HomeMy WebLinkAbout788 CENTER ST - Building Permits'� �sta Mesa Bnilding Department :�PPLICATION FOR PERMIT
P.o.soX3�� `32�8 gUiLDING 'f
COSTA MESA, CALIFORNIA ` `
FOR OFFICE USE ONLY�'—
FOR APPLICANT TO FII.L IN Receipt No. Permit No.
B�i�di�9 j� G� ._ _ �. ��� —
Address V
Costa Mesa, Ci3��01711& Received by Date Rec'd. Date Issued
Nearest � � — ' o� �S
Cross St. L C�� r � q Building
� Address
Mailer � �� � qUsC��� � CostaMesa,�California
Address ��� C�jr/y �% �� v� Nearest t
1 Te�, Cross St. �
CILy �t3 S% ��F No. �'_ Q.yy�l Zone No'bf I Type' Group
Arohitector �-� Lic. Plans�•
Engineer J � � C `` No. Approved
b '`J ' Date
Address ; .�`• , . „�
� City Lic.
Contractor ryo, ��
�. �
Address " _ CIT� �!' i --
Legal �ot� I PLo�•'[:InG pEPr. �
Descriptlon �I No. �!; � I Black � Tract/�rii h) SUBJECi 70 BL�G. DEP7. REG.
(Attach Metes and Bounds) � � � — � }%O — � �
� o.o�V fBld s—T —
Size of Lot .�iCi i� l;(% I Now on Lot +� BY '�ATE o
4seof No.of No.of •^ p
Existing Bldg. � r I Familles � I Rooma � .
Set6ack Line Trom �
i_- Rear Yard aa T — c-'Al �.A �+��_ '
Center of Street O /`/ . Side Yard S E'. . ., �.� � pa �� � ��� � � � ` D
DESCRIPTION OF WORH . ��� .-- . y� �
,"
��tl� Il
New I Alteration I I Addition I �
I b V�J•J
Repair I I Movfng I• I Demolish I
Building No.af - /
6ize J,a���� }( 2� � Rooms % Stories
Exterior Wall Roof n�T/ r nn Tf1 �!]r(�(� � _
Coverin9 I Covering 6l11 I I�P�RO�7��'�
Use of New ^ � J Foundation Location Ins ector � Date
Building / Yl l�l �a uU �'I Forms, Matertals, P
`� rh- Under-Pinning
/ Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the abwe is crorreM and agree to comply Lath. Int.
with all Clty Ordinances and State Laws regulating
building construction. Lath. Ext.
8ignature of � � �
Permittee ��� L�C �"�— Plaster,lnt
AuthoAzed Agt Plaster, Ext
Valuatlon PermitFee$ ^ MasonryReiniorced
� Plan Check $ � Bond eeam
/ ,� D 7J
$ Total
, Fee $ � � FINAL
FONM 204 10�l9 O. G. h 5. , �
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' CE�V �i: R � I
PLOT Pi,AN
8how locatlon and distancea irom
property Iine and between bulldinga
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AFP�O�I�D
' CITY OF COST4 MESA
� � PLsNhIhG D[F1'.
; �SUBJECI TO BLDG. Dc�T. REG.
g}LN�d`'r • DATE��"-
PtAN�yP�lj7
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PF�ECTROOflESS: 788 CENTER ST
� � v�[a�sxame: ROGER VEGA
aooeess: �gg CENTER ST
�•- COSTA MESA,CA
—�
1
AflCH/ENGINEEN:
PDDflE55:
92627
flEG.NO.:
uNiT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; H 06466�
PERMIT NO; B 064669 PLAN CHECK NO; N GOVT; N SIIPP: N
CONSTRUCTION TYPE: 5—N PERMZT TYPE: STR PURPOSE: OTH
UNIT:
PfpMiTTEE: RAYMOND JU CONSTRUCTION (714)96�-2339
aooAcss: 9801 OCEANCREST DR
HUNTINGTON BEACH CA 92646
LICENSED CONTBP�TON OECUNRTION: I tcereCY allirm Itwl I am Iicense0 unGe� Orovition5 0l Ctupter 9(commencinp wi�� $epion
7000) ol Division 3 of Ine Business an0 Protessions COOe. ana my license is in lull force an0 ettett.
ciTv uc.: 0 5 16 8 TRTE LIC.: Ii % O G% 3� C1A5S B
'D'are: —( � Signature: _�
WOBRENSICOM ENSATIONOEC flATION: I�ereGyaf�irmt�atl�aveacertilica�eoicons Itaself.nsurearacenificareofWorkers'
Comoensation Instl�ance. ar a cenifie0 copy tner¢of (�cti0n 3800, lab. tl.
