HomeMy WebLinkAbout630 SKYVIEW LN - Building Permits0
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77,FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 630 SKYVIEW LN
Suite No 71
Vicinity:
Status: ISSUED
Applied: 08/27/2003
. ` Issued: OS/27/2003
Parcel Nunmbec 93405071 -' - " - " - - ISSUED BY:
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Applicant: SCHNIERER; STEVEN. �� ; _=,. �
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Address: 422 JENKS CIR, ` � �� ! -
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jORONA:�CA� ��� - � � J ' . � Zip:-92880� - � . , � � � � ��.�`• �
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Owner ��/LIND CHARLES G - � ' �-� � % i j A ` ���
Address '630SKWIEW�LN.� ,AA�-`�- .� �.,��
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�! �� �' � COSTA MESA, CA Zip:� 92663
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� Contractor: 'ALLIED PLUMBING - HEAT.ING - AIR CONDITIONING • � * �
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' Address: • 422 JENKS CIR � - _ _ . - • � �
� � � ' � '- ' - , � � Phone: 714-998�300 �- - ; _ , � . � " � �
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� . : � " . CORONA;�CA� Zlp: 92880 ' ��� - - � , � ,
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, , ;� � , License: 610780 `� , `.. r•'', •- . �
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� �'� �� - � SCOPE OF PERMIT�''., � ' �'
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•`1� ,� A, ` CHANGE-OUT OF A WATER HEATER IN AN EXISTING'RESIDENCE. ;,%� �� �� 1�'
:
� t�' �' �l NO�OTHER WORK AUTHORIZED WITH THIS.P.ERMIT. � i�� �- �� J ��
� �� ; �
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� � • '� � �� A,, '` .FEE SUMMARY � ', �� �� f ,'� r
�V AA`.� ' , _� AMT� �'QTY - „ - , ` AMT . ��QTY' . a --' ^ j �' . , I y AMT
ISSUEFEE�C�,� $2350�V`��� ` LaundryTub/Washer,.- $000 0 Sump�Pump� ;�/�,$0.00
BackFlow irrigation�; � -$0.00� � 0 �`�, , , Landscape Irrigation ^ $0:00 "0 , ��Swimming Pool � $0.00
BackFlow Preventer-� �_ '- $0.00 � � 0 � - � RTrap - � $0.00 0 � � �.� Trap Primer , ; � � � $0.00
Bathtub �V � = . $0 00 - - . 0 - - "�Pressure Regulator � � - $0A0 0 - ' ,Uririal'� � ' �' � $0.00
Clarlfier System ,. � � �$0 00' �� 0� : � ` 'Process�P_.iping-(per 10 ft). � . $OAO 0- . Vacuum Brkr BkFlow(1-4) $0.00
Connect Qce,Soda,etc)��� $0.00 � � �0 � - - Receptors - - " - , $0.00` � �0 � �. Vacuum BrkrBk�flow(5+) $0.00
DentalUnits '�$0.00;,, 0�..'���`, � :Septic7ank_, $0.00- l0 � �. Wash,Basin � $0.00
Dishwasher $0.00 � � 0 � Sewer Cap for Demo �. ' � "$0.00 � 0 � � Was6�Basin Set $0.00
Drain, Floor $0.00�� ,' 0'�- �� Sewer Connect � ' � �$0.00 ' 0 ' WasJe and Vent System $0.00
Drain, Rainwater $0.00 �0-,;�� >� ' �_Sewer Private Line\ �, ' ,$0.00�` 0 - �:� '-�Wa[er Closet (Toilet) $0.00
Drain,Roof $0.00 0 ���--�.,'�Showerv- , $0.00. O���lj-' WaterHeater/vent $12.30
DrinkingFountain $0.00 0 ��Sink,`bsr=- . �,;�;,.$0.00"!l0 ��� WaterPiping(InstorRep.) $0.00
Expansion Tank $0.00 0 Sink, commercial— -- $0:00 0 Water Re-pipe $0.00
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This pertnit 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 780 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaa�ae lfl�oo)
WORKERS'COMPENSAnON DECLARATION: � ' �
1 �ereby effirtn under penalty of perjury one of ihe fol win9 dedareilons:
❑� I have anC will ma�ntain e certifiwte of consent lo self-Insure for workers' compensatlon, es provided for by section 3700 of ihe Lebor Code, (or the pertortnance of the
— /work for whlch t�i5 pertn�t Is Issued.
�1 1 have an0 wlll maintain workers' compensatlon insurance, as required by secUon 3700 of ihe Lebor Cotle, br Ne pertortnance of ihe work for which this pertnit is issuetl.
My workers' comp �satlo Insurence cerder and policy number are:
Certier. Z()(`it� �'�`��GY'lCGtv-� Por�Yr,�mca,: l,JG2�13fi�43-61
(lhls sec(ion need not f7e comp/etetl i! Ihe permft fs velued et one hundred dollers ($100) or less.)
