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Home My WebLink About424 BERNARD ST - Building Permits(714) 754-5273 • Fax (714) 754-4056 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 424 BERNARD ST 41920210 npplicant: HARRIS, MICHELLE Address: 1060 TULARE DR COSTA MESA, CA Owner: HARTSHORN, DARREL�D TR Address 6019 PRADO CIR� . . " ANAHEIM;CA Contractor: T H ELECTRIC Address: 1060 TULARE DR COSTA MESA, CA Phone: 714.556.1790 Zip: 92626 Phone: Zip: 92807 _- Phone: 714.556.1790 Zip: 92626 License: 791459 SCOPE OF PERMIT CHANGE-OUT OF A SERVICE AND SUB PANEL IN AN EXISTING SFD. . 1SERVICET0200A;�YSUBPANELT0200A � ' -� NO OTHER WORK AUTHORIZED WITH THIS PERMIT. ISSUE FEE Temp service test Res. a/c package New Res (7-2 units) New Res (3+units) � Pool / Spa Lighting Fixts , Recept Outlets , � , Switches Nan Res Appl � ' � Res Appl Service to 200a � . Service to 1000a � , Service over 1000a Motors to ihp Motors to 10hp Motors to SOhp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 Quantity 0 0 0 0 p' 0 0 0 ' 1 0 0 0 0 0 0 0. 0 1 - FEE SUMMARY . Temp Dist System / Lighting Busway /100 ft � Standing Section . � � -Misc Electrical Equipment Transformers up to 7 kva/kw �� ..............:.up to 10 kva/kw .................up to 50 kya/kw -. .. .................up to 100 kva/kw - ....:.............over 100 kva/kw � � Low Voltage Equipment ` - . Low Volt Wiring System /�Ckt , Misa Conduit - - � � Misc. Conductor . � Circus ( gen or nde) � , Circus (meCh dde or lights) - Christmas Tree Stand . Fireworks Stand ' � � � Other Eleclrical Fee - � �Investigation Fee Plan Check Fee Status: ISSUED Applied: 03/29/2004 Issued: 03/29/2004 ISSUED BY: 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 $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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and rela�ed regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commencetl within 180 days, or if work is suspendetl or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetions and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2d46a6(600) WORKERS'COMPENSAnON DECLARAPON: I hereby attirtn under penalry of perjury one of tha following tleclarations: ❑ I heve antl will maimain e canificete ot consent to salt-Insure for workers' compensation, es provided lor by saction 3700 of Ihe Lebor Coda, for the pertortnence of the work for w�ich t�is pertnit is issued. ❑ I have end will mainlain workers' compensation insurence, es required by section 3700 0l Ihe Lebor Cotle, tor tha pertormance of Ihe work for which Ihis permit Is issued. My workers' compensatlon Insurence carner end policy number are: Carrier: Policy Number: (Thls section need not be complefed 1! fhe Oermit is veluetl ef one hundred dollars (5100) or Iess.J �I�certify lhat in ihe peAormence ot Ihe work tor which this permil is issueq I shall not Bmploy eny parson in eny manner so es to become subjacl to the workars' compenselion I� allfomia, and a8�� If I should 6eCome sublect Io �he workers' compensatlon provlslons ot Sectlon 3700 ot t�e Lebor Cotle, I s�ell forthwl(h comply wit Mese pro ions.. �� % ' / Applicant Signat�"-'� i - �-Vtr�--�-o� Date: d-3 /��/0�00 7 WARNING: FAILURE TO $ECURE WORI(ERS' COMPENSATION COVERAGE I$ UNLAW FUL AND SHALL SUBJECT M! EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED TH(%15AND OOLLARE ($100,000), IN ADDITIIXJ TO THE WST OF COMPENSATION, DAMAGES AS PROVIDEU FOR IN SEGTIIXJ 3]OB OF TME LABOfl CO�E, IMEREST, AND AiTORNEI^S PEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm thai I am Ilcensed undar provislons of Chapter 9(commancing with Sactlon 7000) of Divislon 3 ot the Business and Professlons Code, enA my Ilcense Is in full rorce antl eHect �ic. s / .'r� a Ciass x C� —/(J Contrectofs SignaWre: T N. EG L=C7.e �C �� /\ Dete: 03 - a- y-1� O oU i CONSTRUC710N LENDING AGENCY: ❑ I hereby aHirtn Ihai there is a constmction lending agency for ihe peAormance ol the work for which this permit is issued. (Sec. 3097, Civil Cotle). � Lender's Name: Londer's Address: Signeture: Oete: OWNER-BUILDER DECLARATIONS: I hereby eMirtn ihat under penalty ol Der�ury that I am E%EMPT FROM TME CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, eusiness antl Profeuions Code: Any ciry or counry whic� reQuires e permit to construct, elter, improve, demolish, or repair eny structure, pnor to its issuance, also raquires the epplicaN tor such permit lo lile a si9ned statemant t�et �e or she Is Ilcensetl pursuent lo the pmWsians ot the Contrectors License Law (Chepter 9(commencing with Sectlan 7000) ol DiWsion 3 oi the Business end Professions Code) ar thet he or she is axempt therelrom end the basis for the allegetl exemption. Any violetlon of Section 7031.5 by eny epplicent for e permit subjects the epplicant to a civil penelty ot not more than five hundred tlollars ($500).): ❑ I, es owner of Ihe propeny, ar my employees wlth wages es l�eir sole compensetion, WILL UO THE