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HomeMy WebLinkAbout2984 REDWOOD AVE - Building Permits • CITY OF COSTA MESA lie (.aria Rite, BUILDING DIVISION F4 A�"a 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov � Veil 1 FOR INSPECTIONS CALL:(714)754-5626 %b..o ,_# PERMIT NUMBER: BC12-00002 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 01/04/2012 ISSUED BY: KJB JOB ADDRESS: 2984 REDWOOD AV CM Suite/Unit: APN: 13921501 . Zoning:R1, , . Vicinity: . - • Primary.Occ: • Const Type: V-B SQ. FT: 0 Valuation: $9,900.00 SCOPE OF WORK: KITCHEN.REMODEL. NO STRUCTURAL WORK INCLUDED. ELECTRICAL TO INCLUDE: 6 LIGHTS, 7 OUTLETS, 1 SWITCH. RELOCATE KITCHEN SINK, GAS REPIPE, 1 GAS OUTLET. WATER RE-PIPE./CHANGE OUT FAU AND RELOCATE TO THE ATTIC- 70K BTU ALL LIGHTING SHALL COMPLY WITH TITLE 24. : OWNER: MCNAUGHTON, ROBERT AND TRACEY Address: 2984 REDWOOD AVE - Unit: Phone: , City/State/Zip: COSTA MESA;CA APPLICANT: FARTHING,SCOTT Address: 904 DOGWOOD - Unit: : Phone: 949-500.2870 City/State/zZip: COSTA MESA, CA CONTRACTOR: FARTHING DEVELOPMENT INC • License No. 560875 Rhone: 949-500-2870 Address: 904 DOGWOODUnit: - Cell: City/State: COSTA MESA,CA • .ZipCode 92627 ARCHITECT: - License No. , PHONE:± ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY • . • • Building Plan Check: $0.00 Building Fees: $181.25 ' Electrical Fees: $38.90 • Mechanical Fees: $44.65 Plumbing Fees: $59.05 SMIP Residential: $0.00 SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: • $324.85 **Refer to fee receipts for all fees paid for project kr HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 'Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day,Memorial Day,Independence Day, Labor Day,Thanksgiving Day and Christmas Day :L. 3. `NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related 'regulations.(Ord. No.92-28,§ 1, 12-21-92) 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 final approval will result in the expiration of this permit. edor P, INSPEC11ON TYPE DAT INTDIALS CODE ii INSPECTION TYPE DATE INTInAI.s .1616 Fixed System Final Fire Prevention 206 Final Mechanical :1266 Pool Spa Final 208 Final Plumbing • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention TO 29,2 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy '11— . a • WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance.as required by section 3700 of the Labor Code, for the performanc= of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation once carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: '41\C O p / 1 / person is required to descend,will be made in connection with work authorized —1/ � by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not be completed tf the permit is vat -d al one hundred dollars(5100)or less.) 2 Art 2Sec.341,Title 8,Califomia Administrative Code). P cy Number: 0 As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless i ued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Coall forth th comply with these provisions. C / –�/ T/ / O Division of Industrial Safety Permit Number: Applicant's Si a re Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires, with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full fort/: .nd effect. C7 �i i a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# r Class# 5-Co O 7 S . (Section 25533 of the Califomia Health and Safety Code, with some s/ j i t P((/ / � exceptions, requires registration with the Costa Mesa Fire Department by / e each business which at any one time has on hand a quantity of acutely c.reel.f �a ur./ Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031 5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested 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 information be famished on applications for non-residential building permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the Califomia Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 8. (If'yes", attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.).' information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signator r ) /�// Signature Date t 3057-46(]/OT) Antllor Authorized Appli W nt Dale . S Simplified Prescriptive Cser Linen Pi of Compliance. 