❑ I cerGly t�et in Ue Pertortnance of the work far w�ich this pertnit is issuea, I s�all not employ any person in any manner so as to become subject to the workers'
compensetlon lews t Califomla, e e that if I shoultl become subJect to the workars' compensetion provisions of Sectlon 3700 of t�e Lebor Cotle, I shall fort�wlth
wmptywithihese �p
ApplicentSignature�p � Date: ��%f �3
WARNINO: FAILURE TOSBa1RE WO RS' COMPENSATION COVEMOE IS UNLAWFUL AND SHALL SUBIECT M! EMPLOYER TO CRIMIWIL PEWILTIES AND CML FlNES UP TO ONE MUNDRED
TiqU$FND OOLLARE (S1 W��I. �N ADDRION TO THE OOST OF LtiM/FENSATION, �AMAGES A$ PROVIDED FOR IN SECiION 3�O60F TME UBOR CODE, INfERE$T, AND ATTOpNEI"5 FEES.
LICENSED CONTRACTORS OECLARATION:
I hereby affirm t�et I em
force end effect. Lic. q
CONrectofs Signeture:
of Chapter 9(commencing wilh Section 7000) of Division 3 of the Bi
Class p
Date: _
end my Ilcense is in full
CONSTRUCTION LEND�NG AGENCY: '
❑ I hereby aNirtn the� thera Is a construction lending agency for Ihe pedortnance ot the work for which thls partnit is issued. (Sec. 3097, Civil Cotle).
Lentlefs Neme: Lentlers Address:
Signelure:
OWNER-BUILDER DECLN�AnONS:
Dete:
I hereby etfirtn Ihet und6� penelry oi perjury that I em EXEMPT FROM 7HE CONTRAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Busineu end Professions
Code: Any ciry or counry which requires a permit to construct, elter, improve, demolish, or repair eny structure, prior m its Issuance, elso reqWres ihe applicant for such pertnit
to file a signetl stetement that he or she Is Ilcensed pursuent to the provlslons oi Ihe Contrectors License Lew (Chapter 9(commenang with Section 7000) ot DIviSlon 3 of the
Busl�ess end Pmtessians Cotle� or thet he or she is exempt thereirom end Ihe besis for t�e alleged exempllon. My violaUan a15ecUon 7031.5 by any applicsnt tor a pertntt
subfecis the eppllcant to a civil penalry of not more ihan five �untlretl dollers ($500).):
❑ I, as owner of �he property, or my employees with wages az their sola compensation, WILL DO 7HE WORK, antl tha structure is not intendetl or oMeretl tor sale (Sec.
7044, Business and Protessions Coda: The ConiraIXore License Law does not appty to en owner of properry who builtls or improves Ihereon, and who does such work
himseH or hersetl P� �hrough his or her own employees, provitletl ihat such improvements era not intentled or oftered for sele. If, hov.ever, the builtling or improvement is
sold within one yea� of completion, ihe owner-builder will have ihe burden at proving t�at he or she did not build ar improve for purpose of sale.). '
� I, es owner o1 the�p(operly, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS b wnstruct the project (Sec. 7044, Business entl Professions
Code: The canireGtors License Le�w does nat apply ro en owner of properry who builtls or Improves ihereon, end who conVacts br such project wlth a conirector(s)
license pursuent to �he Contractors License Laws.).
� I em exempt undecsec. ����� Business antl Pmfeuions Code for this reeson:
Signature: Date: �
.._�
Owner ID venfietl by dnvers Ilcense. ❑ Ves � � No DrlveYs License No. Expires:
Vetlficallon ot Ownership by (rype ot document, I.e. - property tex blll or deed):
DIVISION OF INDUS7R�� SAFETY PERMR CERTIFICATION:
❑ I hereby certlly that no excevetlon five (5) or more feet in depth into which e pereon is required to descend, wlll be made in connection with work authodzed by this
permit, and thet no building structure, scallolding, falsework, or demoli�ion or dismantling Ihereof, will be more ihan ihirty-six (36) taet high. (Chflp. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifomia Adminisirative Code). �
❑ As owner-builder, I will not employ enyone to do work w�lch would require a permit irom the Division ot Industrial Setety, as notetl ebove, unleu such person hes a
pertnit to do such Work irom the division.
Signature: Date:
Division of Intlustnel Sefery Permit Number:
CERTIFlCA7E OF COMPLLINCE AND AIJTliORRATION OF EMRY: I certify under penalry of perjury that I heva read this epplication entl state Ihat the Informelion given is
corteq. I egree to comply with ell stete laws end ciry ortlinances relaqng to builtling constructlon, and authodze representetives of the Ciry of Coste Mesa to enter upon Ihe
above-descnbed property 1ar inspection purposes. I agree nat to occupy or ellow accupancy at eny building euthorized by ihis permit until finel insDeclion:
GOOE I. INSVECTION TYPE
7878 FixeC System Final Fire Prevention
1288 Pool Spe Final
200 Final RaRoof
201 Flnal BIocWRetaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Finel Demolitlon
812�/�3�e
Date
jlfaj$ R�$ CODEt INSPECTIOXTYPE
206 Finel Mechflnical
208 Finel Plumbing
� 270 Final Electrical -
212 Flnal Fire Preventlon
220 Final Plenning Approval
222 Final Site
250 Final Building�Occupency
QeiE Ir�e�s
,Bu.t�i,�y�17
COSTA
P.O. B
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tA BUILDING-SAFETY DEPARTMENT
200 COSTA MESA. CALIFORNIA 92626
F:, i �'•
�P-7'ti�,..=QO 53P:s ..;:t:11:0.7�
FOR BUILDING PERMIT
. BUILDIN ^'��V��� � � .SL
ADDRESS �
'( PE .: �
OWNER HII,TZER ENTERPRISES-BROOKVIEW A.P• NO. T�d�� � � `� �
BUILDING
!
