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Home My WebLink About692 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: 692 W 19TH ST 42224220 PRAUM,S7EVE 1049 MELRO$E �, ' � !�� - Phone: (714)231-7501 , i � �. � PLACENTIA. CA ,� . " , Zip: 92887 . � �; � �� owner.�, �DI,PIETRO, NICOLAS�P - Address j �1800 PENINSUWI PL�' �, , � ; � � %. � j' Phone: � ," COSTA�MESA,�CA Zip: 92627 / i . , �/:,i� � . Convactor. .' ORANGE �LECTRICAL CONTRACTORS Address: 1049 MELROSE � - , - � - 'Phone: (774) 980-2300 . PLACENTIA, CA - � Zip: 92887 � Status: ISSUED Applied: 0&/0512003 Issued: O6/O6/2003 ISSUED BY: ,� � � _ �\ � - � :�, � . , � . `� �� -�, . License: 747129 , SCOPE OF PERMIT � CONVERT EXISTING OVERHEAD ELECTRICAL SERVICE TO UNDERGROUND FEED. FEE SUMMARY �uantiry ISSUE FEE 50.00 - . Temp service test 50.00 �Res. a/c package � � $0.00 � New Res (1-2.uniLsj�, �. $0.00 0 New�Res�(3+units)' � � $0.00 0 Pool % Sp,a , / �V`; ;, 30.00 � 0 , LightingFixts � `�., 50.00 0 a ''� - Recept0utlets �'��50.00 0 - Switches �', � ' • 50.00 - 0 - Non Res Appl �' � " , � 50.00� � 0 � . Res Appl � � � �-' 50.00 �� 0 Service to 200a � _ � � SO.00 �o. . � seN�oe co �000a �-. : � ssz.�s-- �� Serviceover1000a��.�: . '--50.00 0 -_ � Mo�or� io �np �� ' � ao.00 ' �o- � Motorst010hp $0.00. �� , � 0�- ; , Motors t0 50hp � � $0.00 � 0 �, - Mororsro�oonP 'so.ao� o . Motors over 100hp $0.00� � � . 0_ _ . Communicadon drops $0.00 � - 0 _„. � Sub panel to 200a $0.00 �0� -. _ "" �- - - - Pole Light Pkg $0.00 0 � � Sign Circuils Eo.00 0 Temp Dist System / Lightlng � Busway I100 ft Standing Section , Misc Electrical Equipment Transformers up to 1 kva/kw ...... .....up to 10 kva/kw :.... ..............:..up to 50 kva/kw .................up to�)00 kvalkw ..................over100 kva/kw� - Low Voltage Equipment Low Valt Wiring System I Ckt Misc.�Conduil Misa Conductor . Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree StanB � � � Fireworks Stand , . � Other Electncal Fee � Quantiry $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 -- ., i 0 ao.00, �� o ao.00 0 ao,00 0 ao.00 0 ao.00 0 $0.00 0 $0.00 0 ao.00 0 ao.00 o' ao.00 '; o �$0.00� InvestlgationFee- -,�� -- � $0.00 Plan Check Fee� " , � 30.00 Reinspection�Fee a0.00 NOTICE: The work authorized by ihis permlt shall compty with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21•g2) EXPIRATION: Thls pertnit shall automatically ezpire and become void if work is not commenced within 1 BO deys, or if work Is suspended or ebandoned lor a period of 180 days. ' INSPECTIONS: In order tor the work authorized undar this permit to be eonslderetl legal, such work must comply with all epplicable codes, and ell requlred Inspeetlons and final apprqvel must be ob�ained. Failure to oblain Inspections and final approval will result in ihe expiration of �his pertnit. FOR INSPECTIONS CALL: (714) 75q.5626 zaa�ae la'oo� WORKERS'COMPENSAnON DECLARAnON: - I hereby aflirm unOer penalry of pgr�ury one ol the iWlowing dederatlons: ❑ I heve entl will mflintain e cbrtllicate of consent to sefl-Insure tor workers' compensatlon, es prodded for by sec�ion 3700 ot the Lfl6or Code, for Ihe peAortnence of Ihe wark for whlch Ihis'pertnit is Issuetl. jjT 1 heve erW wlll meintfli� worlcery' cpnpqnsaryp� Insurance, as required by seclion 3700 of the latwr Code, for the peAOrtnanCe of Ihe vrork tor whicli thls pertnit La Lswetl. , My wotke compen�allonJnsurance caMer anC pollcy number ere: C-0� Cartier. �(a :Fc 1-�a n Policy NumDer. 27 1 (Th/s secHon neetl nof be complefey N tt'e permltls val�ed et one hundred dW/ars ($100J or less.) ❑ I certify that fn t�e Derto ance of the work lar which this permit is issued, I shell not employ any person in eny mannar so es lo become subleci to the workers' compensation laws ot C�mie, egree Ihat It I should become sub�ect lo the workere' cwnpensatlon pmWsions oi Sectlon 3700 of tha Lebor Cotle, I shell torNwith comply with these Provlsl n5. / ('� 2 ApPlicant Signeture: _� � Date: l�� `i —� 7 WARNINO: FAIIURE TO SECURE WOpI(ER$' COMPEN$�TIpN COVERAGE IS UNL4WFLL M'D SHALL SU9IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED THOUSrWD OOLLARE (Et00.000�.IN AppRpry 7p 77�E CQST OF COMPENSATION, DMMGES PS PROVIDED WR IN SEGTION 3]OB OF THE UBOR CODE, INfEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm Ihet I em Ilcensetl untler provLsiw�p t Chapper 9(commendng with Section 7000) ot Dlvlsion 3 of Ihe Buslness end Prafessions Cade, entl my Ilcense is In tull iorce entl eNect. uc. p 1�-i ") I 1�1 p(1 11 n Ciass a� o ContrectorsSignaWre: Date: �i.