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Home My WebLink About3199 FAIRVIEW RD - Building Permits� CITY OF COSTA MESA ' o "'F BUILDING DIVISION it� � 77 FAIR DRIVE, COSTA MESA, CA 92626 • Q14) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us �.�� POR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: E10-00057 PERMIT TYPE ELEC APN: tpn01002 JOB ADDRESS: 3;99 EAIRY,IEW RU GM Viciniry: STATUS: ISSUED DATE ISSUED: 04109I2010 ISSUED BY: Suite/Unit: SCOPE OF WORK: ELECTRICAL PERMIT FOR THE INSTALLATION OF A 200 A METER PEDESTAL. OWNER: CITY OF COSTA MESA PHONE: Address: Unit: CitylState/Zip: APPLICANT: BRAp , B(o�-L� I Address: 9316MABELAVE Unil: PHONE: 951-271•2227 CirylStatelzZip: SOUTH EL MONTE, CA CONTRACTOR: CALIFORNIA PROFESSIONAL ENGINEERING License No. 793907 Address: 9316 MABEL AVEUnit: PHONE: 626�452-8658 City/State: SOUTH EL MONTE, CA ZipCode: 97733 CELL: ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: . Reinspection Fee $0.00 TOTAL FEES NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia slatutes antl related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for fhe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE�. �NSYEC710NTYPE 0� INTIiIAL COOEt INSPECTIONTYPE D� INif111L$ 1816 Fized System Final Fire Preven6on 208 Final Mechanipl 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electncal x gl�f � 10 H� 201 Final BIocWRetaining Wall 212 Final Fire Preventlon 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 200 Final Demolition 250 Final Building/Ottupan�y WORKERS' COMPENSATION DECLARA710N: I here�y affirtn untler penally ot pe�ury one of the lollowing declarations: p I have an0 will maintain a certificate ol consent to self-Insure (or workers' compensalion, as pmvitled for by section 3700 of Ihe Labor Code, for the ed nce of the vrork (or which lhis permit is issued. I have and vnll mainfain v.orkers compensatbn insurence, as required by s Uon 3700 of the Labor CoCe, for the perfortnance of the work for which Ihis permit is issued. My workers' compensation Insu2nce carrier and policy number are: �� ;� r 1 � � � Carrier. ✓iG� (�Msecmneeanot+ce.m(1�/Wg�reo/QMepemr�ayuvvlveaatwTen�mOretlyqlars t00)aless) PolicyNumber VVV� 07 Z)��V ❑ I certify thal in the peAormance o( Ihe work for which this permit is issued, I shall not employ any person i ny manner so as to become subject t4 t�e vrorkers' compens � n f alifornia, and agree that if I shoultl become bject lo the co p nsation pmvisions o( Section 3700 of � e La e. I ! t o y with these provisions. �--�—/c� ' /oo��m's SignaWre Da1e WARNING: FAILURE TO SECURE WORHERS' COMPENSA710N COVER4GE 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, INTEREST, AND A7TORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing Mtith Section 7000) o� Division 3 of the Bus'mess arW Pro�essions Code, and my license is in full force aTnd effect. Lic. # � �/ lass # C/� nlra c s $igndWre Ddle CONSTRUCTION LENDING AGENCY: ❑ I hereby af(rcm that there is a consWctbn lending agency for ihe perfortnance of the nork for wfiich tttis permit is issued. (Sec. 3097, Glvii Cotlej. Lendefs Name: Lender's Address: SignaNre Da�e QWNER-BUILDER DECLARATIONS: � hereby aK�m Ihat under penalty o! perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or lhe lollowing reason �Sec. 7031.5, 8usiness antl Pmfessions Cotle: Any city or counly which requires a permit to conswct, alter, improve, demolish, or repai� any structure, prior to its i„suance, also requires the applicanl for such pertnit to file a signed statement thal he or she is licensed pursuant to the provisions Of Ihe Contractors License Law (Chapter 9(commencing with Seclion 7000) Of Division 3 of lhe 6usiness antl Professions Code) or ihat he or she is exempt iherefrom and lhe basis for the alleged exemption. Any violation o( Section 7031.5 by any applican! /w a permit subjects the applicanl to a civ'd penally o( rtot more than five hundred dollars (5500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and the slructure is not intended or aHered !or sale (Sec. 7044. Business and P�otessions Code: 7he Contraclors license law Eoes not apply to an owner of property v+ho builtls or improves thereon, and who dces such vrork himself or herself or thmugh his or her own employees, provided that such improvements are not intended or oflered for sale. If, however, the building or improvement is sold within one year of completion, Ihe owner-builAer will have the 6urden of proving that he or she