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Home My WebLink About740 PAULARINO AVE - Building Permits� � ' � CITY OF COSTA MESA � • � + BUILDING DIVIS/ON i � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (774) 754-0856 • www.ci.costa-mesa.ca.us �.4��. FOR INSPECTIONS CALL: (714) 754-5626 �� PERMIT NUMBER! E07-00873 PERMIT TYPE ELEC JOB ADDRESS: 740 PAULARINO AV CM Vicinity: SIDEWALK STATUS: ISSUED DATE ISSUED: 1 012 512 0 0 7 ISSUED BY: RMD SuitelUnit: SCOPE OF WORK: INSTALLATION OF A NEW t00A PEDESTAL METER ON SIDEWALK. OWNER: CITY OF COSTA MESA Address: Unit: PHONE: - City/Slate2ip: APPLICANT: WILLIS, JANAE M PHONE: 909-933-9345 Address: Unit: Ciry/State/zZip: - • _� CONTRACTOR: VCITELECOM Address: 1921 W 11TH STUnit: PHONE: 909•946-0905 City/State: UPLAND, CA ZipCode: 91786 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: 30.00 Electrical Permit Fee: $54.00 Reinspection Fee $0.00 TOTAL FEES $54.00 u 0 License No. 765716 CELL: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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. 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 flnal approval must be obWined. Failure to obtain inspections and fnal approval will result in Ihe expiraGon ot this permit. CO�Ef. INSPECTIONTYfE �R]F IN1f1UL5 , CO�EI INSVEC110NTYPE �j�F INTRULS 1818 Fized System Final Fire PrevenUon 206 Final Mechanical 7268 Pool Spa Final 208 Final Plumbing 200 Final Re-Rool 210 Final Elec�ncal 1!� � ..� -. �� 207 Final Block/Retaining 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'COMPENSA710N DECLARATION� I here5y affrm i,htler penalty of peryury one of lhe tollowing declarations: ❑ I have anC will maintain a certificate of consent to self-Insure for workers' compensation, as pmvitletl for by section 3700 of Ne Labor Cotle, for t�e performance of the work for which this pertnit is issued. I have and will maintain workers' compensation insurance, as requireC by n 3700 of Ihe Labor Code. !or Itre peAormance of the �wrk (a which this pertnit is issued. My workers' compensation Insurance cartier antl policy number are: �p /� ( �}- / � Carrier. i� �(LC IL'Q-�%LP %1! C cL�%.5 -�J • �(if45secfmneatl(no�tb/eI `pleletldHrope�mflsvaMtlatme�urdreC40ars(5100/alav.) P1olicy.Num�ber: /�- lN � j� S�n ��i �i ❑ I certify that in lhe peAormance of the work tor which this pertnit is issued, I shall not employ any person in any manner so as to become subjecl to the workers' compensation laws of Califomia, anG agree thal if I should become subject to the workers' compensation provisions of Section 3700 0l the /L�berCe e, I shall (orthwith comply wilh these provisions ' / 1�..—. ,� Y Q� `Appht�anfs5ipnature �Data� ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLAFtS ($100,000�, IN ADDRION TO THE CAST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn that I am licensed under provisions of Chapter 9(wmmencing wilh Section 7000) of Division 3 of I�e Business and Professions Code, and my license is in full force antl eflect. Lic. #- � 7 Class # C- C-/Q — '� � / ontracmrlsSlgnamre ` te� CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affum that there is a conslruction lending agency for the peRortnance ot the v.ork for v.fiich tNs pertnit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Atldress: OWNER-BUILDER DECLARATIONS: I hereDy aRirtn that untler penalry o( perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW br the follovdng reason (Sec. 7031.5, Bu5ine55 and Prof855ion5 Code: Any Ciry or County which require5 a permit to construct, alter, impmve, demolish, or �epai� any SWCNre, prior to its issuance, also requires the applicant lor such permit to file a signed statement Nat he or she is licensed pursuant to Ihe provisions o( the Contractors License Law (Chapter 9(commencing wit� Section 7000) 01 Division 3 of the Business and Pro(essions Code) or Ihat �e or she is exempt therefrom and the basis for Ihe alleged exemption. Any violation of Section 7037.5 by any applicaN for a permit subjects the applicant ro a civil penalry o( not more than fve hundred tlollars ($500).): ❑ I, as owner of the propeAy, or my employees wilh vrdges as Iheir sole compensation, WILL DO THE WORK, and the structuie is not intended or ofleretl for sale (Sec. 7044, Business antl Professions Code: The Contractors License Law does not apply to an owner of property who builtls or improves lhereon, and who tloes such work himself or herself or lhrough his or her ovm employees, provided thal such improvements are not intentled or offered for sale. If, however, the buildinq or impravement is sold within one year ol completion, the owner-builtler will have the burtlen o( proving Ihat he or s�e did not build or improve tor purpose of