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Home My WebLink About392 19TH ST - Building PermitsCITY OF COSTA MESA � B1I/LDING DIV/SJON > � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 •�wnv.ci.costa-mesa.ca.us �.�� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBE . E08-00373 PERMIT TYPE ELEC STATUS: ISSUED APN: 42630113 DATE ISSUED: 09/2212008 _ - ISSUED BY: RMD ' i ` I � r JOB ADDRESS: 392 E 19TH STs'CM ,, �' , Suite/Umt �� , vicinity: . ". .- . � �- . ' : , � . . SCOPE OF WORK: ELECTRICALPERMIT FORSERVICE PANEL UPGRADE TO 100A:� ,''. A l' . ., I Y' . , F OWNER: COZAD, RAY ( Address: . � 16515 CAT7LE DR � ��UuiF. �? � � ' � PHONE: � „ ,�� . � �City/State/Zip: : SPRINGVILLE;CA � � - .. .: , �.. -. . . , ; ., . � , . . . � , ,� . . APPLICANT: CEDERQUIST STEVEI�: ,� ; , ��. ,' �� ^�Address: ' � ` � 2338 BUNKERHILL WAY.. Unit: ' PHONE: 714-743-8027 ' _; �:r � ;:,,.., r�� .-, '"� City/State/zZip: "-':COSTA'jMESA CA�� '� �'� ' � M�';qi CONTRACTOR: CORNERSTONE^PROPERTY SERVICES INC. , License No. 903979 '��! Address: 2338�BUNKERHILL WAYUnit: - � - � � . � � � �PHONE: 774•743-8027 �, . City/State: COSTA MESA, CA � ZipCode: .92626 - CELL: ' � ��; , , ., , . ." �� , . ,. �. . ,�� :, ' � � �.�. . . � ..�� .,. �� . � „ . - -. . , , ��.., �'el ,. � - , -_ . , : . „ - ' , ' � "- . , , i ELECTRICAL PERMIT FEES � � �� ` '' � Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 � Reinspection Fee - $0.00 . . '. TOTAL FEES $54.00 ' � . � , ,� � NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ortl. No. 92-28, § 1, 12•21-92) � � EXPIRATION: PERMIT EXP�RES'I60 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 oodes, and all required inspections and flnal approval must be obtained. Failure to obtain inspeclions and final approval will result in the expiraGon of this permit. cooe� ixsv�cnoxTrre p� LNIlP�45 S�.S INSPEC110NTYPE , � �j/jf, � INTI11AL5 1816 Fixed Syslem Final Fire Prevention 208 Pinal Mechanical . 1288 PoolSpa Final 208 Final Plumbing � �� 200 Final Re-Roof 210 Final Electrical 201 Final BIocWRetaining Wall 212 Final Fire Prevention ' 202 Final Faclory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Sita 2f14 Final Demolition 250 Final Builtling/Occupanry WORKERS' COMPENSA710N DECLARATION: � I hereby aKrtn under penalry of perjury one of the following declarations: ,, ❑ I have anA will maintain a certificate of consent to SelNlnsure for xrorkers' compensation, as proyitletl for by section 3700 ot Ihe Labor Cotle, for the peRormance of the work for wliich this pertnit is issued: ❑ I have and will maintain v.arkers' compensation insurance, as roquired by secYan 3700 of the Labor Code, for the performance of the work for vfiich this permit is issued. My workers' compensation Insurance carrier and policy number are: `I"�-�Fa/�- 2iv6�-� S�iui.uGc Camer (Tnis sMm nBetl rro10e mmpletetl d tne peimrt is valuetl at ana nu�tlre0 Mlars (E1001 wless ) P�cy.Number: �Z��o �� _ ❑ I certify Ihat in the peAormance of the work for 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 California, and agree that i( I should become sub� ct 10 the workers' compensation provisions of Section 3700 of � the Labor tle, I s rthwith compJy� these provisio s. � Lfb e. ' Applican' SignaWre �� WqRNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO GRIMINAL 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, IMEREST, AND qTYORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under pmvisions of Chapter 9(commencing with Section 7000) of Division 3 ot lhe Business and Professions Gode, antl my license is in (ull force and eHect. � � � Lic: #-' "�""� Class # �— � �"'�[ / �'� Co�acbr's Signawre DaVte.�, CONSTRUCTION LENDING AGENCY: ❑ I hereby a((�mn that there is a constructbn IerMing agency (or lhe performance of the v.ork fa which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: _ Lender's Atldress: Da�e OWNER-BUILDER DECLARATIONS: I he�eby aKrm that under penalry of perjury ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or wunty which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant !or such pertnit to file a signed statement Ihat he or she is licensed pursuant to the provisions of the`Contractors License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of the Business antl Professions Cotle) or ihal M1e or she is exempt therefrom