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Home My WebLink About794 VICTORIA ST - Building PermitsCITY OF COSTA MESA BUILD/NG DIV/SION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca. FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: E08-00192 PERMIT TYPE ELEC STATUS: ISSUED APN: TPN007265 „d, _ ;,DATE ISSUED: 06/11/2008 ISSUED BY: RMD ,' s ' JOB ADDRESS: 794 B VICTORIA ST CM ' `' Su'ite/Untt *' B Vicinity: SIDE WALK , - SCOPE OF WORK: INSTALLATION �OF A 200A��SVC`PANEL FOR A NEW PEDESTAC'LOCATED_IN�PUBLIC RIGHT OF WAY. REF#: P508-00850. - ._ y e. c OWNER: CITY OF COSTA MESA_;'�„ "- � „ ,- Atldress: :Umt ' � � ^ � �.� � PHONE: � � . City/State/Zip; .: � � ' � . � i .: � . . . . APPLICANT: HARPER;,BART ��'_� Address: 704 DRY GULCH PLACE- Unit: PHONE: 951-520-0434 . City/State/zZip: NORCO, CA " CONTRACTOR: HARPER ELECTRICAL"CONTRACTORS INC � :�License No..�„-779882 : ' Address: 704 DRY GULCH`PCACEUriit:�- �,.' '�� ` �� -� �' � � � -. i � PHONE:-�-.--951=520.0434 -.'- City/State: � NORCO, CA 1�ZlpCode 92860�';' - CELL:�� ELECTRICAL PERMIT:FEES , Electrical Plan Check Fee::" t. '$0.00 Electrical Permit Fee: ":$54 00 Reinspection Fee $0 00 TOTAL FEES $54.00 ' < < �- 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 applirable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the ezpiration of this permit. GOOEt. INSPEC710NTYPE ORTE INiI� COUEN INSPECPONTYFE . OATE INiI11RL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 PoolSpa Final� - 208 Final Plumbing � 200 Final Re-Roof � 210 Final Eleciriwl "Sp (.(%Ud ��— 201 Final Biock/Retaining W all 212 Final Fire Prevention 202 Final Factory Fire Place - 220 Final Planning Approval 203 Final Sign 204 Final Demolition 222 FinalSite 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent lo sel(-Insure for vrorkers' compensation, as provided for by section 3700 of Ihe Labor Code, for the pedormance of the�vrork for which �his permit is issued. . � I have and will maintain workers' compensation insurance, as required by sectan 3700 of Ihe Labor Code, for [he peAortnance of the work for vmich this permit is issued. My workers' wmpensation Insurance carrier and policy numberare:/� /�l/ / g�� Carrier: Yiucx+'<%'�-�'✓4�i ( � � (inusect�unnee0�ro�bewmpete0i/mepermrtarv/alued/a��rne—h�un� /4re0 lars(Ef00)aless) �Policy Num6er: 1,t� �� Y�/ l U— �� ❑ I certify that in ihe peAormance of lhe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to ihe vrorkers' compensation laws o( California, and agree that if I should become sub' [ lo [h workers' com ensation provisions of Section 3700 of the Labor ort w0.h co ly with these provisions. �` �/� �x pli nl's gna e Date NING: FA L RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn 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 �fuyll fyq{c�(e�/ ntl eHect. /� Lic: #��7/ U o� Class # v—�� r%— ��—� � 9n . _ _ Oate STRUCTIO LENDING AGENCY: ❑ I hereby aKrtn tha[ there is a consWctbn lending agency tor [he pedortnance of the work for wfiich Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: Signalure OWNER-BUILDER DECLARATIONS: I hereby aKrm that untler penalty of perjury that I am ExEMPT FROM THE CONTRACTOR5 LICENSE LAW for the following reason (Sec. 7031.5. Business antl Professions Cotle: Any city or couMy which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit to file a signed statement Nat he or she is licensed pursuant ro the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) o( Division 3 of ihe Business antl Professions Cotle) or that he or she is exempt therefrom an0 the basis for the alleged exemption. Any violation of Seclion 7031.5 by any applican� for a permit subjec[s the applicant [o a civil penal[y of not more than fve hundred dollars ($500).): ❑ I, as owner of the property, or my employees with vrages as their sole compensation, WILL DO THE WORK, antl the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contracmrs License Law does not apply to an owner of property who builds or improves thereon, and who does such vrork himself or herself or through his or her own employees, proJided that such improvements are not intended or offered for sale. If, however, the buildinq 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 constmct the project (Sec. 7044, Business and Professbns Code: The contractors License Law does not apply to an ovmer of property who builds or improves thereon, and wfio con[racts for such prqect with a contractor(s) license pursuant to the Contractors License Laws.). � ❑ I am exemp[ under sec. Business and Pro(essions Code (or this reason: Slgnalure 305]-06 (3/0]) Owner ID verifed by driva ,ise. ❑ Yes ❑ No Dnver's License No. Expires: Verification of Ownership Dy (type ot document, i.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: - ❑ I hereby certify that no excavation (rve (5) or more feet in tlepth into which a person is required to descentl, will be made in connection with vrork authorized by this permit, and lhat no building strucWre, scaffdding, falsev.nrk, or demolition or dismanUing Ihereof, will be more than thirty-six (36) (eet high. (Chap. 3.2, Grp 2, AA 2, Sec. 347, Ttle 8, Califomia Adminisl2tive Cotle). ❑ As ovmer-builder, I will not employ anyone to do vrork which woultl require a permit trom Ihe Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Appliranfs SignaWre Dale Division of Intlustnal 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 hazartlous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safery Code requires, wi[h some exceptions, ihat a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one lime tluring a reported year a quantity of hazardous materials equal m or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas al standard temperawre and pressure). 2. Does or will the appliwnt or present or future building occupant need to file a registration form (or acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Healih an0 Safety Code, with some exceplions, requires registration vn[h the Costa Mesa Fire Department by each business which at any one time has on hand a quan[ily of acutely hazardous matenals equal to or greater than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperaWre and pressure). 3. Does or will the applicanl or present or future building occupant need to prepare an RMPP (Risk Management and Preven[ion Program for acutely hazardous materials)? � Yes ❑ No (Section 25534 ot the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparalion, certifcation and fling with the Fire Department of an RMPP by businesses which are required to register acutely hazardous matenals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Satety Code been fully complietl with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the vrork which is the subjec[ of this application a permil for such construction or motli(ca�iOn fmm the Soulh Coasl Air Quality Management Districl or from any other air pollution control disMct or agency? ❑ Ves ❑ No (SecYwn 65850.2 of ihe Califomia Govemment Code requires that the requestetl infortnation be fumished on applications for non-residential building permits). 6. Will any part of the facility to be constructetl untler this permit be within 1000 feet from the ouler boundaries of a school? ❑ Ves ❑ No Q('yes", Ihe faciliry must meet the requirement of Sections 25534 and 42303 of the Cali(omia Health and Safety Code). 7. If a permit (rom the South Coas[ Air �uality Management District or other air polWtion contml district or agency is required for [he work which is the subject o( Ihis application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been matle9 ❑ Ves ❑ No, 8. Qf'yes", attach certificate of compliance fmm ihe appropriate air polWtion control Offiter�. CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the in(ormation given above is correcL I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Si9naWre Dale 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 correcL I agree to comply with all state laws and city ortlinances relating to builtling construction, and authorize representatives ot 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 y this p rmit uNil final inspection. r I (s oale � //—O 'Mtllo AW�o x � pliwnt Oale / �� 'i