70LICY NO.: E%P. O�TE:
COMPRNY:
%� Cenilied copy is �ereEy tumis�ea. ❑ Cetlifiea copy is titeG with the ciry BuilGinp Oivision.
�ate: Applicant:
E%EMPTION fPOM WOPIIEFS' COMPENSATION OECIAIWTION: (�h¢ Settion ire¢0 mi Ct mmWe;td it �he pttmt 61W dIE IwMrW (3100) or 1¢55�.
I certity ttut in ��e �eMormancB o� t�¢ xrork �or w�i[� lh4 permit is issue0, l stall noi employ any person in any manner so as to become
subject to t�e Wo�ke� Comce�s io�n law)s of CaGfamia. //�/
Date:___a��� al' Signature:��,��' ��+
NOTIC ' II, alier makin this Ce ar ron, yau stroultl EefAme suh ttt to the orker5' e ion provisions of ine Labor
Cotle. you mUSi Iorihvn�� COmply wi(h Suth pmvisions ar tNs permit 5tull U8 Oeeme re R�te�
CONSiBUCiION LENOING �GENLY: I �ertby allum that t�ere u a construction IeMin9 apenty lor the ce�ormanu ol t�e work lor
wnicn Inis permil Is i5sue0 ISection 3W7, Civ. C).
LENOEN:
AUOPESS:
JOB DESCRIPTIQN ; T/O EXISTING & REROOF WITH BOR. SQ FT: 2,500
CLAIM VALUE: 2,500.00 CALC—VALUE: 2,500.00 GROUP OCC: R-3 /M-1
COMMENTS: SMOKE DETECTORS REQUIRED PER THE 1991 ED. OF THE UBC
�****�*�r�rit*�*it**ir***x�**itir*it*�*���x�+t�*+��**r*it+t*�r�*+r*if�*at�r**+r��*+��***+�**+E***��+F
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 REAR; £T IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING RE(� • PROV: PARCEL: 42920114 2NE: REF NO;
F'LANNING N6TES> -
>
if iF if �f i! �IE iE if 1E it if if it 1E iE iE i! iE if it 1E it iE it ff if ik iE �f iE fE it iE iF iE i(-1.' it it if it iE if iF if iF 9f 1! iF iE iF 1E iE iE iE ik if iE iF if iE iE iE if if ?f if i6 af iE iE aF it M iP iE IE M if
D E V E L O P M E N T S E R V I C E S' R E Q U I R E M E N T S
20NING APPROVEP BY � DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: �/��l�c ' DATE: ___Iy�T)
*�ir�t*i�i�******�t**�e**ir**�r*�r*x�i��r�r�r**+r +�+�� er�TFwr**�*+�u�***+�*******S�* *+r� **
!F if if if if ik fE if 1E ih if % iE iE �f ifM ff if jE �! if if if if iE iE iE if iF if M!f it if it k iE iFif % M if iF iE iE 1E if 1E #if 1f 1� M iE if iF 1f i4 if iE iE if Yr ff ?f iF iF if if % M iE M IE if 1E if
LEGALIZATION;N F E E S U M M•A R Y STRUCTURAL SEGMENT;Y
OWNEPBUIL�EROECURnt10N: Iee�eUyani�mthatlamexem9�iromSheContractors StatalkenseLawfo�Ne�otlowinBreason BLDG PMT PLUMBING EL£CTRIC• MECHANIC FIRE SMIP/RES GRADING
(Semion 7031.5 B�siness anU Prolessional CoOe: pny ciiy of couniy winch repuires a permit to canstmct, alter, imprwe, Eemolis0. or p ERM I T 5 4. 0 0
repair any struclure. priw �a its iuuaxe. also repNres i�e a0D4cant Iw sucA Oerrrvt to file a sipneE siatement that he/s�e a licensetl S �
pursuant to ine o�o���s af ine Conirac�wi Siate Lkmse Law (Chapter 9lwmmentino xitn SecUon 70W) ol Didsion 3 0l �ne Business � S M I P/ NON —A E S
antl Pml¢SSiQnS fAtlt) Or Ihal IIE/Slie 6 eMemp� I�eretram an0 ihe Oazi5lar I�e alitped eremDtlon. My vi013ti0n ol Setlion 70315 �y PLAN
