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Home My WebLink About526 19TH ST - Building Permits�� ►, I 942� � ��, ��/ �yf . C'aSTA MESA BUILDING-SAFETY DEPARTM�JT��"�"J P. O. BOX 817 C09TA MCBA, CALIFORNIA For Applicant fo Flll In Completely . /TYPE OR PRINT BUILDING L'�7/y� /�/ % ADDRESS �J f�[l 1ij/ COSTA MESA, CALIFORNIA . �� cirr l.. .'// . � ho.' ._. ARCHITECT TQL. OR EN61NE8R ' NO. AD_ .SS `- CONTRACTOR ,��r A�DREBB /--�� / Z .�GG:1��a./NUNGL� CITY �j LIC.NO. , 3_J NEL i � ✓✓V $IiE 1 � NO. OI BLO06. � OF LOT ryoW ON LOT USE OF � EXISTIN6 BLD6. BETBACK LINB PROM �� CENTER OP HTRB6T REAR YARD BIDE YARD LBFI' � RIOHT DESCRIPTION OF WORK BUILDINO � SIZE EXTERIOR WAL`� u»C oF eu�Lplf1G AND WORK TO �" � `�H/i'/L .�.C/�i � HEPEBY �CKNOWLBDOt TM�T 1 XA ANO BTATE THAT TH6 ABOV6 IB COI PLT WITH ALL CITY ORq�NANC[i AN BWLDINOCONBTRUCTI N. SIGNATURE OP PERMITfE AUTHORIZ6O A6fiNT / /�% /�, �- 8TOR1H9 � � ��C�;''�J�� av 1 � 1963� INANCE DEPT. APPL�CATION�FOR �ERMITjTA MESA BUILDING FO� D�flte U58 On�y cu ZONING NO.OR U860PN1 PLANO ^ 1111L�IN0 VARDS APPROV ED MAIN BUILDING iOM C/l STREET ) VAR. ii � � �� 6HALL BE LESS THAN VARD9APPROVED ACCESSORY BUILDIN6 DATE N 90. Ff. � APPLICATION TH8 AMOtINT BMOWN UNOEN VALUATION 16 PON TX8 � i8H TO COM- PURP088 OI 68TABLI6NIN0 A PERMIT FEB ONLY. Q R[OULATINO yA�,UAT10N �.D p PERMIT FEE $ � j m /JA// l S�9e e-� LA EC � �— � ^ LL a�._.L� � .i (714) 754•5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 SIGN PERMIT Job Address: 526 W 19TH ST Suite: Viciniry: Status: ISSUED Applied: 07/20/2005 Issued: 07/20/2005 Parcel Nunmber: 42210316 ZOning: - ISSUED BY: .4pp�icane FRANCISCO RAMIREZ"- ' Address: '� �//'.-�: �, : �-- � , � ' � - � " . / ; - �! , � �.,.� � � . Phone:, 714-92&0443 �, , , . -,�' , - � %i� � - . Z�p:- � � - i. � �� A � /� � - _ '_' � ' ,_ - . . Owner � : �CASELINI; ANTONIO L ,�, .' � ; � �� , . 1 Adtlress; �155TERRAZP,CT .- � � �� / � : � � Phone: 94&283-5728 ' � - COSTA�MESA, CA Zip: 92627-1714 � � �"„ ' � �,� . �%%!' � �Z�S . 'Contractor;' FRANCISCO RAMIREZ � , � ' � �•�.. �� , �iAddress: � 23 VIA�HACIENDA % , , � _ - . ' � � .".�;?� '�.Phone:'714-928-044/3 � . . . � ' RANCHO SANTA MARGARITA, CA � �Zip: �92688 �—,� l� , � . ; . � � , �,. -i �-,, .: - -Cicense: 723485 - . Arch/Eng: ' ir; . ---" - , Address: � � - �� i � , . , � �\ „ Phone: c. -� � _ . , ' . ; � Zip. �\ i r, _ ' _ _ _ _ , . . License: - � j � . `% ,>v -, ,�� `/ /'- • -� . -, � - - � , - � � � \: ' " -' "SCOPE OF PERMIT , 20 S�.FT. ILLUMINATED, CABINET SIGN FOR'MULTISERVICES�NBC" , _ FEE SUMMARY,- Plan Check: , $21.22 - '. Calc Valuation: � S�5o.o0 ' $0.00 � � Permit: , � $32.65 � � -� � � • Claimed Valuation: �� 5�so.00 �,SMIP,Com: � �` �, � $0.50 ' � " � � � OtheF: . �;�� $0.00 � `;;:,� �� - � � ,� � � �,$0.00 =-' - • � ��, � � �' � " .. . Inspection: � �' �$0.00 � � � � '= '� .�.,; -.� , � ��\ $000 � _, _, i , � r /i �`. �� $0 00��, � � ' ��-\ C,� � � ' � �� : .r, . - j ;� � , � Total• �� $54:37i� � ��t � � � � ,�" � �, �� , �: ;� � �1. �� i � .� - _ / / , i ��j,� ��/j �� - � _PLANNING &ZONING= �� ` ' i';'' V '; ` � � �. �. - � ��' NOTES: ' , - . , � � ' �. .. � � � � � - „, ,. �-i '- NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21•92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In ortler for ihe work authorized under [his permit to be considered legal, such work must comply with ell applicable codes, and all required Inepeetlona and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALI: (71<) 7545626 aao-ao �aw� WORKERS'COMVENSAnON DECLApArON: � I hereby affirtn untler penalry of perjury one o1 ihe following Oedarations: ❑ I have end will melntain a cenificate of consent to selt-Insure for workers' compensatlon, es provitled lor by section 3700 ot ihe Lehor Catle, for Ihe pertormence of the work for whlch this pertnit is Issued. ❑ 1 have end