2111161te,cirlen tial HI IIVAC ilfteratiuus' CF-:L.k-A1,'1-IT\'AC annuli..'bones 1 awl;i -7 • She Address: linlorcenmrn Agency.' I brier[1�/{�Z I )'ermil IL l- C:undnimred •Duct insulatiu>(< ( _ . • • EgUinnrenl•I.voe_r List (viburnumEfficienc+r' . l Floor Ares renuirenrcn, I�(; Titernwstal - ❑ Packaged Unit - 1 Over IP f�,of due ti B'furnace 8-APUE- O COl' Served by system addntl tie las iu D Setback Cl Ltdonr Coil OSEER ❑f95PF • /•' (/lam nbenrhpreseru.time/Lr• • of arc uchtin to(Space ❑Condensing Unit • . ❑EER_' I❑Resistance• instilled) _ .. D011ier }.'1 G (CL 1,.1-SJ . J.Equipment Type: Choose the epmpment being metalled;if more.Ilium 01.‘,.:-Sy stem,use smother CR,I It-fil.'l-F)V AC for eaoh.system. • 2. Minimum Equipment EciisivaitieJ3 SEER, 7E%AWE,7.71iSPF for typical residential systema. . _ _ • . . • •Contractor(DobtimbntiitioiiiAntlwrix)ltespunsibie'Designer`s-llecbnrntiiinStinernent) _ .. .. _ _ I certify that this Certifmatp of Compliance documentation-is accurate and complete. ' • . . . • I am eligible under Division 3-of the Calibous business and Professions Code to accept responsibility for the design identified-on this Ceniftcate of Compliance. . . . • • .. , . ,. .. • I certify that the ener6�'.features and pertprmance specifications.for the design identilued ort this'Certifrcaie of Compliance contonn Mille - • • requirements of Tills 2A,]'and 1 and 6 of the California Code of Itcgulatinnc. . . . - ._ . . . ' • _ The design fentures identified on this Certificate of Compliance are consistent with the information documented on other.ppplicable. ..- r•-- : -• -- compliance forms,worlsYieets,.caleulations,.ylans and spectfieations submitted Iii the enforcement agency for approval with llte,petmit. , . . ._ . ... . . . aoulication: / /1 .. -. Name: . er;ar . - ;Sigmmur_:. 411.7.-...H.:: .. . _ ... ... .. nCompanp:' ._'r.. -: Deice/y/l�.. .. . .. .Address..' : .11)(71 �!/ythca / , . _.... .;.,. j.License:q(1> 64,„.. .7.5.--7 • .City/StatelZip: • l©GJ tilt_ Li � ( e/ i 7 I Pitons: ( ���!!�7 S-.93�Jam'• • . • • • • • 2 vu:;/(esidenlial Conspl iancr Torn;; March 2010 V/^vei.L,nn1!WIVU 2?Qx.L bVeI;! G'd:Ar,CuTT6f TZL frit.722.1.L':T.TazwEfDA7Etr1L) 2(1(18 Budding Energy Efficiency Standards Re,gidential EfV'AC AIi:er-afioru --Clirriate Zones Ti and 3 titr-oitgil 7 Gz-t — C.asril: ,lis-9 BUSINESS AND PROFESSIONS CODE,SECTION 7110 Willful or deliberate disregard and violation of the building laws, including the California Building Code,and' local permit requirements constitutes a cause for disciplinary action horn the Contractors State License Board working in conjunction with the local building department. This action may consist of fines up to 25:(1(10 per violation or suspension/revocation Of a contractor's license. WHEN IS A PERMIT RECIUIRED? A written construction pencil shall he obtained from the enforcement agency prior to the erection,construction, reconstruction, installation,relocation, or alteration of any mechanical system,except as permitted in'Appendix . Chapter I., Section 11.2.2 of the 2007 California Mechanical Code. Projects requiring permits include,but arr.not limited to: • New ETV AC installation • HVAC Changeoul • Replacement of furnace,coil, FAU, or condenser •• Relocation of an existing FIV AC unit Adding-or replacing more thanv40fi ducting.in unconditioned space .. ' 20118 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24;Parr 61 REOUIRE1t NTS INCLtTDE: - • ... _ I. FIeating.equipment must have a minimum 78%AFUE(Exception: Wall &floor furnaces;-room heaters): • ' . 