. Electrical Conduit-Undrgrnd.
�"8; �F.oundation 59. Gas Ptpe, O Undrgrnd., Test f' /
• r
z 9;', Water Pipe-Undrgrnd. . � 60. Backwash Lines, P�Trap, O;Undtgrnd.
i
10. Structural Floor System � ' 61. APPROVAI TO DECK .�% �
11,' ProPerty Sewer line & House Connection 62. Backwash & Receptor-Pinal
t2. Seq3er Cap 63. Heater & Vent-Finaf
73. Roof Drains • 64. Plumbing System - Final ��. �
14. Ro�gh Plumbing �. ,;� 65. Electriwl�Fi�al �'
15. Rough Electri�yl�Conduit '" � 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approvai ��
1�. Rough Wiring Sign 66. APPROVED FOR PLASTERING
18. Rough Elec[rical-T Bar Ceiling 69. POOL/SPA SYSTEMS PINAL
79. Rough Neatfng & Air Conditioning FtRE DEPT. REQUIREMENT
�y + r � �'
20. Rough Fapto y Fir'eplace '�'�" '� ' -' -�" APPf#OVA'LS-� ' Pehnit #
:'r. 't:, _ -. rf-�
21. �Ducts, in:Structure: • � •• •• -+'� • � ' � � " 70. � Untlergiounli Hydro ^
22. Ducts, Ventil'ating; �' ' �� ' � � , :� w� 77, product,Piping �-Gas ❑Oil
23.GasPipe;flough&Tesi , :•<� f, � 72, UndergroOndFlush-.� -
24. Roof�Framing" '! ` �"' r`' � = _ ; 73. Undergrn8. Stoiige 7a�k � Gas ❑ Oil
25. Roof.Sheathing r.. , ,� � � � ^ � 74� Ovechead Hydr6 � � �
26. T�Bar Ceiling �Strtitturall & MonoCoat �� �! R ., � '� ^� � 75.�ry Chemical .� ' �' �'
27. �F,rame and Flashing,. 4.;•.�; i;• ,�. „ 76. Dry Standpipe[-�.� *
28. Lathing&Sid±ng:S-'-+ ��`;;;. ;�;�-:.- - ^� 77: FIXED,Sl7STEM'fINA�. � -
29. Insulation -� c�!. " � �� .. _ �. �� � I �� 7g' FIRE PREV. FIN'AL � �• ��
' 30. Drywall Mailing .' " � "'��" I ( � ,HEALTW DEPT•REQUIREMENT
, 31. Plaster Brown Coab �?� i inp� �� ~ � � `, p 79° FINAL I.ClSPECTION t ' -•
32. ��Iectrical=�Pow,er Meter=Final ' ''�� ; � 1' �' 8QP FOOD CERTIFICATE ISSUED '
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. . . .. r• .� �r _ ;.. . � 7Z
� 33. �Finai;Etectric. Rj �. -,y � y ,' � Notes: �, 7ry • � � � �,
� 34. FinatHeating.&AirCond'rtionirtg'' ��'- _�* �` _ i ...�. .. _ �.=G�'��� � . .�
T . ... �. �. m- ��x ,
35. �Einal'GaS,•PiPa:TeSf ; - . ,' 1, - •� �. . � "'• , . ..
r. �
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' 36. Hood�or�6anoPY a' ' -. "� -� � , 1. � ° 'n`
i -' - - - ��: f. � - bl
r' i'V� " '�.,. a. � • :,
; 37.'EdnaLFactory Fireplace i r,;, ( �F j; � mni
� 38. F.inal��Plumbing H � � �� . _ .:+ . � � �* = � � �.
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39. Watei Service�Final. ` ' ' + '; (' ' ' � ' :
�• - -
, 40. Gas Service�Final - - • . ��,^ .• ' n = � �'
I ��: -
� 47. Solar pomestic-Finai •- " ' " : °' "
, _ , �, , c .
� 42. Backflow Preventer, � �� -- ( i� '> � • ' -� '
n>.`1r� �
43. Backfiow Irrigation. �, . -. - - _ ; �. ; - • . " . - -
44. landscape Irri9ation�SYstem.� � • �r�. • C; "k : _ .- ^ -. �
� 4 � 1'
45. Sound A�tenuation ` , , :�;• �•• .,: � - _ ' �' �_' t , . _ ; ^ -
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'46. �Handicap.Regufatioris •-. � � + • ' C ? . � +
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�7. FlNAL STRUETURE & BUILDING �0- �
48. F1NAL PLANN)NG�. = � + �� �
"49. Electiic flelease to Etlison � �' ._' i�
50. Gas Release to Southem Califomia�Gas Co � ' . I•
51. CERTIFICATE OF OCCUPANCV }
Date
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Date � Inspector �
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