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ADDRESS 740 N. La Brea Avenue ` �+ODFES 1
TRACT �.C..T LOT BLOCK
a � arv Los An eles CA 90038 ko�937-2171
z
Z Q �NSTRUCiION W ADD F P
o� LENDEq United California Bank ,�
am
� � BRANCH Main Branch
J N I OWNER
m J ADDRESS 60� .5. .S rin St. L.A. 90054 � _„wE ) �fy
J m ARCHITECT TEL. SE � �� �� $ 0/
a OR ENGINEER Fields & Silverman N. 653-016
U �
FIFE
WCL ADDRESS 113 N. San Vicente, Beverl H111 ZONE TVPE GROUP
aW
APPROVED
�� J Z CONTRqCTOR Geor e J. Heltzer BV DATE
m2
�� A�DRESS 740 N. La Brea Avenue i
w w TEL. ZONE NO.OF USE OF NEW gCON1%O
z� ��T� Los An eles, CA 90038 No. 937-217 3t P�-^"� 2 eui�owc ,F �A,�
� W � STATE GTY �'ARDS APPROVED VAflDSAPPROVED
y� �ic. No. 3144 LIC. NO. ' MAIN BUILDING ACCESSORV BUILDING
�� SIZE . NO.OF BLDGS. (FFOM C/L STREET)
OF LOT NOW ON LOT qOM FT b FT.
USE OF n_
EXISTING BL�G. �fJ= F . � FT.
F SIZE OF NO. OF
Z NEWBLO(�. ROOMS STORIES Z L.SIDE FT. FT.
EXTERIOR WALL ROOF �G' �
V COVERING Plaster COVERING WOOa ftEAR —�(�FT. FT.
aUSE OF BUILDING AND WORK TO BE PERFORMED i D4STANCE BET. BET. MAIN &
d Resi ntial MAIN BLDGS. ACCESS. BLDGS.
a C�1��1�J � CURP.#��,r�/ APPROVEDO 20—��
0
~ . APPFOVEO
�
O T �
� � �
V 1 �ereby ecknowletlpe xnat 1 have roatl this aDP���axion antl rtare
� chet the e0ove information is correct antl epree to comply with
� � ell laws repubNnp builtling construttion, antl I shall not amploy T�
F eny Derso� �� ��oletion oi the workman's comoe�mNon laws of
m
. y Me Stata of Caiifornle. Q� 0 Cj� �� � o
� ? I heraby certify ffia[ I am properiy licensetl as a conttacior un0er �'� SQ. FT. � _
the Smm of Caiifornie Business entl Protessions Cotle, Dlvisicn3, THE AMOVNTSHOWN UNDER VALUATION IS FOR ^�
Chepmr g, antl thet such licenses ere in t�ll force antl effect, ar I TME PURPOSE OF ESTABL6HING A PERMR FEE ONLV:
il am ezerr�pt from Me pro�� ions of the Stete of CellforNa Business
VALUATION n
antl Professions Cotla, Di ion 3, Chapter 9. PERMR FEE $ � �� �
�
$i0�etut@ p{ /� Jn m
Permittep $/'/�/ �l� 1r�� PLAN CHECK $ � 4� E
� �/(/L! �
LL
Authorizetl Apent TOTAL FEE S
c
b
a
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y
PFOJELT RDUNESS: 6 3 O SITYVI EW LN
owxcx s xame: pASCO MANAGEMENT CO
nooness: P.O.BOX 2968
COSTA MESA, CA 92628
FflLM/ENGINEEfl: 6 4 1— 0 5 9 3
pU0PE55:
flEG.NO.:
UNIT:
UNIT:
PEHMITTEE: ORION CONSTRUCTION ( 714 ) 363-0727
aooeess: Z8 OAKCLIFF DR
LAGUNA NIGUEL CA 926�77
LICENSEU CONTBACTOB UECIABATION: I hereby a��irm �hai I am licensetl unUer D�ovisions of hapter 9(commencing wi�h Section
7000) oi �ivlsian 3 0l Ihe Business antl Pmfessians Cotle. antl my license is in full torce and effec�.
ciTruc.: ��� srnreuc.:485459 c s B >
Dale. � � Signature: _ —✓'�
WONHEFS'COMPENSATIONOECLAflFTION: Iherebyaffirm atlh eacenilicateoic enttoselbin oraceniliwteotworkers'
Compensa�ion Insurance. or a cenifiea copy �hereo� (Sec�io . Lab. C).
roucvxo.: 046-93UNIT03554 E%P.ORTE: OSIOLI9�I
^OMPANY: STATE FUNL�.
, Certi�ietl copy is hereby lurnishetl. I_}�' Cenihed copy is ' with �he ci�y BuilAing Division.