will maintain workers' compens�tion Insura� uireA by sectlon 3700 of Ihe Lebor Catle, tor Ne pertortnarroe of Ne woAc far wNch this pertnit Is Issuetl. My workers' compensation Insurance ce i er entl poli umh�e e: Cerrier: Policy Number: (Thls sectlon need nof be camp/efed!! the it is /ued one huntlreO doflers fS1001 or less.) ihetint�e isetlon law with Ihese (E10p.000),IN LICENSEDCONTRACTORS I herebv aHirtn Ihet I em Iicene CONS7RUCT10N LEND ❑ I hereDy attirm thet Lenders Name: Signature: �ch this pertnit is issueQ I ahell not employ any person in any manner so as to becoma uD�ect to theq�orken If I should become sub�ect lo the warkers' compensetlon provisions of Section 3700 oi t�e Lebor Codq, I shell ISATION WVERAOE IS UNIAW FUL AND SMFLL SUBJECT AN EA17'LbGER T COST OF COMPENSATION, OAMAGESlS PROVIDED FIXi IN SELTION 3]W with Sectlon 7000) of Dlvislon IMEREST, AND ATfORNEY'S FEES. and Professioryc Catle, antl my license Is in full lending egency lor the peAormance ot the work for which this permit is issued. (Sec. 3097, Civil Code). LendeYs Atldress: —_ Date: OWNEN-BUILDER DECLARATIONS: I hereby eftirtn that under penalry of per�ury Ihat I em EXEMPT FROM TME CONTRACTOHS LICENSE LAW for Ihe following reason (Sec. 7031.5, Buslness antl Professions Cotle: Any city or counry which raquires e permit to consiruct, alter, improve, tlemolish, or repair eny structure, prior ta its issuance, elso requires the applicant for such pertnil to file e signetl stetement that he or she is Iicensed pursuent to ihe proNsions of the Coniradors LJcense Law (Ghepter B(commencing with Sectlon 7000) of Dlvlsian 3 af Me Business and Pmfessions Code) or that �e or she is ezempt therefrom entl tha basis far tha elleqed exemptian. Any vlWatlon oi Sectlon 7031.5 by eny epplicant for e pertnit sub�ects ihe epplicant to e civil penelry of not more ihan five hundred dallars ($500).): ❑ I, as owner ot Ihe praperty, or my employees with weges as t�eir sole compenselion, WILL DO THE WORK, end ihe structure Is not intentletl or oifered tor sele (Sec. 7044, Business end Protessions CoOe: The Coniractors Llcense Lew does not eppy lo an owner oi property who builds or improves thereon, and who tloes suCh work himsetl or hersell or through his or her own emD�oYBes, pmvided that such impmvements are nat intended or oftered lar sele. It, however, the builtling or improvement Is sold within one year of completion, t�e owner-bullder will have the burden ol proving that he or she tlitl not builtl or improve for Durpose ol sele.). � ❑ I, as owner of the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTBACTORS to consWct the pro�ect (Sec. 7044, Business end Professions Code: The contractors Licanse Lew Goes not apply to en awner of properry w�o builds or impmves t�ereon, end who comracts tor such pro�act with e contractor(s) license pursuant to Iha Contractors License Laws.). ❑ I em exempt under sea Businass antl Professions Code for this reeson: Signature: Date: Owner ID veritietl by tlriver's license. ❑ Yes ❑ Na Oriver's License No. Expires: Ved�icetion of Ownership by (rype oi dacument, i.e. - propeny ta�c bill or deed): ___ DIVISION OF INDUS7RIAL SAFETY PERMR CERTIFICATON: �� ❑ I hereby ceNty Ihat no extavetion tive (5) or more teet in depth into w�ich e person Is required to descend, wlll be metle In connection with work euthonzed by this permit, antl �hat no builtling strudure, scattdding, telsework, or demdi�ion or tlismantling Ihereoi, wlll be more Nan Uirty-six (36) feet high. (C�ap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Atlministretive Code). ❑ As owner-builder, I will not employ enyone to do work which woultl requlre e pertnit irom the Division oi Intlustnel Safety, es nated above, unleu such person has e permit to tlo such work from Ihe tlivislon. � Signature: Division of Intlusirial Sefely