HomeMy WebLinkAbout1117 SANDI LN - Building Permits 4,
'DORMS BUILDING: 1117 SANDI LN UM' CITY OF COSTA MESA BUILDING PERMIT
knNADE'P'ww'w PERKMAN MANAGEMENT
/
PERM NO: B 085006
A0°" 800 S BROOKHURST #2A
/ ANAHEIM CA 92804 PERMIT NO: B 085006 PLAN CHECK NO: N GOVT: N SUPP: N
96-201 `l
APPL.WIUNg ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: •. ' UC.NO.: JOB DESCRIPTION : T/OFF & REROOF W/COMP SHINGLES SQ FT: 3, 400
ARCS OR ENG'S ADDRESS: Y UNIT:
CLAIM VALUE: 3, 400 , 00 CALL-VALUE: 3, 400 . 00 GROUP OCC: R-3 /
CONTRACTORSNAME J D JONES ROOF CRAFTER ( 714 ) 826-4827
CONTRACTORS MMUNG 6011 SAN YSIDRO COMMENTS: REROOF 2300SF DUPLEX W/COMP, ADDRESS INCLUDES 1119 SANDI LN
DDRE
Ass: BUENA PARK CA uC.NO.: 435996 *********************************************;tat;++ETH***************;e*;F******RH;e*i:*
90620 • um: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter S SE TBACK S
•
(commencing with Section 7000)of Dation 3 of the Business end Professions Code,and my license is in fug force end effect.
CRY LIC.NO.:029223 LIC.CLASS: C 39 LIG.NO.: 435996 EXP: 09/97 MAIN BUILDING ACCESSORY BUILDING
Dem: ID -2-9') . camrae, bJohta 2.0eP tra.-(-t't4e . FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License law for the
Ir hollowing reason(Section 7031.5 Business and Professions Code:Any ally Cc county which requires a permit to construct,altar improve. PARKING REQ: P RO V: PARCEL: 42204216 Z NE: REF NO:
demolish,or repair any structure,prior to is issuance.also requires the applicant for such permit to file a signed statement Net he or she
is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 70(0)of DNeioe,3 d the PLANNING NOTES>'
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section .•>;.. •• .i
•
7031.5 by any applicant for a permit subjects the applicant to a civil penally d not more than fire hundred dollars[$5001). *******************************************************************************
❑ I,as owner dthe pronely ormyemployees with wages estheir sole compensation,will dothe work,and the structure anot intended D E V E L O P MEN N T SER R V I C E S R E !4 U IR EME N T S
or offered for sale(Section 7044,Business and Professionsnot Code:The Contractors License Law does apply to en owner of property
who bolds or improves thereon,and who does such work himself or herself or through he or her own employees,provided that such ,..'
improvements are not intended or offered for sale.If.however.the building or improvement is sold within one year el completion,the ZONING APPROVED BYDATE: •
owner-builder will have the burden or proving he or she did PM build or improve for the purpose of sale).' /
❑ I.as owner of the property,am exchsively contracting with licensed contractors to construe project ope(Section 7044,Businessnt
a
Professions Code:The Contractors licensedoes Law not apply to an owner of property who builds or Improves thereon and who BUILDING APPROVED BY : DATE:
contracts for such projects with a co treeor(s)licensed pursuant to the Contractors License Law). r I
❑ lamexempt under s«dw: B.ApC..for thereason: APPLICATION ISSUED BY: DATE: b at
*************,************************************ ****************- . .x . - **
Date: ower__ LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y
I do hereby certify that I am aware of end understand the requirements of Calomle Health and Safety Code Sections 25505,295+1,and
25534,and Nat I or any future building occupant wig'will not(circle one)need to comply with said state codes and the requirements for
