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Home My WebLink About1596 SANTA ANA AVE - Building Permits >w tet* ave JOB NO. 11-1866 ADAMS • STREETER IRVINE • RIVERSIDE CIVIL ENGINEERS INC. Jan A. Adams • Randal L. Streeter October 10, 2012 City Building Inspector City of Costa Mesa Development Services Department 77 Fair Drive • Costa Mesa, California 92628-1200 Subject: Civil Engineer's Certification of Rough Graded Building Pad Project: 1596 Santa Ana Avenue and 307 E. 16th Street Reference: Grading P G12-00019 Addr: •venue and 307 E. 16th Street, Costa Mesa,CA Own= .s, LLC General Contractor: RSI Construction In accordance with the City of Costa Mesa Grading and Excavation Code and the requirements of the Building Code, I certify approval of this project as outlined above, to rough grade. Rough grading of the building pads has been completed substantially in conformance with the approved grading plan and in full compliance with said codes. Certification includes horizontal and vertical control for building pads as listed above. This approval does not include placement or compaction of soil, which is under the purview of the soil engineer. OQpOFESSJON � ) (/ 00�`'011a--8T 9F By: r" • � 3 Date: October 10, 2012 yy Weeao E Nicholas A. Streeter, RCE#70862 (!_.Z allx Wi' o� Project Manager Adams Streeter Civil Engineers Inc. 94` Cfvn, r* °F CALICO" 15 CORPORATE PARK • IRVINE, CA 92606 • Tel: (949) 474-2330 • Fax: (949) 474-2362 2900 ADAMS STREET, SUITE A-400 • RIVERSIDE, CA 92504 • Tel: (951) 352-4100 • Fax: (951) 352-6200 . . & . ; •iADBRESS f..-.C-.1. --C-I B.17`---! .;1,-..•.r.I -rlit.:67 TRACT__L. a7 !. PMt itc.v. • " , . LoT' DATE 7-•"/P• . . . . - BLOCK AMT. . - . . BUILT-IN -S : ROOM AND FINISH DETAIL . .I'UNIT4'14.4Aiirtilt4iti. ILd-1 niCC.- 32 • '6P1- ,FLAT °'D'cr----- 7;- ROOMS FLOORS FLOOR FINISH .4. • INTERIOR FINISH ...L.. 63 7 GABLE • ''' KIT j3-FAN - _..... 1 3 _ mATETim. ....file._ WAILS .k.ccitiN9s REMARKS..,..... Ir4 SHEET.. 0 OF.' D .-.- '71 _...... 7C-Hiii--77 RANGE ''''•-•--• C5 C E.DATE' --- - iARsmSPt CUTUP •-• OVEN' EST.HALL . _ I,_ ____ 66 USE CODE TYPE • . Z•Siiihr;LE - •'11151.00;SPER----,T LIVING . --,..---.-• G7 DISTRICT ' . "SidAK 6. RE RIG_ERATOriT -- utNiNG . .7C614-P0 SHINGLE-- -FOOD CENTER 4 TRACT NO. • 'COMPO ROLL - _ "Cd1 C7 771; . '.-:-Titira-SM5Vir-- T ITZATZ9B-Ari•-7------- -j .2____. .:-.flj. ---- . "------ 59 CONS?.DATE --- . •TILE VAC CEEAN DCC ----- -1------ '' - -1- ---"---- - ' - .J....._ _ __ -7'•-f-AV.--- - -------- • , 4,-..-U-I./..1.... -- ---•--...---•-• 72 trroctivc YEAR .. ---. _._-_-- - • ' ---'7-1-(-: •:-&-r."1-th.ocit ,HEAT „ Klr:CAB. METAL OP IHW [--' 7 171- WALL CAD FT. 73 DEPRECIATION•TABLE . ;roania---- - :-FORCED N ri or ao.&LAO.Tar-nit mic 1 LINO' SPLASH RASE CAPS FT. •- 74 FUNCTONAL PLAN 1 L j' .•1.Z3 Elt,Til •AT30 a E WALL R GRAM74- BATH DETAIL . , _ .....___. _. _..... 75 TONDITION 1 CD ES X pi IM F T. CEILI44•-1 •-FL.NO. , FINISH FIXTURES • '..• -EXTERIOR R-Ar. bT647-4i FLOORS WALLS WC IA IUB SI UI EDIFINISH GRADE I PULLMANS 75.. WORKMANSHIP' I D.2 E.1: 3 at, •. • .' 75TUCCO-7-7---i rITEXM...L.7 , . . SHEATHING.• Eso MR E•ONo Er. t'e.. / / i _ _ ____ T7 TOTAL ROOMS ----r=:im v2,1-= - rsitioto• ' I ot LIVING -•!RMS . 4 • ; 0 - •rrSHINGLE . COOLING Ir . , • - - -I. --i:: . ... b. . SHAKE 7 REFR. _- 1 79 DINING'HMS • ASBESTOS EVAP. WALL - - • " • ' T.