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Home My WebLink About668 17TH ST - Building PermitsCITY OF COSTA MESA �, BIIILDING DIYISION DEVELOPMENT.SERVICES DEPARTMENT PERMIT pia� �sa-sz�3 • F� (»a� �sa-aass Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: 668 W 17TH ST MEDIA ONE CABLE N BOX TPN99086 MEDIA ONE Owner. CITY OF COSTA MESA Address �,"' � � � - � ELECTRICAL PERMIT Phone: Zip: Phone: Zip: Contractor: EVANSJE ENETERPRISES DBA: WEST COAST CABLE Address: 5425 BERRYHILL DR � � CA . � Phone: , (714) 985-0417 YORBA LINDA • , Zip: 92886 - � � �License: 734530 , PERMIT NUMBER E99-01189 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 12/15/1999 Issued: 12/15/1999 ISSUED BY: d'(�%� � SCOPE OF PERMIT , INSTALL ELECTRICAL'METER FOR NEW CABLE N POWER SUPPLY FOR -MEDIA ONE-. � � - �� FEESUMMARY� � 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 t000a� Service over 1000a Motors to 7hp � Motors to 10hp Motors to 50hp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole Quantity $23.50 $0.00 - $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $OAO $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 0 0 0. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 - 7emp Dist System / Lighting �" Busway I700 k ' . _-Standing 6ection Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 70 kva/kw ..........-.....up to 50 kva/kw . .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt W ring System / Ckt Misc. Conduit Misc.ConduIXor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL.CALCULATED FEES $54.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authonzed by ihis permit shall comply with all epplicable handicap access requirements under Califomia statutes and related regulations. (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 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 Inepectione end final approval must be obtained. Failure to ob�ain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'. COMPENSATION DECLARATION: I hereby aHirm untler Oenalry oF perjury one ot the lollowing Oeclarations: ❑ have end will meintain e certificate of consem ro seN-Insure for workere' compansation, es provitletl far by sectlon 3700 of the Labor Code, tor Ihe pertortnance oi ihe work for which Ihis pertnit is issued. I have antl will meintain workers' compensatlon insurance, as required by section 3700 of �he Labor Coda, for tha peAortnance o1 ihe work for which �his pertnit Is issued. My workere' compensatian Insurance carner and policy number ara: Carrier: Policy Number: (This section need not be comp/efed il fhe permit is veluetl et one hundretl dollars ($100) or less.) ❑ I certify that in the pertortnance of the work for which ihis pertnit is issued, 1 shell not employ eny person in any menner so as to Decome subjecl lo the workers' compensation laws of California, and agree ihat if I should become subject to the workers' compensetion provislons of Section 3700 of ihe Lebor Cotle, I shall fort�with comply with these pr�/ �sians. / Applicant Signeture: ��I /'��_✓�� oa�a: �z� z�/y s WARNINO: FAIIURE TO SECURE WORKERS' COMPENSA710N COVERAGE IS UNLAWFUL AND SHALL SU8IECT AN EMPLOVER TO CRIMINAL PENALTI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDITIIXJ TO THE WST OF COMPENSATION, OAM4GE5 AS PROVIOED FOR IN SECTION 3]O60f THE LABOR CADE, IMEREST, AND AiTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm ihat 1 am licensed unggr,proyisic force entl ettecl Lic. a ComradorsSignaWre: � .�' Chapter 9(commencing with Section 7000) ot Oivision 3 of Ihe I Class x Date: Cotle, and my license is in tull CONSTRUC710N LENDING AGENCV: ❑ I hereby aflirm ihat lhere is a constmction lentling egency lor the peAortnance of the work for which this permit is issuetl. (Sec. 3097, Civll Cotle). Lentler's Name: Lendels Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm Ihat untler penalry of perjury that I em E%EMPT FROM 7HE CONTRAC70RS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or counry which requires a permit to construct, elter, improve, demolish, or repair any strucWre, prior to its issuence, elso requires Ihe epplicant for such permit to file a signad statemant ihat ha or she is IicenseA pursuani to Ihe provisions of the Coniractors License Law (Chapter 9(commencing with Section 7000) o� Divlslon 3 of the Business antl Profeuions Code) or ihat he or she is exempt iherefrom anC the basis tor the elleged exemption. Any violation ot Section 7031.5 by any eppliwnt lor e permit SuhJedS the epplicant to a civil penalty ot not more than five hundred dollars ($500).): ❑ I, es owner oi t�e property, or my employees with weges as iheir sole compensation, WILL DO THE WOFiK, entl the structure is not IntenAetl or ottered for sale (Sec. 7044, Business and Pmfessions Cotla: Tha Contraaars License Lew tloes noi apply to an owner at pmperty who builds or improves thereon, antl w�o tloes such work himself or herself or thmugh his or her own employees, provided that such impmvements ere not intandetl or oflered for sale. tl, however, the building or improvement is sold within ona year of completion, ihe owner-builtler will have the �urtlen ot proving Ihat ha or she did not builtl or improve for purpose of sale.). ❑ I, as owner oi ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions Code: The contrectors Licanse Law does not aDPly Io an owner of propeny who builds or improves ihereon, and who comracts tor such project wl�h a contractoqs) license pursuant to iha Contractors License Lews.). ❑ I am exempt untler sec. Business end Professions Cotle lor ihis reason: Signeture: Date: Ownar ID verifiad by drivers license. ❑ Ves ❑ No Driver's License No. Expires: Verifica[ion ot Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby cenity Ihat no excavation five (5) or more taet in depih Into which a person is requiretl to tlescend, will be matle in connection with work euihonzed by ihis permit, entl that no building sirucWre, scalloltling, felsework, or demolition or dismantling ihereoi, wlll be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Title 8, Celitomia Adminisirativa Code). � As owner�builder, I will not employ anyone to do work which would require a permit Irom iha Division ol Industrial Safery, as noted above, unless such person has a pertnit to tlo such wnrk from ihe division. � Signawre: Date: Division ot Industrial Safery Permit Num6er; CERTIFICATE OF COMPLIANCE IWD AUTHOROATION OF ENTHY: I certity under penalry ot perjury thai I have read this application and stata that the information given is correct. I agree to comply wilh all state laws and ciry ordinances relating to builtling construction, an0 euthorize representatives ot the Ciry of Coste Mesa to enter upon the aDove-tlescribed property for inspection purposes. I eqree not to occupY oi allow occupancy of eny �uilding authorized by this permit until tinal inspection. ��Si�ture Ot Legal Owner(s) Date Gt �2/.z�'/Q% —�/ n�d/Or Authorized Applicant �—T Date 1616 Fiaed System Final Fire Prevention 1266 Pool Spa Final 200 Final RaRoot � 201 Final Block/Retaining Wall 202 Final Fectory Fire Place 203 204 24d8<8 Finel Sign Final Demolition 1tQIDAlfl �QQEj INSPECTIONTYPE 206 Final Machanicel 208 Final Plumhing 270 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinglOccupancy r'1.513 �I/ ■ NI RfIALS