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Home My WebLink About2482 FAIRVIEW RD - Building Permits % ,ice-' p CITY OF COSTA MESA ' - 4BUILDING DIVISION ,_>4-•i -t, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F t PERMIT JE04-010,88 %sonny" `/ (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2482 FAIRVIEW RD Status: ISSUED Suite No Applied: 10/01/2004 Vicinity: REAR SFD Issued: 10/01/2004 Parcel Nunmber: 41914214 Applicant: WENGERT, DAVID ISSUED BY: 4410P,', a Address: 2482 FAIRVIEW WAY - - - ,, . Phone: 714-556-2205 COSTA MESA,CA Zip: 92626 Owner: WENGERT, DAVID , Address 2482 FAIRVIEW WAY - , Phone: COSTA MESA,CA Zip: 92626 , Contractor: OWNER-BUILDER Address: Phone: _ . Zip: License: 000000 • - SCOPE OF PERMIT ` ` CHANGE-OUT OF AN EXISTING.SERVICE TO 200A. NO OTHER WORK AUTHORIZED WITH-THIS PERMIT. ' . ` FEE SUMMARY Quantity - ' Quantity - - ISSUE FEE $23.50 _ Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package , $0.00 Standing Section , $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0, , ' New Res(3+units) ' - $0.00 0 Transformers up to 1 kva/kw $0.00 .0 ' ` - ' Pool/Spa $0.00 0 _ up to 10 kva/kw $0.00 -"'0 ' Lighting Fixts $0.00 0 _ • - up to 50 kva/kw $0.00 -/0 Recept Outlets - $0.00 0up to 100 kva/kw $0.00 .' 0 Switches $0.00 0 - over 100 kva/kw . $0.00.":' 0 Non Res Appl $0:00 -- 0 Low Voltage Equipment ' •" ' $0,00 0 Res Appl ' - $0.00 , 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a v ' " $30.50 ' - 1 Misc.-Conduit Service to 1000a , ', $0.00 -0 Misc.Conductor - - , " $0.00 0 Service over 1000a-, IN " $0.00-/ 0 - -`` . , Circus(gen or ride) c , $0.00- "'0 ' Motors to 1hp `\ $0.00 0 - - Circus(mach ride or lights) .- $0.00 i 0/" " Motors to 10hp $0.00 , - 0 - Christmas Tree Stand $0.00 ''0'- ' Motors to 50hp $0.00 ` 0 Fireworks Stand • - $0.00 0 Motors to 100hp N-$o.0o _ '0 Other Electrical Fee ' ; $0.00 Motors over 100hp " Communication drops $0.00 - 0 ' N Investigation Fee -$0.00 Sub panel to 200a $0.00 0 - Plan Check Feet_ _ $0.00 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: 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 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. FOR INSPECTIONS CALL: (714)754-5626 • 2446-46(6/00) AS o a WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Carder: Policy Number: (This section need not be completed if the permit is valued atone hundred dollars ($100) or less.) I certify that in the performance of 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 Califon a, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these D Ision Applicant Signature: "s Ill l Date: 7 WARNING: FAILURE TOS CURE WORKERS' COMPfNSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm 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 full force and effect. Lic. p Classq Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Buslness and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building 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 construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pu uant the Contractors License Laws.). ❑ I am ex e t unqbf sec. Business and Professions Code for this reason: Signature: Date: —O Owner ID verified by tldver's license. Yes ❑ No Drivers License No. Expires: — Verification of Ownership by (type of tlo um I. i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial 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 hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled with the Costa Mesa Fire Department 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 temperature and pressure). ..........._..........._.........................._....................................................__..__.._...................................................................._._..__....................................................__....................-......._.............................._._..........._...._._......_...._. 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely 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 temperature and pressure). ........................ .......................................................................................................... .... .................................................................................................................................................. _......... ........ ... ........... .................... .............. _........ _................ . 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ............................................................................................................................................................................................................................................................................................................................................................................. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ................._..........._................_............................................__... _... _............................................................................................................................................................ ____....... _............................................. ................... _.......... _....... 