- •'' PAS • - ---- - " 1 - I I . I IFAMILY RMS • ':: 0 wn t..,...ALUMINUM- MISCELLANEOUS STRUCTURES _ __-____-_‘ n ..... EN .' 4113RiCK.VEN• ._ FIXTURES 1. • 81r_O --- TOW . . .....- . • -2 -I -irrto STONE•VENP ......,FEW FATIT--' 9" STRUCT. ENO. CON EXT. ROOF FL INT SIZE COST 82 NO.OFAIED RMS •''• N3 =9 93 TRTITT-DF BATH mos ; -I: - 01 77---77--/70.1.0,61---""-- 'DM •M.WIDOWS_nil REC. _2.2.13_ _ --4•; P .r__ • . ,,, Pal - 84 OTHER ' -4 .CSMT MI-STEEL ' rz./.. ....4c,A' _ I ..L.-__•.--Le 3:m CI 7. "Tsuo•k•-, „A1:77 ., FOUNDATICM.I 4":-":1J2ift d.' ."- ' . 0 85 CENTRAL HEAT-YES.1.3,ria to, - ,t,t,-.. to, _ • r!7..... GOLIEFICIE J_Efl•Ala -- zas.,Ar,a...7••••,..mv•-• T F A G coNcorre SLAR 1/7..tr'..L-7-2.0.5 n eke _,c...e_...._.,p___ BB df CENT.-COOLIN .TES GF0"ir.10 N Silt!GL.DOORS CONCRETE •L• x, 1. -, DP4:11Cd7S,di' •P'5' ,_,____.• ...-.....- ...... EU DOSI LE‘,2.E.41514SEErisd....i.a., ,.4 4. Or rrildi . , ., REMARKS - ---- COSVPACTORS ' , . ,._ - , --I- ---- - ----- , -,C 0 BB QUALITY CLASS -Yt•' •".••4 . . . vs 1 Trr,C71-1-„,,,r• ' -:..:44.,,•_•" tiel_r_H.; T.TT r Tir-ri • _[4.-..:LP , . ism 1-, _ .,. : 11-4- 1-4-4,-- -•-.--I- •-•'•-I r -.4.!-•.: IT t! _ i..17 I 1 i , i ;.• ; . , ; ,.., .1, i - • 90 101FIR AREA * ' ' -1 4-1-1. 1 1 •'.-I I • t '-' '- T T I f..! ''- 1'-I-11- . 4-- 1 r l'''.. M 1 4,1 2nd FLR AREA . 4- •. :.-.1--1.- :tr.-. - • , i.- ;..J.-_1.. .- -.....,-_...4_,_-_.,-1_1........t-.2- ..--....L----2 - ..11.4 1 -,...}- 1. .1 14. .-4-.-1 ,.....i . 1 1 a 14-1 .-fr 1 1 • , .-14---.1-4-1-" , ' 1 " -I--L.: ' . ' 97 prid FLA rocron. '' ' " . 1 '' • ; ' ,.._.--.1-4- ' 4 " 1 1 " ' ' ' -' 11 ' , 11 1 , I -- • . 1-- t -I-4'• t.1-1,--- ,-- i-f-i-- 11, : 1-1-4-44:1-11--1--tH r 1 1-1-H, -11 1 rl ;,- •[rI " RRI AIR AREA' • 1 . ••••• . .. I • f i . •.1-H • t..-1-r- 1-1-1 : . , , Ti ;', I t , . . 1-a • • •- • • • • 1_4_7... I • --7- 94 Trd FLR FACTOR ••• 4, 4-7-1- .147:4:1-' t' * I 1-• I • • 1:4- 4-i..If I 1 1. 4-iLL -L. A.4.44._LLH. L- - {-. • 4-11- 1-11 1-.- 1 .--:I I 11 -L - F d , r ., ,; .., „ . . . .,....„..,...„44,44.,._ ,_,__ _ _ _ _ ._ _._., r, i _„„ . , ii ..i., „ „ ,. ,... a ,,,,..,...,_,.,.__H-r. " ATE'E AART°77 • 1 t ' 1 'TN- . ' T . 1- 1 1 '1'21.1 hi. - 1-H" u 4 -a 17 FIN 13S.MT. R.EA.94 FIN O;MTFAOTOR _ ... 4t- 4 jI •-r • _r__,... 2_ Hr s ;, I . i I .t, , 1.14 . . 1,4-tt4;1/firtli,,it -4-4-i-iti---14 : : : s I- • H-f-lt-i'-i+1-, i-H-"--too ustrim DENT FACTOR ' --i "1.1 4i i I I'. J ::I : i•[ -"1 LIT 1 1- -• -4.1.- 1--111-3L---1 •I'177..21..4'"-'tr.7 .___.-1-.1 - ' ' • ,-rt.. , 1.91 AE/DIT/ONS FACTOR •- 'i • 1 1 " - Iria , - 1-1- 1-4.4-1.42.14. -.2. Li i ... 1 : , • f, ' t .L' L y---t-' , ,‘ - 4 7 'L. • '1,... T' • 1 i.1: $ I ' • , f , ; tri LI pi.1 .11.1- 4,-.1t1 tilio3 PORI?'TOTAL COST ------i4 --- -I---"i"- -t- hi-.r,- -T41 t - t 'I.--7-"' -.1 LIILL'-..- ,,,, .,,,,,,....-'r • . : -- ---s- 4 r-t-i • lair:1_141 - -.i--1-4.- LI ,,,f-1_, , : ---,Try' '4-r:a ' ' UNCOV PATIO COST ,... ,....: _. ._.x...1..__cirri. -.1-4-.•I;..,t , p1,,,-iip in 3 i-4-1-•-i7-1,:.- - r-r-i-r,-1-4-Tric.:11-1 1-1°` FP C°Wr ' ... 1.1. • ":7, -'-t";-.-11- -1-1-1-1'-f-441- 1,f- ft--it:, ..„ , -fr.--irl t r -I-, t t1-11;i-z-1-1-i-H-t-Ef-H-: I , : 1. ; : I, ; f-Fir,4-H-144--,4÷ t 1 : d : . I - _ 1......., , _._, ., EXT.17 COST : LT:„ TI"--11-717-id'i-rii...