antl Ihe basis tor the alteged exemption. Any violation o1 Section 703�.5 by any applicaN for a permit subjects the applicant to a civil penalry of not more than five hundred tlollars ($500).): ❑ I, as ovmer of ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not inlentled or offefetl for sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes not apply lo an ovmer ot propeAy vRio builds or improves ihereon, and who dces such work himself or herselt or Ihrough his or her own employees, provided that such improvements are not intended or oflered for sale, I(, however. the building or improvement is sold within one year of comp�efion, the owner-0uilder vri11 have ihe burtleh of provi�g 1ha1 he�or she ditl�not build or improve tor purpose of sale.). . . ❑ I, as ovmer of the propeRy, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro consWcl Ihe project (Sec. 7044, Business antl Protessions Code: The contraclors License Law dces not apply lo an ovmer of property wfio builds or improves ihereon, and who contracts for such project with a contractor(s) license pursuant to the Coniractors License Laws.). , ❑ I am exempt untler sec. Busipess and Professions Code (or this reason; 305�-A6�3/0]) Owner ID verifietl by driv�. _ ncense. ❑ Ves ❑ No �A�ver's �icensa No. Expires: �Verification of Ownership by (rype of document, i.e. • property tax, bill or tleetl�: OlVIS10N OF IN�USTRIAL SAFETY PERMIT CERTIFICATION: . ❑ I hereby certify Ihal no excavation frve (5) or more feet in depth into which a person is required to descend, will 6e made in connection with vro�k authonzed by lhis permil, and that no building strucWre, scaffolding, falsework, or tlemolition or tlismantling thereof, will be more than Ihirty-six (36) �eet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Atlminislrative Cotle). � As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Induslrial Safety, as noled above, unless such person has a permil lo tlo such work from the division. Appliwnfs SignaWre DiviSion of InduSirial Safety Permit Number: _ NAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to (le and certity a Business Plan for emergency response to release or threa[ened release o! a hazardous material? ❑ Yes ❑ No (Seclion 25505 of the Califomia Health and Safety Code requires, with some exceptions, Ihat a Business Plan be filetl with the Cosla Mesa Fire Department by every business which has at any one time during a reported year a quantily of hazardous ma[erials 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 temperature and pressure�. 2. Ooes or will the applicanl or preseat or tuture building occupant need to file a registration fortn for awtely havartlous materials? ❑ �es ❑ No (Section 25533 of the Califomia Health and Safety Code, vn[h some exceptions, requires registration with the Costa Mesa Fire DepaAment by each husiness which at any one time has on hantl a quantity of awtely hazardous materials equal to or greater than a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic (eel o( compressed gas at slantlard temperature and pressure�. 3. Does or will Ihe applicant or preseN or Wture building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Healih antl Safery Code provides that the Costa Mesa Fire Departmem may require the preparation, certification and filing with the Fire Deparlment of an RMPP by businesses which are required ro regisler acutely hazardous materials with the Fire Departmenl. 4. I( an RMPP is presently requiretl, has Section 25534 of the Califomia Healt� and Satety Code been fully wmplied vrith? ❑ Yes ❑ No 5. Does or vrill the applicant or present or future building occupant require for Ihe work which is the subject of Ihis applicalion a pe�nit for such construGion or mo0ification trom ihe South Coast Air Qualiry Management Dislnct or fmm any other air pollution control district or agency? ❑ Yes ❑ No (Section 658502 0( the Calitomia Govemment Code requires that the requestetl infortnalion be lumishetl on appliw[ions fa non-resitlential building pertnits). 