any aDDlicanl lor a Oermil 5u01e��5 1�¢ appliwnt to a civil penaliy ol noi mom �han five �unAreU Uollars �5500). 1 S S UE F EE
I, as oxmer ol me omoeny or my em iayees wim wapes as meir soie compenution, will ao ine wone. ana ina Bi1ILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ smcwre is not intended or olhreo lor saie I�ecuon 70a4. Buvneu anA Pm�euional CaAe: TAe Comraciors' Stata ticense Law TOTAL S----> S 4, 5 0 0. 0 0 ,0 . 0 0 S 4, S 0 S 4. S � , 0 �
Eoes not aFoly to an owner oi � pmoeny who builUs or im0�aves �hereon. an0 wno aoes sucn woA nimsell/hersell or tAmup�
nis or ner own emoloyees, pmviAeA ina� sucn imO�Ov¢menl5 are n01 intMOeO Or ofl¢red �or SatE. II, 11owEvef IAB EuilEinp Or
impmvem6ntiswl0.wt�moneyearofcompleiqn,ttieovmerwipluvel�00urUenolprovinpMJs�eEianotOuJEorimprove REVENUE DIVISION TOTALS--> COLLECTPD: 54.50 OVER/SHORT; 0�
m�meo�icoseoiuiel. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owne� oi ine DmDeny, am e�clusNery coniractinq wit� Iicense0 mnl2clors Io cansimcl I�e Omlect �Section 704/, 6usiness 5 4. 0 0 , S Q
❑ and Pmlessions Caae: TAe Conlractors Slate Liceme Law Uces not apDN �o an owner of pmpefry wAo OUAOs or imprmes t�erean �
antlw�Otonlrat�S�0�5uChprOjet�Swi�haCanlraClor�S�liten5epur5uanll0lhefAnlracl0r5'$IaieLiCen58Law).lamaWaa {p{p{4{F.x.N.#il.{�.*.7�.x.{F�(.�(.{f�{N,*{�.**{�{f*�(,{�,{t**.��,*{�,{�{�,*„X„�K,H„�*{�{�„x,.�**,*.K,.�**,*,ff*,x,*,*„K,*,**,�*,*�,******�,***,�
Ihai pmal ol ��eir WorkEfS Compen5d�ion in5urant¢ ShOWC he D�aviQeE IO me.
� I am e.emD� unAer Senion: 8. 8 P. G I N D I V I D U A L F E E B R E A K D O W N
io��n�s�eason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
oate: QN1B' SFR 2500 REROOF BY VALUE RESIDENTIAL NO�pNE 1.00 2,500.00
I tlo hereby cerlity IM1a� I am aware ol antl untlerS�anE ��e repuiremenis o� Cahbmia Meall� and Safeiy CoAe 5¢Ciions 25505, 25533, antl p
2553o ana tha11 oi arry tutuie Wi10mp occupam wiNlwln nm �cnGe onq neeE to compry ritn sai6 sfate cWes antl tlre �equi�ements irn a K END O F F EES y.
permit lor conslmqion m motlilica�ion Imm Ihe Air�Manapemeni OiSlrici. PeSiGential conslmc�ion aDO�ications are eK¢mpl IrOm �
inese pmvisians. R E D
Date: Applicani: _
1 hereCy ¢tlAy I�a� ��va rea0 �N5 apD���an and Slate tlwi l�e
ordinances antl Siate �ws relaling io OuilOing constmciion ane �er91
o�o0etly larinspeG�io purposes. �
Oale: 35ignaWre: � �
Griver's License ol �u� Sttmiiy �:
mdlion i5 wrrect. I ag¢e lo comD�Y �t� all ciiy antl county
repre5enialive50t Ihis tiry lo en�er upon t�e above�menli0ned
164��ab Wnito—Bmlaing: Grean—CWe Eniorcemenl: Canary—Applrcant; Pmk—Pevenue; Golaenrotl—Assessor
EXPI
{ncorn te Inspections
�� \ �a�.
,�at�, � a" �..�: s'g ���-
L �
SMOKE DETECTOR
REQUIRED
, nr
l�l ��fl1L�i^•S(_�L�Z��'1��rPi T%�'�1 ��,�:
DATE: IG�'0�'3 71flE: C��:..