[�_6? CONSTRUCTON LENDING AG�NLV: ❑ I �ereDy aMirm thet there b a ton9truction lending egency lor ihe peAortnance of the work tor which this permit Is issued. (Sec. 3097, CiWI Coda). Lendef9 Name: Lendefs Address: Signature: Dete: OWNER•BUILDER DECLARATONS: I hereDy aflirm thal under penelry ot per�ury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Profession5 Cotle: Any ciry ar wunry which requires e permit to consiruct, elter, Improve, demdish, or repalr any structure, prbr to its issuence, also requires the appliwnt tor such pertnit �o file a signed stetemen� ihet he or s�e Is Iicensetl pursuent 10 Ihe provisions o1 the Conirectors Llcense Lew (Chapter 9(commencing wIN Sectlon 7000) ot DMsion 3 at ihe Business end Professlons Cotle) or Ihet he or she is exempt therelrom antl t�e besis tor the alleged exemptlan. Any vloletion ol Sectlon 7031.5 by flny epplicant for a permit subJects Ihe epplicant to e civil penelry of not more Ihan Nve �untlretl tlollers ($500).j: ❑ I, es owner of t�e property, Or my employees wlih wages as ihelr sole compensetion, WILL DO THE WORK, end the structure Is not Intentletl or oNereC lor sele (Sec. 7044, Business and Protessions Code: The Contractors License Lew tloes not epply Io an owner ot property who builds or improves thereon, entl who tloes such work himselt or herself or t�rough his or her own employees, providetl that such improvemenis ere not Intended or offered lor sele. If, however, the building or Improvement Is sold within ane year of compleGon, Ihe owner-builder will have.tha burden ot proving that he or she did not build or improve for purpose oi sale.). ' ❑ I, es owner ot Ihe D�Werty, 8m EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTOpS to construct the pro�ect (Sec. 7044, Business antl Proteulons Code: The contrec�ow lJcense Lew tloes not appty to fln owner oi property who bullds or Impmves thereon, entl w�o comracts for such praJecl wilh a conirector(s) license pursuent to the ContraMors License Lews.). ❑ I em eaempt under sec. Business end Professions Cade for this reason: Signeture: Date: Owner ID verllled by drivers Iicen�. ❑ yes ❑ No Drivefs License No. Verlticatlon of Ownership by (rype of doament, I.e. - properry ten bill or deed): DIVISION OF INDUSTRIAL SAF�7y PERMR CERTIFICATION: Explres: ❑ I hereby certlfy that no excavetlon Me (5) or more leet in Oept� into which e pereon is required to tlescen4 will be made In connection with work eut�orizeE by t�ls pertni�, and Ihat no bullding slruMure, scaNdding, falsework, or tlemdition or dismantling thereot, will be more Ihen Ihirty-six (38) lea� high. (Chep. 32, Grp 2, Art 2, Sec. 341, Titla 8, Calltomia Adminlsiretive Cotle). ❑ As owner-hullder, I wlll no� employ enyone to tlo work which wauld requlre e permit irom the D'Msian of Indusirfel Satery, es noteG ebove, unless such person haq e permil lo Co such work trom the tlivision. Signature: Data: Dlvlsion ol InCusirial Setery Permit Number: CEHTIFlCATE OF CAMPLIANCE /WD AllTHORPJITON OF EMRV: I certity unOer penelry oi perjury thet I �eve read this eppllcelion end slate tha� �he Information given is correct. I egree to comply wlth II stete laws entl dry ordinances relating lo builtling constructlon, end authorize representetives of Ihe Ciry oi Casle Mesa to enter upon the ebove-described property tor in. Bttion 0 ases. I egrea not to ocwpy or allow occupancy ol eny builtling authodzed by Ihis permlt until final inspection. SI tu O Le I Owner�s) �^ _� n� Date �V Niid/Or Authaiz ApPlltent Daio SOOE I. INSiECTIONME 1618 Fl:ed System Finel Fire Preventlon 1268 Pod Spe Finel 200 Final RaFoof 201 Final BlocklRetalning Wel1 202 Flnal Factory Flre Plece 203 Flnal Slgn 204 Final Demdltion PeIF. Q�E64 CODEt MsvecnoNnve 206 Finel Mec�anicel 208 Finel Plumbinp 210 Finel Electdcal 212 Flnal Flre Preventlan 220 Finel Planning Approval 222 Finel Site 250 Final BuilOing/Occupency