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Home My WebLink About2441 RUE DE CANNES - Building Permits `��.` MFS►. CITY OF COSTA MESA BUILDING DIVISION PE IT NUMBER ' DEVELOPMENT SERVICES DEPARTMENT 4• • PERMIT r B99-01735 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2441 RUE DE CANNES Status: ISSUED Suite: Applied: 10/27/1999 Vicinity: UNITS 2441 THRU 2449 Issued: 10/27/1999 Parcel Number: 43913225 Zoning: Applicant: COOTER, LYLE ISSUED BY: Address: 23015 DEL LAGO Phone: (714)583-1858 LAGUNA HILLS CA Zip: 92653 Owner: BRITTANYWOODS HOA Address 2440 BRITTANY Phone: COSTA MESA,CA Zip: 92626 Contractor: PRO-TECH WEATHERPROOFING Address: 23015 DEL LAGO Phone: (714)583-1858 LAGUNA HILLS CA Zip: 92653 License: 620476 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING 5-UNIT CONDOMINIUM BUILDING(68 SQ). REROOF OVER EXISTING LAYER OF SHAKES WITH "STONE-COATED STEEL METRO SHAKE'(ICBG#ER5218)-1.4 LBS.SUBJECT TO PRE-ROOF INSPECTION. *5-UNIT CONDOMINIUM BUILDING: INCLUDES UNITS 2441, 2443,2445,2447,&2449 RUE DE CANNES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $21,000.00 Permit: • $335.25 Claim Valuation: $21,000.00 SMIP Res: $2.10 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $337.35 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. 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. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ftrork for which this permit is issued. Ivhave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' pensation Insuriapnce carrier and policy number are: Carrier: C-1..-4-N MAI Policy Number: 517,10t O'Z'" >0 (This section need not be completed it he permit is valued at one hundred dollars($100)or less.) ❑ 1 certify that In the performance of the work for which 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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: �/ K¢p 'Co Date: !I7) 2 f WARNING:FAILURE TO SECURE WOR S MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5700.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS 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.Lic.# h to "7 Class# C--1 Contractors Signature: Y Date: /O T -i ff CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,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)of Division 3 of the 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 a civil penalty of not more than five 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(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves 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 sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:'The contractors License Law does not apply to en owner of property who builds or improves thereon, end who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title B,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions, that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). -_...._.__ _..._..._a...._,- occupant to file a,.regstrat_n form 2 Does or will the applicant or present or future building occupant need to file a registration fofor acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the 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. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? in Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? LJ Yes L-I No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE 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. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of 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. Signature Of Legal ner(s) Date And/Or Aut dzed Applicant /0 Date 11 ;ODE r INSPECTION TYPE RASE INRRALS CODE r INSPECTION TYPg DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final . 208 Final Plumbing 200 Final Re-Roof iii/Q/7 5AIL 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention _ 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 t4,0 q CITY OF COSTA MESA u � .4 BUILDING DIVISION PER IT NUMBER F I ""T`' ' DEVELOPMENT SERVICES DEPARTMENT °• "1�1 PERMIT ' a..a�„w d E99-01003 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT • Job Address: 1914 KAUAI DR Status: ISSUED Suite No Applied: 10/26/1999 Vicinity: Issued: 10/26/1999 Parcel Nunmber: 13951103 ISSUED BY: Applicant: GLENN MARTIN Address: 130 N. GILBERT Phone: (714)578-0090 FULLERTON. CA Zip: 92633 Owner: STEWART, CARA NECESSARY Address 1914 KAUAI PL . Phone: COSTA MESA,CA Zip: 92626 Contractor: RENAISSANCE DOORS AND WIN Address: 130 N.GILBERT Phone: (714)578-0090 FULLERTON,CA Zip: 92633 License: 490375 SCOPE OF PERMIT REPLACE 2 WINDOWS IN THE GUEST BEDROOM AND OFFICE AREA WITH TWO NEW BAY WINDOWS AND RELOCATE ELECTRICAL LINE. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa 50.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a 50.00 0 Misc.Conduit $18.20 1 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp 50.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops S0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 • Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $41.70 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS 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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. 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. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'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 performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number are: Carrier: • Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which 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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: f v - WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS 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.Lic.# kms\O 31 S Class# Contractor's Signature: Date: \O - .b -q0 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,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)of Division 3 of the 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 a civil penalty of not more than five 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(Sec. 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves 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 sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present 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 end Safety Code requires,with some exceptions, that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ _..-_ 2 Does w or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the 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. