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Home My WebLink About328 SANTA ISABEL AVE - Building Permits, , � CITY OF COSTA MESA eva��va �►v►s�oN F . � 77 PAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us �, � FOR INSPECTIONS CALL: (714) 754•5626 9`qe„�u fi PERMIT NUMBER E08-00006 PERMIT TYPE ELEC STATUS: ISSUED APN: tpn007237 DATE ISSUED: 01/0212008 " ISSUED BY: SOK ._ � ; % -� - , . ,, . . t 4 JOB ADDRESS: 328 SANTA ISABEL AV CM . Suite/Unit: . ,., . ,.... .. , , Vicinity: . � -� . ' - � ` _ - , . . . � � -;-...,..,.. . ...._.,... , `;..,. . . .. .,�� SCOPE OF WORK: INSTALL NEW 100 AMP�SERVICE METER PEDESTAL FOR "AT AND T' - � -�;�' _ r��t=� � ' . . '_ OWNER: pTY OF COSTA MESA .�,Address: Unit: � PHONE: ' - ' �� -�City/State/Zip: ; � � " APPLICANT: JANAE WILLIS . ', ' � ' `� �_" . . � Address: ��,. � 1921 W 17TH ST Unit �� PHONE: 909-946-0905 � . _ City/State/zZip� :.>,UPLAND,CA . � . , CONTRACTOR: VCI TELECOM:�� r" � - License No. 765716 �� Address: 1921.W 11TH STUnit: � PHONE:'_.909-946-0905�� . .. - " �� , City/State: UPL'AND, CA _ � 2ipCoder�91786 �-�� - ^� � �� '- �. ... CELL: � � � , � - �: ... _ � - . ELECTRICAL PERMIT FEES ` - _� . ' � � � Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Reinspection Fee $0.00 � TOTAL FEES ' `' tl$54:00 ^ " ' �. . � .. i ` � -- (�:. f -i l i r .. . ' . i ..-�- � i �� "',. r �... �^.'1' . .. ' .. .. =; .J,'_�. . 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: 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 final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. GOUE �. INSPEC110NTVPE DATE INTRIALS CODE1 INSGECTIONTYPE ORTE IN1111RL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final . 208 Final Plumbing � V " 200 Final Re-Roof 210 Final Electncal � 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 Demoii�ion 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARA710N� I hereby aKrtn under penalty of perjury one of the following declarations: ❑ I have antl will maintain a certifcate of consent [o self-Insure for vrorkers' compensation, as provitletl for by section 3700 0� the Labor Code, for the �ertormance of lhe work for which lhis permit is issued. I have antl will maintain v.orkers' compensation insu2nce, as required by section 3700 0! the Labor Code, for the perfortnance of Ihe vrork for which Ihis permit is issuetl. My workers' compensalion Insurance cartier and policy number are� / �,Q Carrier: � / (�( ��.� ��e (TMs s� comWe�� a valuetl al me huMretl tldlars (5f00) a less.) PolicyNumbec� � � �.�c�� i� C� ❑ I certify that in the peAortnance of the work for which Ihis permit is issuetl, I shall nol employ any person in any manner so as to become subject to Ihe vrorkers' compensation lavrs of Califomia, and agree that if I should bewme subject ro Ihe workers' compensation provisions of Section 3700 of Ih ode, I shall forthwith comply with ihese provi ions. � Apphcanl's SignaWre le NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IrfTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby aKrm thal I am licensed under provisions of Chapter 9(commencing wi[h Section 7000) of Division 3 of the Business antl Prolessions Code. and my license is in tull force/ a,,nd effect. /�— Lic .� [� u! Class # l� — � Convacmr's SignaWre �ate CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm Ihat there is a construction lending aqency fa Ihe performance of Ihe wurk fa wfiich this pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Dale OWNER-BUILDER DECLARATIONS: I hereby affirm t�at untler penalty of perjury tha[ I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5. Business and Professions Code: Any city or county which requires a pertnit to wnsWct, alter, improve, demolish, or repair any slmcture, prior to its issuance, also requires the applicant tor such permit to fle a signed stalement that he or she is licensed pursuant to the provisions o( the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle) or that he or she is exempt Iheretrom and tha basis for the alleged exemption. Any violation of Section 7037.5 by any applicant for a pertnit subjec[s the applicant to a civil penalty of nol more than five hundred tlollars ($500�.): ❑ I, as owner of the propeAy, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or oftered for sale (Sec. 7044, Business and Professions Code: Tha Contrectors License Law tloes not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or t�rouqh his or her own employees, providetl that such improvemenis are not intentletl