Date:
ApPlicani:
E%EMPTION FBO�q�R'0„oEma^LOMPE NSW7�fON0 EWIA hp1�lONP Tlt is issue0n I�Shall oot ePnplo1y anyhperseti,ifi any manne so'as t�o'become
I cehity Ihat in tfie
sublect Io Ihe Warkers' Compensa�ion laws of Calitomia.
Da�e: Signature:
NOTICE: II, atler making �his declaration, you ShoWA Oecome subject to ihe Work¢rs' Compensatian pmvisions oi the Labot
Coae. you must bhAwith com0ly with such pwvisions ar ihis permit shall �e deemed revoke0.
CONSTNUCTION LENOING AGENCY: I �ereby a��irm �hal lhere is a coretmciian lending agency br I�e peAormance a� Ihe vrod for
w�ich this permit is issuetl (Seciion 3097. Civ. C�.
LENOEfl:
R�OHESS:
OWNEB BUILOEP OECIABATION: I here�y attirm that I am exempl imm ��e Conlractors' S�a�e License Law �or �he �ollowing �eason
�Section 7031.5 Business anA Pmfessional CoOe' Nny ci�y oi county which requires a permit to consiruct, alter, impmve, tlemolish, or
repair any simcWre. prior b ils issuance. also requires Ihe apPlicant for sucll permit to file a signeJ statemenl ihat he/she is lice�sed
pursuam io the D�ovisions ot i�e Coniracmrs Stale License Law �Chapter 9 �commencing with Seclion 7000) of Division 3 oi the Business
and Pro�essions Cade) ar ��al he/she is exemp� there�mm anJ Ihe �asis for �he allegetl exemp�ion. Any viola�ion o� $ection 703L5 by
any apP�icant �or a permii 5ubjeci5 �he applicant �o a civil penalty o� nol more than five hundreJ aoliars (5500�.
I. as owner ol ihe Dropeny or my employees with wages as their sole compensation, will Ao ihe work, antl Ihe
❑ s�mqure is nol in�endetl or offere� br sale (Seclion 7044, Business ana Pm�essional CaUe: The CantracioR' S�ate License Law
aoes nol aDPly Io an owner ot a Dmpehy w�o Ouilds or improves thereon, and who does such work himself/Aerself or Urough
his or her own emDloyees. DmviOetl Ihat such impmvemenis are no� in�ended or oiferetl �or 5ale. I( however t�e �uiltling ar
improvemenl is soltl wi�hin one year oi comple�ion, the owner will �ave Ihe 6urden at pmving he/s�e Oitl no� �uiltl or impmve
br ihe purpose of sale).
I, as owner oi ��e pwpeRy, am exclusively conVac�inA wi�A licensed conlracrors m cons�md �he O�oleci (Sec�ion 7044, Business
❑ an0 Protessions Cotle', T�e Contracrors' State License Law tloes not apply �o an owner oi pmpetly who hwl0s or improves ihereon
antl wha comracts lor such pmlecis with a coniractor(s) license pursuant to ihe Contractors' State License Law�. I am aware
Ihat pwo� ol iheir lNorker's Compen5aiion insurance s�oultl be providetl �o me.
� I am exempt unGer $ection: B. 8 P. C.
lor Ihis reason:
Date: Ownec
I do here0y cenify Ihal l am aware of antl untlerstantl ��e requirements of Califomia Heal�h antl Safeiy Code Seclions 25505. 25533, anU
25534 antl ��a� I or any lulure huileing occupant will/will no� (circle one) neetl �o compry wii� SaiA s�a�e co0e5 antl lhe reQuiremen�s lor a
permi� �or consimction ar modification fmm the Air �uali�y Management �istric�. Fesitlential conSlmciion ap0lications are exempi imm
Ih¢Se pmvisions.
Oale' ApPlicant:
I hereby cerli�y ihat I have read lhis applicatian antl state thal Ihe a�ove inbrmation is wrrecl I agree lo comply wi�h all city antl counry
or0inance5 antl sla�elawsrelating�o building conslmdion an0 hereby aulhoriierepresen�atives althis ci�ylo enieruponlhe abave�men�ione0
pmDeriy lor inspectian Dur0ose5. �.i� �/_/�
�aie: " Signaiure: / � �'t^� / --+ ���
Driver's iten5e a Sotial 5¢turi�y N: *�-�
Aoolicant Pink—Revenue: Goltlenrotl—Assessor
PERMIT NO: B
CONSTRUCTION
JOB DESCRIPTI
CLAIM VALUE:
COMMENTS: X
*�r�*�r**�r�r�e***
CITY OF COSTA MESA — BUILDING PERMIT
063671 PLAN CHECK NO: N
PE: 5—N PERMIT TYPE: STR
; REPLACE SIDING NER#224 UNITS 630
600.00 CALC—VALUE; 600.00
PERM NO: H 06367
GOVT: N SUPP; N
PURPOSE: REP
SQ FT: 600
GROUP OCC; R-1 /
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Z O N I N GS ERTEB�AUCIxRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT I IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT � IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ •' PROV: PARCEL: 93405012 2NE: REF NO:
PLANNING NOT'ES>
i ''n..
