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Home My WebLink About557 PAULARINO AVE - Building Permits- CITY OF COSTA MESA � . o F BI/ILDING DIVISION i� � 77 FAIR DRIVE, COS7A MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us : .� �.�'�v fi FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: E09-00088 . . ,. . PERMIT TYPE ELEC STATUS: . ISSUED APN: TPN007248 DATE ISSUED: 04/10/2009 ISSUED BY: RMD JOB ADDRESS: 557 PAULARINO AV CM Vicinity: PUBLIC RIGHT OF WAY Suite/Unit: SCOPE OF WORK: ELECRICAL PERMIT TO INSTALI A V-RAD CABINET LOCATED ON PUBLIC RIGHT OF WAY FOR "AT&T". OWNER: CITY OF COSTA MESA PHONE: APPLICANT: CURRY, DAVE PHONE: 909-230-5170 CONTRACTOR: HHS COMMUNICATIONS Address: 305 N SACRAMENTO AVEUnit: City/State: ONTARIO, CA ZipCode: 91764 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Reinspection Fee 30.00 TOTAL FEES $54.00 Address: Unit: City/State/Zip: Address: 305 S SACR4MENT0 AVE Unit: City/State/zZip: ONTARIO, CA License No. 913107 � , PHONE: 909-230-5170 , . CELL: NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In order for the vrork 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. CO�E� INSPEC110HTYPE ORTE INIITIRLS C0� INSiEC110NTVPE OATE INit11RL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 PoolSpa Pinal 208 Final Plumbing �� 200 Final Re-Roof 210 Final Electnwl 201 Final BIocWRetaining Wall 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 � ' � WORKERS' COMPENSATION DECLARATION: I hereby atfrm untler penalry ot perjury one of the following declarations: ❑ I have and will maintaiq a certifcate of consenl lo self-Insure (or workers' compensation, as provided tor by section 3700 of the Labor Cotle. for the performance o( Ihe work for Which this permit is issued. ❑ I have and will maintain worlcers' compensation insurance, as required by section 3700 of the Labor Cpde, �or the peAortnance of the vrork for which this pertnit is issued. My work@rs' compensation Insurance cartier antl policy number are: 1 �1 ��Carrier. �L7/uAa� (/A/Oil �/C (This SeIXbn need no( be mmp�etetl rl(he pe�mrt is valuetl al one huntlietl ddlms (5100) oi less ) PolicyNum6er: �wiL' ��Z/� ❑ I certity that in the perfortnance of Ihe work (or 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 Califomia, antl agree that i( I should become subject to the workers' compensation provisions o( Section 3700 of Ih�eborCb , I s all forthwith comply wilh Ihese provisions. � y-/D-o9 Ay iiwm's5ignat � Date WARNING`. F�URE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN�S UP TO ONE HUNDRED THOUSAND DOLLARS (5100.000), IN ADOITION T6 THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTOR$ DECLARATION: I hereby aRrm ihal I am licensed untler provisions of Chapier 9(commencing with Seclion 7000) of Division 3 of the Business and Professions Code, and my license is in full (orce anry effect. �1 A Lic. /� � Class # /f C� �� -/D • D `� . rador's SignaW� Dale CONS7RUCTION LENDING pGENCY: � I hereby aHirm that there is a construction lending agency fw the pertortnance of the �ork for which this permit is issued (Sec. 3097, Civil Code). Lender s Name: Lentler's Address: Signature Da1e OWNER•BUILDER DECLARATIONS: I hereby affrm that under pynalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or lhe (ollowing reason (Sec. 7031.5. Business and Professions Code: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires Ihe applicant for such permit lo fle a signetl statement that he or she is licensetl pursuant to lhe provisions of Ihe Contractors License Law (Chapter 9(commencing vrith Section 7000) of Division 3 of the Business and Professions Code) or Iha[ he or she is exempt Iherefrom antl the basis (or Ihe alleged ekemption. Any violation of Section 7031.5 by any applicanl for a permil subjetts the applicant ro a civil penalry of not more Ihan five huntlred dollars ($500).): ❑ I, as owner ot the property, or my employees with �vages as their sole compensation, WILL DO THE WORK, and Ihe sWCNre is not intended or oflered br sale (Sec. 7044, Business and Prolessions Code: The Contractors License Law does not apply to an owner o( property who builtls 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 oflered for sale. If, however, the builtling or improvement is sold within one year of completion, Ihe ownerbuilder will have the burden of proving that he or she ditl not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CON7RACTING WI7H LICENSED CON7RACTORS to construct the project (Sec. 7044, Business and Professbns Code: The contryctors License Law dces not appty to an ovmer of pmperty who builds or improyes thereon, and vfio contracts (or such pmject with a cmt2ctor�s) license pursuant tothe Contractors License Laws.