_ ., ,
I CGNSTRUCTION AND PLANNING P�� 'PA
'�`1APPROVALS Permit# Oate �n:pector AppROVALS Permit# Date Inspector
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steei Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. �" 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Eiectrical Cqnduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgrnd. 60. Backwash l.ines, P�Trap, Cl Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent�Final
73. Roof Oreins ' 64. Plumbing System • Final
74. flough Plumbing 65. Electrical-Final
15. flough Electrica6Conduit 66. Solar SYstem-Final
76. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Eiectrical-T Bar Ceiling 69. POOL/SPA SYSTE�AS FINAL
19. Rough Heating & Air Conditioning fIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Duc[s, in Structure 70. Underground Hydro
22. Ducts, Vemila2ing 71. Product Piping OGas OOiI
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing �/ �r_G%3 (p�.,� I4. Overhead Hydro
l
26. T�Bar Ce�ling (Structural� & Monocoat 75. Dry Chemical
2�. Freme and Flashing 76. Dry Standpipe
28. Laihing &$iding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL �
30. Drywall Naiting HEALTN DEP7. RE�UIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriral Power Meter-Final 80. FOOD CERTIFICATE �SSUED �
33. Final Electric Notes: � '
34. Final Heating & Air Conditioning
i
35. Final Gas PiDe�Test ' (0� 2���'3_ `-� /� �
�� o�
36. Hood or Canopy � f� --�- .
/
37. Final Factory Fireplace ` � ,I . � �
�4
38. Final Plumbing �
39. Water Service�Final k
40. Gas Service-Pinal ,�
47. Solar pomestic�Final ' �'
42. Backflow Preventer ' -
43. Backflow Irrigation � 1. '' "
�-.
44. Landscape Irrigation SYs2em _ � �
, 45. Sound Atrenuation ;� i ��
46. Handicap Reg�lations " i �
�ve
47. FINAL STRUCTURE & BUILDING �. �-
46. FINAL PLANNING '
�
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OP OCCUPANCY
No. Date
��
�— i
�� I
PflOJECT ROUflESS: % B B C ENTER S T
OWNEfl'SNAME: REBKOWITZ ALICE
nooncss: 788 CENTE�t ST
COSTA N,ESA,CA 92627
(774)642-6164
AHCH/ENGINEEfl: flEG.NO.:
ROUflESS:
UNIT:
UNIT:
PENMITTEE: ALICF. REBKOWI'CZ ( 714 ) 548-0184
aooeess: 788 CENTER S'T
COSTA MESA CA 92627
LICFNSED CONTflACTOB oEC1ABATION: I hereby alliim ihal I am licensee unee� pmvisions of Chapter 9(commencing with Sec�ion
70f10) ol Orvis�on 3 ot �he Business and Pmhssians CoGe. anC my license is in tull b¢e and eHect.
CITY LIC.: STpTE UC.: CLASS:
Date: Sipnature:
WOflNEflS' COMPENSA710N OEClABA7lON: I hereby allirm Inal I nave a cenifiCate ol consenl to self-insure or a cenificate al Worker5'
Toensalion Insurance, or a cenilied copy thereof (Seclion 3800. LaU. C�.
�LY NO.: EXP. ORTE:
arnvaxr:
❑ Cehihetl topY is her¢by tumiSheU. ❑ Cenifietl caDY is 1ite0 vnih the ciry Buildinp Oivision.
Dale: ApD�ican�:
ECEMPTION FflOM WOPItENS' COMPENSATION OECLAflATION: (IloS seaian neeE no1 Ue mmpkle0 if Ue permit B lor wre �uMreG (5100) a les5�.
1 cetlity thai in Ihe pedormance ol lhe work lor whicA Ihis Oermit is i55ue0. I s�all not employ any person in any manner so as �o �ecome
suORtt lo t�e Workers Cqmpensalion Laws ol Calilami 1p (/ \
Oate: �" i �� �Z SignaWr�` ` \ ` 1�
NOTICF: It. aner making IN5 declaraiion. you s�oulU be[eml�5u0ject io �Ae Workers' Campenutbn pmvisions ol ihe Labor
Code. you mu5i forlhwiih tom0ly wi�h SUth pmvisions or l�is permit S�all 6¢ AeemeO fevoke0.