Permi� Number: B Date: Will the epplicaN ar presant or future bulltling accupam neetl ro flle entl cenly e Business Plan for emergency response ro release or Ihreatened release of e hazardous ma�erial? ❑ Ye5 ❑ No (Section 25505 ot the Celifomle Heel�h and Safery Code requires, wlih some exceptians, thet e Business Plan be flled with ihe Coste Mesa Fire Deparlment by every business which has at any one time during a rePortetl year a quanUry of hararOous materlels equal to or greater then e weight of 500 Dountls, or a volume o155 gallons, uoes or wm me aDP��em or presem or wwre omioing occu0am neeo �o me e regrsvaaon iortn ior ernery nazamous me�enais r �,,,� res LJ no (Section 25533 of ��e Califomla Heal�h end Safety Cotle, wllh some ezce tions, requires reglstretlon with the Cosla Mesa Fire Depertment by eaU 6uslne55 whlch et eny one tlme �as on hantl a quentiry of acutely hazardous meterials equePto or greater ihan e waight ot 500 pounCs, or e volume of 55 pellons, or 200 cublc feet of prepere en (Section 25534 of the Califomla Hea1N entl Satery Code provides that the Coste Mesa Fire Depariment may requii oepanmem of en RMPP by businesses which are requiretl to register acutey haiertlous matedels wit� ihe Fire Dep; ..............................................................................._.................................................................................................,...................................................................... If an RMPP is presently reduired, has Sedion 25534 of the Celifomie Health end Safery Code been fully complied wi ......................._............................__....................._........................'___'........................�..._..............__...........................'_'.................................. Daes or wlll the applicent or preseM or tuture builtling accupant require br Ihe work which Is Ihe su��ect oi lhis e p Irom �he South Coasi Air Quelity Menegement Ols�dct or Irom any ot�er air pollmlon control Alsitict or egency7 �' (Sectlon 658502 ot Ihe Califomle Government Code requlr09lhet Ihe requesteOlntorma�ion be fUrnished on epDliCO ...................._..........................._"......................_....................................._............................_..........................__................................_................................... Will any pen oi ihe teciliry lo be constructetl under ihis pertnit be within 1000 leal trom Ihe outer boundaries oi e schi Qf yes', Ne facility must meet ihe reqNrement Of SeCtions 25534 end 42303 0l Ihe Califomia Health entl Safery Cotl ................._._..._...................._._.................—__.�_'................._—'...............__.............._.......—._................................. I� e permit from �ha SouN Coest Air OualilX Menaqement DiSinct or other eir polWtlon wn�rol district ar egency molication. have ell of Ne ElsGosures orescnbed bv Celitomla Health end SefeN Code Sectlon 42303 Deen metle? � preparetion, certllicetion and filing with Ihe Fire mt. ..................................................................................._................_ ❑ ves ❑ No ................ .........................'_'............._.._..........._...._............. on e pertnit tor suc� wnstructlon or modificetlon �J N� for non-resitlential Culltling permits). .......................... _........................................ _................. _................ ❑ Yes ❑ No ................................�._........_.._............._...............—....... �quired for the work which is Ihe sub�ec� of �his Yes ❑ No CERTIFICATE OF COMPLIANCE: I cerllty that under penalry of per�ury the Information given ebove is correct. I agree to comply with ell stete laws and ciry ordinences regartling Hazertlous Matariels end Emissions. Signature: Date: CERTIFlCATE OP correct. I agree ro ebove-described q cooe ". 