6. Will any part of lhe facility to be co�slructed under this permit be within 1000 teel trom the outer boundaries ot a school? ❑ Yes ❑ No Qf'yes". Ihe faciliry musl meet the requiremeM of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7. If a permit (rom the SouM Coast Air Quality Management District or other air pollution control disMct or agency is required for the work wtiich is lhe subject ol this application, have all of ihe disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Ves ❑ No 8. pf'yes", altacK certificate �of compliance from the appropriate air polWtion coNrol aKcer�. � � ' � � � CERTIFICATE OF COMPLIANCE: I certiy that�u�er penatty ot�perjury Ne in(ormation given above is correcL I agree lo comply wit� all state laws and ,ciry ordinances regarding Hazardous Malerials and Emissions. ''' Signalure ' ��e ' � CERTIFICATE OF COMPLIANCE AND AUTHORIZATION �OF ENTRY: I certify un0er penalty of perjury that I have reatl this appliwtion and-state that lhe informalion given is correcl. I agree lo comply wilh all slate laws and cily ortlinances relaling to building cons[ruction, and authorize representatives o( the Ciry of Costa Mesa to enter upon I�e abpve-described propeAy (or inspeclion purposes. I agree�no[ to occupy or allow occupancy o( any building authorized by this permit until final inspection. _ - Signaly� of legal Owpa _ e � _,C !!! � � V—A�dlorB, iorize4Ap01iwn1 Date' "'" � ��" 16419 , COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOl( 917 COBTA MEBA. CAIIFORNIA For Applicani fo Fill In Complefely TYPE OR PRINT BUILDING -'l/.ra T .iblL � _ _ _ _ COSTA MESA CALIFORNIA '9Y I. �'vz,q� TEL. 81ZE G Xo. oR BLDGB. OF LOT X��p xow oN Loi USE OR �' �,�/ELL/ N G-a er�erwr a� nr � 9HT0�GK LINB PPOM I� / /� I // LEFf / RIGHT 7 -� DESCRIPTION OF WORK /�BO Sq. Fr. Rooms � sroa�es � ,WpL�F�i9NG I ROOF G� D M/� i uLCo COVHRING JILDJ NS'. AND WORK TO BE PERRO MED �C G, -O" 7C /.?d'-O�� `oG/G ,FEE RECEIVED FEB 1 5 I96Q � FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Offlee Use Only lIHCHIPT NO. IlRMITiNO. � � COSTA MESA. CALIFORNIA FIHE ZONING ZO INO. OP � /I U8H OP NBW PlANB // BIIILDINO L80AL ,�/ OHBLPIPTION /! O I � � A. P. NO. N% YAROS EVES APPROVED ALLOWEC ICBHT[li LIN6 8T.1�.*�.yy � APPROVED st� 1 HBReSY ACKNOWL6D06 TXAT 1 HAVB HBAD TX18 APPLiGT10N THg �yOUNT 9HOWN UNDHR VALUATION 19 IOR TH8 AND 9TAT8 THAT TH8 ABOVB IB CORR6CT ANO AOli88 TO CON- pYlV098 OP lBTABLI9NIN0 A PBRMIT P!C ONLY. PLY WITM �LL CITY ORDINANCEB AND BTATH LAWB Ii60YLATINp au��DlNo coNeTRUGT1oN. VALUATION � 81GNATURH OF � �� PERMIT FEE S � PERMITTE� S � PLAN CHECK $ �� ■ AUTHORIZED AGENT i O 4 _� � C057A'MESA BUILDING-SAFETY DEPARTMENT p. O. BOX 9f7 COBTA M66A. CALIFORNIA For Applieanf fo Fill In Complefely TYPE OR PRINT i BUILDING ? L' �% f� �% A�DRESS COSTA MESA. CALIFORNIA OWNER /! �v�. �C!�Ci �% MAIL �' . _ � STATE . r THL. NO. TEL. TEL. NO. OF BIDGB. USE OF EXI3TING BLDG 6HTBAGK LINB FROM �NTex tlM BTReeT REAR YARL SIDE YARD I LEFT � RIGHT DESCRIPTION OF WORK WALL iILDING At G " , � FEE R�ECEIVED �' APR 101982, FINANCE DEPT. ��i' CiTY Of COSTA MESA APPLICATION FOR PERMIT BUILDING fi For Office Use Only +�" aece�vT no. reRM�� S�9 COSTA MESA. GALIFORNIA FIRE ZONING ZONPf� I PLAN9 � I BUIIDINO6W � �l ('� LE6AL Tl\ L�I� l �� Iti� '� DEBCNIPTION A. P. N O. I I�_' 1 I G�`�' 7 YARDS EVES � APPROVED ALLOWED venT6R LINE BTJ .0 ' / cT � T _� I HEHEB�" ACKNOWLEDGH TXAT I HAV6 REAO TH18 MPIJGTION TMQ AMOUNT SHOWN UNDEft VALUATION 18 FOR TX¢ ANO 9TAT8 THAT TH8 A00V6 18 CORRL'Ci AND AGPEB TO CAM- pURP08E OP E9TA8LIeHING A PERMIT FHE ONLY. PLY WITM ALL CITY ORDINANCEB AND BTATE LAWe R6GUU1TIN0 BUILaINP CONBtRUR10N VALUATION 8I6NATURE OF CG �� PERMIT FEE $� PERMITTE /% � S / � X PLAN CHECK $ —� AUTNORiZED AGENT ,_�, TOTAL FEE ORANGE COUNTY BUILDING DEPART'MENT I � APPLICATION FOR PERMIT � - 636 Noreh Broadway _ _� ■ ■' �.�-1 � ^ -. r SANTA ANA, CALIFORNIA ' ' V V ,_ l� . . . . . , ' �� . . . .. . � '' . �. • , � • � . . .�.' � w _ � � . . ,ti Z w - � Z d PLOT PUN J ' - � -' - � - � ' � `�p _ - o . . a ' . ' '- ¢ _ .. . - � � ' � . . � a ' . � . . � • . ' . .. .. � . ... � - . ' . . � - i'.- . , ' _ , c` � .. ' _ _ _ " ' ._ _ __ __ "' __ � . , ..'. ' '� �� . ' . . . . . . . .. . " . � � . � �, . ' j • • , . ' _ _ ._` , iY . '_ .. .� , . � . ' '.J ' _' ' _ _ ' „ _ . . c�`. ' ... ' , _ . , . .' ... . _ . . ��Y ` r .. � r ` , . t 0 W N STREET� •�' ' •' . . . . .. . � ^ ' Y '� ! � ' � . . w � ' . � . - . _ .. ' . i .. _ ' .. . ' . . � • . ��` . • . � . � � Y � . - 1 � . . . . � � ♦ t. � • .r._. _ .. 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