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application aaEermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? IJ Yes L I No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). . - 7....a a permit from the South Coast Air DManagement is at or other air pollution controln 0bt agency is Yes for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Ves ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE 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. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of 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. Signature Of Legal Owner(s) e \b - Db -'-N And/Or Authorized Applicant Date CODE 1 INSPECTION TYPE RAE INTRIAL$ CODEC INSPECTION TYPE DATE, INTRIALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 1,�JQ 200 Final Re-Roof _ 210 Final Electrical It- "1-!7 eil 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 r401 CITY OF COSTA MESA REQUEST FOR OC U I LOVE ® c.1Y OF COSTA MLS. r ANTI DEPT. TRACT NO. 10148 DATE Fe�ruary 22, 1979 LOT NO. 25 PM ADDRESS12 11213t415I6 2441 Rue de C�RDTPS The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. / BY �• -? c- --id •urcha -r BY ,si. Developer and/: authorized representative BY Lender Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONST fR�UCTI N PERMIT ,r P MIT NO. TRACT NO. LOT NO. UNIT NO. h 7319 10/13/87 5.00 TL Project Address .9N4 t I [v1...' .TT,. (ft n n ea l 3 06 97 Applicant's Mailing Address Y F /6Aro'�'k Ce��/ �` TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION LJ REPAIR Owner's Name Cj��W1 Phone:94%pxl[v 7 CI CONVERSION ❑ DEMOLISH ❑ OTHER A,p # Zone Sit __ L _ / DESCRIPTION OF WORK/USE OF BLDG. Address .t'Y(J(/ S Main Building: • Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING I-I_YFOUNDATION ❑ STRUCTURAL E Front 0 Address pp��--qq/�M ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam- /4g A • LA Phon flo'fiqm� .❑ OTHER nn???331-1;_ ala Fri /gyl Gc �y� / PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) �`J�V� I (lN LG,r� C'f / / 11 s..v,�ly�' to CONSTRUCTION TYPE VALUATION$ $ R �... qq �/ K Left G oK City License No. ` .O� ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: 0 with section 7000) of Division 3 of the Business and Professions Code,and L p my license is in full f• ce .ntl effect. RECUVEU OCT _ C J 19O7 T UcenC . s 49 44 ic- sc/ •l •1a S Date /'•t IN Signature _'/.//UI _I .a 1_nrt_ PLUMBING FEES A_ WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES •01 I hereby affirm that I have a certificate of consent to self-insure or a certificate 606, of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink i Automatic Washer Transformer ❑ 15.50 KW 3800, Lab. p Policy No.tIri3q'O -7 Company i - � Backflow Irrigation Sewer Cap 0 50+ KW Construction Pole Sub. \ entified copy s hereby furnished. CerAifi o y is filed with the city deli vi 'o Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 14-I - / Applicant . EXEMPTION FROM WORKERS'COMP NDECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). 1 Dishwasher Solar Piping (L 7b Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit Is Issued, I / shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1'/:-.8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 1:116-15+NOTICE:If,after making this declaration, you should become subject to the — - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures % Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance 9 of the work for which this permit is issued (Section 3097 'Civ. C.) Interceptors Water Heater Outlets Lender's Name Range Lender's Address Kitchen Sink Water Service Switches Sign - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays Y Generator 00-5 KW 05-15 KW Trash Compactor any structure, prior tom Its he/, also requires the tcto applicant for such vi p ns of P to file a signed statement that he/she is licensed pursuant to provisions of Roof Drains ' the Contractor's 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 five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation,compensation, will do the work,and the structure Is not intended or offered - - - - - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES - . 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 - DEVELOPMENT SERVICES REQUIREMENTS: , employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ID Zoning Approved By Date sale. It, however, the building or improvement Is sold within one year of com• _ - Canopy Type II 0 pf, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date prove for the purpose of sale). s ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By .,.� L .� , oat wjV--/ 2 —A'7 tractors to construct the project (Section 7044,Business and Professions Cotle: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con • - tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ -SMIP $ proof of their Worker's Compensation insurance should be provided to me. - - 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLAN CHECK $ PERMIT Mr PLUMBING $ $':OO ISSUANCE $ Date Owner Heating System&Ducting - Registers ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above ❑0100,000 BTU ❑100,000 BTU ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances _ and state laws relating to building construction,and hereby authorize repre- sentatives of this city to e /er up n the above-mentioned property for • ]J"f inspection (inn y� q- 7 _ MECHANICAL $ TOTAL FEE $ \5 " Signature 1 �// l l �✓i/"1 Date L(" I� -81-7 Drivers' License or 55# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building: Canary -Applicant; Pink -Accounting; 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 2. 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 & Pressu QTest 6. Electrical UFER Grnd. 57. APPROVAL TO COVER GUNITE 7. Footings 58. Electrical Conduit-Undrg__rr�lia. 8. Foundation - 59. Gas Pipe, E Undrgrnd., T.e 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, L 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 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping D Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank D Gas 0 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 38. Final Plumbing j(,cy tZ LED ! ' 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation A4. Landscape Irrigation System 45. Sound Attenuation , 46. Handicap Regulations 47. FINAL STRUCTURE& BUILDING 48. Special Requirements Completed 49.'Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date