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Home My WebLink About430 WILSON ST - Building Permitsm (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 430 W WILSON ST NORTH SIDE OF WILSON (HARBOR CENTER) TPN02001 Applicant: SCHINDEL, CARYN Address: 8210 MONROE ST - � STANTON,,CA " Owner. " CITY OF COSTA MESA' Address Contracror. BAXTER AND GRIFFIN Address: 8210 MONROE ST ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+uniLs) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a , Service to 1000a' Service over t000a Motors to 1hp Motors to tOhp Mators to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intertned Pole STANTON,CA Phone: 714-82E5310 Zip: 90680 Phone: Zip: �Phone: 714-826-5310 Zip: �90680 License: 290768 ISSUED BY: _ SCOPE OF PERMIT INSTALL TRAFFIC SIGNAL ON WILSON BETWEEN�K-MART PLAZA AND HARBOR CENTER. $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00' $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantiry - _ FEE SUMMARY - Temp Dist System hLighting Busway/100 k Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw .....::.........up to 10 kva/kw ...........:...:.up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment � Low Volt Wiring System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand � Other Electncal Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: OS/30/2002 Issued: OS/30/2002 Quantity $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 50.00 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 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornia statutes and related regulations. (Ord. No. 92-28, § 7, 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 period of 180 days. ' INSPECTIONS: In order for the work authorized under this parmit to be considered legal, such work must comply with all applicable codes, and all raqulred Inapectione and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 yJ�.�+.�i(�:ca: WORKERS' COMPENSATION DECLARATION: - I �ereby attirm under penalry of perjury one ot the following declarations: ❑ I have entl will maimain a certificate of consem to self-Insure for workers' compensation, es provitletl tor by section 3700 of the Labor Code, tor ihe perfortnence of ihe work for which ihis permit Is issued. �=1'have end will maintain woBers' compensation insurance, as required by section 3700 of the Labor Cotle, for the peAormance of Ihe work for which this pertnit is issued. My workers' compensation Insurance carrier antl policy number are: � Cerrier:�5-I�G.-�-P CO rn nP SG-F� o r� �l5 .�lw v� GI � [P.olicy Number:_ �� Z D I� 5" (This sectian need not be comp eted d the Oermif is valued et one huntlretl tlollars ($100) or /essJ �--�� ❑ I certify that in the peAormance oi the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cai' ornia, antl agree that if I shouttl bacome subject to the workers' compensation pmvisions ol Section 3700 oF the Lebor Cotle, 1 shall forthwith �ply.wi� se i ns. / ^, . O !ApplicanYSignature: �1LL-/"�C�-�- �-Date:�. S��D � D � � WARNINO: FAIWRE TO SECUfiE WORKERS' CAMPENSATION CAVERAGE IS UNL4WFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE (5100,000�, IN ADDITION TO TNE COST OF CAMPENSATION, �AMAGES AS PROVIDED FOF IN SECTION 3]W OF TME IABOF CADE, IMEREST, AND ATTOFNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, end my license is in full ilv `6' �s�#-7 G-10 ' ��OG�r.r-i oate:—� �130�p 2 . CONSTRUCTION LENDING AGENCY: ❑ I hereby aRirm that there is a consiruction lending agency for the pedormance oi the work tor which this permit is issuetl. (Sec. 3097, Civil Code). Lenders Name: Lentler's Atltlress: Signature: � Date: OWNER•BUILDER DECLARATIONS: I hereby a%irtn that untler penalty ot perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following reason (SecJ031.5, Business and Professions Cotle: Any city or county which requires a permit to constmct, elter, improve, demolish, or repair any siructure, pnor to its issuance, also requires the applicant for such pertnit to file a signed statement Ihat he or she is licensed Oursuent to the provisions ot the Contrectors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or ihat he or she is e:empt iherefrom and ihe besis for ihe alleged e:emption. Any violation of Section 7031.5 by any applicant for a pertnit subjects ihe epplicant to e civil penalty ot not more ihan five huntlretl tlollers ($500).): ❑ I, as owner of ihe property, or my employees with wages es their sole compensation, WILL DO THE WORK, antl ihe strucWre is not intended or oflered for sele (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of property who builas or improves ihereon, and who does such work himselt or herseN or thmugh his or her own empioyees, pmvided �het such improvements are not intended or ottered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden ot proving ihat he or she did not build or improve for purpose of sale.). ❑ I, as owner ol the propetly, am E%CLUSNELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business end Profassions Code: The contractors License Law does not appty m an owner of property who builds or improves thereon, and who contracts for such project with e contrector(s) license pursuant to the Coniractors License Laws.). ❑ I am exempt under sec. Business antl Protessions Cotle for this reason: Signawre: Date: Owner ID verified by dnveYs license. ❑ Yes ❑ No Driver's License No. E:pires: Veritication of Ownership by (type of tlocument, i.e. - property tax bili or daetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hareby certify that no excavation five (5) or more feet in tlepth into which a person is required to descend, will be made in connection wit� work au�honzed by this pertnit, and ihat no huilding structure, scaHolding, falsework, or demolition or dismanBing Ihereof, wiil be more ihan thirty-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec. 341, Title 8, Califomia Administrative Code). ❑ As owner-builtler, I wiil not employ anyone to tlo work which would require e permit irom the Division of Indusirial Safery, es notetl ebove, unless such person hes a pertnit to do such work from the division. SignaWre: Dale: Division of Industnal Safery Permit Number: CEBTIFICATE OF COMPLIANCE AND AUiHORVATON OF ENiAY: I certify under penalty oi perjury Ihat I have read this application ana state that the information given is correct. I agree to comply with all state laws and ci�y ordinances relating to building consiruction, and authorize representatives of ihe Ciry of Costa Mesa to enter upon ihe above-described property for inspection purposes. I egree not to occupy or allow occupancy of any building authonzed 6y this permit uMil final inspection. CODE t. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Roof 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 Finai Sign 204 Final Demolition . �pTE IMIiIr1L5 / Date S�o/n � - �Date=„ COpE I INSYECTION TYPE 206 Final Mechanical 208 Finai Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy �g .2� 5-02 �$