�. ❑'• I am exempt under seC. Business and Professions Cotle (or this reason: Signawre 309�a6 (YO]) Ovmer ID verifetl by tlriver s license. ❑ Yes ❑ No Driver's License No. Expires: Venficacion of Ownership by (type o( tlocument, i.e. - property lax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavation frve (5) or more feet in deplh into wfiich a person is required to tlescend, will be made in connection with �nork authonzed by Ihis pertnit, and that no building strucWre, scaHdding, talsevrork, or demolition or disman�ting Ihereof, will be more Ihan thiAy-six (36) leet higb. (Chap. 32. Grp 2, Art 2, Sec. 341, T�le 8, Cali/omia Atlministrative Code�. ❑ As owner-builder, I will not employ anyone to do work which vroultl require a permit from the Division of Industnal Safery, as noted above, unless such person has a permil to do such vrork trom the division. Applicanfs 9gnalure Division of Intlustrial Sa(ety Permit Number _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre builtling occupant need to file and certify a Business Plan (or emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Secfion 25505 0! the Cafilomia Health and Safety Code requires, with some exceptions, Ihat a Business Plan be filed with ihe Costa Mesa Fire Departmenl by every business which has at any one time during a reported year a quantiry of hazardous matenals equal to or greater Ihan a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressetl gas at standard temperature and pressure). 2. Does or will the applicant or present or fuWre building occupant need to (le a registra�ion form for acutely hazardous materials? ❑ Ves ❑ No (Sec[ion 25533 of the Califomia Health antl Safery Code. wim some exceptions. requires registration vnth the Costa Mesa Fire Department by each business which at any one time has on hantl a quantity o( acutely hazardous matenals equal ro or greater than a weight of 500 pountls, or a volume ol 55 gallons, or 200 cubic feet ot compressed gas at standard IemperaNre 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)? ❑ Ves ❑ No (Sec�ion 25534 of the Califomia Heal�h and Safety Code provitles that the Costa Mesa Fire Department may require the preparation, certifcation and filing with the Fire Department o( an RMPP by businesses which are required to register acutely ha¢ardous materials with ihe Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Heatth and Safety Cotle been fully complied with? ❑ Yes ❑ No 5. Does or will �he applicant or present or fu Wre builtling occupaN require for the vrork which is the subject of this application a pertnit for such construction or modifCalion from lhe Soulh Coast Air Quality Management Di5lfiCl Of (rom any other air pollution coMrol disMct or agency? ❑ Ves ❑ No (Sectbn 658502 of the Califomia Govemment Code requires that the requested infortnation be fumished on applications fa noo-residential building pertnits). 6. will any pan of ihe facility to be constructed untler this pertnit be vrithin 1000 feet (rom the outer bountlaries of a school? ❑ Yes ❑ No (I/ yes", ihe facility must meet Ihe requirement of Sections 25534 antl 42303 of Ihe California Heaqh antl Safery Code). 7. If a permit from ihe South Coast Air Qualiry Management District or other air polWtion control tlistnct or agency is required for the work which is the subject of this application, have all o( ihe disclosures prescribed by Cali(ornia Health and Safery Cotle Section 42303 been matle? ❑ Ves ❑ No 8. Qf "yes", attach certifcate ot compliance from Ihe appropriate air pollWion control offcer). CERTIFICA7E OF COMPLIANCE: I certify that under penalty ol perjury the information given above is correcL I agree to comply with all state lavrs and city ordinances regartiing Hazardous Materials and Emissions. Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penally of perjury that I have reatl this application and state Ihal the information given is correcL I agree ro comply with all state laws and ciry ordinances relating to building consWction, antl authonze representatives of the Ciry ot Costa Mesa to enter upon the above-described pmperty (or inspeclion purposes. I agree nol to occupy or allow occupancy of any builtling authorized by this permit until fnal inspection. 5aWreo egalOwneqs� Da1e -��--� y io •i � � qn01 r�ulponietlAppli n� Q Dalc. 210E )P 51MTCH (MANUAL) 120Qa0 IPM 12NV (REMOVEDON9-O807 OOII-0900/ 20Rd0 iPH 12KV (lNSTALLEDON9-6907 607}6900J ARM(1NSTALLEDON9-690J 6WJ-6900J � ___ Es: ies' w ni . im _ E%'. tA eLSa - 11 � P � � EX: 1614209E SO' POLE E%:} FHa 7 LAs �� <' RISER PR�. IN: 1. J' TO 2' R ISER L 184 RACK (] SPOOL) 2- 16B DEAO END INSL � L � ��C u � /.�_ H3 �.�..a. __ f _ —___ � cr � �=' � w. r�-,�,o�, FIJl�IMCII � � � � I O IN�'M�d�Tf [OnC. _i , r.we[cewe ATdT LIGHT SPEED f 00AMP METER PANEL 170240 1PH 3�v ESTIMAiED DEMAND:BKW w. z.9ex . �. � cv, - - - T u ierw.er Ri5£R �ET.VL ��\��H:��f CREW NOTE: ' RULE 15 COMMERCIAL LINE EXTENSION WORK ORDER. ' LANE CLOSURE / TRAFFIC CONTROI REQUIRED. ' TNIS WORK ORDER MUST BE N/ORKED WITH AI# 9-6903 6033-6900. } Q �a3 �s� a�o� Q o PAULARINO AVE U _' "_' "'___' _ _ — rmv SR# 1080535 DESIGN# 160697 PRODUCT# 261623 MSR#1059058 ProJectManagcr:M>(EMARSWlli JoOName: ATSTLIGH�3FFIDSRF?6/37J80 V�cinMMaP. Piannor STFVFNRANIIFV.In�Inolinn'555R411ARPYl<VFfrtCidMcSG!`A � � ,_