apermit forws+Nuction Or modification from the AiatmSy angemem District.Residential opmtwionapp$�ians are exempt these ese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/REST GRADING
provisions. PERMIT 87, 25 ' . 50
Date: _ Appicam: SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of declaims:one of the following de : PLAN
❑ I have and veil maintaina cerlifcme o consent to self-insure for workers'
compensation, d as provided for by Section 3700 the Labor. ISSUE FEE
''I Code.for the ped«menceof the work for which this permit isissued
l
h I have and wil maintain workers'compensation insurance.as reguired by Section 3700 of the Labor Code,for the perfonnance of the TOTALS----> 87. 75 0 . 00 0 . 00 87 . 75 87 . 75 . 00
work for which this permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier: STATP Film! EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 87. 75 OVER/SHORT: . 00
Policy Number 285-UNITO0rl74 '; 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TGT GRADING PLAN-CHECK
(This section need not be completed I the permit is for one hundred dollen;ItIX)or less) 87, 25 . 50
o I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner s as to •
becomeagreeCalifornia. subject lo the workers' ****at******************************************************'1t*******************
compensation provisions d Section 3700 of the Labor forthwith complyh, - . . ions
Dale: I O—2—ct—I A. INDIVIDUAL F E E BR E A K D O W N
to me
Warning:Failure cum workers'compensation coverage I.and Isubect an employer to anndndpwluaa and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil Ones up to one hundred thousand dollars($100.000), y� lion to the cwt of compensation damages ss provided for In
Section 3706 of the Labor Code,Interest,and attorney's feesCOST
3400 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 400 . 00
CONSTRUCTION LENDING AGENCY:I hereby affimm under penally of perjury that there is a censlydion lending agency for the END OF FEES
performance of the work for which the permit is issued(Section 3097,Cit C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify lhat I have read this application and 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 the city to enter upon the abwa..neatened property
for inspection purposes.
JENNIFER HAUSER 1&92-1997/12:18 DNfg7,75
PERWI�Iggi913197
P-IN a �) p
�S (..-. Date: �0-� - Vee6
//� n e of Owner/ OpliramVConireaor
(5151.46 WP) White-Building A Safety:Green-Fle:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor
_ - - - POOL & SPA -- ...
- _
CONSTRUCTION AND PLANNING - -
Date Inspector Date Inspector
APPROVALS Permit# `- _ • APPROVALS Permit# I f
• 1. Temporary Electrical Service or Pole • - 52. Pool & Equipment Location; - I `
2. Soil Pipe-Undrgrnd. , •• ' _ , .53. Steel Reinforcement -•i
,3. ELitncal'Ctnduit Utility-Undrgrnd. - 54. Forms
•
'4, Electrical Conduit-Undrgrnd. • 55. Electrical Bonding _ -
Sr. Steel Reinforcemem . , 56. Rough Plumbing & Pressure Test -
6. Electrical UFEfi-Grnd. • 57. APPROVAL TO COVER-GUNITE V. Footings - . . 58. Electrical Conduit-Undrgrnd. ,_
•81. Foundation r - = - 59. Gas Pipe, 0 Undrgrnd., Test' • ',
9. Water Pipe-Undrgrnd. 60. Backwash Lines;P-Trap, O UCdrgrnd. '
11
10.•Structural Floor System 61. APPROVAL TO'DECK 11. Property Sewer Line& House Cor ection 62, Backwash &, Receptor-Final/ "
12. Sewer Cap _ 63: Heater & Vent-Final -•• I - "
13. Roof Drains , - '
i'64. Plumbing System - Final I.1
14. Rough Plumbing " . - ; ,
g Y _ 65. Electrical-Final � �
`• 15. Rough Electrical-Conduit' 7 #+' - 66. Solar•System-Final , •., • .
