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HomeMy WebLinkAbout1828 Bowsprite Ln - Building PermitsPROJECT ADDRESS: 1828 B OW S PR I T E LN UNIT: OWNER'S NAME: MR OPPEN ADDRESS: SAME t 642-8912 �'ARCNIENGINEER: REG.NO.: ADDRESS: UNIT: PERMJTTEE: JOHN DEXTER (714)974-7274 ADDRESS: 1973 N SACRAMENTO ORANGE CA 92667 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the _Business and Professions Code, and my license is in full force and e CITY LIC.: 017 srATE u: 3 3$ 4 3 2 SS: B Date: `7 �'� Signature: WORMERS' COMPENSATION DECLARATION: I hereby affr t I have a certificate of consent to self -insure or a cerfificate of Workers' Compensation Insurance, or a certified copy thereof (Se 3801), Lab. Q. POLICY NO.: EXP. DATE: _7MPANY: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Budding Division. Date: Applicant���' EXEMPTION FROM WORMERS' MMPENSATION QEMAFLATION:. (iivs section not be txKrupfetrd d the is to hundred {SifID} a less}. I certify that in the performance of the work for which this P' sir shag not employ=1ner so as to become subject to the orkers' Pompensalion La` at Califo ni Date: q� 5 ' Signature: NOTICE: ff, a e making this du daration; you shoal mm subject to the Workers' Compe provisions of the Labor Cade, you mast forthwith compty with such pr or this permit shag be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby atfi that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097'Civ. C). LENDER: ADDRESS: I OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construcl, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statemem that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 a civil penalty of not more than We hundred dollars (5500). 1, as owner of the property or my employees with wages as their sole compensation, v9l do the work, and the ❑ structure is not intended or offered for We (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an Owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of cemptetion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not appy to an owner of property who builds or improves thereon and who contracts for such projects cYth a contractors) license pursuant to the Contractors' Slate License Law). I am aware that proof of their Worker's Campens;:Wn insurance should be provided to me. ❑ I am exempt under Section: B. d P. C. fur this reason: Date: Owner: I do hereby cerlity that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533. and 25534 and that i or any future budding occupant willlwdl not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction apprrcahons are exempt from these Provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree mply with all city and county, ordinances and state laws relating to building construction and =,�, presentatives of this ' toe er menbone� property for iins ection urposes. Date: r I Drivels License or Social Security N: 164146 White—Buildings; Green—Code Enforcement; Canary—Applicant; Pink --Revenue; Goldenrod—Assessor I CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B) 048056 PERMIT NO: B 048056 PLAN CHECK NO: 04756-90 S GOVT: N'SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD JOB DESCRIPTION ; 210SF OPEN LATTICE PATIO COVER SQ FT: 210 CLAIM VALUE: 3,000.00 CALC-VALUE: 2,898.00 GROUP OCC: R--3 / COMMENTS: XON Z O N I N G R E Q U I R E M E N T S SETBACKS REQUIRED -- —-- — MAIN BUILDING ---------- —-------- ACCESSORY BUII�LIDIING-- — —— FRNT: FT IN REAR: 7 FT 6 IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REO• PROV: PARCEL: 00000000 ZNE: PDR— REF NO: PLANNING N TES> LATTICE PATIO COVER > 7 iEiE*###'1E##dE##�tiFdkil##iEiE##iEiE•###�Ei@3E?'E##�E�(•iE##♦F3F'iE'�#'}f-#*#iFii##iF#####iEiE#jEiF'Kr�E##iEikjF�FiFiEiE�EiEiEdEiF# 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 'S ZONING APPROVED BY DATE: r� BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY- DATE: 1I # iF # # 91" iE # #'E # ?'E dE dE iE # i!E I(- TE iE ili F # iE iE it• i4 -1t iE # �E iE it iE 3E ik it iE # iE'1E � # jt iE it # it• �E � jl• iF i4 TE iE TE;t it iF'1E 1E # iE iF'1F'1E'!E iE'uE.iEiF �E i4.1t- � � jt ib IM LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC ,MECHANIC FIRE SMTP/RES GRADING PERMIT 54.0050 SMIP/NON—RES PLAN 35.10 ISSUE FEE -' BUILDING -DIV-> PERMIT ISSUE PLAN,CH'ECK TOTAL PAID DUE TOTALS ---- > 54.50 0.00 .