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Home My WebLink About850 20TH ST - Building Permits0 CITY OF COSTA MESA O'KpMFs,y BYILDING DIV/SION i�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax p14) 754-0856 • www.ci.costa-mesa.ca.us � � FOR INSPECTIONS CALL: (714) 754-5626 '4y�,i•' PERMIT NUMBER: E09-00165 PERMIT TYPE ELEC STATUS: ISSUED APN: 42250317 DATE ISSUED: O6/22/2009 ISSUED BY: KJB JOB ADDRESS: 850 W 20TH ST CM vicinity: Suite/Unit: SCOPE OF WORK: 200 AMP SERVICE UPGRADE AND RELOCATE. OWNER: THOMAS, ROBERT B TR Address: 909 W 20TH S? Unit: PHONE: Cily/State/Zip: COSTA MESA, CA APPLICANT: DAVID E BURGER PHONE: 9493313692 CONTRACTOR: DAVID E BURGER Address: 374 COSTA MESA STUniC City/State: COSTA MESA, CA ZipCode: 92627 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Reinspection Fee $0.00 TOTAL FEES $54.00 sr- GC �� r Address: 374 COSTA MESA ST Unit: City/State/zZip: COSTA MESA, CA License No. 835541 PHONE: 949-3313692 CELL: � '��fyr.�.� ;�1(j..��£,?'i'�j`5 NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Calitomia statutes and related -fegulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 4NSPECTIONS: In order for the 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 lhe expiration of lhis permit. GOOEM. INSPEC7IONTVPE DRTE INTITAlS COOEt INSPECTIONTVVE UFTE INTITALS i616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �n 200 Final Re-Roof 210 Final Elecirical "4� �./ '"� 207 Final BIocWRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 FinalSign 222 FinalSite ''��ry:-'�.'Z�'•"� 204 Final Demolition 250 Final Builtling/Occupancy WORKERS' COMPENSA710N DECLARp710N: I hereby aKrtn under penalty of perjury one of the (ollowing declarations: ❑ I have antl will maintain a certificate of consenl lo self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, lor the peAormance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by sectbn 3700 of the Labor Cotle, for the pertormance of the work for vfiich this pertnit is issued. My workers' compensa ion Insurance carrier antl policy number are: (��/� �//�� , Carrier: V P�1/ r r�+v �rn�:euo��e�e`eZ�mpTted0lhep mpg ��onenunorcedoBars(E�oO)aiessJ Policy Number: I certify that in the pedormance O( the work for which this permit is is d, I shall not employ any person i� any manner so as to become subject to the workers' compensation laws ot California, and agree that if I should become su6ject to the workers' compensation provisions f Seclio 3700 of the La� C e', I II foN c mply with these pr visio s. O n � Applicanl's Si e ate WARNING: FAILURE 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 7HE LABOR CODE. IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 0( the 9usiness and Professions Code, and my license is in full force and eHecl. �ic. u C-/d — � C�ass tt `� Comraclor's SignaWre Da CONSTRUCTION LENDING AGENCY: ❑ I hereby affrm Ihat there is a ConsWction lending agency for the peAormance of lhe vrork for wfiich this permil is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Dale OW NER•BUILDER DECLARATIONS: I hereby affrm that under penalty ol perjury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to wnstruct, alter, improve, demolish, or repair any strucWre, D�or to its issuance, also requires the applicant for such permit to file a signed statemenl thal he or she is licensetl pursuant Ib the provisions ol ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code) or that he or she is exempt therefmm antl the basis for the alleged exemption. Any violation of Section 7031.5 by any applicaN for a permit subjects the applicant lo a civil penalry o( not more than frve hundred dollars (5500).): ❑ I, as ovmer of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the sWCNre is not intended or oNered for sale (Sec. 7044, Business antl Pro(essions Code: The Contractors License Law does not apply to an owner of propeAy who builds or improves thereon, and who does such work himself or herself or through his or her ovm employees, provitled that such improvements are not intended or oflered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burtlen ot proving that he or she did not build or improve for purpose o( sale.). ❑ I, as owner ot the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construcl !he pmject (Sec. 7044, Business and Professions Code: The contractqs License Law dces not apply to an owner of pmperty who builtls or improves thereon, antl who contracts for such pmject vrith a contractor(s) license pursuant ro the Contradors �'cense LavS.