k if 1f if �f k!t 1flf iflf 1f 1f �f IF if iF if 1E1f k iE �E �E 1FiFiF IF ik iE if iF if iF�f �k�f �E 1f if if �f �f if jf iE if �f iE �FlF�E IE�f �k �f 1F �FiE �E �F1FiE if if if iF �Fif IF ik ik it �f i�lF it IE 3f
D E V fi 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=�T S
� rr
20NING APPROVED BY DATE; �"
BUILDING APPROVED BY : DATE:'
APPLICATION ISSUED HY; SI.� DATE: .�
Iflflfif�Flflfiflk�Effjkifff�flkkikikikik�f7FiF7FiF{f'iFiF�iF iFlFiFkkMifiFiEi!lt.iFlE� _ ifiF
M�f ikif iE iF kif �F iE iFiF if jf jflE!! M�f IFif k IF �FiE kiF iE 1F iE if �f 1E 1t�f iF�tif 1E if iF iF iF iE iF iE iF iEiF IFiF if �EiE �1E 1E iF iE M iF ff iFiE �k iF iEiF iFiF iFiF k if k if �f �f iE iF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAI. SEGMENT;Y
�
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 17.00 50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 17.50 0.00 0.00 17.50 17.50 ,00
REVENUBLDGVPMT PLUMBING ELECTRIC�MECHANDt FIRE��SMIP�TOT/SG�RADING PLAN—�HECK
17.00 .50
�F IE if iF if if af iE it iF k 1f if itik iF Iflk 1F k lkif if it iF 1f iE!! iE it iF iF iF iFiF iF if �k if it iF iFiF �F k�t ikiflF �E�F if If i! 1t�FiF iflf 1k ik If dEiE i! iE#k i! 1E 1Fi! �k It 1f iF iE i! iE if
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 600 ALTER BY VALUE RESIDENTIAL NOZONE
END OF FEES
1.00 600.00
ai ooi�s�\Y-ooitis�i� TOT i7,sa
DATE: 08/?t�/?3 TZI1E: 13:51
CONSTRUCTION AND PLANNING � "� - _ P� & SPA
APPROVALS Permit # - � Date Inspector APPROVALS Permit #_
7. Temporary Electrieal Servi� or Pole _ - 52. Pool &� Equipment Location
,i :_
2. Soil Pipe�Undrgrnd. � �_, 53. Steel Reinforcement
, 31 Elettri{:al CondiSit U�litV-Und�gmd. �� � 54. Forms
� i•_ir
�-A; �le�trieel Condu�tokJ?drgrnd. j', . 55. Elecfrital Bonding
"�K Ste'el R�einforceMe1t\_ `'x � ' 56. Rough Plumbing & Pressure Test
y�'�� '.�'�' �� '" 57. APPROVALTOCOVER�GUNITE
:+6;;r�Ce�ctrical UFER,G{�d. r.
i�,Zc7f.00tings -.� � � - 58. Electrical Conduit-Undrgrnd.
r, � + � '
�;� Fo�ndation � �� - 59. Gas Pipe, � U�drgmd., Test
� 9. Water Pipe-Undrgrdd. � - . 60. �Backwash Lines, P-Trap, O Undrgrnd.
10:� Suyctural Floor System " � 61. APPROVA� TO DECK �
• t t. Property Sewer Lin@-& Hoti;e Connection . 62. Backwash & Receptor�Final �
i
12• Sewar CaP , y 63. Heater & Vent-Final
73. Roof Drains • � 64. Plumbing System - Final
14. �Rough Plumbin� � " ' , 65. Electricai-Pinal
15. Rough Electrica:l`-Conduit 66. Solar System-Final -
i 6. Rough Elettric Wiring 67. Fencing & Access ApP�ovai
77. Rough Wiring Slgn 68. APPROVED FOR PLASTERING
18. Rough Electrica1-T 8ar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating'& A�r Conditioning FIRE DEPT. REQUIREMENT �
,., .�-: tT a+�-+a�f-� a�. a' �- N
20. �fiough F@etorq FireWlace i ;ni �'7 + O ;� 7'� ! 'pppROVAt-S�.^•�Eer�It # � � �T'
r Itt •-� -� >�• ) r"NWL� > t rt'
ru '" c 1 f-<<_ kS .r. �-� �7 ".1a- f Q S7'7�f Pi :r' [r,
21. �uCls; i�,$truCtur'e: � � .. .. ��y- x � �J ��x a -d0. �ndergrouryd-NY,dto z
22. DucZs. Venti�yiingr+- i f::: ��y � <L� _ � t. Product�Pl�irig D"a4 ❑Dii
23. �6as �PI e�Rou`h &'F�sc ' ^ .e �s r-, x F � �' � � d , `-'
�.p�, g� i p,S ,.M b. S O,..R,�2. Undergrbund�Flus��.,, F., -o
� s +� , � i :�.i � ..� . ., � ,i
24. ifioo.f.�Framing. �� *. i!�H •�t� •�� � b' �: +�73.uQlndergrnd?Storagesiank O Gas l7 O�l'
- x. �: n! •. [:] .': O .'.: # .. .-, Hr-•O r
� - ., ,. �; , ,ti;,; x '74.�O.v�rhead Hydro,� K
K J `. .. .}
26. rT-Bar�,Ceiling (Struciura0 & l�ionocoat .�c � m - t.y:n x 75.:Ory Chemical '7 !: i-+ �7 1
27.'Rrame and Fiashin9' �¢s : tr y m;: i�6.•'�t� Standpipe �-;� o� T;,.