did not build or improve for purpose ol sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH lICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and Pm(essbns Code: The Contraclors License Law dces not apply to an ovmer of property who builds or improves thereon, and who contracts for such projecl with 2 cmtracta(s) license pursuant to the Contractas License LavS.). ❑ I am ezempt under sec. 6usiness antl Protessions Code for this reason: aB^a��e Doie ]OS'l�a6 (YO]) Owner ID venl�ed by drive��s license. ❑ Yes ❑ No Oriver's License No. Expires: Verification of Ovmership by (lype of document, i.e. - property lax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify that no excavation (rve (5) or more feet in tlepth into which a pereon is required to descend, will be matle in connection with wnrk aulMrizetl by this pertnit, and that no building simcture, sca(fddinq, false�wrk, a demolitbn or tlismantling thereof, will be more Ihan thiAy-shc (36) (eet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Calilomia Administrative Cotle). �' ❑ As ovmer-builtler, I will not employ anyone to tlo work which vroultl require a permit trom Ihe Division of Industrial Safety, as noted above, unless such person has a permit to Co such work from the division. AOWiwnl's Signalure Dale Division of Industnal Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future builtling occupanl need b fUe and certily a Business Plan for emerqency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Sectlon 25505 of Ihe Calilomia Health antl Sa(ery CoCe requires, witn some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quanlity of hazardous matenals equal lo or greater than a weiqht of 500 pounOs, or a volume of 55 gallons, or,200 cubic feet ol compressed gas at s�andard temperature and pressure). ''' 2. Does or will Ihe applicant or present or future building occupant neetl to file a registration (orm for acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Satery Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hantl a quantity of acutely hazardous materials equal to or greater than a vreight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperawre and pressure). 3. Does or will Ihe appliwnt or present or future builtling occupant need to prepare an RMPP (Risk Management and Prevention Prpgram for aculely hazardous matenals)? ❑ Yes ❑ No (Section 25534 of Ne Califomia Health and Safery Cotle provitles thal the Costa Mesa Fire Department may require the preparation, cenifiwtion and filing wit� the Fire Department of an RMPP by businesses which are required to register acutely ha7artlous materials vrith the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the appficant or presenl or luWre buiftling occupant require !or the work which is the subjecl of this application a permit for such construction or modifcation Irom the South Coast Air Quality Mana9ement District or from any other air polNtion control tlistnct or agencyT ❑ Yes ❑ No (Section 65850.2 0l the Calilomia Govemment Code requires that the requested infortnation be lumishetl on applicatqns for non-residential building pertnits�. 6. Will any part of the (acility to be constructetl under this permit be within 1000 feet from lhe outer bountlaries of a school? ❑ Yes ❑ No (If yes ; fhe (aciliry must meet the requirement o( Seclions 25534 antl 42309 o( tha Califomia Heallh and Safery Code). 7. If a pertnit from lhe South Coast Air Oaality Management District or other air pollution conlrol tlistricl or a9ency is required for the vrork which is t�e subject of this applitalion, have all o( lhe d'isclosures prescribed by Cali�omia Health antl Safety Code Section 42303 heen made? ❑ Yes ❑ No 8. Qf yes", attach certificate of compliance from the appropriate air pollution wntml oKcer�. CER7tFICATE OF COMPLIANCE: ! certify that under penalry of perjury the infortnation given above is correct. I agree to comply with all stale laws and cily ordinances regarding Hazardous Materials and Emissions. SiBnaWre Oa�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty ol perjury thal I have read this application and state that the information given is wrtect I agree to comply vnth all state laws and city ordinances relating ro huilding oons[ruction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-described property for inspeclion purposes. I agree not to occupy or allow occupancy of any building authorized by t's pertnit until! I in ction. r ol i tt Daie 2 � �'/'-�C� An p A ieU d�nnl Da�e