5 Does or will the applicant or present Or future building occupant require for the work which Is the subject of this a plication appemit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ................................._._..................._................b"a'...................ted.................h"i"s...........................ithi...........0''f.e,e"t.................................................ti'e".....................00"'1............ .......................................................................................... 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (if "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ....._............................_..........._........................................_.__...... _.................................................. .._....._........._......__.........................................................__.........._._.._........... _............. .................... _._.......... __.... _..... _....... 7 If a Dernit from the South Coast Air Ouality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ................._............. .......................... .............................. ................................................. ............................................... _.... _..... ...... ....................... ............................................................ ................................................................. I......................... 8 (Ii'ves", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORLZATION OF ENTRY: I cenity under penalty of perjury that I have read this application and state that the information given is corn 1. I agree to comply with all state few and ci riff nces relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the eb descn r arty to inspection p oses. of to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature O al a s) Date And/Or Authorized Applicant Date CODE 1. INSPECTION TYPE Qr ff, INTRIALS CODE! INSPECTIONTYPE gAIE Lf{jIVALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 . Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place - 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition - 250 Final Building/Occupancy OWNER nAvnxr7mJ Aecnr DATE H_l f._TQ NG PE L1_711_94 LOT m TRACT Ingg¢IRE ZONE VALUE$ 49.600.00 INSPECTIONS Si nature Data ITYPE IT GROUP ZONE solL SUBCONTRACTOR MITS GAS Data Num bei Si nature WATER Plumbin ROUGH PLUMBING PROP, SWR. LINE (._j HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIP CONDITIONING TEMPORARY SERVICE OR POLE ' UNDERGROUND POWER 0 ROUGH WIRING Heating and Vent. TRENCHES IJ FORMS 'STEEL REINF. [ _7 A Q FLOOR SYSTEM Ale - BOND BEAM [, STEEL REINFORCE SHEATHING I - a FRAME AND FLASHING fl I LATHING — IN flOUi A PLASTER, BROWN COAT STRUCTURAL. FINAL HEATING. VENT., REFRIG. AND A.C., FINAL �} PLUMBING. FINAL AND GAS TEST ELECTRIC, FINAL ' RIIII OINF. FIYGI _ C, COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only - 7001 4/t\8/791 96:97 ,TLI, APPLICATION FOR STRUCTUR;CeFERMIT-'qf-`r,",� I., RECEIVED BY BUILDING^ s, ADDRESS L ` A.P. NO.- OWNER OR c �. BUILDING n 1 ADDRESS L TENANT sa)��71/L+ ' MAILING cPA� Nn G ADDRESS Lu.NO. _ T LOT BLK. TE L. 213 CITY l t "1 1..�.c5 VZ NO. 10 5 2- 1' 44 NEW I ADD LTER IRE AIRMOVING DEMOLISH CONSTRUCTION LENDER BRANCH ��) OWNER �u!/ ADDRESS VALUE ARCHITECT TEL. V-5 USE / E OR ENGINEER N k 3 rel' ADDRESSjj� S ZONE TYPE GROUP/ p� CONTRACTOR Ct tr APPROVED BY DATE ADDRES TEL. 13 CITY NO. STATECITY APPROVED SETBACKS 3 LIC. NO. 55 LIC. NO. I 1 NO. OF BLDGS /� SIZEOF I D (FROM k 2RFTT)G G LOT 2 �� NOW ON LOT ONT USE OF EXISTING BLDG. R. Separate permits are required for L. SID electric, plumbing and heating work: REAR FT. WORK TO BE PERFORMED USE OF BU/�ILIID��ING ANDATE PLANNING ACTION �( ag--V —7y 9 ISI— i4u APPROVED APPROVED I hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of Calif la Business and Pro sslons Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and , uch I' se are in ull force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt fro the rov I s the St to of California Business VALUATION PERMIT FEE E end Professions od� ivi o C tar 9. PLAN CHECK E 3i Signature of .3O PermitteeS //� �t TAX E 3y Authorized Agent Date TOTAL PAID E N a i� C_ COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION i6WR 1166 6fiN. PERMH 87.00 P.O.BOX1200 COSTA MESA, CALIFORNIA 92626 t� REC a PERMIT�� *TQ For Applicant to Fill in Completely — Use Ink Only 1 V BUILDING A.P. ADDRESS OWNER OR �nA TENANT NOGG t NG ADDRESS Kd/s MAILING UNIT OR SPACE NO. ADDRESS r TR.NO. LOT BLK. ,'c TEL. 2l CITY ALLS, NO. L NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION C LENDER J BRANCH OWNER ADDRESS VALUE ARCHITECT TEL. USE $ OR ENGINEER ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR By DATE ADDRESS TEL. CITY NO. STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. IF ROM C/L STRE ET) SIZE NO. OF BLDGS. OF LOT NOW ON LOT FRONT FT. USE OF EXISTING BLDG. Separate permits are required for L SIDE FT. electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED APPROVED BY LATE 1 hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. the Sure of California Business and Professions Cod., Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and th s h licenses are n full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: em exempt from ha p vis(ons O t State of California Business VALUATION PERMIT FEE $ and Professions otla, 3, ter 9. jlo PLAN CHECK E Signature of Permittee S //�('�Jy 4 TAX E �— or , Authorized Agent Date TOTAL PAID E