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Home My WebLink About871 17TH ST - Building Permits��MF9 t � o, r _ r J �'°ae„� e� ��ia� �sa-sz�a • Feu (�ia) �sa-aess Job Address: Suite No Viciniry: � . CITY OF COSTA MESA ' BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 871 E 17TH ST MEDIA ONE CABLE N BOX Parcel Nunmber: TPN990259 npp�icant: MEDIA ONE Address: Owner: CIIY OF COSTA MESA Address � - � - • - ELECTRICAL PERMIT Phone: Zip: Phone: Zip: Contractor: EVANSJE ENETERPRISES DBA: WEST COAST CABLE Address: 5425 BERRYHILL DR � - CA . Phone� � p14) 985-0411 YORBA LINDA ' � .�Zip; 92886 " . � � ��License: 734530 , , " . ...-5 ` _ , � _ � . . ISSUE FEE Temp service test ' Res. a/c package New Res (1-2 units) New�Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Motors to 1 hp � Motors to 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole PERMIT NUMBER E99-01193 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 12I1511999 Issued: 12/1511999 ISSUED BY: �� i � SCOPE OF PERMIT INSTALL ELECTRICAL� METER fOR NEW CABLE N POWER SUPPLY FOR -MEDIA ONE-, � $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 so.00 $0.00 530.50 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 �� FEE SUMMARY Quantity _ Temp Dist Syslem / Lighling � -" Busway /100 ft � ' _ -Standing Seclion, Misc Electrical Equipment Transformers up l0 7 kva/kw ................up to 10 kva/kw . _ ...........:.....up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw � � Low Voltage Equipment � Low Volt Wiring System / Ckt Misa Conduit Misa Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electricai Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 so.00 0 so.ao 0 $0.00 0 $0.00 0 $0.00 50.00 $0.00 $0.00 . TOTAL,CALCULATED FEES 554.00 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authonzed by ihis permit shall comply with ell applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRA710N: This permit shall automatically expire end become void if work is not commenced within 1B0 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all � requlred Inepeetlone and final approvel must be obtained. Feilure to obtain inspec�ions and final approval will result in �he expiration of this permit. POR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby effirtn under penalry of perjury one of ihe tollowing tleclarations: � ❑ I heve and will maintein e cerllficate of consent to selFlnsure tor workers' compensation, es provided tor by sec�ion 3700 of the LaDor Code, for ihe peAormance ot ihe rk far which t�is pertnit is issued. I have an0 will maintein workers' compensaLon insurenca, as requlred �y section 3700 of tha Lebor Code, br tha pertortnance of Ne work tor which NIs pertnit Is issued. My workers' cnmpensetian Insuranca carrier end policy number ere: Carner. Policy Number. (This secNon need nof be comp/efed!! fhe permil ls valued et one hundied dollare (5100) ar less.) ❑ I certity that In the pertormance at the work for whic� ihis permit is issueQ I shell not employ any person in eny manner so as to become subject to the workers' compensation laws af Calilomig, end agree that il I should became sub�ect to the workers' compensatlon provisions of Section 3700 ot ihe Lebor Cotle, 1 shall torthwith comD�Y with these pro�vi� �on/y/ // /�q Applicant Signatu�e: it�G(>' ✓�� Date: / /_ ' .Z �' / / WARNING: FAIWRE TO SECURE WORKQq$' ppA1PENSATON COVEfiAOE IS UNIAW FUL AND SW1l15UB1ECT AN EMPLOVER TO CRIMINAL PENALTIES ANO pVIL FlNES UP TO ONE HUNDRED i1qUSAND OOLLARE (5100,000). IN ADDIT�pN TO THE COST OF COMPENSATION, DAMAGES /S PROVIDED FOR IN SECiION 3]OB OF THE IABOR Cp�E, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLqpATION: I horeby aMlrm ihal I am licansed untler proNslons ol Chapier 9(commencing wl�� Sectlon 7000) ot Division 3 0l Ihe Business entl Professions Cotle, antl my license is in full torce end ettecL Lic. p Cless k C�� O ConlrectofsSignature: �� . Dete: /7�20•99 