16. Rough Electric Wiring - - . ' :67. Fencing & Access-Approval
1
' 17. Rough Wiring Sign - - e 1 68. APPROVED FOR PLASTERING -
18. Rough Electrical:T Bar Ceiling - ..,i• - '
69, POOL/SPA SYSTEMS FINAL
19. Rough Heating-&Air Conditioniinig T ` " - - s;-r -_ - FIRE REPT.JiEQUIREMENT
20. ,Rough Factory Fireilace - - T t -.APPROVRhS-r:' Permit# ' _
•
21. Ducts, in Structure ' '• -• • - ` s -a '� '" - 70•-Under'grovnd Hydro '
22. Ducts, Ventilating ? - , :-• , '� 71. Product.Piping OGas 0Oil
t _ ,
23. Gas Pipe-Rough & Test _ to : IT; • ,'i 72• Underground Flush y
24, Roof-Framing• ' 71
• ' I T 4-.. ` 731 Undergrrid.Storage Tank 0 Gas 0Oil
r
25. Roof Sheathing <. B - 74. Overhead H dr6 , ?
/lel: y
26. T-Bar Ceiling (StructLral) & Mono-coat a ;, • 75; Ory Chemical • ' I J ' F
27. Frame and Flashing ; :, r, k 7' -4 "' r 76. Dry Standpipe -1.4 t
28. Lathing & Siding -• ' "' -' 'i s •-' 77_ FIXED SYSTEM FINAL.-I
I t-
29. Insulation • z' r - I ;: 78: FIRE PREY. FINAL t. -
" 30. Drywall Nailing -- (. ` :+ :HEALTH DEPY.`REQUIREMENT
-
'
• 31. Plaster Brown r .
wn Coat • _ 'r 79. FINAL INSPECTION • - .
32. Electrical,Power Metbr-Final • j� 80_ FOOD CERTIFICATE ISSUED-
33. Final-Electric-• ` , i-- Notes: :Y . ' _ -i'iT!
34, Final-Heating & Air Conditioning's 1 _ - � i '!
•• 4
35. Final GasTipe,Test; ; - c 'f . = = 7•
' 36. Hood-or Canopy '4.t - - _ i r' 7 - -.'*'
t.
37. Final Factory Fireplace -. : -t- I: j
_ 38. Final Plumbing ` - ' L F ,
';'
_
„r r 14: _ - I:
39. Water Service:Final .. zis - . 4' . -
- 40, Gas Service-Final i ..... r.� { ' -
41. Solar Domestic-Final - li. 51 I' .� : -
4.
42. Backflow Preventer i' - • -
. ! j -
--43. Backflow Irrigation , . ' - --
•
44•. Landscape Irrigation System • S1 y T r ,. I . ', y
•
45. Sound Attenuation r i - ri ., . _ j
4f:. Handicap Regulations - r •+ T'
7
47'. FINAL STRUCTURE & BUILDING - 'u/7/'' `- -*
! i ,
m._
, ..
48. FINAL PLANNING' . - I .:i • Ir.
4g. Electric Release to Edison ' • • . - ._ r
t - ' l l} � _ -. irks!at
50. Gas Release to Southern California Gas Co I+ ' - - ^ �` w
51. CERTIFICATE OF OCCUPANCY - : • - - ._-_I i'. "ti
No. Date
I/
City of Costa Mesa Planning Department
Post Office Box 1200
77 Fair Drive
1110 q yy p1"� Costa Mesa,California 92626
119i� (7141556.5245
REQUEST FOR OCCUPANCY
(Single Family Residential or
Condominium Units)
•
Tract No. 9-#„eg/ Date k-/S- 77
Lot No. 9
Address 7// 7 s��/ �, Gc i —e- C;rt��a 4'-C
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) Ze2c.4 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 "2 "( MO—DenloLP-Q Sagegeiti
RECEIVEDPurchaser
CITY OF COSTA MESA •
P' ,"J:'!litr r.'!”)1" / - --
By /
AUG 1 5 1977 eveloper and/or Authorized
RM
PM , Representative •
/
71819110(11112111213141516
By•
a�C.ri , / - e
c e de/ F
CMF 0569-26
•
/;
t>7
- City of Costa Mesa Planning Department
=Post Office Box 1200
� - 77 Fair Drive
� m Costa Mesa, California 92626
C 1�5i�I 1110 (714) 556-5245
REQUEST FOR OCCUPANCY
(Single Family Residential or
Condominium Units)
•
Tract No. %98-/ Date 9- /g-- 77
Lot No. / //
— -- - Address /�/ 7 S5',/cli /Arne_
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) h-e_ (was or were) to/a, 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.
By7/ .,
ourcheser
By
Be toper �d . >u thoriri ed ed
epresenta ive �I '
By (n/// pze� cam!
fr
Lendeer/-7�"CMF 0569-25 - Z
3 OWNER 'PROPERTIES WEST, INC. DATE 10-14-76
Q JOB ADDRESS 1117, 1119 Sandi Lane BUILDING PERMIT NO. 40623
GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Duplex w/3 Gars .