`;35.10 89.60 89.60 .00 REVENUE DIVISION TOTALS--> COLL`ECTtIt � 89,60 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 54.00 }• .50 35.10 I N D I V I -D U A L' .�F E E B R E A K D O W N, •r TYPE QTY D E S C R I P T I p'N,, UNIT COST TOTAL COST 5 SFR 210 RES -PATIO COVER -POST '&,,T',RELLIS 13.80 2,898,00 END OF FEES 01 00064767-00064769 T 0T 91.60 DATE: 07/09/90 TIME: 12:08 ACCOUNT a: 0130720005 01 0025 003 00064767.00064769 07/09/90 01 Cl( TEND °9.60 C_0NSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PO SPA APPROVALS Permit # Date Inspector i. -Temporary Electrical Service or -Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 54, Forms 55. Electrical Bonding 5. Steel Reinforcement 7-2,�- J,,, 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, © Undrgrnd. 10, Structural Floor System 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 Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T B2r Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough !-seating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling {Structural} & Monocoat 75, Dry Chemical 27, Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV, FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 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 w 38. Final Plumbing t 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation 46. Handicap Regulations FINAL STRUCTURIM & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date PROJECT ADDRESS: 18 BOWS P I UNIT: 61 Dw R's NAMg KAUFMANN & BROAD ADDREs 180 N. RI.VERVIEW DR . SUITE 300 ANAHEIM, CA 92808 ARCNIENGINEER: MIKE WOO DL E Y REG.NO.: C I �_7?D ADDRESS: 180 N. R I V E RV I E --.d DR IT 300 PERMrREE: ANAHEIM. CA 92608 KAUFMANN C- BROAD {714)921-0500 ADDRESS: 180 N. R I V E RV I EW DR ,300* ANAHEIM CA 92808 LICENSED CONT CTOR DECLARATION: I hereby' ensed under provisions of Chapter 9 {commencing with Section . 7000) of Division of the usiness and Professions ode, and my lic a is in full force and effect. , CITY LIC.: TATE UC.:3344 LASS: Data: Signature: WORKERS'OMPENS ION DECLARATION: I hereby affirm iha ve a certificate of consent to self -insure or a certificate of Workers' Compensat n Insurance, or a certilied copy thereof (Section 3 Lab. C). `OLICY NO.: 4189-1fl9D ' ; EXP. DATE: 03/07I90 COMPANY.IR R NS I N S C1Certified copy hereb lumished. R] Certified y is filed wit the city Building Division. Date: ' I - Applicant: r EXEMPTION FR M WORM S' COMPENSATION DECLARATION: {This 4on need not be completed if the permit is for one hundred (5100) or less). I certify that in the performance of the work for which this permit is ued, I shall not employ any person in any manner so as to became subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after,r ialdng this declaration, you should become subject to the Workers' Compensatiod.provisions obilie Labor Code, you must forthwith comply with such provisions or this permit shall he deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a,const_ructiod lending agency for the performance of{the work for which this permit is issued (Section 3097, Civ. C). a LENDER: 'ADDRESS: r OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city o1 county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7DDO) of Division 3 of the Business and Professlons'Code) or that he/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 a Civil penalty of not more than live hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property,who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year. of completion. the owner will have the burdemaf proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects wKh a contractors) license pursuant to the Contractors' State License Law)- f am aware that proof of their, Worker's Compensation'insurance should be provided to me. ; ❑ I am exempt under Section: r B.