-04-1- 14:1-r-iri44-1-41 F144-.1-i--14-f-44 411 ,-r 4-r %, " . . • L i- 1-t1;._, -r 1 i . .t. ; 1 I I_ . . . . --17-r-T 1 ; .1 ; -. - Ion EXTPLBGCOST _ . ... -.. •l.I ' ; :4-1-1-1-1-. ig -* .4. .I--- •-..-r.i...!+-1 t•.{4 . -..±.4-ti-i-i+-4-+H.J.441-4-.-t-4.!it, GAR CLASS,DFT .. .•••• ;....%, 7 1 i•' 1 . .- 4., ..T. ' 7 4 I ...I-t-' -u-rFit.i , III GAR CLASS ATT' ' T ' •T•T''- HTFITI•t' .4•t '4.171!:M'' :lin i-i-Ht 4:'• 1-t1-.Irl::1""-- -71 11+1- taill:1- T 47- ' 'TT' • ' . C 117 GAR AREA . .., ' 5' • • COMPUTATIONS ' - _.APPR. DATE C.a. IJC W; -1:1" --r-t71113 FW AREA x/ . . . ITEM FACT. AoREA ' R .UNIT COST *I. FW COST _ No, COST _.,__- - 4415 FENCE COST • i .'• .; IS mi;• , :.#4•M ,.. • . ' - - ---,-.,--•-S^ . • _ .. . : rit,,,,•„:, , I. . .. 7POOL . . _ .,,, FM• • ' . . ' . 119 DOCK IMPS COST,:. • . ?rt.. - . . 1:11 ttrI.:. , .. . ' .120 DOCKIIMPS DATET 'LT •• L ' . ' ... . 121 DEFERRED MAIM'.'YES 0 127 4 • 'II;t1TP'l , - . -- . • ."1":1-: , ____ --- . . 12S 4 .'r"l' :' • .. ..--....-- • - . RCN RES• . - . 124 .. ..• , •- .• ' " ' • - • -RCN-" .% .RCLND. . .. •. , I • . . 1: ... ;4-: • •1 • 4.- ........,-,.....„. . '. - Pool&Dock 126 • . ,' 1 . • CITY OF COSTA MESA o5 .s, BUILDING DIVISION Fj 6"a 77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.aov t. FOR INSPECTIONS CALL: (714)754-5626 '"'°° ere PERMIT NUMBER: BC11-00553 PERMIT TYPE: B_COMBO ' ' ' STATUS:. ISSUED • Sub Type: DEMO ALL DATE ISSUED: 11/02/2011 ISSUED BY:" RMD - • JOB ADDRESS: 1596 SANTA ANA AVCM - . Suite/Unit: APN: 42532126 - "Zoning: , , , - . Vicinity: ,Primary Occ: . - Const Type: V-B SQ. FT: 0 Valuation: $15,000.00 SCOPE OF WORK: DEMOLITION OF A 1,088 SF HOUSE; 1,028 SF HOUSE;A 468 SF DETACHED GARAGE AND 54 SD PLAY STRUCTURE. OWNER: SCEL P LLC Address: 620 NEWPORT CENTER DR Unit: 12TH FLOOR Phone: 949-270-3620- • - City/State/Zip: NEWPORT BEACH, CA APPLICANT: GORDON,LISA Address: Unit: : Phone: 949-720-1116 City/State/zZip: CONTRACTOR: R S I CONSTRUCTION INC License No. 930239 Phone: 949-720-1116 Address: 620 NEWPORT CENTER DRUnit: 12TH.FLOOR • Cell: City/State: NEWPORT BEACH,CA ZipCode 92660 • ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $163.31 Building Fees: - $251.25 Electrical Fees: $41.70 ' Mechanical Fees: $0.00 Plumbing Fees: $52.90 .. SMIP Residential: - ,$1.50 SMIP Commercial: • $0.00 Bldg Std Admin Fund $1.00 . TOTAL FEES: $511.66 "Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/1812010 - 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 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. 4 OSE r. INS�P cnoN M[ PATE INTmALS CODES INSPECTION TYPE DATE NAlrOlaS 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 202 Final Factory Fire Place 220 . Final Planning Approval 203 Final Sign r 222 Final Site 204 Final Demolition k I- J'---- Flir 250 Final Building/Occupancy 1 • 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: _ 0 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized Ni.fG.O i. a jr,ir-r1py� t,G>t.},epq. (� by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: Y`r�r"F�l vwv or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be completed A the permit is valued at one hundred dollars($100)or less) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: G� i hbtg rD :J 11 1 I • 0 As owner-builder, I will not employ anyone to do work which would L9- 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 issued, 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 L.bor Code,I s- • h ' —; • with these provisions. i /1/'2'11 Division of Industrial Safety Permit Number: Ap.t�nfs Signature / [ 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 force and effect. a registration form for acutely hazardous materials? 