�28. Lathing&SicEing . vi �yz�„ x ; z, :•.: • 77,7FIXEDS`FSTEM�tNAL• ��
.,.� ..
�-29. Insulation� -' ' � ' ' " ' g Y ' '. 78.'" IRE PREV. PIf�lA�L ' y
v S � K 't. � } ,'�
..7 ' S s t . � � . �
�30. Drywall Nailing >. > :-� hlEALTH:pEPT+RfiQUkR�lVIEI
�31. Plaster Brbwn Coat � � ' * ' ,�Z9.`IZINAL INSP�CTIbiN *' ' `r �;7
r7 s)- I h F. 9
��32.��Iectriral�Power Me[e{,Final j�E� s�, i i� ; 80. f00D CE(iTIFIC'AiE ISSUED `
33.'Fin�f Eleciri�� a .� ' ;. �n ` �` lTNotes: �' `7�- " '�
� m + ..� � x. * r i� l "J?� NP7
� H �-. cc . ... ,� � - � . r• � �
i�4.�Final=He'a,ting:� Air,�or�ditionin`g.S n -• > ;� S i�'.;: • ,S �;'
35..Final�Gas�PipE.Test" �d "� � ^ ; ' ^ �' �� =`��' � �T' S��
x � �. x �-� .. a � 50 .:h-, ,_i_..
.36.'Fiooj;or'Cano • y .�` ; Y - ,�' . , � K ", ".
PY x'�'7 I:+" a� .r i1 � It il:.. �ir�
� Hr-�
97.'Final'Fad4ory Firepl2ce+ ' S':*' a � Ot �'e'. i�� � p7
Y C I � {11
38. Final•Plucnhing Y xp� � •• •• C i. �� � R , � �--. • � �
i39. WatecSer.vice-Ffna�� -� � �•� " J r° '-'T �• c C
r' ,
�40. Gas Service-�,iJ'nal _ . � � J ; x �� '� ' - �
d�� Y - c�: �t�^
;41. Solar pomesticPinal � r.l � •• �< <�, � ^i� . '
.y r x � r -:0 7 s' �
�42. �Backflow Preventer' `' :�i ; "' , . �� '"�� A :`
., 1: ' z .0 : 1
43. Backflow Irrigation- -=�a ' ' T'�- "= '-+
_ 1 � �: i K
.r �. i � . R, x tf �.�
;�4. Landscape Ir�gatiorj System,n�r�= � � � .7 = � • ;� ;;�, .R �.,
�
:45.�.Sound AttenLatiom< ...�.^,F, t� -. . _ - - ; i c'� i, i-: �s� :cS x � .
�n �1� i. �_,. J r, � ti:� X'
;46. `HandicaP;Re§�ulatio�s S �T. `r ��z s '� � � -. . ••� ''`
_ :; � •. �:� � o S x
--i;---
a�.;F, INAL STRLICTU%� & BUkC`DJNG ��� ti0 i T w
48.;FINA�PLANNING'. ' �`'� � ` ��" { �' ` `�
� h I � (-• r,:'.i %. '( .[,
c49, Electiic Releyse to -disan � . � - � �� � -
r .` !� � _
.50. Gas Fielease to Soutfiem Califor�ia Gas Co ° �; ` � �� _ , � ,, ��,. �, J
t-
:57. CEq71PICATEOF'�CCUPANCN � �" y �� �;y,� _ ,. f� �
No._ .__ _ Oate T
Date Ilnspector,l.
0
r�
, •'4
i
r
��'
\
CiTY oF COSTa/�"f ESn CONSTRUCTION �PCy/o` MIT
Project Add�ess /�-�� ��!���� L, v
Applicant's�Mailing Address ` '
�
Owner's Name �('�/.� �E �f P�hone,�}5-07�.
Address 6 �� �-f�1r1.1%/�- �'/`� •
%
�.Arch/Eng. - License No.
Address ,/ �p����,
Contractor'sName /7•C•�i//RPN� //� Phone(>!S7-�L
Address (msiling) ��SJ��Oj ��lr60�C�.P� s%r;/1/77�V
City License No. �GK�2 ' -
LICENSED CONTRACTOR OECLARATION
I he�eby aftirm thaL, 1 am licensetl untle� piovi51on5 of Charte� 9(commencinc
with: section 7000) ot DiviSion 3 of the Business antl Professions Cotle, anC
_my ilcense is in tull�rce andpjtecL , � , ' �� ��
Applicant to till tn all spaees exce0< those witnin heavY ooraer Iines anG sign all a
PER NO. TRACT NO. LOT NO.
. -,,n � � .
�.3te � Signature
�N�JRKEftS' C MPENSATION DE LAR
�.�Aereby aftirm that I have a cevtificate of consent to Selt nsu�e o� a certiticate
� of Workers' Gompensation Insurance, o�.a certifletl copy thereot (Section
3800, Lab. C.) ' '
PoliCy No. Gompany
eCertifietl,copy is he�eby fumishetl.
