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Home My WebLink About662 TOWN CENTER DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-meSa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 662 TOWN CENTER DR 41005144 Applicant CARYN VANSCHINDEL - , � - - Address: 8210 MONROE ST - � ;�'� , � . � - � �''� �i %�: _, Phone: 714-82&5310 '� ' STANTON, CA�/,- �- Zip: 90680 - � / �. . ;ii� - �. . � . . , . <' �i � ` \ .- . i' . ' i j ': Owner:�OUTH COASLPLAZA %ONE TOWN CENTER DR ASSOC i .� / � , __ - Address� % ET AL \ , � , � i/ � , i'.-�" . � _ � � ��COSTA MESA, CA� � Phone: � , � 3315 FAIRVIEW RD Zip: � " /..�i Contractor: BAXTER AND GRIFFIN Addiess: 8210 MONROE ST � � � � - -� 'Phone: 714-8265310 � � , � .STANTON, CA , �" � � �� Zip: 90880 � � � , � . � , � License: 290788 � Status: ISSUED Applied: O6/11I2003 Issued: O6/11/2003 �� : ��Ir� �: � \ � ., � � � . . � , . _ ..� � `� �, . � , �- �, SCOPE OFFPERMIT � � � � INSTALL METER PEDESTAL ON PRIVATE PROPERTY.'�, l� " ��" , . ELECTRICAL TO INCLUDE: SERVICE TO 200 AMPS FOR A NEW LIGHT SIGNAL FOR CROSSWALK. �. . � Quantity ISSUE FEE $23.50 , Temp service test \ $0.00 , Res. a/c packege , ' $0.00 New Res (1-2 units) � � ;, $0.00 NewRes'(3+units)' '�`,. $0.00 Pool / Spa J � � � $0.00 \ Ligh�ng Fixts,' - , � ��$0.00, � Recept Outlets;; � , $0.00;� � � sW��ones ��;,�, �� so.00; ��;� � Non Res Appl `� � � ' $0.00 �'- Res Appl � � �' " $0.00'�. . Service to 200a �� \ - ' $30.50 -', � Service to 1000a A -��. $0.00,�,' - Service over t000a � `� � $0.00 ; �- Motors to thp A� $0.00 � Motors to 10hp � $0.00 .� Motors lo SOhp $0.00.� � ._ Motors to 100hp $0.00 - Molors over t00hp $0.00 Communication drops $0.00 Sub panel to 200a $0.00 0 0 0 0 0 0 0 0 1 0 �� 0 0 0 0� 0 ; _Q 0 0 FEE SUMMARY : _ . Temp Dist System / Lighting Busway/t00t1" . . Standing Section , . -� MisdElectrical Equipment , Transformers up to 1 kva/kw .: . , • < " ................up to t0.kva/kw .. . .....:...........up to 50 kvalkw ; � . .................up to 100 kva/kw � , ...................over 100 kva/kw Low Voltage Equipment - Low Volt Winng Systerri / Ckt � . Misa Conduit - - Misa Conductor � � . Circus ( gen ar ride). '� � ' - Circus (mech ride or IighLs) , � Christmas Tree Stand . -. , � �- Fireworks Stand � � � - � Other ElecVical Fee , �, �- --- - _ Investigation Fee ' Plan Check Fee �uantity � �$0.00 0�� $0.00 0 $0.00 0 so.00 0 $0.00: -, �, 0 $0.00 � 0, $0.00 " 0 so;oo 0 $0.00 0 � $0.00 0 $0.00 0 $0.00 0 $0.00 0 . �� $0.00� �� 0" $0.00 �" �� 0 $0.00 " 0 $0.00 0 $0.00 $0.00 $0.00 NO710E: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a pariod of 180 days. ' INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetlone and final epproval must be obtalned. Failure to obtain inspections and final approval will result in the explration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 2ad&a8 (8I00) WORKERS' COMPENSATION DECLARA710N: I hereby ettirtn under penalry at peryury ona of the following tleclarations: ❑ I heve and wlll meinteln e certificate of consent to self-Insure for workers' compensetion, as provided Por by sec�ion 3700 of Ihe Lebor Cotle, for Ihe pertormance of Ihe �work for which thls permlt Is issued. I heve end will maintain workers' compensatlon Insurance, es reduired by sectian 3700 oi the Lebor Code, for the perfortnance of the work tor w�lch ihis pertnit Is Issuetl. My workers' wmpensatlon Insurance carrler and policy number ere: Certier. S-f�G-� O Cb m n 7��v+5u ��i.� v� 0� ' Pdicy Number: �%Z �i ��'I �J � ZDD �j. (7nis section need nor be comp red i� rne vermir is vemed er one nundred aonars �5 �oo� or iess./ ❑ I certify that In the pertortnance of the work tor which Ihis pertnit is issued, I shell not employ eny person in any manner so es ro become subject to the workere' compensetion laws ol Celitomia, antl agree t�at if I ahould becoma sub�ect to Ihe workers' compensetion provisions ol Section 3700 ot t�e LaDor Code, I shell fonhwith complywiththeseppyis' ns. � � ` II' ID�- Applicent Signature: � � (' 'i Dete: ��' WARNINO: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNIAWFUL AND SHP1L SUBJEGT AN EMPLOVEF TO CFIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED hKKl$AND DOLLARE (5100,000�, IN ADDfT10N TO THE C0.5T