.., ..,GENERAL
No. 115-031-17 LOT TRACT FIRE ZONE VALUE 551,000.00
._,NAP
Si nature Date TYPE V GROUP I & J ZONE PDR—MD
sOIL
. +4-6 it 2' .7 SUBCONTRACTOR PERMITS ISSI4ED
GAS .4 rys 7 q . Dote I Number I Signature
WATER (4 G,. vss ( 4`t.77 Plumbing
\ROUGH PLUMBING r 1.n.5 0./7.71 u �/ 1a•3-7G 7e^)4.iS-.---
PROP. SWR. LINE ❑HOUSE CON. 0 Ops �I !. 1 . 7—a 1-71 77 a i 9-1---
,``SPRINKLING SYSTEM /' �
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING i' j _ 5',a.(777
TEMPORARY SERVICE OR POLE %''
UNDERGROUND fl POWER 0
ROUGH WIRING A 3��� Hfatin n'Ldd Vent.
�C�✓.
TRENCHES ❑ FORMS-0 STEEL REINF. Q/,p- (� '� { .3•-23-77 /9593 +--
FLOOR SYSTEM 9 + 1 Z.,' ����f�1.K 9,:714-77 /.37/O/—
BOND BEAM n STEEL REINFORCE n `•
SHEATHING At* 3 I^ +/
FRAME AND ( 2 FLASHING,� C 3-a '27
V
LATHING - IN OUT n IMS6+L et„7,/aC( 4'-1-171.,.77
PLASTER, BROWN COAT .
STRUCTURAL. FINAL �t� Elect(,,,'�—���/�' G� . �(-O ,/
HEATING. VENT.. REF RIG. AND A.C., INAL rocs S�IZ 7 e • � 0471 3/i7 I1j /'
PLUMBING. FINAL AND GAS TEST R -sets r
ELECTRIC, FINAL s G
BUILDING, FINAL -.1210--o-- /7D.,2
q SP„ro001377 't**94.Q7
4n623 SEP 30-75rrl,l,
✓ COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applican to Fill in om r Intel — se O�, , PITON FOR STRUCTURAL PERMIT
i i , RE , p,tlV [�/�TE_R�ECEjj(E. DATE ISSUED
BUILDING n(���411.s� ��/IIIYYY yyyFFF��B Gl JR ''//))
ADDRESS r-sy,.� « s.- _
IPER PER I 0
OWNER .///v_`C_ .1 ^S ^A.P.NO ' 17 I f' _ '1
MAIL - BUILDING (1J.(�I,s , It aff �1W�
ADDRESSa.' 9.1yyy /V/ ff r �/. ',n ADD- - —yzeal ��.�,-,► IL-Y
CITY �j�/Di S/aP i NOL.A._�//a TRACT4S,Q(J LOT9O BLOCK
CONST UCTIO EW ADD ALTER REPAIR MOVING r)FMOI ISH .
LENDER
BRANCH jY�''7J�� / i
OWNER/!'-O anti-5, kelf S/ /,,,c •
ADDRESS
y� /` VALUE ) rr-�^�
ARCHITECT \// ®� TEL./s�i�1/2 US 3C-73-ii l V L' U
OR ENGINEER Gdr� i`A•�- NO.((�G !
FIRE
ADDRESS 47 ` j4 /a. ” ZONE T "E ." GROUP .J' I
/� A lid APPROVED �4
CONTRACTOR /-/ t BY / I/! DATE ar/2. --/,�S
ADDRESS a� ZONE �ts� NO.OF n USE OF NE VVV r
CITY NO.TEt-ylt^'r,v PLAN$ C— BUILDING(_ 4... G
► STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
r IFR C/L TREE )
bra SIZE NO.OF BLDGS.
0. OF LOT 72 QCO NOW ON LOT FR FT.� FT. / , '
y USE OF
1 R S OET. C ir. /4 ,
EXISTING BLDG.
C
Fal- Separate permits are required for L.SIDE 1 FT. FT.
electric,-plumbing and heating work. d FT. FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
F DISTANCBL B BET. MAIN.&
A �) MAIN BLDGS. (/ ACCESS.BLDGS.
Q �•G • , \ C.0 P - r DATE .
APPROVED /0-7,-
APPROVED •
Xi"' -DA E .