sale.). ❑ I, as owner of the propeny, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo consWct the projecl (Sec. 7044, Business and Professions Code: The cont2ctas License Law dces not appty to an ovmer of property who builds or improves thereon, and who cmt2cts fw such project with a contracta(s) license pursuaN lo tte Contractors License laws.). ❑ I am exempt under sec. Business and Pmfessions Cotle for this reason: 305]-4613ro1) Ovmer ID verifed by dnv�e. ❑ Yes ❑ No Dnver's License No. Expires: Verifcation of Ovmership by (rype of document, i.e. - property lax Dill or tleedj: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certily that no excavalion frve (5) or mwe leet in tlepth into wfiich a person is requiretl lo descend, will be matle in connectbn with work aulhorizetl by this permit, antl Ihat no building stn�cture, scaffdding, falsewnrk, a demolitbn or tlismantling Ihereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, M 2, Set. 311, Ttle 8, Cali(omia Administ2tive Cotle). ❑ As owner-builder, I will not employ anyone to do work vfiith vmuld require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from Ihe division. Ap01iwn1's SIB^aWre Division of Industrial Sa(ely Permi[ Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicant or present or future Duiltling occupam naed to file and certify a Business Plan for emergency response to release or threatened release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the Calitomia Health and Safety Cotle requires, with some exceptions, l�at a Business Plan be filed with the Cosla Mesa Fire Department by every business which has at any one Ume tlunng a reportetl year a quantiry of hazardous materials equal ro or greater Nan a weigh� ot 500 pounds. or a volume of 55 gallons, or 200 cuDic feet of compressed gas at slandard temperature antl pressure). 2. Does or will the applicant or present or fuNre building occupant need to file a registration torm for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of Ihe Califomia Health ana Safety Code, with some exceptions, requires registration with the Costa Mesa Fire DepartmeM by each business which at any one (ime has on hand a quantiry of acutely hazardous malerials equal to or greater than a weight ol 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlartl temperaWre and pressure). 3. Does or will tne applicant or preseM or �uture building occupant neetl to prepare an RMPP (Risk Management antl Prevention Program lor acutely hazarCous materials)? ❑ Yes ❑ No (Section 25534 0! [he Califomia Health and Safely CoCe proviCes thal the Costa Mesa Fire Department may require the preparation, certifiwtion and filing with the Fire DeDartment of an RMPP by businesses which are requiretl to register acutely hazar0ous matenals with lhe Fire Department. 4. If an RMPP is presently required, has Section 25534 0( the Calilomia Health antl Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the appliWnt or present or future building occupan� require (or Ihe work which is Ihe subject of this application a pertnil for such ConSWclion or motlification fmm Ihe South Coast Air Quality Management District or fmm any olher air pollWion control aisirict or agency? ❑ Yes ❑ No (Sectbn 658502 of the Califomia Govemment Code requires that the requested information be (umished on applications for rqn-residential builtling pertnits). 6. Will any part of lhe faciliry to be consWctetl untler this permit be within 1000 feet fmm Ihe outer bountlaries o( a school7 ❑ Ves ❑ No (If'yes", the lacility must meet the requiremeN of Sections 25534 and 42303 o( the Calilornia Health and Safety Code). 7. I( a pertnit Irom Ihe South Coast Air Quality Management Distncl or other air polWtion control disiricl or agency is required for the v.ork which is t�e subjecl of lhis application, have all of the tlisclosures prescribetl by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", atlach certificate of compliance fmm the appropriate air polWtion control oKcer). CER7IFICATE OF COMPLIANCE: I certity that under penalty of perjury the information given above is correct. I agree to wmply vrith all state laws and ciry ortlinances regarding Hazardous Materials anA Emissions. Signalure CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 certify untler penalty of perjury that I have read this application and state that the infortnation given is correct I agree to comply with all state laws and city orCinances relating to building construction, and authodze representatives ot the City of Costa Mesa to enter upon the above-descnbetl property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by IhiS permit until fnal inspection. Si aWreofLeBalOwner(s) ate MNO/ Au1�OnzeC AppllmnL . Dale �— . �_ .