OF COMPENSATION, UAMAGES AS PROVIDED FOR IN SECiION 3/060F THE LABOR OODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby alfrm that I em licensad under provisions oi Chapier 9(commencing with Section 7000) ot Division 3 oi the Business end Professions Cotle, an0 my license is in full torce entl eHect Lic. q `� % Class k C-� � O Contrectors signature: � oate: _�P ll_ d'3J � CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn Ihat there is a consiruction lentling agency lor iha peAormance of Ihe work for which this pertnit is issued. (Sec. 3097, Civil Code). Lendels Name: Lenders Address: Signeture: Date: OWNER•BUILDER DECLARATIONS: I hereby eHirm Ihat unCer penelry of perjury that I�m E7(EMP7 FROM THE CONTRACTORS LICENSE LAW for Ihe following reeson (Sec. 7037.5, Business anG Professions CoGe: Any ciry or counry which requires e pertnit to consWct elter, improve, tlemWish, or repair any swcture, prior to its issuance, also requires the applicant for such permit ro file e signed stetement that he or she is Ilcensetl pursuant to the prarisions ol Ue Contrectors License Lew (C�aprer 9(commendn9 with Section 7000) ot Divisian 3 oi the Business and Profeuions Cotle) or that he or she is exempt therelrom and the �esis for Ihe alleged exemption. Any violation of Section 7031.5 by eny eDP�icant for a pertnit subjects Ihe applicant ro a civll penalry ot not�ore than live hundred dollars ($500) J: ❑ I, as owner oi Ihe properry, or my employees wilh wages as their sole compensation, WILL DO THE WORK, end the structura is noi intendetl or oNeretl for sale (Sec. 7044, Business anG Professions Gode: The Contrectors License Law does not apply lo an owner ot properry who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, providetl �hat such improvements ere not intended or oHeretl for sele. H, however, ihe bullding or improvament is sold within one yeer ol complation, the ownervbulltler will hevethe burden of pmving ihet ha or she did not buila or improve for purpose of sele.). � ❑ I, as owner ai Ihe properry, em E%CWSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to cOnslruct the pro�ect (Sec. 7044, Business entl Protessions Code: The contractors License Law tloes not eppy 10 an owner ol pmperty who builds or Imprwes thereon, and who contrects for such project wlth e contrecior(s) licen5e pursuent to ihe Contractors License Laws.). ❑ I am exampt under sec. Business and Professions Code for this reason: Signatura: Date: Owner ID verifietl by tlrivefs license. ❑ Ves ❑ No Orivers License No. Expires: Vedilcation of Ownership by (type of daument, i.e. - properry taa blll or daed): DIVISION OF INOUS7HIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity thet no excevation Five (5) or more feet in depth inio which e person is requiretl to tlescend, will be metle In wnnection with work euthonzeC by ihis pertni4 and Ihet no building sWcture, sceHolding, falsework, or demolition or dismaniling thereof, will be more ihen thirry-slx (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Celltomia Adminisiretive Code). ❑ As owner-builtler, I wlll not employ enyone to do work which would raquire e pertnit from Ihe Division of Industnel Sefery, es noted above, unless such person hes e permit to do such work Irom the division. Signeture: Dete: Division of Intlusirial Safery Permit Number: CERTIFlCATE OF COMPLI/WCE AND AIJfHOR1ZAT10N OF ENTHV: I cenity under penelry o� perjury Ihat I have read ihis epplication and state that the infortnation given Is correct I agree to comply wilh ell state laws end clry ordinances relating to builtling conscructlon, entl authodze representutives of the Ciry o1 Costa Mesa to enter upon Ihe ebove-descnbed properry tor inspection purposes. I egree no� Io occupy or allow occupancy ot any builtling authonzed by this permit until final inspection. COPE �, INSVECTIONTYVE pdIE 1�` 1616 Fixetl System Final Fire Preventlon 1268 200 Pool Spe Flnel Final Re-Root 201 Final BIocWReWining Wall 202 Final Fectory Fire Plece 203 Final Sign 204 Final Demolition uate ��// /D � Date COOE� �NsvernoNnae 206 Finel Mechanical QAg L�Lfl 208 Finel Plumbing ') Q 210 Finel Elecirical QI 212 Final Pire Prevention 220 Finel Planning Approval 222 Final Site 250 Final Building/Occupanty