W 4IOLD FOR SPECIAL REQU!R=MMMENTC
oI hereby acknowledge that I have read this application and state in
ge that the above information is correct and agree to comply with
f;14 all laws regulating building construction, and I shall not employ m
Z any person In violation of the workman's compensation laws of /(/'
5 •the State of California. y3..//[.�� �nt/+Alp{^
/// /SQ. FT. 1 / //'P,`IiN 7 a
3 I hereby certify that I am properly licensed as a contractor under f4{1
the State of California Business and Professions Code, Division 3, THE A OUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: _
am exempt from the provisions of the State of California Business in
and Professions C Division 3,Ch
VALUATION PERMIT FEE $ e
C N
Signature of ��pL/�� r .✓ PLAN CHECK $ g 1 �/ c
Permittee
O. U.
__ S Iileji TAX $ "7 i U.
U
Authorized Agent TOTAL PAID $ 4/7 O,7
72
-4, .
tr 17 1Ll-7b�-:1;', O[) 838 o*.r:: 191QU
90&53
r COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ��11
For Applicant to Fill in Completely— Use Ink Only A ION FOR STRUCTURAL PERMIT
J /'� RE eY DATE RECEIVED DATE ISSUED
BUILDING ring
f///a '/Dr /. I
ADDRESS / ``_( /Val (�.�1/ /
�.y� //I �•.�•. PERMIT NO.
OWNER Part/ b (L its/ /A,c G ,s
MAIL ADDRESS////�//f �U/. L
oti
ADDRESS
TEL.
CITY NO. TRACT I LOT BLOCK
CONSTRUCTIONN_ EW_ I ADD ALTER REPAIR MOVING DFMOI ISH
LENDER \,/X/`
•
BRANCH MIT- ell
r /�t r
OWNER `/�^�yf '/rzl//�s��
ADDRESS a /299 -W .ygLUE
ARCHITECT TEL. USE _�r •I�f^.M� $
OR ENGINEER N . I L
FIRE I
1
ADDRESS ZONE TYPE �GROUPr ✓(
APPROVED
CONTRACTOR BY DATE
ADDRESS
TEL ZONE NO.OF USE OF NEW
CITY NO.
PLANS BUILDING
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE I NO.OF BLDGS. (FROM C/L STREET)
O. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
.'n-, EXISTING BLDG, R.SIDE FT. FT,
co
HSeparate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work.
IO - REAR FT. FT.
(.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
GI
MAIN BLDGS. ACCESS.BLDGS.
VAR.# DATE
C.U.P.# APPROVED
KL
APPROVED
> —ELY ._DATE
CO
._
•
a I hereby acknowledge that I have read this application and state in
CO that the above information is correct and agree to comply with n
O. all laws regulating building construction, and I shall not employ co
Z any person in violation of the workman's compensation laws of s
[:7 `-
.l. the State of California. _
I hereby certify that I am properly licensed as a contractor under _ SQ. FT. _ co
N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business VALUATION 606---?
and Professions Code,Division 3,Chapter 9. PERMIT FEE $ N
m
PLAN CHECK $ m
Signature of • 0
Permittee $
TAX $ Li
U
�J
Authorized Agent TOTAL PAID $ /9/
2 7
� ih
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 51 7564 ,I I�2tJ� --
66, — T
.," CITY9F COSTA MESA CONSTRUCTION'PER MIT PERMIT NO.OO/'• p TRACT� NO. LOT NO: 'UNIT NO.