2. Central air.conditioners S•.heat pumps.less than 65,000 Fitu/hr must have a minimufn l3'SEER. 3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2: 4. A setback type thermostat.(24 hr clock with four set points) is required for all alterations. • .5. New or replacement ducts must meet the mandatory requirements of Section 1.50(ml:• ' _ •• All joints and openings in the in the I-NAC system must be sealed. . . . - • • Only UL 181,UL 181Af,-or UL 1 81B approved tapes.or mastic shall be used to seal ,duct openings. •• Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. Flex ducts must he connected using a metal sleeve/coupling. - Flex ducts that arc suspended must be supported every 4ft. max for horizontal none with no more than 2" of sag between supports and 6 ft. max for vertical runs. 6. The CF-672-IV1ICB-04 must be completed and signed by the installing contractor. The inspector will collect this forrn and verify that the model numbers are the same as the installed equipment. • I (TIE RECEIVED .% 9 2' � JUL 131959 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA i - CITY OF COSTA MES :_ FOR APPL/CANT TO F/LL /N COMPLETELY APPLICATION •FOR PERMIT TYPE OR PRINT BUILDING BUILDING 2984 Redwood Avenue ADDRESS COSTA MESA, CALIFORNIA FOR OFF/CE USE ONLY • ��uy OWNER Homes Valley Inc.- RECEIPT NO. 1�C>2OQa MAIL 1 'I RECEIVED BT DATE LREECCEEIVED _T�E��/slSbU�E.DL� ADDRESS aµ9 E. 17th. St. >S ( / �/ 7I 7 / n5 ii BUILDING CITY Costa Mesa TNO.LI81159 ADDRESS ARCHITECT Carlson & LIC.OR ENGINEER NO. COSTA MESA, CALIFORNIA _ Garden Grove FIRE I -' W ti ADDRESS ZONE /1 , i i J Dike CONTRACTOR Sf. Colegrove, Inc. LIC.NO. 167293 BYPROVE. `/ . ham re- DATE —7r0 o/ ADDRESS. 419 E. 17th St., Costa Mesa ZONING / q//q-�--Q–�������// 2 ZONE o NO.OF USE OF NEW DESCRIPTION I NO.. 251, I BLOCK I TRAG12 f\ t I PLANS 2 BUILDING /Vets ------ TT ii4 ,(`t. r' A.P.NO. BYPROVED \ V�Li DATE 1, '0151 „. SIZE /� NO.OF BLOCS. YARDS ` 4�'�^EVES OF LOT 74 X 105 INOW ON LOT none REQUIRED ALLOWED . USE OF (CENTER LINE STSO e�� EXISTING BLDG. FRONT �/" FT. IN. SETBACK LINE FRETM 5'T.' REAR YARD 301 R.SIDE y FT. IN. CENTER OF STREET J ff • SIDE YARD I LEFT 1W 1RIGHT SI L.SIDE 3 0FT. IN. DESCRIPTION OF WORK 1 2. REAR `J FT. - IN. NEW %I ALTERATION I II ADDITION • REPAIR I II MOVING I II DEMOLISH I SIZEIDING16O1 ROOMS 6 STORIES 1 . EXTERIOR WALL, ROOF COVERING ' staucco COVERING rock USE OF BUILDING AND WORK TO BE PERFORMED Single family residence with attached garage. , • Plan . I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION. VALUATION �p[[ ��������(( > SIGNATURE OF "a„,/, _ - PERMIT FEE $.ybw�✓– ' PERMITTEE F � /�S s 15,928 PLAN CHECK s__1.8 00 ' AUTHORIZED AGENT Dike Colegrove, Inc I TOTAL FEE $' �*' s� . i 2&"-1 i, OWNER HOMES VALLEY, INC. DATE 7-9-59 JOB ADDRESS 2984 Redwood Ave. BUILDING PERMIT NO. 9827 GENERAL CONTRACTOR Dike & Co1�ProYe Inc.. VALUE $ 15,928.00 AP. No. LOT 251 TRACT G 822 FIRE ZONE DESCRIPTION OF WORK S/res.w/8'tt.gar INSPECTIONS Soil DATE GROUP I & J TYPE V ZONE R1 _ Underground So U.G. Water- 7.--vc .- 9 PERMITS ISSUED _ Underground Gas' SUBCONTRACTOR DATE NUMBER Overhead Water and Gas _ Rough Heating 4-/S-5Q lellnw , b ;2_ -70 7/ k _ Rough Plumbing • /1'r S 7-//--699 i/i/. , Q ' - - . -z ' -/-L` % ,3._" Miscellaneous � _ j Prop. Swr. dine.- House$on. St. Swr. )'q - pie.,:..-4 Ie,.,A- qj Ti'k i is- & co'n/ _�dliso i Heating, naltem !I VS(Y4^ Heating, Final LR�/�Q 4Q' t-N'" Plumbing Fixtures df/ 5 Final Gas Test /¢-(t '� Construction Pole _ _ Ir ' Underground Power Rough Wiring —lam 7:w n, nig��'J.uio o.rr 9-/4<s-y /,/9 5'✓ Trenches,4-..{ ff. Forms 6//i-Steel f014/� 7-r1 _ Floor System Steel Reinforce Chimney Re-Rod Bond Beam Sheathing /&4- A-IG--i9 - - Frame and Flashing ' it 4'46 -5-y Lathing, In(., Out I ' d- Q. j 0-h"7 Plaster, brown coat 1 .4i V. to-jt-''f Plumbing Fixtures, Final /S-; f Electric Fixtures, Final AAAA Building, Final m.../.9 .14.6 .0 OCCUPANCY (- Form 210-3M-4-59 . 