or oftered for sale. If, however, the building or improvement is sold vnthin one year of completion, the owner-builder will have the burden of proving Iha1 he or she ditl not build or improve for purpose of sale.). ❑ I, as owner of the property. am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business and Professbns Code: The cont2ctas License Law dces not apply to an ovmer o( pmpeny who builds or improves thereon, antl who cont2cls for such project with a contracta(s) license pursuant to ihe Contractors License Lav.s.). ❑ I am exempt under sec. Business and Protessions Code for Ihis reason: 305]�a6(YOi) Owner ID verified by drivc. _�ice, .. ❑ Yes ❑ No �Driver's License No. Expires: Verificatton of Ownership by (lype of document, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby cert'rfy that no excavation frve (5) or more feet in depth into wfiich a person is requiretl ro descentl, will be made in connection with work authonzed by this permit, and that no building slrucWre, scaffdding, falsework, a demolition or dismantling thereof, will be more Ihan thirty-six (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 341, Title 8, Califomia Adminis[21ive Code�. ❑ As ovmer-huilder. I will not employ anyone lo do vrork which would require a pertnit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Appliranfs SignaWre Ua�e Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future builtling occupant neetl to file and cerlify a Business Plan for emergency response to release or threalenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 of lhe California Heal[h and Safery Code requires, with some exceptions, that a Business Plan be filetl with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous matenals equal to or greater than a weight o/ 500 pounds, or a volume o� 55 gallons, or 200 cubic feet of compressed gas at standard temperaWre and pressure). 2. Does or will the applicant or present or tuWre building occupant need to file a registration fortn (or acutely hazartlous matenals? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safe[y Cotle, with some excep�ions, requires registration with ihe Costa Mesa Fire Department by each business which at any one time has on hand a quantiry 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 stantlartl temperaNre and pressure). 3. Does or will ihe applicant or piesent or fuWre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Ves ❑ No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing vnth the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous materials wilh the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Satety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fuWre builtling occupant require for [he work which is ihe subject of ihis appliwtion a permil for such constmction or modification from Ihe South Coasl Air Qualily Managemen� Disinct or from any other air pollution control district or agency7 ❑ Yes ❑ No (Section 65850.2 ot the Califomia Govemment Code requires Ihat the requested intortnation be fumisheA on applications fa non-residential building permits). 6. Will any part of [he faciliry to be cons[rucletl under this pertnit be wilhin 1000 (eet from the outer boundaries of a school? ❑ Yes ❑ No (If'yes", the facility must meel lhe requirement of Sections 25534 antl 42303 of Ihe Califomia Health and Safety Code). 7. If a permil fmm the South Coast Air Quality Management District or other air pollution control district or agency is required tor the vrork vmich is the subject of this application, have all of Ihe disclosures prescribed by Califomia Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No 8. Qf'yes", attach certificale of compliance from the appropriate air polWtion control officer). CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury the information given above is correcl. I a9ree to comply with all state laws antl city ordinances regarding Hazartlous Materials and Emissions. Signalure Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenify untler penalty of perjury that I have read this application and state that the information given is correcL I agree to comply with all state laws antl city ordinances relaling to building consWction, and authorize representatives of the City of Costa Mesa to enter upon ihe above-described property for inspection purposes. I agree not to occupy or allow occupancy ot any building authorized by this permit until final inspection. SignaWreo(LegalOvmer(s� �te �� Antllo� AolM1onzptl AOPIi W nl le