Project Address 1 � � 1 . • AA/n, I L Nit L(p �Q l�C/r I�' ' 1 •
: i 1• ' I ` •_
Applicant's Mailing Address I i'�'1—D 514 PiK cc. ; TYPE OF CONSTRUCTION IL�J NEW L-1 ADD ALTERATION H REPAIR JJ �((�� •
• {�)'{i�
• Owner's Name' C/-112E CA A/SIa`( Phone C,S�1'l-1 ❑ CONVERSION ❑'DEMOLISH ❑ OTHER - A•P'#• 4ZL 64 ` —� - ---- i- ZOOe Y VM"`
•
' DESCRIPTION OF WORK/USE OF BLDG.'SK�TL/C'. . LI v1 NG2Ot, -
Address ..,1 ill' S/�1✓AI LN:' j , S Main Building: ' , ccessory Building. ,
1� • E Z
Arch/Eng: •^ • License No. • TYPE OF PERMIT ❑ GRADING El FOUNDATION L�STRUCTU RAL T Front O
Address - I TENANT' ❑ ELECTRICAL ID PLUMBING ❑ MECHANICAL B Rear i N
• Contractor's'NameCtq l'y 1- SK`'ILIG't}'tj Phones '- y�? ❑ OTHER �,,; , C Right -" a " - - N
L, PROJECT DESCRIPTION SO- FT._ OCCUPANCY _ _ G
Address(mailing) /;7gy/.-I) 3/c7 R�2/� ' CON STRUCTION TYPE y - VALUATION G� S Lef . ./ ' f i R
City'License No. �7T S3']' ZONE GRADING CU.YDS: ACRES' Ping. Ref,# I Parking Req./Provided E
LICENSED,CONTRACTOR,DECLARATION - -`� _ / I..� Rep./Provided
I hereby affirm that;1;arn licensed under provisions of Charter 9 (commencing Remarks: /C-SC 3l 2�6 7 Planning Notes: V - Ni
' with section 7000).af3Division 3 of the Business and Professions Code,and _ - _ T
• my license is in f�l.force antl effect. .2 `r .. _ - S
' License Class { in F• "enseN d cr✓S
Date /� nafSignature' ��.. .�. . PLUMBING -FEES ' ' - ' •
WORKERS'COMPENSATION-DECLARATION '- Bar Sink - Showers _ t' 'ELECTRICAL - FEES
I hereby affirm that I'hatee a certificate of consent to self-insure or a certificate - - - -
of Workers' Compensation+Insurance, or a certified 'copy thereof (Section Backflow Preventer - Service Sink -
3800, Lab. C. 4 ' - i 1 - Automatic Washer ' Transformer 0 15-50 KW -
Policy No. �� l�]�- � ` Company ,•, F,tC 04 r' Backflow Irrigation •
- Sewer Ca - _ - - - 0 50+ KW
- Certified copy is hereby furnished. p Construction Pole Sub.- �'•
-tVt' d copy issdlled with the city Bu g ton. �y Bathtubs _. • •
Sewer Connection Cooking Unit Meter Dug to 100 amps i Y
Date U/ A' Applicant I)1/ate - • . _ _ '
1, EXEMPTION FROM-WORKERS'COMPENSATION DECLARATION Clarifiers •, Solar Collectors . . Dishwasher - -- - Meter Dover 100 amps '
I
(This section need not be completed if the permit is for one hundred ($100)or . Dishwasher
less). t: + SolarPiping - . , Dryers ❑Gas DElectric Sub Panel
�. I certify that in the-performance of the work for which this permit is issued, I - - - _ -
shall' employ any person aws of any manner so as to become subject to the • Drinking Fountains Solar Tank Fan ' - Motors ❑0-1 HP D%-8
Workers' Compensation Laws of California. - - . •. -
Date Signature. Floor Drains • • Swimming Pool•w/Spa F.A.U. ' Inc'• .Solar 09-15 HP'016-15+, '
NOTICE: If,after making_rovisieclaraf the you-should become-subject to the _ -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal ' Fixtures '
comply with such_ provisions or this permit shall be deemed revoked. - MiCrOWave.