- & P. C. for this reason: Date: Owner: t I do hereby certify that I am aware at and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant willlwil1 not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and a information is correct. I agree to comply with all city and county ordinances and s[a laws rela ' to building consiru on and hereby auth representatives of -this city to enter u t hove -mentioned property for inns[ tion purp es. Date: + Signature: Driver's Licele or Sae' I Security N: 1641.46 White -Building; Green -Cade Enforcement; Canary=Applicant: Pink-Ravenua: Goldenrod -Assessor CITY ©F' t3STA MFSA = BUILDING' PERMIT PERMIT, NO:. G 044960 PLAN CHECK NO: , ` N• GOVT: 'N SUPP: N CONSTRUCTION TYPE: V -N' ' PERMIT TYPE: ELE MEC PLU STR PURPOSE: NES r JAB DESCRIPTION SFii _ S'Q FT: 2, 910 ; CLAIM VALUE: 1697417*00 . CALC-VALUE: 169,.416.74 GROUP 'OCC:, ,R-3+. IM -,1 - COMMENTS: PC1234-89A Pfl-$143.73 { Z O N I Al GS ER EBQAUCIKRSE M ,E N T S` ; ------------ MAIN BUILDING .ACICESSORY'BUILDING"-_---_ _ FRNT: 5 FT IN REAR: •15 FT 4 IN FRNT: FT, IN REAR: FT IN LEFT: 5 FT IN RGHT: 5 FT IN .LEFT: FT IN_RGHT:FT I,Nl PARKING (REQUIRED: 2 PARKING PROVIDED: 2 PARCEL: 004243M33 Z!DNE: PORMR 0 PLANNING,NQTES> SINGLE FAMILY RESIDENCE WITH AN ATTACHED TWO CAR GARAGE. > .HALF OPEN PARKING- -SPACE, PER UNIT GUEST PARKING PROVIDED".. � r D F V E -:L O : P M :IF+ .M T . � .S. `EL ;R''�V.' I= C E' S : 'E Q U I R Emi" . I�E 11REMENV Z©NI NG APPROVED BY ' �. J _ < RATE: _ mfrs_'., 4 ,BUILDING APPROVED FM :: ,` ` DATE; 'AAP�PyLyICATTIIOONN IISSSSUyEED..yByg':,= yy;yDAAyTyEy: YY �YTY #!•�`T Y#'ll'TYT T#�M T#•���- •, LEGALIZATION :N F .E .E S L M J4 A R Y. STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC` MECHANIC FIRE SHIP/RES GRADING PERMIT 884.59 41.50-- - 82.99 32.75 11.86 25% ;0 % 25% SHIP/NON-RES PLAN , 'ISSUE FEE 3.00 15.00 15.00 , ' BUILDING -=DIV->. PERMIT ISSUE 'PLAN -CHECK TOTAL � PAID pUE TOTALS --r-> 1053.60 33.00 00'00' 1086.60 1086.60 .00 ; .REVENUE'DIVISION TOTALS--> COLLECTED: 1086.60 OVER/SHORT:. ..Do BLDG PMT PLUMBING ELECTP-IC MECHANICFIRE 'SMIP/TOT GRADING PLAN -CHECK 684.50 44.•50 -97.99., 47,.75. ; . 11.86 I N D I V •I'• D U A L�F E .E' B R E A K 'D 0 W N TYPE QTY D E S C. R I'� P T 1'0 N UNIT; COST TOTAL COST SFR + 2371 DWF-TYPE V -WOOD FRAMV --GOOD 67.70 16n*516.70 SFR 76 RES -BALCONY, EXTERIOR STAIRWAY 13.54 1 1111029.04 SFR 46.3. RES=GARAGES TYPE- V 17.00 ' 7*871*00 ELE 2371 NEW RES BLDG FOR 1 OR 2 UNITS/ SO FT .03 .82.99 MEC I INSTALL. FORC/AIR FURN <= 100 K BTU/H 9. or) 9.00 MEC' I .REFI? IGERATION SYSTEM <=,100-K BTU/H 9. r)Q 9.00. ; MEC 5 GAS PIPING SYS 5+ OUTLETS PER OUTLET .75 3.75 MEC I. FACTORY FIREPLACE 6.55 6.50 MEC' 1 VENTILATION FAN CONN TO SINGLE DUCT- 4.50 �' 4.50 FLU 2 BATHTUB r 2.00 4.00 FLU ' I DISHWASHER 2 -OD 2.00 tit i t1f�I A' 1 s : 1 J CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Polei 52. Pool & Equipment Location . r �:.Soil.Pipe-Undrgrnd. 53. Steel Reinforcement ctrical`_ 54. Forms r3>:�Erle.CdU 4.`Etectricai Conduit-Undrgrnd. 55. Electrical Bonding 5.rSieel`Reinfdreemeht • 56. Rough Plumbing & Pressure'Test 4.'6:: Ebectrical UFEWGrnd. 57. APPROVAL TO COVER•GUNITE I '7._Footings E f r 58. Electrical Conduit-Undrgrnd. �t L r y.. - r t ♦r - 1 . 8.1.-Foundation• i 59. Gas Pipe, 0 Undrgrnd., Test 9.[Water Pipe-Undrgrnd. •, It ?Sol Ldp 60. Backwash Lines, P•Trap, ❑ Undrgrnd. 10. Structural iFloor System _ 61. APPROVAL TO DECK ; 11. Property Sevver Line, & Ho4se'Conriection fit• Backwash &Receptor-Final r 12. Sewer Cap 63. Heater & Vent-Final - 13. Roof Drains`=-'.-. 