9827 ADDRESS OFBIJPas: 2984 REDWOOD AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT OWNERS NAME IFIL TN:POWELL, NORMAN R �F"RRM NO: B 077322 ADDREStPOWELL, MARY J _ 2984 REDWOOD AVE PERMIT NO: B 077322 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA,CA 92626549-1974 pPL.AIMING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: 0TH ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF REROOF W/COMP . SHINGLES SQ FT: 4 , 400 ARCH,OR ENG.'S ADDRESS: wit: CLAIM VALUE: 4 , 400 . 00 CALC-VALUE: 4, 400 . 00 GROUP OCC: R-3 / CONITRACTORSNAMBLINNERT ROOFING, INC. ( 714 ) 632-1900 , CONTRACTORSMMUNG 2851 LA CRESTA COMMENTS : REROOF 2400SF RESIDENCE W/COMP SHINGLES ADDRESS:ANAHEIM CA uc.NO.: 664319 **SE******SEiFK-***xN****K-**irit**Rt*Rt**SE****iERf-af-***K-** eEREif-***Rt*SEK-**af-*SE*x-*ie******St*** '* 92806-9920 WIT: Z 0 N I N G REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaky of perjury that I em licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code.and my license is in full force end effect. CITY LIC.NO.062160 uc.cuss:C39 uc.Ng1664319 EXP: 05/96 MAIN BUILDING ----- ACCESSORY BUILDING - !� ZS-C1.6 �v1�`/y_ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Data 2 Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby afE •--^ -. .,.m• from the Contractors license Law for the ' following reason(Section 7031.5!Harshen and Professions Code:Any city a coumy whith req nmconewa,alter,improve, PARKING REQ: PROV: PARCEL: 13921501 ZNE: REF NO: demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)d Div'ion 3 of the PLANNING NOTES>>. r..? Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section > . 7031.5 by any applicant for a permit subjects the applicant to advil penalty of nal more than five hundred dollars l550011. **********************************************************************.*****{(*** ❑ I.as owner of the properly or my employees with wages as their sole compensation,will do the work.and the structure is not intended D EVEL OP MENT SERVICES R E Q U I R E M E N "T,-S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply loan owner of property who builds or improves thereon,and who does such work himself or herself or through he or her own employees,provided that such improvements are not intended or offered for sale.I,hw oever,the building or iptovament is sold within one year of completion,the ZONING APPROVED BY DATE: ' owner-builder wilt have the burden of proving he or she did not build or improve for the purpose of kale). ❑ Las owner of the property.am exclusively contrading with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED B Y : DATE: Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who , contracts f«such projects with a coMrarmr(s)licensed pursuant to the Contractors License Law), I ❑ I am exemprunder Section: B.aPc..forthereason: APPLICATION ISSUED BY: Yl DATE: Dd°. Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAI71SEGMENT:Y I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and 2ess34.and thald«any future building pent olid/wtl n�e(drola one)need waompy wish said date codes and me requirements f« BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/REST GRADING permit for construction or modificationh the Air Giy1r gement Dislria.Residential construction applications are exempt from these 1 provisions. PERMIT 99 . 75 . 50 Date: Applicant: SMIP/NON-RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the fdlwing declarations: ISSUE FEE o Ihave end wit maintain acertificate ofconsent toself-insure for workers'compensation,asprovidedfor bySedion3700oftheLabor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Cade,for the performance o new«kf«w:nmapemneiesued. TOTALS----> 100 . 25 0 . 00 0 . 00 100 . 25 100 . 25 . 