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Home My WebLink About348 17TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa•meseF�GsCTRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 .1ob Address: 348 E 17TH ST Suite No Vicinity: Parcel Nunmber: Applicant Address: Owner. Address i/ contractor. Addressr i ,1.. TPN007017 1�P1:/R��U9� -_ ��,,: . , ;:"„ , '-�� " ; , CITY�METER � ', � - ;.�.' ' � � j , , - , � ' �.. / � � ' i % / �; �OAK ENGINEERING 1305 W�2ND ST � ;'; � POMONA,CA � Phone> , _ ' - - ZiP „ . i' .�Phone: � - , Zip: Phone:` 909-629-5150 Zip: 91766 , � License:854281, , ., i, ' " ' SCOPE OF PERMIT INSTALL UP T0.200 AMPS SERVICE PANEL ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+unils) Pool / Spa Lighting Fizts Recept Outleis Switches Non Res Appl Res Appl Service to 200a Service to 7000a Service over 1000a � Motors to 1hp Motors to tOhp Motors to SOhp Motors to 100hp Motors over 100hp , � Communication drop3. ' � Sub panel to 200a � �; \ Pole Light Pkg Sign Circuits � ' Temp Pwr Pole Intermed Poie ISSUED BY: Status: PENDING Applied: 03/OS/2007 Issued: ��/ // I� �/ •v \J ; , �'� i � . � i ', FEE SUMMARY � � � �� Quantily � � � Quantiry 50.00 : � � �� .i � . ',' � , �Temp Dist System / Lighling � � 50.00 0 50.00 ' � _ �,�1.' J� Busway"/�100-ff � , _ $0.00 0 � 50.00 � . - , . _ Standing Section�-� 50.00 0 - ,' $0.00 ', 0 Misc Electrical Equipment - 50.00 0 50.00 0 �" Transformers up to 1 kva/kw 50.00 0 . 50.00 , 0' . ..• � � .., ; �, � ...:............up,to 10 kva/kw , 50.00 0 . 50.00 0--- _- � -�-- - -- ....:.. �:.up_to 50�k'va/kw 50.00 0 ; �.._. 50.00 � 0 ' (�...i..........:�up to 100 kvalkw � 50.00 0�" � 50.00 0 ................: over-100 kvalkw 50.00 0�-', - 50.00 0 Low Volta9e Equipment _$0.00 0".' 50.00 � 0 Low Volt Wiring System I Ckt � 50.00 0� $30.50 1 Misa Conduit $0.00 "0 � 50.00 0 � Misa Conductor 50.00 �- �0� � $0.00 0 Circus ( gen or ride) $0.00 !%, 0 - 50.00 0 ' �� , - Circus (mech.ride or lights) , 50.00' � ' 0 50.00 0 �� Christmas Tree S}and, _ 50.00 �� 0�, $0.00, � � 0�. - . Fireworks Stand � �a� :�� :� ' � 50.00' 0 $0.00 0 . � ,OtherEleciricalFee� � � $0.00 $0.00 �. . 0 - � . , / , $0:00 -��0�� ' ` ' InvesiigationFee� � �/ 50.00�/� �� /,' � �, .$0.00�� 0�� PlanCheckFee--, _ �i" ,SD.00,A / �� $0.00 �" 0'�-� - � - . Reinspection Fee . - � � . : 50.00 ' � > ; 50.00� . � 0 " _ � . . i „ . .50.00` _ � � 0 TOTALCALCULATEDFEES,;E0.00, ' - 50.00 .. p� - �. , : -� � �'i . _. ' - . _�.. - , "4 �"- . � COMMENTS / SPECIAC CONDITIONS� ' . ' - -. , ,i' ; �. NOTICE: The work authorized by this permit shall compty with all applirable handicap access requirements under Califomia statutes and related regulations. (Ortl. No. 92-28, § 1, 12•21•92) � EXPIRATION: This pertnit shall allomatically expire and become void if work is not commenced within 1 BO days, or if work is suspentled or abandoned for a period of 180 days. INSPECTIONS: In order for the work euthorized under this permit to be consldered legal, such work must comply with all applicable codes, end all requlred Inspectiona end final approval must be obtained. Failure to obtain Inspectlons and tinal approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5826 2ad8i8 (6W) WORKERS'COMPENSAnONDECLARATON: � I herehy eMirtn untler penalry of perjury one ol ihe following tleclaratlons: ❑ I heve end will malnlein e certilicate oi consent to sell-Insure br workers' compenseHon, es provided lor by section 3700 oi the Labor Cotle, tor the pertortnence of the /work for whlch this pertnil is issued. '�� heve end wlll meintain workers' compensetlon Insurance, es redulred by sectlan 3700 af the Labor Code, for Ihe partormence of the work tar which Ihls Dermit Is Issuetl. My workere' comRensetlon Insurence cerder antl policy number ero: T n / Carrier:-�FNELLQS INDEM/N�(`, �.JmOFi�� Pdicy�aer. IJIcUI'I�n�22I G�7� '(T7ris'Section neBd nof be co/np/el9Olf fhe Oermlf 15 velued Bf one hun red don rs(S�oo) or less.) ❑ I ceNiy ihat In ihe perlormenca of the work for which ihis permi ' Issued, I shell not emplay eny person in eny menner so as to become subject to the workera' compenSellon lews oi Califomia, entl pree U t If I should bec me ub�ect to Ihe workers' wmpensatlon provislons of S lon 3700 0l Ihe Lebor Cade, I shall forthwlih comply vrith these rov lons. .� `� A�canl'Signal'ure: "ue��'�.