CONSTRUCTION LENDING AGENCY I Gas Service I ' Outlets Water Closet ' Device Boxes ! }
' I hereby affirm that there.is a construction lending agency for the performance _ 1 Pole Light • ,
of the work l for 'which this permit is issued (Section 3097 Civ. C.) - jInterceptors • Water Heater ` - ' i
Lender's Name p r Outlets Range •
,
•,- Lender's Address. ' - • i . Kitchen Sink : . •; .. .. Water Service . . Switches '- Si n - { -.- ---
OWNER BUILDER DECLARATION I 9
, I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections 1
following,reason (Section 7031.5 Business and Professional Code: Any city or _ : 1
countywhich requires aper mit to construct,alter,improve,-demolishant or repair ! ' ! s
any sructure„priior to its issuance, also requires the aplicant for such permit •P-Trap Lau ndry Trays t • Generator ❑0-5 KW ❑5-15 KW Trash Compactor r
i to file a signed statement that he/she is licensed pursuant to the,provisions of ROOF Drains r '
the Contractor's License'Law (Chapter 9(commencing with Section 7000)Of -. t ,
•Division 3-of t the-Business and Professions-Code)-or that}he/she is exempt • - - . - -- - - - - - -- - --- -- - -- - - '
I therefrom and the-basis for the alleged exemption. Any violation of Section • I '
7031.5,by any applicant for a ;permit subjects the applicant to a civil '
Oenalty of not•more than five,hundred dollars($500). I` ,> l ' '
I, as 'owner of.the property or my employees with wages as their sole Reinspection Fee V $15 ' Issue Fee $ 3 - - •-
compensation will tlo'the work,and the structure is not intended or offered ' Reinspection Fee $15 Issue Fee $ 3
for,sale (Section 7044„ Business and Professional Code: IThe Contractor's - MECHANICAL 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 R QUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type ❑ ��
/ Zoning Approved By Date ��� �
sale. If, however, the building or improvement is sold within one,yearotof dn.
Canopy Type II 0 / - t
- pletion, 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). - r
0 I, as owner of the properly, am exclusively contracting,with licensed con- I Duct-Structural• r Refrigeration System Application It ued By <eDaa �V -
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's.License Law does not apply to an owner of property who ! Duct-Ventilating ❑0-100,000[TU 0100,000 BTU SU MARY OF FEES - _
• builds'or improves,thereon, and.who contracts for-such projects with a con- ' - - ,
tractor(s) license pursuant to'tne Contractor's License Law). I am aware that Exhaust System Q I R E O BUILDING PERMIT $ s `SNIP , ' $ _ O.So.
❑ Multiple❑ System Repa /Alteration
proof •of their Worker's'Compensation' insurance should be provided to me. •E - PLA N.CH ECK $� � PERMIT -
❑ I am exempt under Section B.& P.C.for this reason -- Firepl/Fact.Blt. ICBG# ' - Fire Dampers _ 5'ec,1 flb •
PLUMBING $` ISSUANCE - •$ -
Date • - Owner - - - - Heating System& Ducting Registers = PLAN CHECK 25% $ ENERGY P C. .$I hereby certify-that I have read this application and state that the above 00-100,000 BTU 0100,000 BTI. _- --'ELECTRICAL . ,$.: GRADING ' S.-_ - -.
' information is correct: I agree to comply with all city and county ordinances - .• B '
and state laws relating-to buildi g construction, and hereby authorize repre - ua- -_ ' . ' PLAN CHECK 50°.6 $ • MICROFILM. $• _
sentatives of thl city me upon the. above-mentioned 'property f - - Q -
inspection purp es. F L J/ - - • MECHANICAL $ • . TOTAL FEE $ _ 2(r t7
Signature ' / • .!
Reinspection Fee . '$15 Iss Fee - $ 3 PLAN C ECK 25% $ . ,
,7 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 & Pressure Test -
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings - • 58. Electrical Conduit-Undrgrnd. r-
8. Foundation - - 59. Gas Pipe,-0 Undrgrnd.,Test '
%
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. I '
10. Structural Floor System 61. APPROVAL TO DECK . C
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ..: ;
12. Sewer Cap 63. Heater & Vent-Final Ni-
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
l
17: Rough Wiring;Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL i
19. Rough Heating & Air Conditioning • . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# h' _
21. Ducts, in'Structure 70. Underground Hydro
•
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test • 72. Underground Flush .- .
24. Roof Framing ' -
73. Undergrnd.Storage Tank 0 Gal 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 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 c .
38. Final Plumbing - i
39. Water Service-Final ' ' - •
40. Gas Service-Final - t '' . .
41. Solar Domestic-Final - - '-
-42. Backflow Preventer ,
-43. Backflowirrigation - - •� .
•
,44. Landscape Irrigation System - $ 6: ..
45. Sound Attenuation •
4 EXPIRED
46. Handicap Regulations Incomplete InspeCLIo11S
47. FINAL STRUCTURE & BUILDING rsira -
Date
•
48: Special Requirements Completed %
49. Electric Release to Edison ' ' .;
. 50. Gas Release to Southern California Gas Co - •-.
51. CERTIFICATE OF OCCUPANCY
No. Date •
. 1