CONSTBUCTION LENDING RGENCY: I hereby alfirm ihat t�ere is a constmction IenGinA aqency lor itre pertarmance ol ihe work lor
wnicn ihis Dermit is issued ISection 3097, Civ. C).
LENOEN:
aooness:
OWNEfl BUILUEB OECNNATION: I hereby allirm that I am exemD� ��om I�e Contractors' Slate License Law tor ihe following reason
(Seciion 703L5 Business ane Professional CaAe: Any ci�y ol couniy whic� rzpuires a permii ro consimct, alier, impmve, demotis�, or
repair any Slmciure, prior lo its issuance, also requires Ihe aD0licani lor such permit to lile a signetl Slatement �hat he/she is IicenS¢a
pursuant to the pmvisions of the Contractors' State License I.aw (C�apter 9(commencing with Section 7000) ot Division 3 0l t�e Business
antl Protessions Caee) or Ihat he/she is evem0� ��erelrom anA ihe basis for Ihe alleAetl exemption. Any violation of Section 7Q37.5 �y
any applicantfor a permii SuUjeclS ihe applicantlo a civil penalty o� not more �han �ive hundred Oollars ($500).
I. as owner ot tlle D��Deny or my employees wilh wages as Iheir Sole camPensatian, will da the wode, and the
S�mtlurei5 no[inlenJeU Oro��er¢O�OrSale�SeC�iOn 704A, Bu5ine55 anU PIOf¢SSIanalCotle', The Con�rat�ors' State License Law
tloes not applV �o an uwner of a propeny wlw buil05 orimproves ihereon, anE who does sucn work himself/herself or ihrouBn
his Ot Aer own emDloyees, pwvitletl �hai SUC� imprOv¢menis are nof intenUed or oflere0 lof Sale. If, hOwever �he bUilAing or
imOwvement is so10 wi[hin one year of completion, �he owner wi0 have Ne hurAen o� Dmving he/she tliU no� UuilU or improve
�or Ihe purpose ol sale).
I.as ownerof��e D�opetly.am eeclusively contrac�inp wi�h Iicen5e0 conVaciorsto constmctihe pmlecl�5eciion 7044, Bu5ine55
❑ anU Prolessions CoOe: Th¢ Conirattors' S�ate License Law Does not apON �o an owner of pmcenY who bmlds or impmves t�ereon
anE who tonlratl5 �Or 5uth pml¢Cf5 wil� a tOnirattm�s) IitenSe Oursuan��0 �he Can(ratlOrs' Sia�e Litense Law),I am aware
t�al pmol o� their Worker'S Compensalion in5uran[¢ ShoWA be provide0 �o me.
.� � am exemp� un0er Secuon: A P 7 O 4 4 B. 6 P. C.
mrmisreason: NOT A CONSTRUCTIO M�I/T
Uate: � - e� �' �2 Own ' R ` ` _ _
.
I tlo nere0y cenily Inat I am aware af anJ untlerslanA Ihe reQuiRmenls of Califom'a,Hedit� an0 Salery COUe Section5 25W5, 25533, antl
2557a an�t�ai lor anyluture building occupanivnll/vnll nol (circle one�neeG 10 compty wiih saia Slate cotles andihe reQuiremeni5�ora
permit for constmc�ion or modiliw�ion �mm IAe Nir Oualily Managemenl Disirip. flesidentul con5iruclion aOD����bn5 are exempt irom
Ihese pmvisiuns. / 1
Date: � � aZ7 � �Z- Fpolicam:�� 4 � `, —
I �ereEy cer�ity�hat i�ave readihis applica�ion anG sla�e��atl�e a�ov¢ in�orma�ionis correcL IaA�ee to tomply wilh allciiy anG counry
ordinances and s�aie laws relating �o Duilaing wnsVuciion anU �ere0y autlwnze re0resematives ol this ciry to enter upon Ihe ahove-mentioneA
pmperry �or inspectian purpo5e5. r/� `
�ate: ��Z � - ` �-- Signalure� � `-'� `\ -
oriver's �icense or Socia� Seari�y x:
16<ba6 Wbite-Builtlinp; Green-Cotle EnlorcemenL Canary-Aoolicant: Pink-Pevenue: Goltlenrotl-qssnconr
CITY OF COSTA MESA — HUILDING PERMIT 1� U; 1 5 1'
PERMIT NO; IB 056015 PLAN CHECR NO: N 1; u.
