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Home My WebLink About465 WILSON ST - Building Permits� CITY OF CO$YA MESA " . BUILDING DIVISION F. 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ww.v.ci.costa-mesa.ca.us �.�� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER E08-00003 PERMIT TYPE ELEC APN: TPN007225 JOB ADDRESS: 465 W WILSON ST CM Vicinity: STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: - ISSUED 0110212008 SOK SCOPE OF WORK: INSTALL NEW 700 AMP�SERVICEMETER PEDESTAL FOR"AT,ANDS" ', ' _, F � r ... �' OWNER: CITY OF COSTA MESA �, Address: 77 FAIR DRIVE Unit: PHONE: � - . City/State/Zip: COSTA MESA, CA APPLICANT: JANAE WILLIS PHONE: 909-946-0905 - . CONTRACTOR: VCITELECOM . Address: 1927 W 11TH STUnit City/State: UPLAND, CA E��.�, � ' .. _ ELECTRICAL PERMIT FEES Electrical Plan Check Fee: Electrical Permit Fee: Reinspection Fee TOTAL FEES -, Address: � 1921 W 17TH ST Unit: : � -- ' City/State/zZip: ? UPLAND, CA . License No. 765716 PHONE:'��909-946-0905 ' � , � 2ipCode: 91786 � - . CELL: $0.00 $54.00 $0.00 $54.00' "'� , �, , �. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California slatutes and related regulations. (Ord. N0. 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 authorizetl under this pertnit to be considered legal, such work must comply with all applicable codes, and all required inspections and Fnal approval must be obtained. Failure to obtain inspections and final approval will result in ihe ezpiralion of this permit. G00 1. INSPEC710NTYPE D� INiIiIRLS COUEf INSPEL➢ONTYPE �ATE IN7fIlALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 PoolSpa Final , 208 Final Plumbing �� 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall ' 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 FinalSiqn 222 Final Site 204 Final Demolili0n 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATIOI. • I hereby aKrm under penalty of perjury one of lhe following declarations: ❑ I have and will maintain a certifcale of consent to self-Insure for v.orkers' compensation, as provided for by section 3700 of the Labor Cotle, for tha peAormance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as requiretl by lion 3700 of the Labor Code, for tha pedormance of the wvrk for which this permit is issued. My vrorkers' compensalion Insurance carrier antl policy CameerareV � � A�X�(-�('J�! � (TnissedonneedmtE�enmcm�npe A�tdhe�peimd.d�vaNeda�melrunCrMdetlars(5f00)aleu) Policy Number: ��1 _� /�'r I 1� d� ❑ I ceRify that in lhe performance of the vrork for which this pertnit is issued, I shall not employ any person in any manner so as to bewme subject to the workers' compensation lavrs of Califomia, and agree that il I shoultl become subject to the workers' compensation provisions of Section 3700 of or Code, I hall f hwith comply wilh ihese provisi ^ns. � d- c Appliwnfs SgnaWre te W ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE UNLAWFUT 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 THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I �ereby aKrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of Ihe Business and Professions Code, and my license i in full force nd eflect. Lic. � p �� class # ,� C G (/�� `_ ConVatlOr's SignaWre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affum that there is a constmctbn lending agency fw the peAormance ot the work fa wfiich tNs pertnit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: SignaWre Dale OWNER•BUILDER DECLARATIONS: I hereby aKrtn Ihat untler penalty o( perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sac. 7031.5. Business and Professions Code: Any cily or counly which requires a permit to consiruct, alter, improve. tlemolish, or repair any structure, pnor to its issuance, also requires the applicant for suc� pertnit to file a signed statement that he or she is licensed pursuant b the provisions of the Contractors License Law (Chapler 9(commencing with Section 7000) o( Division 3 0l Ihe Business and Pmfessions Code) or that he or she is exempt therefrom and the basis (or the alleged exemption. Any viola[ion ot Section 7031.5 by any applicant for a permit subjecis lhe applicant to a civil penalty of nol 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 slructure is not intended or oftered for sale (Sec. 7044, Business anC Professions Code: 7he Contractors License Law does not apply to an oxmer of property who builds or improves thereon, antl who does such work himself or herselF or through his or her own employees, provided that such improvements are not intended or oBeretl for sale. If, however, the building w improvement is sold within one year of completion, ihe ovmer-builder vrill have lhe burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the propeny, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construcl the projecl (Sec. 7044, Business and Professions Code: The conlractors License Law does no[ apply to an owner of pmperty who builds or impmves thereon, and who contracts (or such prqect with a coniractor�s) license pursuant to the Contraclors Ucense Laws.). ❑ I am exempt under sec. Business and Professions Code for ihis reason: Owper ID verified by dr, lic�. .❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (lype of document, i.e. - property tax bill or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation frve (5) or more feet in depth into which a person is required to descend, will be made in connectbn with wvrk authonzed by this pertnit, antl that no building swcNre, scaHdding, falsework, a demolition or dismantling thereof, vrill be more than ihirty-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 347, Title 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to tlo work whic� vrould require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such v+ork from lhe division. Apphcanl'S SignaWre Date Division of Intlushial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building occupant need to file and certify a Business Plan for emergency response [o release or Ihrealenetl release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safery Code requires, with some exceptions, tha[ a Business Plan be (led with the Costa Mesa Fire Department by every business which has at any one lime dunng a reported year a quantity of hazardous materials equal to or greater than a vreight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressea gas at standartl IemperaWre antl pressure). 2. Does or will the applicant or present or future building occupant need to file a registration fortn for acutely hazardous materials? ❑ Yes ❑ No �(Section 25533 of lhe California Health and Safety Cotle, wilh some exceptions, requires registration with the Costa Mesa Fire �epartment by each business which at any one time has on hand a quantity of acutely hazardous materials equal lo or greater than a weighl of 500 pounds, or a volume of 55 gallons, or 200 cubic teet of compressed gas at slandartl temperature and pressure). 3. Does or will the applicant or present or fuNre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safery Code provitles lhat the Costa Mesa Fire Depariment may require the preparation, certification and filinq with ihe Fire Department of an RMPP by businesses w�ich are requiretl lo register acutely hazardous materials wilh the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safery Code been fully complied with7 ❑ Yes ❑ No 5. Dces or will the appliwnt or present or tuture building occupant require for the work which is ihe subject of this application a permil (or such conslruclion or modification from the South Coast Air dualiry Management District or from any other air pollNion control dislnct or agency? ❑ Ves ❑ No (Seclion 658502 of Ihe Califomia Govemment Code requires that ihe requested information be fumished on applitati0n5 for non-re5idential building pertnils). 6. will any part of the tacility to be constructed under lhis permit be within 1000 feet from the outer bountlanes of a school? ❑ Yes ❑ No Qf "yes", the facility must mee� �he requiremen� of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a pertnit from the South Coast Air Quality Management DisMct or other air polWtion conUol district or agency is required for the work which is the subject ot this application, have all of the disclosures prescnbetl by Calitomia Health and Safery Cotle Seclion 42303 been made? ❑ Yes ❑ No 8. Qf yes", attach certifcate of compliance from the appropriate air pollution wntrol officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply wilh all state laws and city ordinances regarding Hazardous Matenals antl Emissions. Signawre Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application antl state that the information given is correcL I agree to comply with all state laws and city ordinances relating to building construction, antl authorize representatives of the City of Costa Mesa to enter upon the above-described properry for inspection purposes. I agree not to occupy or allow occupancy of any building aulhorized by this permit until final inspection. � ( 9natyre of qs) e SiB�aWre Date � � 305]-<fi�3101) - AnG/orAulM1onze0Ap01icant Dale