CONSTRUC710N LENDING AGENCY: ❑ 1 hereby ettirtn ihat t�ere is e constructian lending egency for the pertormance of the work br which this permlt is Issuetl. (Sec. 3097, qvil Cotle). Lender's Name: Lentlels Atldress: Signature: Date: OWNER-BUILDER DECLARA710NS: I hareby eHlrm t�at under penalry of per�ury that I em E%EMPT FROM TFIE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professions Cotle: My city or counry whic� requires e pertnit to construc�, alter, improve. Aemolish, or repair any sirucWre, prior to Its Issuance, also requires �he applicant tor such pertnii to file a signetl stetement that he or she is licensed pursuant to the pmvisions ot the Contrectore Licanse Lew (Chepter 9(commencing with Section 7000) of DiWsion 3 ot the Business antl Protessions Code) or ihat �e or she is eaempt Iherefrom end Ue basis for Ihe elleged eaemption. Any violation ot Sectlon 7031.5 by eny aDD��nt tor a permit subJecfs Ihe eppliwnt ta e ciWl penaljy of not more than live huntlretl tlollars (8500)J: ❑ I, es owner ot t�e propeny, ar my employees with weges es their sole compensation, WILL DO THE WORK, and the structure is noi intended or oHared tor sale (Sec. 7044, Business and Professior�s Coae: Tha Contractors License Law tices not apply to an owner oi DroPerty who builtls or improves thereon, and who does such work himselt or herselt or throu9h hig or �er own employees, provitletl t�at such improvements are not intendetl or oNeretl for sala. If, however, ihe building or imprwement is soltl within one yeer oi completlon, the owneo-builtler will have Ihe burden ot proving that he or she ditl not build or impmve for purpose of sale.). ❑ I, as owner ot Ihe property. ar� E%CLUSIVELY CONTRACTING WIT1 LICENSED CONTRACTORS Io conslruct the project (Sec. 7044, Busines5 and PrOfessions Code: Tha contractors License Law does not eppty to an owner of property who builtls or improves thereon, and who croniracls for such prolect with a coniracior(s) license pursuant to the Contractors License Lews.). ❑ I am exempt under sec. Business and Professions Cotle for this reason: Signature: Date: Owner ID venfietl Cy tlrivers licen5e. ❑ Yes ❑ No Drivels LicenSe No. Ezpires: Venfication of Ownership by (type of tlocument, i.e. � property tae bifl or deedJ: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity that no escavetion flve (5) or mora leet In Aepth Into which e person Is requlretl �o descenq will ba made in cannection wIN work aut�onzetl by Ihis permit, end that no bulitling siructure, scatfoltling, lalsework, or demolitlon or tlismantling thereot, will be more ihan t�irry-six (36) feet high. (Chap. 32, Grp 2. An 2, Sec. 341, Title B, Callfomia Atlministretive Cotle). ❑ As owner-bulltler, I will not employ enyone to tlo work which would require e pertnit Irom the Division of Intlus�nal Satery, es notetl ebove, unless such person has a permit to do such work trom Ihg division. Signature: Date: Oivision of Industdal Salery Pertnit Number: CERTIFlCATE OF COMPLJANCE AND AIJTHORIZATON OF EN7RV: I certify untler penalry of perjury that I have reatl this epplicetion and state that ihe intormaUon given is correct. 1 agree to comply wit� all sigte laws end ciry ortlinances relatlng to 6uilding consWction, end authonze representatives ot t�e Ciry of Costa Mesa m enter upon the above-descAbed property for inspectfon purposes. I agree not to occupy or allow occupancy ol any builtling euthonzetl by t�is pertnit until final inspection. ��/ S�gnewre Ot Laga� Owneqs) /1, z0' q9 oate �� And/Or'qulhorized Applicant Date CODE �. INSVECTONTYVE 1616 Flxed System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Finel ReRoof Final BIocWReteining Well Finel Fectory Fire Plece Flnel Sign 204 Flnel Demdilion 2a64s �E �/� �ppE1 INSPECTIONTYPE 206 Finel Mechenical 208 Finel Plumbinp 210 Final ElecMcal 212 Final Flre Prevention 220 Final Planning Approval 222 Final Site 250 Flnal euiltling�Occupanry .WI-'