1616 1266 200 201 202 IANCE AND with ell stpll Fire Prevention Final Block/Relalning Well Finel Fectory Fire Place A710N OF ENTRY: I certity untler penalry af perjury that I have read Uis epplication enC state Net the intortnetion given is dry ordlnances relating to hullding constructlon, and euthorize represemetives oi Ihe Ciry of Costa Mese to enter upon ihe I egree not ta accupy ar ellow occupency of eny 6uilding euthonzed by Ihis permit until finel inspection. PAff. II�LS COOE I INSVECTION TYPE 206 Final Mec�enicel 208 Finel Plumbing 210 Finel Elecidcal 212 Finel Fire Prevenllon 220 Finel Planning Approval 203 Final Slpn 222 Finfll Slte 204 Finel Demolllion 250 Finel Bulldinp/Oxupency PdIE Ii�ALS (��a) 75as273 • Fau (714j 754•4856 • www.ct.costa-mesa.ca.us // hA1F1 UM�Vb� GV31A MtJX� liX HLOLO ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 526 W 19TH ST 42210316 Applicant FRANCISCO RAMIREZ Address: 23 VIA HACIENDA . - , ' - � - - � Phone: 714-92&0443 RANCHO SANTA MARGARITA, CA `, Zip i � ._ /�� / � / �� / i i.- _ Owner.� � CASECINI;ANTONIO�L"'-�' � � � �� Address� ! 155 TERRAZA CT " - ; �'� 92688 ' � � �, �'- /� Phone: 949-283-5728 , „ - . COSTA MESA,'CA 2ip: ' " /% ' i O RAMIREZ t92627-1714 Stams: ISSUED Applied: O7YL0/2005 Issued: O7I20I2005 ISSUED BY: i i j : 4Zg�� T�� 3 D , DA� , Contractor. FRANCISC . � �°�_ � 'Address: 23 VIA HACIENDA: � �= �i' �� ' � . . - � , � �i. ' , ' ' , . • . , ��:�Phone:� 714-92&0443 -, `, , , � RANCHO SANTA MARGARITA, CA Zip: 92688 � , �� _ , ^ - e � .. � - __ /' _' ' 20 SD.FT. ILLUMINATED, CABWE license. 7234 5 ELECTRICAL TO INCLUDE: 1 SIGN CIRCUIT. � ,� � . \ .. , . \: . � NBC" REF.: SBOS-00089 FEE SUMMARY � - Quantity � � � . � Quantity �� .ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0'- � Temp service test $0.00 ' Busway I100 ft; $0.00 0`,' �. Res. alc package • 50.00 � SUnding Sectlon ' $0.00 0�- , � New Res (1-2 unils) ��' 50.00 0 '•- Misc Electrical Equipment 50.00 %�0 �� NewRes�(3+units)-' V�� $0.00 � 0 ,�.�'�"�� T2nsformersuptotkvalkw $0.00 ��'0 �� ; Pool / Spa ,. � �� $0.00 0 �' ' '� � " � `.up to 70 kva/kw b0.00 "' ; �0 " � . . r �. . .... .......... Lighting Fixts �. ; , ��$0.00 0 "� `� � � - ...:......:......up to 50 kva/kw $0.00` 0 Recept OuOets;. - � �50:00� � ' 0:=� � � � � � � � �� J= `� -. . � . .................up to 100kva/kw ''� : $0.00' 0 � Switches � � ,�� /� $0.00? ? - 0� � � -� , � ...................over 100 kva/kw , �$0.00 - . 0 Non Res Appl� � '� $0.00 � �� ,0 �- � Low Voltage Equlpment _ ��,� � $0 00 'i -0- Res Appl ,� � „ � 50.00, -0� � � ' � � Low Volt Wiring System / Ckt- � 50.00 ��0� � � � Service to 200a � � � _� �, g0 00 - , , '0�; � � � � �,,, - ` Misd Conduit . . 50.00 . 0 - � -" - Service to 1000a �� 30.00 ; �� 0 - � �Misc. Conductoi. ��$O.QO/ ,0 " - Service over t000a ��A$0.00� �� ' 0A � � = Cirbus-( gen or ride) -. �; $0.00 j 0,: � Motors to 1 hp � �� $0.00 - �i . 0" ' � ' Circus,(mech nde or lights) ', � `$0.00" ,, 0 MOtorS t0 10h � ' � `�� p $0.00�- "0 �� : - �ChdstmasTree�SWnd'� _-$0.00 0 Motors to SOhp $0.00 - -� 0 � � .-Fireworks Stand. � ': i $0.00 0 Motors to t00hp 50.00 �� 0 � � `- �Other Electrical Fee - � � $0.00 Motors over 100hp $0.00 � 0 - � . . Communicatlon drops $0.00 0 - _ -' - �Investigation Fee � 50.00 Sub panel to 200a $0.00 0 �"- Plan Check Fee $0.00 Pole Lighl Pkg $0.00 0 Reinspeclion Fee $0.00 NOTICE: The work authorized by this permit shall compty with all applicable handicap access requiremants under Calitomia statutes and related regulations. (Ord. No. g248, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void il work is nol commenced wtthin 180 days, or if work Is suspended or abandonad for a period of 180 days. INSPECTIONS: In order for the work autharized untler this permit to be consitlered legal, such work must comply wlih ell 9ppliC2ble codes, and ell raqulred Inapectiona and flnal approvel must be obtalned. Failure to obtain inspections and final approval will result In the expiiation of thls pertnit. FOR INSPECTIONS CALL: (714) 754-5626 . 