0 Yes ElNo Lic.# -' 1 fuo a 1 Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by . 1 l'kli each business which at any one time has on hand a quantity of acutely ors Signature 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). ❑ 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 ❑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 658502 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 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 0 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 California 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? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8 (If'yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for • • 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 am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. property,❑ I, as owner of the 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 0 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. Signature o • -2.1......, Date Signature Date 305]-061310]) [/1 Lid I An•+ •utM10 Applicant- Data PROJECT ADDRESS: 1596SANTA ANA AV UNIT: CITY Or COSTA MESA — BJI;,il. LC, PERMIT PERM NO: Y. 0J4761:OWNER'S NAME: G1EBS, r'LAVE E'TR ' ADDRESS: 2128 MIRAMAR DR PERMIT NO: M 0i9766 PLAN C1:cCK NO: N GOV',. : N S./.id : N BALBOA, CA 92661 ( CONSTRUCTION TYPE: V—N PERMIT TYPE; MEC PURPOSE: OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : C/O FAU SQ FT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / ADDRESS: ABC HEATING & A/C ( 714 ) 540-0972 2951 GRACE LN COMMENTS: SMOKE DETECTOR REQUIRED C .M. CA 92626 **** ***1i>E*****X**�E*#*###x > #Xrs ****,E>tgEX**X#*****)Y#TEXxN***XXXXX**X#*TE*Kxk;tX % K;: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY uc.: 00F041 STATE UC.:13329 t„l C20 Dat/)/ —JG' yi Signature�C _ _ _ MAIN BUILDING ACCESSORY BUILD:NG WORKERS'COMPENSATION DEC RATION: ;hereby affirm that I have a certifies consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Ch ClLEFT; FT IN RGHT: FT IN LEFT: FT IN RGH':'; r': IN POLICY ND.: 943535 EXP.DATE: 01 /01/93 COMPANY: REPUBLIC PARKING REp• PROV; PARCEL: 42532126 ZNE: REF NO: ❑ Certified copy is hereby furnished. O Certified co yiiss f/filedwith tyescity Building Division. PLANNING NOTES> 1 y Oak! D? p"4 O ' / Aw //i .(/ > / EXEMPTION PROM WORKERS'COMPENSATION OECD N: (This section need not mpNled if the permit H for one hundred(S1C0)or less). DEVELOPMENT S E R .V I C E S REQUIREMENTS I certify that in the performance of the work for which this rmit is issued,I I t employ any person in an annex so as to become • subject to the Workers'Compensation Laws of Calif ZONING APPROVED BY • �/J DATE; Oa(K / C r6---1 a n re' • NOTICE:If.atter making this declaration,ye cold become subject to the tis'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall corned revoked. • CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the pertormance of the work for APPLICATION ISSUED B Y• ' u\A WA D ATE: (0I3 o ( 5 \ which this Detrol)is