- � I 1 - � 1 WARNINCi: FNLUfiE TO SE RE WORI(ERS' COMPENSATION COVEMOE IS NLAWFUL rWD SFIA�L SUBIECTlW EMPLOYER TO CRIMINAL PENALilES AND CML FlNES UP TOONE HUNDRED T/iOUSAND DOILAFE (St W,000), IN AODIT1qJ TO TME COST OF CAMPENSATION, DMMGES AS PROVIDED FOR IN SECTION 31060F THE IABOR CODE, IMEflEST, AND ATTORNEI^S FEES. LICENSED COHTRACTORS DECLARATION: I hereby effirm that I am lice �s�ed� pn�der� ro�vlsic forca aM=flec-CQc q __��"� Contradors Sloneture: n ... .� wit� Seciion 7000) of Division 3 of Ihe Bus`ness �nd ro(�ssigns Cade, antl my license Is in full Cle�� s.s�M. � ((�� l� coei : �— �� -n`� CONSTRUCTON LENDING AGENCV: ❑ I hereby eMirtn thet there iv a consiruction lendinp egenty lor the peAortnence ol the work for whlch ihis permit is issued. (Sec. 3097, Civil Code). Lentlels Neme: Lentlefs AtlOress: Signature: Dete: OWNER•BUILDEH DECLAHATIONS: . I hereby eflirtn Nat untler penelry ot perjury thet I em EXEMPT FROM 7HE CONTRAC70RS LICENSE LAW for Ihe tollovring reason (Sec. 7031.5, Business en0 Professions Cotle: My dry or oounry wNU repuires e permlt to consWct, elter, improve, Certrolis�, w repair any sWcture, pnor to Its issuance, fliso reqWres ihe apD��ent for such pertnll to file a signed stetemem t�at he or she is Iicensetl pursuent ta the provisions ot t�e Contrectors License Lew (C�epter 9(commendng with SecUon 7000) of DMsion 3 of the Business end Pmtesslons Cada) or lhat he or she is exempt Iherelrom and the besis for the elleged eaemption. Any violation af Section 7031.5 Dy any applicant for e permit subjects the epplicem lo a ciW penelry of not more than tive �undred dollare (5500).): ❑ I, es owner o1 ihe property, or my employees with wages es their sole compensation, WILL DO THE WORK, end the structure is not intended or ottered for sale (Sec. 7044, Business antl Protesslons CaCe: The Contractors License Law doas not epply to an owner of property who builds or imprwes thereon, and who does such work himsetl or herselt or through hls or her own employees, provitled ihat such improvements are not intentled or oMered tor sale. H, however, Ihe building or impmvement is sold wiihin ona year of completion, tha owneo-bullder wlll have Ihe Durtlen ot D«�9 ihat he or she did not build or impmve tor purpose of sale.). ' ❑ I, as owner ot the property, em E%CLUSIVELV CONTRACTING WITF1 LICENSED CONTflACTORS to construct ihe projecl (Sec. 7044, Business antl Professions Code: The comrectors License Law tloes not epply to an awner at praperty who bullds ar improves Ihereon, entl who contrects for such pmject with e wntractor(s) license pursuant to t�e Contreqors License LewsJ. ❑ I em exempt under sec. Business entl Professions Cade lor this reason: Signature: Date: Owner ID verilled by drivers Iicense. ❑ Ves ❑ No Drivefs License No. Ezpires: Vedficetlon of Ownership by (rype of document, I.e. - pmperry tex bill or dee0): DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICA710N: ❑ I �ereby certily Ihai no excavetlon Ilve (5) or more leet In tlepth into whlch a person is required to descend, will be made in cannection with work euthorized by this permit, end t�at no building sWdure, sceHolding, falsawork, or demWitlon or dismamling thereol, will be more ihen t�irry-sla (36) leet high. (Chflp. 32, Gry 2, Art 2, Sec. 341, 71I1e 8, Celifomie Administrelive Code). ❑ As owner-builtler, I wlll not employ enyone to do wark which would require e pertnit Irom ihe Division ot Intlustrial Setery, es noted ebove, unless such person hes e permit to do such wwk Imm the division. Signature: Division ot Industnal Safery Permi� Num6er: Date: 1 WIII the epplicent or Oresenl or fmure building occupent need b tile end cenify e Business Plen for emergency response to releese or threetenetl release of e heiardaus meterial4 ❑ Yes ❑ No (Section 25505 ot ihe Celifornie Health end Sefery Code reQuires, wilh some e:ceptions, thet e Business Plan De tiletl with the Costa Mesa Fire Departmenl by every husiness which has at any one tima during e reportetl year e quantlty ol helardous metenals equal to or greater than e weight o1500 pountls, or e volume of 55 gallons, .or 200 cublc teet ot compressed ges e� stentlerd temperature end pressure). .......... .....�................._._............_..