Certifietl copy is tiletl with th¢ City Builtling Division. ,
Oate Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl if the permi[ is for one huntlretl ($100) or
less).
I tertify ihat in the pe�formance of th¢ work f0 MCTtfri e�mit is issuetl, I
sM1all no[ employ� an person in any manner o b¢co su ct to the
Workers'��i oj�� pse ws of Calit
. Date —/—/.L Signature
�NOTICE!If, af[e makin9 this tlecla�a[ion, you 5 e 5 ject to thC
Workers' Compensation provisions of tne Labor Cotle, you m st (orthwith _
compty with mch provisions or IhiS permit Shall be tlee etl revoketl.
CONSTRUCTION�LENDING�AGENCV �
1 nerety aifirm that there is a construction lentling agency for the performance `
ot the work for which this permit.is issuea (Section 3097 Civ. C.)
Lentler's Name ,
Lentler's Atltlress - '
OWNER BUILDER �ECLARATION
I hereby affirm that I am exempt from the Contractor's License Law-�for the '
following reason (Section �031.5 Businass antl Protesslonal Cotle: Any city or
wunty which �equires a permit to.conSt�uCt, alter, improve, tlemolish�o� repair
,vnv cnucture._ nnnr t� its issuance. also�reouires the aooliwnt for such"oermit
..g.._
theretrom and the basis.for the allegetl exemption.•Any;violation of Section
]031.5 by any applicant tor a permit subjects the applicant to. a civil
, enalty ot not more than five huntlretl tlollars ($500).
� I, Ss owner of the property or my employees witb wages as their sole
� compensation, will tlo the work, anC the structure is not intentletl or oifered
for sale (Section 7044, Business antl Protessional Cotle: The Contractor'S
License Law tloes not apply [o an owner'of a property who builtls or improves
tbereon, antl who does such work nimself/herself or through his or her own'
employees, provitletl that such improvement5 ar¢ nOt in[entletl o� offe�ed for
Sale. If, however, the builtlin9 or Improvement is soltl within one year o( mm-
D�etion, the owner will have the bu�tlen Ot proving he/she tlitl not builtl o� im-
prova for the purpose of sale). , . � �
❑ I, as owner o( tM1e'property, am exclusivelycoMracting with licensetl <on-
tractorsto construttthe Droject (Section ]044, Business antl Profe55ions CotleL
The Contractor'S License Law tloes mt apply to an owner af property who
builtls or improves thereon, antl wno'contracts for such,projectz with a ron--
tractor(sS license.pursuant�to the Contractor's License Law). I am aware that
proof ot tneir Worker's Compensation insurance shoultl be p�ovitletl to me.
❑- i am exempt untler Section B. 8' P. G. for Ihis reason,
Date Owner ' '
I heretiy certity thaY I�nave reatl thiz application antl state that�the above
information is correct: I aoree ro comply with all citv antl countv ortlinances'
tleelarations.
TVPE OFCONSTHUCTION LINEW LJ ADD �ALTERATION IJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER �
DESCRI��SH��RKcg/U��� LDG.
TYPE OP PERMI�GRADING�g F UNDATION STRUCTURAL
❑ TENAIVT ❑ ELECTRICAL y�PLVMBING• ❑ MECHANICAL .
❑ ATHER
PROJECT DESCqIPTION 5i]. FT: � oCCUPANCv
CONSTRUCTIONTVPE ' VALUATION$
ZONE � GRADINGCU.VOS. ACRES
Remarks: �
� PI
Bar Sink
eackflow Preventer � �
BackflOw Irrigation
Bathtubs
Clarifiers y
Dishwlasher • a
Drinking Fountains
Floor Drains
Floor Sinks
. Gas Service Outlets �
Interceptors
Kitchen Sink
t Lavatories ' -
P-Trap
Roof Drains -
,I Reinspeetion Fee � $15I ,
, , . ; MEI
Boiler. " _ '
Duc[ - Under Ground�
Duct+Structural ' '
Duct - Ventilating '
Exhaust System ❑ Multiple ❑
Firepl/Fact. BIt. ICBO #
Heating System & Ducting
❑ 6100,000 BTU� O 100,000 BT
' I antl state laws relaUng to Dulltlln con5[luc[IOn, antl Ileleby authollze fepre-, .
sentatives of i cit o ente pon the above-mantionetl pr erty for
inspection � ��
Signdture Date �
Drivers' License or � Rainspeetion Fee '$15
CMF 0865-46, rev. 10/84 White - Builtling; Canary - ApplicanL Pink - Accounting; Goltlenrotl - Assassor
Showers
Service Sink
Sewer,Connection
Solar Collectors'
Solar Pipin9 •
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet .
Water Heater -
'Water Seivice ' �
Au[o-Wash .
Laundry Trays �
Isue Fee
Hood or Type I ❑
Canopy Type I I ❑
Refrigeration System
❑6700,OOOBTU ❑700,
System Repair/Alteration
Fire Dampers
Registers
Issue
FEES
A.P. # ' '
5 � Main Building: _
E
T Front
e Rear
A
C Right
g Left
Ping. Ref. #
Planning Notes:
'� Automatic Washer
Construction�Pole Su
� � Cooking Unit "
� Dishwasher
' Dryers ❑Gas 'DEIi
Fan �
F,A.U.