00 _O I have and wit maintain workers'compensation insurance,es required by Section 3700 of the Labor Code,for the performance of the ]S" work for which this pens)is issued.My workers'coon s tion insurance carver and policy number are: Carrier: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 100. 25 OVER/SHORT: . 00 Potty Number: 285-96U0001026 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed lithe permit is for one hundred dollars(StOJ)or less) 99 . 75 . 50 ❑ d codify that in the performance of the work for which this pens)is issued,I shall not employ any person in any manner so as to became subject to the workers'compensation laws of California, agree that i d should become subject to the workers' ******************************************************************************* compensation provisions of Section 3700 of the Labor Code,I a I dhwih comply with those provisions. IND I VIDUAL F E E BREAKDOWN J Dale: y-23-9( APPI lid ^A1r / Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal penalties and TYPE QTY D E S C R I • P T I O N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(3106000),In addition to the cost of compensat/ond damages as provided for In Seddon M gon37ofinwInterest, attorney's SFR 4400 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 400 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there d a construction lending agency for the END OF FEES performance of the work for which the permit is issued(Section 3097.CN.C). - LENDER'S NAME: • LENDER'S ADDRESS: I certify that l have read this application end mate that the above information is correct.d agree to campy with all ply and county ordinances - LI- -'G=r- "r" • -i2ti'•Y7; --1 .' - d„ w and stale las relating to building conatrudon and hereby authorize representatives of this ply to enter upon the atom-mentioned properlyLTA Tc, 1-2 ;.'9 T:rC for inspection purposes. ORGE CAUCAS Pdnt Name / ` _ Date: 4FZ3—`4i Sgnatnre MAene1 VA pplicanvContraaor (5151-46 W P) White-Building&Safety;Green-File:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . - ti 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement -3.. Electrical Conduit.Utility-Undrgrnd. .. 54. Forms Z. - 1 4-Electrical Conduit-Undrgrnd. 55. Electrical Bonding` 1. 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test }tl 6.' Electrical UFER Grnd. 1 _ _ 57. APPROVAL TO COVER-GUNITE 7. Fbotings • 58. Electrical Conduit-Undrgrnd. • 8. Foundation I159. Gas Pipe, 0 Undrgrnd.,Test 1 9. Water Pipe-Undrgrnd. - ._t ' i 60. Backwash Lines, P-Trap, O"Undrgrnd. • 10. Structural Floor System Vs-2 1 61.• APPROVAL TO DECK .' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 'i a . 1 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains , • 64. Plumbing System - Final 14. Rough Plumbings 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 'CI 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. Duces, in Structure . _ - - • 70. Underground Hydro 22. Ducts, Ventilating ' - i - ' 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test - , - 72. Underground Flush - 24. Roof Framing _ 73. Undergrnd.StorageTank OGas OOil 25. Roof Sheathing _ y/, / , 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 - l , ' 78. FIRE PREY. FINAL - 30. Drywall Nailing • . - 'HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80: FOOD CERTIFICATE ISSUED ' 33. Final'Electric- Notes: 34. Final Heating & Air Conditioning . . ,-, 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. FinaiPlumbing - - 39. Water Service-Final . 40. Gas Service-Final - - . - 41. Solar Domestic-Final '. 42. Backflow Preventer _ 43. Backflow Irrigation • 44. Landscape Irrigation System - - 45. Sound Attenuation• 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING S !�"�-r 48. FINAL PLANNING -- - f - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co1 51. CERTIFICATE OF OCCUPANCY No. Date