__....................................................................._....._.........................._................................................................................................................................ .................................................., 2 Does or will the epPlicant or present or luture 6uilding occupent neetl to tile e repistretian lortn tor ecutely hazertlous matedals7 ❑ Yes ❑ No (SecNon 25533 0l t�e Califomle Healih and Selery Code, wl�� some excepNons, requlres registratlon with the Cwta Mesa Flra Department by eech buslness which at eny one time hes on hend e quantlry o1 ecutely hezerdous meteAels equal to or greater then e welght of 500 pounds, or e wlume of 55 gellons, or 200 cubic leet ol wmpressed gas et stenderd tempereWre end pressura). .............................._"...................................................................................................._.._..__............._......._-..�........................_....................................................._._�._......_.._......_"...._...._......................................... 3 Does or wlll Ihe epplicant or presem or luture bullding occupant noed to prepare en RMPP (Rlsk Menagement end Prevention Program tor acutely hazertlous matedals)7 ❑ ves ❑ No (Section 25534 ot the Calilamis Health and Sefery Code provides thet the Costa Mesa Fire Department mey require the preparation, certificetion antl filinp with the Fire oepartment ol en RMPP by buslnesses which are required lo ragister ecutety hazerdous materlels with the Fire Depertment. _._.......—._._ _.....--- .............._......�.........--------- _.........----..........._.........._..-- --------._.._...---................� 4 Ii en RMPP is presently requlreE, has Section 25534 of Ihe Calitomla Healt� entl Safery Cade been lully complied wiN7 ❑ Yes ❑ No "_"'...._.— ........._........._._ .................._.__... _......__..................._........._......_............."'___'....._...—..........._.............................,...................._... 5 Does or will the epplicent or presont or WWre 6ullding occupent require lor the work whic� Is Ihe sub�ect of this e pliw�ion a permit tor such constructlon or modilicatlon tmm Ihe South Coast Air �uallry Manegement Dlstdct or Irom any oNer alr polWtion contml tlistrict or egenc%� � Yes �J No (Section 65050.2 of the Celitomia Govemment Catle requires Ihet t�e raquesietl iniormation ba tumished on appliwiions tor non-resiAentiel builtling pertni[s). ..._.........__....._........__ ...............�..._......_................._............._._._..'_" _"' _'......_......_..........._. _.... 6 WIII any part of the tadliry lo be constructetl under this pertnit be wit�in t0001eet irom the outer boundanes of a schod? ❑ Yes ❑ No (If yes', the fadliry muSl meet t�e requirement oi Sections 25534 an0 42303 at Ihe Califomia Health antl Safery Code). ._ .................._""...—"—.............................................._..........................................._.._.._............._.....__................................................................._..__._._..._..._....._...........__.._.........................._...... 7 II e pertnR from Ihe Sauth Coest Air Oueliry Menagemem Distda or other eir pollution comrW distnct or egency is required tor tha work which is the subject ol Ihis Bpplitetlon, �ave ell ol Ihe ClSclasures D�ebcribetl �y Celitomie H691Ih end Sefety CoAe SeMion 42303 been mede7 ❑ Yes ❑ No ........_ .............._............_..�..........._'_'._._._..._.._�......._......_.............._........._......._. _....�—".............................._...__...._...'_' '_—......"_'.................."_'.... B (If yes', ettech certilicete of wmplian[7from the eppropdate eir polWtion contrd ottker). CERTIFICATE OF COMPLIANCE: I qertity that untler penalry of perjury the intormetlon given ebove is correcL I agree ro comply with all stete laws anC ciry ordinences regartling HazeMous Meterials end EFnissions. Slgn3ture:, �1 _— Date: CERTIFlCATE OF COMPLUWCE AVTMORVATON OF EMRV: I cenity under penelry of perjury Ihat I have reaG �his applicetion antl state Uat the inlortnatlon given Is correcl. 1 agrea to comDty'�I�h ell s te laws end clty orOlnences releting to building mnstrucUon, end euthodze representaGves of tlie Ciry at Cos1e Mesa to enter upon t�e ebove-described property for inspe. ion purposes. I aprea not to occupy or allow accupanq of eny builtling eulhorized by Ihb permit untll finel inspectlon. COOE t. MsvecnoNrrre - 1616 Fixed System Final Flre Preventlon 1266 Pool Spa Final 200 Finfll Re-Raot 201 Final BIocWReteining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolitlon PAIE It�lS ate _T�, ^ ll ate WpE• INSPECTIONTYPE , 206 Final Mechanicel 208 Final Plumbing 210 Final Electdcal 212 Final Fire Prevention 220 � Final Planning Approval 222 250 Final Site Final Building/Occupenq GGi'--- ��