244&48 (H/W) WORKERS'COMPENSAnON DECLARAnON: 1 hereby attirm unAer penalry of perjury one of Ihe fdlowing OeGaratlons: 0 I liave end will maintain e ceNlitate oi consent to self-Insure for workers' compensation, es provltleE for by sectlon 3700 of the Lebor Code, lor Ne peAartnance of the work for which Ihis pertnit is Luued. ❑ I have arM will maintein workers' oompensatlon in///urence, as required by secUon 3700 ot Ihe Lebor Cotle, lor Ne peAortnence ot tha work Iw wNc� Ws peimit 7s iswetl. My workers' cnmpensatlon Insurance cartier anp polity numb f ere: Cerrier: k � � Policy Number: (7T/s sectlon need nat be aompleteC ll fhe permif !s I lued one h red dallers (Sf00) or less.) �Wrtify.that in the peAortnence ot the ork ch thi rtnit Lv issued, I shell not employ eny person in any menner so es to become sub�ect ro tjia workers' wmpen`setion lews of Calitomla, erW g t It I s Id become sub�ect to the warkers' compensatlon provLqlons of Secilon 3700 f the Lebor 6tle, I shall torNwlih � wlth these proNsions. w�n{t Signe['uie�`" Dete: ��'" O r� W NO FNLURE TO SECURE WORKERS�O \TION COVERAGE IS UNLAWRIL AND 5lNt1 SUBIECf AN EMPLOYER TO CRIMINAL PE! ES AND�/ FlNES UP TOONE HUNDRED THOUSANDDOLLRRER��)��NADDffIC�TO EC STOFCOMPENSlT10N,OFMAGESISPROVIOEDFORINSECfIdJ3lOBOFTMELABOR E,INTERE$T,rWD�TTORNEY'SFEES. LICENSEDCONTRACTORS I herehxadlrm�Ne4l�em�lkeru CONS7RUCT10N LENO ❑ I hereby attirm Ihat Lentlers Neme: Slgnature: wi�h SeCtlon 7000) of Code, entl my Ilcense Is in lull a constn�ction Iendinp epenry lor the pertormence o11he work lor whlch this pertnil Is issuetl. (Sec. 3097, Civll CoAa). LenAeYs Atltlress: Date: r OWNER-BUILDER DECLARATIONS: 1 hereby eHlrtn Nat u�er penalry of per�ury thet I am E7(EMPT FpOM THE CONTRACTORS LICENSE LAW tor the tdlowing reason (Sec. 7031.5, Business end Professlons Cotle: My dry or counry which requires a permit to cOnstruq, elter, Improve, Aemolish, a repair eny st�ucture, pAar to ita issuance, alw requires Ihe epD��eN for such pertnit to file e signetl statement �het he or she is Iicensed pursuent to the proWsions of Ihe Cantrec[ors ticense Law (Chapter B(cammendng wlih Sectlon 7000) of Dlvlsion 3 of ihe Business flnC Professions Cotle) or Ihet �e or she is exempt theretrom entl Ne besls for the elleged axemption. Any Ndation of Section 7031.5 by any epplicent for e pertnit sub�ects the epplicent ta e Gvll penelry ot not more than tWe hundred dallars ($500j.j: ❑ I, es owner of the properry, or my employeas with wages es lheir sole compensation, W ILL DO THE WORK, en0 �he strucNre is nat InientleG or otteretl for sele (Sec. 7044, Busineu end Professions CoCe: The ConlreMoro License Law does not appy to en owner of property who bullds or improves Ihereon, antl w�o does such work himsefl or herself or t�rouph his or her own employeas, provided ihat such improvemenis ere not IntendeA or oNeretl tor sale. It, haxever, the building or Improvement Is sold within one year oi wmpleilon, ihe ownerbuilder will heve the burtlen oi proNng Ihat he or she did no� builtl or Impmve tor purpose oi sale.j. ' ❑ I, es owner of the property, em EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business flnd Protessfons Code: The conlreIXors LJcense Lew tloes not appy ro an owner oi proparry who bulltls or Improves thereon, entl w�o contracis lor such pro�ect with a conirector(s) license pursuant to the Contractors License Lews.). ❑ I em ezempt under sec. Business entl Professions Code tor this reason: Signature: Date: Owner ID veMetl by tlrivefs license. ❑ Yes ❑ No Drivefs llcense No. E<pires: Verlficatlon of Ownership by (rype of dacument, i.e. - praperry taz bill ar tleed): DIVISION OF INDUS7RIAL SAFETY PERMR CERTFlCATION: ❑ I hereby certily thet no excavatlon Me (5) or more feet In Oepth Into which a person Is requlred to tlescen4 wlll be matle In connection with work euthorized by this permit, and Nat no building suucture, scattddinp, lalsework, or demoliiion or tlismentlinp Ihereol, will be mare then thlrry-six (36) feet high. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Tllle 8, Calitomla Adminlstretive Code). ❑ As owner-bullOer, I will not employ flnyone to tlo work whlch would require e pertnit trwn Ihe DMsion ol Industrial Selety, es noteA ebove, unless such person �es a pertnil to do such work trom the division. Sipneture: Date: Dlvision oi Indusirial Sefery Pertnit Number: HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION: 1 WIII the epplicant or presem or fuNre builtlinp occupant nee0 to tile enC cenity e Business Plen tor emerpency response to release or Ihreetened releese of e hezertlous materlal? ❑ Yes ❑ No (Sectlon 25505 W the Celilomla Heallh anC Satery Cade reqWres, with some ezceptlons, that a Business Plen be flletl wlih Ihe Coste Mese Fire Department by every business which has at eny one Ume during e rep�ned yeer e quantiry ol haiardous materlels equal to ar greater then e welght o1500 pountls, or e volume of 55 gailons, or 200 cubic teet of compressed gas at stendaN tempereNre end preuure). ........_- ................_._....._..—._........_. _.................__....................__...................................................�..................... _..............�....""'_""_ 2 Does or will Ihe epplicant w present w hrture builaing ocapent need ro tile e registretion lortn fw eatety hazerdous materials7 ❑ Yes ❑ No (Sectlon 25533 W t�e Celtlomla Health entl Selery Cade, with eome exce hons, repulres replstretlon wIN the Costa Mesa Flre Depariment Dy eech buslness whlM at arry one time hes on hend e Quentlry of ecutety hazertlous meterials equaP�o or grester Ihen e weight oi 500 pounAs, or e volume of 55 gallons, or 200 wbic feet ot �r wlll th❑a epplicanl o� present or tuture EuilOing occupent need to prepare en RMPP (Risk Menagement end Preventlon Program for ecutely hazerdaus materials�7 No on 25534 of ihe Califomla Healih and Sefety Code provides Ihat the Caste Mese Flre Department mey requlre the preparetion, certllicatlon end filing with the Fire M1ment of en RMPP by Duslneues which ere required to register ecutely hevardous metedels wlth the Fire Depertment. 4 If en RMPP is presen0y reQuireQ has Section 25534 ot tne Gelllomla HealVl en0 5etery (:o0e Deen tuny compueC w¢n"t V ves V rvo .........—._' _..._ ......................._._�."'..._ .. 5 Doas or win the epplicant or prasent or tuture building occupaN require tor the work wNch is t�e subject of this e pllcation a gertnit for such wnslruction w Irom the Sauth Goest Alr Oueliry Management DlsVki w trwn erry oNer elr pdWtlon conird dl5irlt� or egenty7 � Y69 �J No (SecUon 658502 of Na Calilomla Gwemment Code requirBs �he� UB requestetl Infortnelion be fumis�eU on epplicetlms far non-residantlal building permib). ..............__..................._..........__.........................._...._............._ ........__....._.._._..........................._.............................................................__..... ._...._..__.._ B W ill any part of the tapliry ta be conSWcted unAer NI5 permil be within 1000 teet from t�e outer boundariaz of a schod7 ❑ Ves ❑ No (It Yes'. the fedliN must meet �he reGuirement of Sections 25534 erW 42303 ot Ne Califomia Health and Safery Coda). Slgnamre: CERTiFlCATE OF wnect. I epree to GODE �. 