64•-Plumbing System • Final 14, Rough Plumbing (•X4> 65. Electrical-Final 15, Rough 816ctrid1-Conduit Solar System-Final 16. Rough EtectriaWiring f d Fencing & Access Approval `17. Rough Wiring Sign 68.- APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &,Air Conbitionjag FIRDEPT. REQUIREMENT E•'-.� ... Y' rr • �Y I• [- APPROVALS ,. Permit # 1 r r •r r ._ "I 11 � r 1 I � 20.; Rough Factory Fireplace t i r -_ � l�.� ✓ r s. w: ,} r 21.E Ducts, i�" Structu're�, ; " " ti ;� x 4' r y # 0. Under gr d Hydro 1: 9 uL�, __7 /''� �.y 22.-DUcts, lientilatinr 9 t_ s • F- f �, { . c 71 , Prod uct•P.iping ❑ Gas 0:Oil 23.'Gas'Pipe=Rough & Test i r t t .72. Under round Flush *' g t_- r r 24: 'Roof Framin •.• r r- •-r- 9 � I. t::: _ �. :-� Storage Tank Gas ❑ Oil ,• •..,_.Ill t. .� > :.. ;; -,. ,73.--Undergrnd. ;d 25. -Roof Sheathing �i ti. i. t ?,�(� � i *' 74, Overhead Hydro, # 26 .'T-Bar Ceiling-(Sir�tctural) &'Moriocoat rx s r r , je Chemical 75.>DryC _-- •-. ,tir n �. r. -s K. 27.�Fraine and Flashing: = r ' t r �p e�- 76. Dry Standpi'p'04 '.._ 28. Lathing`& Siding,�.; r• � 1, 77:-.FIXED SYSTEM FI�NAU' e, - r t. �, r• :29. Insulation 78:FIRE PREV. FI� l_ -r �"ll -■ i. � r •+s r. 30. Drywall Nai{ing t T-IM •."-i,. t+ HEALTH DEPT;; �1EQUIR9M�NT r t`31 • Plaster Brown Coater " r FINAL I NSPECTION-- Power Meter=Final{ `-moi 1 1s` FOOD CERTIFICATE -r-rr ,_32.`_Electrical � ISSUED, r 33�Final Electric, ft i i r• t ' r , es: - • r, ; _ - .-r r r`34 _Final Heating & AirrL:Co6ditioning �'r' ' 6 (� 1 •r� `'' r 'n �t r~ r t 1.(�r13 r:, ...nc; V�� t ,�dig �- .1' -�35,FinaI Gas Pipe-Tests, �: r . 1 1 IS' (, /> h• s •- I 1 1 J � • Hood or Canopy ► -' 1.�_r 1-E s . I ; l:r • , ^ J M37,-Final Factory Fireplace:.,; I r �,� �,RiQ'ir s --4, -• �a r J= r f •. J. /. c, K f t r" 1138. Final Plumbing '' r-/� •� - ' 1 # r- 1 h yu, l ,. i t 4: 1--1 <rd.' ;,39. Water Service#Finals: i + 1 I.t x. .r. ►, i it L X40. Gas Service Final rr a �rlh-' tt I I ii- t F- r C • t: r, i- r t t1t ale E I 1i r r • IL [: -41. SolarDomeiic-Final _ s! t l n ` tr 1 I jir r '-- a i -••. �.` 7C _ r 42.* Backflow Preventers •• ti - I t �< �. 1 t r 1 l r 'L • •. 43. Backflow Irrtigationp. ;- "'s, ,.,t * s;-,. .. �� �r r, • .. • . 44. Landscape irrigation System '° '- `-~ r'' `i �- # s r`j ` `' ?. `'' c ' K. ..' .rJ u.iu�l 45 ,Sound AttenuatioCn -+,. „';,_ , xr� r r r r•r r , -, .,•* ... t :� . - ,. ._ ;,• «•- 46.4 Handicap Regulations '- - s{ w"r c' =�� = r vc• 1 r=ye l ^l i* tir tt - 47 rFIN'AL STRUCTURE & BUILDING-r .� 48. FINAL PLANNING r �_r_ ..�.. t �- 5• I rr• - y t'- er s y -- E 49., Ele'ctric:Release to Edison E / I t'' f1 - .I 50 Southern Gas:Release to SthCalifornia Gas Co ' '- '"I `=r ` 1i. { • ` ' • ' • I is e' ib •• I 't C RI -C-:: t'1 e C L R s, t 51. CERTIFICATE OF-OCCUPANCY 1 Irr_i i` % >- :� r c -+t 4 "• . 4 _ No. Date t-; e-= PROJECT ADDRESS: UNIT: OWNER'S NAMII;,., 'ADDRESS:4 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000► of Division 3 of the Business and Professions Code, and my license is in full force and effect. C& LIC.: STATE LIC.: CLASS: Date: r Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to selWnsure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 38DO, Lab. C). =, LICY NO.: EXP. DATE: "COMPANY: "❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Bulldiog Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed i1 the permit is for one hundred ($100) or less), I certify that in the performance of the work for whith this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Sigrrature: NOTICE: It, after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: i hereby affirm that there is a construction lending agency for the performance of the work tot which this permit Is issued (Section 3097, Civ, Q. LENDER: ADDRESS: r . OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair arty structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that hat i is licensed pursuant to the provisions of the Contractors' State License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any apptiaaat for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55110): I, as owner o1 the property or my erpplayees with wages as their sole compensation, -will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who toes such work himsetf/herself or through his or her own employees, provided that Such improvements are not intended or offered for'sale. It, however the building or Improvement is sold vntlun one year of completion, the owner will have the burden of proving h6she did not build or improve for the purpose of sale). 