issued(Section 3097,Civ.Cl. *'*****'********TE***'***X'********R* 'RR***FRR**1VR R*•***RRR*R*R***************H*ft Rnxc:a LENDER: *******************************************#*************##*******tE*******lf*X** ADDRESS: LEGALIZATION:N FEE _SUMMARY STRUCTURAL SEGMEN•l': N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE SMI P/RES GRAD,NG (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 , 00 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 7000)DI Division 3 of the Business ,,., 2] SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN , ,. any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD ING 'D 1V > PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Processional Code: The Contractors'State License Law TOTALS----> 9 . 00 1 5 . 0 0 0 , 00 24 , 00 24 . 00 , 00 does not appal to an owner of a property who builds or improves thereon,and who does such work himsell/herself or through • his or her own employees. provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 24 . 00 OVER/SHORT• 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of safe). BLDG PMT PLUMBING ELECTRIC MECHANIC . • FIRE SNIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 2'4 .00 . • ❑ 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 with a contractor(s)license pursuant.to the Contractors'Stale License Law).I am aware *####***********#******##***#**i.***##*PE*,lF*#**jf****##**C***#######****##*****#*#* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL 1 F . E `k ' BREAKDOWN ❑ I am exempt under Section: B.&P.C. .4. 1.11 for this reason TYPE DESCRIPTIQ-O N' • , A , UNIT COST TOTAL COST Date: Owner: MEC 1 INST FORC—AIR/GRAV TURN <=' 100 K BTU 9 . 00 9 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and t� 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 END OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from 1 " _ these provisions. A.' . , Date: Appbcant: - , I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county I ,JI ordinances and state laws relating to building construction and hereby authorize representatives of this city to enterYport the above-mentioned property Int inspection purposes. ///J !J�''�� +� dal •-•9.4. Signa}dl✓ � �f�tiY� /J J • Driver's License or Social Security a: 0' 1641-46 Whlre—Bollding;Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Dater 4nspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location C-, 2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms i 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. •4.1. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 1(. 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 Plumbingr/ 65. Electrical-Final 15. Rough Electrical-Conduit i 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 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 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 I 80. FOOD CERTIFICATE ISSUED 33. Final Electric t-j3ohectowie- tat, - cad? 34. Final Heating& Air Conditioning ti/`0% G,,/4 j(-et,-qZ-{•(.p oi-cg (.*cae -crew - t. sN 35. Final Gas Pipe-Test ( t f(-./b-4Z PAU !HSTALLIAIo CCW£ 36. Hood or Canopy i I C an m4-K4,5 VPI sGa-e a f- E. out, 37. Final Factory Fireplace I 1-0 6 E.41c1y4. FPust edE- t. E() 38. Final Plumbing 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 Fiegulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date