CONSTRUCTION TYPE: 5—N PERMIT TYFE: OTH STR PURPOSE: OTH
JOB DESCRIPTIUN ;"COMPLIANCE INSPECTION PERMIT" S{� FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /M-1
COMMENTS: THSS PERMST IS NOT FOR CONSTRUCTION!
**x*��t**�t****�*****rx**x***��r�t**�r*��x�+�**�*�*�***x�***�*�***�**�*******�c*+�***��x�
Z O N I N G R E Q U I R E M E N T S
ssTBAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IiJ REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 92420114 ZNE; REF NO:
PLANNING NiSY'ES>
>
IE if M IE 3Fif iE iF IE if k�)f ih 1E ik k ik iE 1F if iE !E if * If iEiE if iE if iE iE IE 1E iE�lf !E 1k iE iF 3E if IE �)f it iF if iF k if if iE ie if iE iF iE iE iF if iE #!f !F iE jf i(� iE it �?f if if if� �t 1t� iE 3f� !e if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N'T S
ZONING APPROVED BY DATE; �%'
BUILDING APPROVED BY ; r� �,w. DATE: _____
APPLICATION ZSSUED BY;
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LEGALIZATION;N F E E S U
BLDG PMT PLUMBING ELECTRIC
PERMII' 30_00
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M A R Y STRUCTURAL SEGMENT;Y
MECHANIC FIRE Si✓IP/RES GRADING
SMIP/NON—RES
PLAN
TSSU6 FFE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTAL�S----> 30,00 0,00 0,00 30,00 30,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 30,00 OVER/SRORT; 00
HLDG PMT PLUMBING ELECTRIC MECHANIC fiZRE SMIP/TOT GRADING PLAN—CHECK
30.00
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I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UiVIT COST TOTAL COST
INS 1 BUILDING RE—INSPECTION FEE 30,U0 30,00
END OF FEES
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CONSTRUCTION AND PLANNIN L' & SPA .
APPROVA4S Permit # � Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service o� Pole ' � 52. �Pool & Equipment Location ,
i
2. Soil Pipe�Undrgrnd. 53. -Steel Reinforcement ^ �
3. Electrical Gonduit Utility-Undrgrnd. � 54. Forms ' �
4. Electrical Conduit•Undrgrnd. � 55. Electrical Bonding ,
5. Steel Reinforcement � 56. Rough Pfumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPflOVAL TO COVER•GUNITE
7. Footings 58. Electrical Co�duit�Undrgrnd.
8. Foundation ., � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgmd. i 60. Backwash Lines, P-Trap, O Undrgrnd. �, �'
10. Structural Floor System � 61. APPROVAL TD OECK , .. '
it. Property Sewer Line & House Co�neaion 62. 8ackwash & AeceptorFinal . � .
12. Sewer Cap 63. Heater & Vent-Final � � �
13. Roof Drains 64. Plumbing System � Fina� '
14. Rough Plumbin9 65. Etectricai-Final �
15. Rough Electriwl-Conduit 66. So�ar System-Final � �
76. 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 Heeting & Air Cond�tioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. DuMs, Ventilating 77. Product Piping OGas OOiI
23. Gas Pipe•Rough & Test �2. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing � 7A. Overhead Hydro
26. T�Bar Ceiling IStructurall & Monocoat 75. Dry Chemical
27. Frame and Fiashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Intulation 78. FIflE PREV. F�NAL
30. Drywall Nailin9 HEALTH DEPT. REQUIREMENT
31. Plaster BroWn Coat •. 79. FINAL INSPECTION
32. Electrical Power Meter�Final /��. - 80. FOOD CERTIFICATE ISSUED
33. Final Elect�ic Notes:
34. Final Heating & Air Conditioning
r
35. Final Gas Pipe-Test , .
36. Hood or Canopy _
37. Final FactorY Fireplace , �•
38. Final Plumbing '
39. Water Service-Final � �
40. Gas Service-Final '
41. $olar pomestic-Final � �
42. Backflow Preventer � •
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Pegulations '
47. FINAL STRUCTURE & BUILDING �
48. fINALPLANNING ,� '
49. Elearic Release to Edison 1�
50. Gas Release to Southem Califomia Gas Co � ;,�
51. CERTIFICATE OF OCCUPANCY
No. Date