4, as owner of the property am exclusively contracting with licensed contractors to construct the project (Section 7044, Business -❑ and Professions Code: The Contractors' Slate License Law does not appy to an owner of props who builds or improves thereon and who contracts for such projects with a contractions) license pursuant to the Contractors' License Law), I am aware that proof of their Worker's Compensation insurance should be provided -to me. ❑ I am exempt under Section: B. & P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant Will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Atr Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby Certify that I have read this application anq state that the above information is correct. I agree to Comply with all city and county ordinances and state laws relating to building construction and Hereby authorize representatives of this city to enter upon Uri above-mentioned property for inspection purposes. Data: Signature: Drivers License or Social Security K: 141-48 White—Bulldino: Green—Code Entortemeni: Canary—Applicant; Pink—Revenue: Goldenrod—Assessor PERMIT 'N©. G -044960 PLAN , CHECK NO: N PAGE-. 2, TYPE QTY D E S C R I- P T I O N UNIT COST 'TOTAL COST PLU 1 LAUNDRY TUB OR HASHER 2.00 i. 2.00 PLU 2 SH0WER 2000 4.0D PLU 1 SINK„ KITCHEN 2.00' 2.00 PLU 4 WASH BASIN 2.00* PLU 3 WATER CLOSET [TOILET1, 2.00 6.00 PLU 1 'WATER HEATER AND/OR VENT 2.00 2.00 PLU 1 (MATER SERVICE 2.00 2.00 PLU 5 GAS PIPING SYS 5+ OUTL-PER OUTLET.50 2.50 PLU 1 GAS SERVICE 2.00 2.00 PLU 1 CONNECTION TO BUILDING SEWER EA 5.00 5.00 END OF FEET t t . � f CONSTRUCTION AND PLANNING AA?P'ROVALS . Permit # Date Inspector PAUL &SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location Soil Pipe-Undrgrnd. -_ 53. Steel 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59, Gas Pipe, Cl Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P•Trap, ❑ Undrgrnd. 10. Structural Floor System 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 Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Electrical -T Ber Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Cond'tinning u J s..:t.LL FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory -Fir p'laca'_,_'- `�_' 21. Ducts; in Structure 70. Underground Hydro 22. Ducts .Ventilating 71. Product Piping O Gas D Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof'Framing ` ' '"4 µ'ms` 73. Undergrnd. Storage Tank D Gas D Oil 25. Roof -Sheathing 74. Overhead Hydro 26. TBar Ceiling (StfL�trali:&,Monocoat �, .t[6 - - 75. Dry Chemical 27. Frame -and Flashing= i 76. Dry Standpipe 28. Lathing & Siding h ;, • .h.L'` s ' 77. FIXED SYSTEM FINAL 29. Insulation, : r- - M r `- ^t• 78. FIRE PREV. FINAL 30. Drywall Failing' i" F'�;. r HEALTH DEPT, REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power. Meter-Firl .� 80. FOOD CERTIFICATE ISSUED {� T 33. FinaljElectric < <: r. Notes: 34. Final Heaiing & Air Cotrdiiioning �. 35. Final;Gas Pipe -Test r- 's r� �. 36. Hood;or Canopy 37. Final.Factory Fireplace 6'r, 38. Final�Plumbing 39. Water.Service-Final 40. Gas Service -Final 41. Solar.Domestic-Final 42. Backflow Preventer •,a � 43. Back t,ow,lgrigatran.. .. • 44. Landscape-lrrigation-System ' r 45. Sound' Attenuation 46. Handicap Regulations :L 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Sotithern..Llifornia Gas Co e' r & r4 r e 51. CERTIFICATE OF-'OCCUPANCYL No. ' Date