181fi 1268 r �`� Pool Flnal ell ot lhe tliulwures ell or egency 3n matle? Ihe subjecl mce from the eppropriate elr pollution control otticer). I cenify that unAer penalry o1 perjury ihe iniortnetlon given ebove is correct. I egree to compty with ell slata �ews entl dry ortllnances Emissions. Date: Flre Prevention 201 FInflI BIacWRetelning Well 202 Flnel Fadory Flre Plece 203 FIneI5i9n 204 Flnel DemdlGon DRQATON OF ENTfiY: I certify untler penelty ot per�ury Iha� I have read this epplicaUon end state that the infortnalim given is an0 dty ortlinencm relaWg lo builtling conStruMlon, entl authorize representetives oi the Ciry ol Coste Mesa to enier upon Ihe �ses, I agree not to ocwpy or ellow occupency ot any Duilding euthodzed by this pertnit un61 Mel inspectlon. �� COUEI 20fi 208 zia 212 220 INSGEG710NTYPE ' Final Mechenlcal Finel Plumbing Finel Electrical Flnel fire Preventlm Final Planning Approval 222 Flnel Site 250 Finel BuIldinglOccupancy � I�� Job Address: Suitp No Vicinity: Parcel Nunmber: Applicant: Adtlress: . ELECTRICAL PERMIT 526 W 19TH ST 42210316 BART MERRITT Owner. CASELINI, ANTONIO L Aqdress 155 TERRAZA CT COSTA MESA, CA Cootracror. SARMAX ELECTRICAL Address: 9121 ATLANTA AVE SUITE 510 - - HUNTINGTON BEACH, CA ISSUE FEE Temp serVice test Res. alc package New Res (1-2 units) New Res (3+unils) Pool I Spa Lightlng Fixis Recept Outlels SwitChBS - Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Motors W 10hp MolOrs to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits TemD �r Pole Phone: 714-719-2906 Zip Phone: 949-283-5728 Zip: 92627-1714 Phone: (714) 3451270 Zip: 92646 License: 79795a SCOPE OF PERMIT . ADD NEW 200 AMP SERVICE PANEL � ' 323.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 ft Standing Seclion Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up l0 50 kva/kw .................up 10,100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lighls) Christmas Tree Stand Fireworks Stantl . ' Other Electrical Fee � InvesUgatlon Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 06/30/2005 Issued: 07/06/2005 ISSUED BY: Quantity so.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 30.00 0 50.00- 0 �50.00 0 50.00 0 50.00 50.00 50.00 50.00 TOTAL CALCULATED FEES $54.00 NOTICE: Tha wwk aulho�{zed by thls permH shall comply with all appllcaWe handicap access requiremertts urtder Calitomia staiutes arM related i repulations. (Ord. No. 92-28, § 1, 12-21•92) �, EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order for the work authorized under this pertnit to be eonsidered legal, such work must comply with all epplicable codes, and all , requlred InspeeUona and flnel approvel must be obtelned. Feilure to obteln Inspeclians and final epproval will result In tha axpiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545828 2a8-/8 (fl�00) WORKERS' COMPENSATION DECLAqAT10N: I �ere6y etlirtn under penelry ot perjury one of the following tledaretions: ❑ 1 �eve entl will malntein e certiflcete of consent to self-Insure tor workers' compensetlon, es provitled 1or by section 3700 01 tha Lebor Cotle, for Ue petlormence of Ihe work br whlCh this pBrmll 15159uetl. ❑ 1 �ave aiM wm malntain vrorkers' compensatlon insurance. es raqWretl 6y sectbn 3700 of Ihe Lebor Cotle, tor ihe partormence ol Me work br whkh Nls permit Ls Issued. My wakers' compensatlon insurence cartier entl poliq numDer ere: Certier. vB/ue0 ef one or less.) Polity Number. �yFEenity ihet in Ue peAortnence ol lhe work for which I�Lv permit Is issued, l shell not employ eny person in eny menner so es to becwne suD�ecllo Ihe workers' compensetlon laws of Calitomla, end epree that if I ahoultl become sub�ect lo the workers' compensetlon provlsions of Seqion 3700 0l the LeDor Code, I s�ell fort�with COmpty wilh �hese Provisl � / �A pllc�epn�FSigna�ture—i .:. ��.