Fixtures '-
� Device Boxes
Outlets
Switches
- Garba9e Disposal
Generator �0.5 KW
$ 3
�
- -- ��n
'4850 II/26/�5 . .i o.00 TL-,:
Accessory Building:
� s
Parking Req./Provic
Zone •.
Z
O
N
' I
• . N
G
ELECTRICAL � .
- Transformer ���15-50 KW �
0 50+KW '
Meter ❑up to 100 amps �
Meter ❑aver100amps
Sub Panel . �
Motors DO-1 HP 01'/: - 8
Inc.Solar �9-15 HP �i6-15+
Microwave ' -'
Pole Light
, Range � . , �
; Standing Sections
15 KW Trash Compactor
I Reinspection� Fee i!$15 I . � luue Fee . � I. $ 3 �
DEVELOPMENTSERVICESREQUIREMENTS: . � � ,
Zoning Approved By � � Date �
Building Approved By _ Date I'
Appliwtion laued By / ' Oatw. � ��
� SUMMARV OF FEES '
BUILDING PERMIT $ � SMIP $�
PLAN CHECK $ PERMIT
PLUMBING $ � � ISSUANCE $�
PLAN CHECK 25% $ ENERGY P.C. $� �
ELECTRICAL- $ � GRADING ' $
PLANCHECK 50% $ � ' MICROFILM $ � -�y
MECHANICAI . $ TOTAL FEE $, _�' W
PLAN CHECK 25% $ � . � � .
CONSTRUCTION AND PLANNIN� L & SPA ' � " . ' . "
APPROVALS Permit # Date Inspector AppROVALS Permit # � ' � Date' Inspector
1. Temporary Electrical Service or Pole- 52. Pool & Equipment Location �
,:
2. Soil Pipe-Undrgrnd. �- !'j'- 53. Steel Reinforcement ' - � ,;nt ,
3.�.Elect?ica� Conduit l'itility-Undr�rnd:� �� 54. Forms � �
` ' . � � . , ;�,',�� � .
4 t�Electrical,Gonduif-1lpdrgrnd. y . 55. Electrical Bonding ' .'�
.1: -'
5. Steel'fieinforcement ;e�� ��,' � 56. Rough Plumbing & Pressure Test ' . ' • � ,*�-,''�_�
;: _... ,� . � .' _ .f"jJ.
6yElectrica,lUFER;Gr.nd.� 57. APPROVALTOCOVER-GUNITE .
� 7~�Footiu�gs' �' �r> a_�` ;'��� 58. Electrical Conduit-Undrgrnd. � ! ` �
B.�Foundation :^ ri r4;.' =�?' 59. Gas Pipe, O Undrgrnd., TesY - ��ti
9" Water P,ipe-Undrgr�d? . i. �yf� �; j,'! 60. Backwash Lines, P-Trap, � Undrgrnd. � �.
tO.��Structutal Floor System �' � ,;%, i 61. APPROVAL TO DECK ' ;�
':i _:
11.�Property�Sewer Line & HouseConrtection .�`�% 62. Backwash & Receptor-Final
:�z.SeW?l;�P "!(' � f � ' 63.Heater&Vent-Final � �;
13. Roof �Drains �"} � •�� ' 64. Plumbing System - Final �����
. i.,
14. Rougf� Plumbing�� tj �: 65. Electrical-Final , �
15. Rough Electrical-lZ.onduit 66. Solar System-Final . . _ "
i6. Rough Electric Wiring • ` 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � _
18..Rough E{ectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �
19. Rough H2ating & Air Conditioning �FIRE DEPT. REQUIREMENT � �, -
. 20.� Rough-Factory Fireplace APPROVALS Permit # ,
21. Ducts, i�'.Structure ' . 70. Underground Hydro �
22: Ducts, Ventilating 71. Product Piping OGas. OOiI '
23. Gas Pipe'=Rough & Test - � 72. Underground Flush - -
'24. Roof Framirt`g' , 73. Undergrnd.StorageTank OGas ❑Oil �
25. �Roof Sh`eathing • 74. Overhead Hydro �
.�
' 26. �:T-Bar Ceiling (Structural) & Monocoat ' � • ' - - 75: Dry'Chemical ' ' �� � �- - � -
27. FGame 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. Hopd or Canopy ' - . � . .
37. Final Faaory Fireplace - � . � - _ -� �
38. FinalPlumbing 5iv_� L� . -
39. Water Service-Final � � -
40. Gas Service-Final " � � '
41. Solar pomestic-Final ,,. ,
42. Backflow Preventer� �� . ` �
; , .
43. Backflow Irrigation ' � � �
44. ,Landscape Irrigation System . • - '
45. Sound Attenuation, ,
46. Handicap Regulations ' " - � ' ' - ` ' �. '�
47. FINALSTRUCTURE&BUILDING . ' � ' . '' • �
48. Special Requirements Completed � • � � -
49. Electric Release to Edison � � : .
.�
50. Gas Release to Southern California Gas Co � i � .� i�
51. CERTIFICATEOFOCCUPANCY • �
- - . �;
No. Date '
I�«,'^"`�-, �_