�. ❑ I am exempt under sec. _ Business and Professions Code for this reason: Owner ID venfied by driver s license. ❑ Yes ❑ No Driver's License No. Expires: Verifcation o( Ownership by (type of tlocumenf, i.e. - property tax bill or tleea): DIVISION OF INOUSTRIAL SAFEN PERMIT CERTIFICATION: � I hereby certdy that no excavation (rve (5) or more fee[ in dep�h into wfiich a person is required to descend, will 6e made in connectbn with work au[horized by this permil, antl that no building structure. scaf(dding, falsework, p demolition or dismantling thereof, will be more than thirty-s6c (36) feet high. (Chap. 3.2, Grp 2, M 2, Sec. 341, Title 8, Califomia AdminislratNe Code). ❑ As ovmer-builder, I will nol employ anyone to do work which vrould require a permit from the Division ot Industrial Sa(ery, as noted above, unless such person has a permit to do such work from the division. ADOliwnl's Signature Dale Division of Industrial Safery Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building occupant need to fle antl cenify a Business Plan for emergency response to release or threatened release o( a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Sa(ery Code requires. with some exceptions, Ihat a Business Plan be fletl with lhe Costa Mesa Fire Depariment by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperaWre and pressure). 2. Does or will the applicant or preseM or future builtling occupaN need to fle a registration (orm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of ihe Califomia Health and Safely Code, with some exceptions, requires registmtion with the Costa Mesa Fire Department by each business v+hich at any one time has on hand a quantiry of awtely hazardous malenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cu6ic feet of compressed gas at standartl temperature and pressure). 3. Does or will the applicant or present or (uture building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0! the Califomia Health antl Safety Cotle provitles ihat the Costa Mesa Fire Department may require the preparatioq certifica[ion and fling with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous ma�erials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 0� the Califomia Health antl Safery Code been lully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject o/ this applicalion a permil for such conslmction or moCifiwtion irom the South Coast Air �ualiry Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Seclion 658502 of the Califomia Govemment Code requires Iha� the reques�ed infortnation be fumished on applications far nornresidential building pertnits). 6. Will any pah of Ihe (acility to be consWcted under Ihis permil be vri�hin 1000 feet (rom the outer boundanes of a school? ❑ Yes ❑ No (If'yes", ihe facili[y must meet the requirement of Seclions 25534 and 42303 of Ihe Califomia Health and Safery Code). 7. If a pertnit from [he South Coast Air Quality Management District or other air polWtion control tlistricl or agency is requiretl for the work which is the subject of t�is application, have all of the disclosures prescribed by Califomia Heal[h and Safely Code Section 42303 been made? ❑ Yes � No 8. Qf yes", attach certifcate of compliance trom the appmpriate air pollution contml oKcer). CERTIFICATE OF COMPLIANCE: I certi(y that under penally of perjury Ihe infortnation given above is correcL I agree ro wmply with all state laws and city ordinances regarCing Hazardous Materials and Emissions. Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry ot perjury that I have read [his application antl s[ate that the information given is correct I agree to comply with all state laws and city ortlinances relating to building consWction, and aulhonze representatives of the Ciry of Costa Mesa to enter upon the above-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by Ihis permit until fnal inspection. ol L Owne� ) �ale SignaWre Oaie �� 305]-a6(3I0�) Andlor Aut�orrzed App ¢ant Oate -0WNER t, ��JOB ADDRESS 8� ��GE RAL CONTR� �2=1� Lc GROUP l �ECTIONS Trenches Forms Floor System Steel Reinforce Bond Beam Frame and Flashing Lathing, In Oi Plaster. brown coat Fi ias Test Co_ _uction Po �. W, Oth St. 'oR Owner - Builder TRACT PIRE ZONE TYPE ZONE IDATE I DATE 2-6-59 BUILDING-PERR-llT NO. VALUE $ 13I{.00 NORK RedwOOd 1 PLAN NO. SUBCONTRACTOR I DATE NUMBER 8631 APR 1 1 '°62 OWNER wrr.snN_ r-m.�& N�S. CHARLES DATE 11-�S-bl GGNPRAL CONTRACTOR C AP No.l l K_I�79_l7 LOT INSPECTIONS c G. _ 7.5� - TRACT FIRE ZONP �Signature� DA'CE GROUP VALUE 3 3,570.00 DI3SCRIPTION OP WOftK� TYPE v 7.ONE SUBCON7RACTOR FEE RECEIVED �_:i��.�� J NOV 7 1961 COSTA MESA BUILDING-SAFETY DEPARTMENT `�� FINANCE DEPT, P. O. BOX 977 C08TA MEBA. CALIFORNIA ��?Y OF COSTA M�SR For Applicant fo Fill In Complefely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING SiSO �/ �D�� ✓/I ADDRE6S COSTA MESA. CALIFORNIA For Office Use Only ,/� NECEIPT NO. P HMIT NO. OWNER W M/�IL n�A �� '� �'I FECEI EO BY I OAiS HECH�V80 I OATE 199{IED Rl (/ �� -O — / �� eui�oiNc��Si%LV ,�1��-�ci ADDRE68 A MESA. CALIFORNIA � � TEL. ^_ NO. � I NO. OP B1D08. 3rxser REAR YAR! ^ILEFT IRIGHT DESCRIPTION OF WORK „ EXTERIOR WVERINC USE OF BI TO BE ✓ 1 H6R6BY ACKNOWLBDGH �HAT I HAVE RHAD TXIB APPLIGTION ANO BTAT6 THAT TH8 ADOVE I8 COHP¢CT ANO AGREE TO COM- PLY WITH ALL CITY ORO�N�NCEB AN� 9TATE LAWB REOULATINO BUIL�INO CON9TRUCiION/f / I PERMn17TEe OF �//�'/�L(.GfO�I�/�6I/IA/L'.f. AUTHORIZED AGENT ZOt1�� NO. OF ✓' PLANB LEOAL .,��// ICENTEM L1NE BT.1 T�bNING UBE OF NF BUILDIN J��' n... EVES ALLOWED F� FT. � r TM8 AMOUNT 6HOWN UNDHR VALt1AT10N �9 PON TXE PURP09E OP E6TABL�BN�NG A PERMIT P68 ONLY. VA�UAiION /y �� ,� PERMIT FEE $/�/ $ l 57�� PLAN CHECK $ /(/ � l � � TOTAL FEE K 6