�...,�.,�b : -oa,e: —� � 7/6 �f I : FN(i AILURE TO SEWRE WORKERS' WMPENSATION WVEMQE I$ UNUWFUL AND SHAIl SUBIECT AN EMPLOYFA TO CRIMINAL PENPLTIES M1D CML FlNES UP TOONE HUNDRED TMDUS4ND DOLLARE (5100,000), W ADDrt10N TOTNE CQST OF COMPENSATION, OAMACaE$!S PROVIDED FOq IN SECT70N 3]080F 7HE UBOR CODE, INTEREST, AND ATTORNEVS FEES. LICENSED CONiAACTORS DECLARATION: of C�apter 9(wmmencing wIU Section 7000) at Dlvision 3 ot��he�Buslnes nd Professlons Cade, eml my Iicense Is in full Lo`ie�x--- �/o �n � ;:Dete: •7 f/GS CONSTRUCTION LENDINO AOENCY: � 1 hereby emrtn that there U a construdlon Iending epency fw Ne pertormence o1 Ure work tor which tMs pertnit is Issued. (Sec. 3097, Civil Code). Lenders Name: Lentlels Adtlres9: Sipneture: _ OWNER-BUILDER DECLARATONS: Date: I �ereDy eHirtn t�at unAer penelry ot per�ury thel I em E%EMPT FROM TXE CONTHACTOHS IICENSE LAW lor the tollowing reason (Sec. 7031.5, Business end Prolessions CaCe: My ciry or counry whlch requlres e permit to conslruct, elter, improve, demolish, or repair eny sirudure, pAor lo ita issuance, elso requires Ihe applicent tor such pertnit to Ille e slgned stetement thet he or she Is Ilcensed purauent to the provLsions of Ne Contractore Licensa Lew (Chepter 8(cwnmendng with Sectlon 7000) of Dlvlslon 3 of t�e Business end Professions Code) or that he or she is axempt Ihereirom arW Ihe besU for �he elleged exemptlon. Any Wdatlon of SecUon 7031.5 by any applicant tor e pertnit subjecLs Ihe epplicant to e dvil penalry af not more Ihen Me hundred ddlars (&500).�: ❑ I, es owner oi �he propeM, or my employees with weges as Nefr sole compensetlrn, WILL DO TME WORK, and the siructure is not intentletl or oXered for sale (Sec. 70M14, Business aiW Prolessions Cotle: The Contractoro LJcense Law does not epply to en owner of properry who builds or improves Nereon, and who does suc� work himself or herself or Nroug� his w her own employees, provided Ihat wch imprwements ere not intended or ottered far sale. It, hov.•ever, the building or imprrnement is soltl within one yeer of complelion, the owner-builder will heve ihe burden ol proving Ihat �e w she did not build or improve for Durpose ot sale.). • ❑ I, es owner of the properry, am EXCLUSIVELY CONTRACTING WI7H LICENSED CONiAACTORS to construct the pmjeIX (Sec. 7044, Business entl Professions Code: The wntrectors Llcense Lew does not epply to en owner of properry who bulld5 or Improves Ihereon, end who cantrects br suU prqec� with e cantrector(a) license pursuant to the Contrectors License Laws.). ❑ I em axempl under sec. Business antl Pmlesslons Code for �his reason: Signalure: Data: Owner ID verl9etl by Orivers Ilcense. ❑ Ves ❑ No Drivels License No. Explres: VeAllratlon oi Ownership by (type at document, I.e. - properry lex WII or tleetl): DIVISION OF INDUSTAIAL SAFETY PERMR CERTFICATION: ❑ I hereby cerUly Ihet no excevation tNe (5) or more feet in depih into which e peraon Is requlred to descand, wlll he mede in conneclion wiN work euthorized by Ihis permit, and ihet iro buliding struCture, scattolding, telsework, or demdltlon or dlsmentlinp tnereof, wlll Ce more then ihlrty-slx (36) teet hiph. (Chep. 32, Grp 2, Ar12, Sec. 341, Tltle B, Celifomla Adminlsirelive Code). ❑ As owner-6uilder, 1 will not employ enyone to do work whic� would requlre e pertnit Irom ihe DiNslon ol Industrial Sefery, es noted e6ove, unless such person hes e pertnit to tlo wch work fmm Ihe tlivision. Signeture: Oala: Division of Industrial Satery Pertnit Number: CERTIFlCATE OF COMPLI/WCE IWD AllTHORQATON OF ENTRY: I cenify urWer penalry of perjury ihet I heve reed ihl9 epplicetlon en0 stale Ihet itie informetlon pivon is cortect. I egree lo compty wit� ell stata lews end ciry ordlnences retatirig to DuiMlnp construMion, end euthorize representetives of Ne Gry of Coste Mesa to enter upon Ne ebove-tlescribed propeM far �^speclion puryoses. I epree not to occupy ar ellow accupency ot any building euthodzed by this pertnit until flna� inspectlon. COpE �. 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