WORK, entl the structure Is not intendetl or oHered tor sflle (Sac. 7044, Business and Professions Code: The Coniractors License Law does not epply to en owner of property who builds or improves Ihereon, end who does such work himsetl or herseN ar Ihrough his or her own employees, provlded thel such improvements are not Intended or ofle�ed lor sele. If, however, Ihe building or improvement is sold within one yea� ot completion, the owneo-buildar will have the burden ol proving thet ha or s�e tlitl not build or improve tor purpose of sale.). ❑ I, es owner of the property, em E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to conStruCt the project (Sec. 7044, Business antl Professions Code: The coniractors Llcense Lew tloes not epply to an owner ol property who bulltls or improves thereon, and w�o wnirects tor such pro�ect wl�h e contractor(s) license pur5uant tOlhe Con�rector5 Litense Laws.). ❑ I am exempt under sec. Business antl Professions Code for Ihis reason: Signature: Date: _ . Owner ID verified Dy tlrivefs license. ❑ Yes ❑ No Drivefs LicenSe No. Expire9: Veritication of Owners�ip Dy (type af aocument, i.e. - propeny tax DIII or aeea): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify thet no excavetion tive (5) or more feet in tlepth into which e person Is requlred to descenQ will 6e matle In connection wit� work euthodzetl by this permit, and lhat no building siructure, scattolding, lalsework, or demolition or dismantling Ihereoi, will ba more than thirty-six (38) feet high. (Chep. 32, C�ry 2, Art 2, Sec. 341, Ttle B, Califomia Adminisirative Code). ❑ As owner-builder, I will not employ an}rone to do work which would require e permit from the Division of Industriel Satety, es noteA above, unless such pereon hes e pertnit to tlo such work trom ihe division. SignaNre: Date: Division of Industrial Sa(ery Pertnit Number: CERTIFlCATE OF COMPLIANCE ANO AUiHOROATON OF ENfAY: I ceritly untler penalry ot perjury that I have reatl ihis apD��ion and state that the infortnation given is correcL I egree to comply wlth all state laws end ciry ortlinences relating to Duiltling construction, antl eut�onze representatives oi Ihe Ciry ot Costa Mesa to enier u0on ihe ebove-descnbed pmperty for inspection purposes. I agree not to occupy or ellow occupency af eny building authorized by this permit until fnal inspection. COOE I, INSPECTIONTYVE 1616 Fixatl System Final Fire Pravemion 1266 Pool Spa Final 200 Final Ra-Roof 201 Finel8locWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Finel Demoliiion 03-a9✓-. �oa y Date Qa¢, I�A4$ f�Ej INSPECTIONTYPE 206 Final Mechanical 20B Final PIum6ing 210 Finel Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Q� �� OWNER RR(1WN_ W� $ �' � DATE 8-1(—�iL JOBADDRES$ I}ZL� B2T'21gI`d St. BUILDINGPERMITNO. �(�9 GENERALCONTRACTOR pumPr_$nq�dPr VAWE $ 200.00 LO�P# ll�i-28]_-2'j BLOCK TRACT Retainin� Wall GROUP J TVPE 20NE RI� FIRE DISTRICT #(1%6 INSPECTIONS DATE I SUBCONTRACTOR I PERMITSISSUED DATE I Nl1MBER Footing Treneh Foundation Forms and Grade to Rough Framing Plumbing, Rough to Slab Plumbing, Rough Complete Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer Septic Tank or Cesspool Lathing Plastering Plumbing, Fi�eal, Fixtures Compl Plumbing, Final Gas Test Wiring, Final OccupanCy Form 210 GH 1�[ 12.68 os a esa g pa ent 4�6 APPLIpCATION FOR PERMIT 711 EAST 20th BTREET , p U I L D �L N G � COSTA MESA, CALIFORNIA ' �'OR O�FICE USE ONLY . FOR APPLICANT TO�FILL IN � �� r�o.-_ I ParJ� r� Bullding � /�,[ � Address ' Costa Mesa, California Received by Date Rec'd. Da.t�,iy� •esa � v - 1 �v \ / / T �O-�cl. �%7,r%��lo. �-.5,�. �itect or '- Lic. neer No. �ess City Lic. .ractor No. •ess .ega�l I Lot I � ;ription No. Block . Tract aeh Metes and Bounda) i i S -� 8�`� No, of Bldgs. oi Lot �j'� -�q Now on Lot oi No.of No. Of ting Bidq., Familfes Room� ack Line from Rear Vard �,eroi3treet '� � SideYard DESCRIPTION OF WORH ( J�� Alteration I I'Addition I �ir I I Moving I I Demolish I dfng No. of Rooms Stories rior Wall I Roof :ring Coverfng ot New , (� �� _ � �� I hcreby ack and state th� with all Cit building rnn Signature of Permittee _ Valuati� O �� i � HM 204 6-H 2M 5 8" uilding � ddress - Costa Mesa, California earest ross St. APPROVAI.S Fou�dation Location I Inspeetar Forms, Materials, that I have read this Application Lath. Int. �e is correct end agree to comply Lath. Ext ices and State Laws regulating Ext � Reinforced �■ � _. 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"�1. �:. � -� �f. i�l`ei +1l�t :4' ' "_' _ -�L . ..iT."= '.. - : r'�.�_ _ "' .. , ' PLOT P�.AN . . .. , . _ ,:- � � Show locatlon and distances Trom �.c n_��n •�� ' � property Ilne and between buildinga , , �, , �,� . _ �, � � . � . . . ti;.:; � - , - .:, ,. 3 , -- - _,.., ��-- -.:- — - - -- � ' ' �� _ � . i----. �- - :�, - ---' .' --,-'—' -7 . . , . �^. ' ., ' �L'r• ' ' ' . + ' . . 'r � • ,l' . . � ,. - � , i � � .. . t� " . "' _ _ ' "' _' _ ' ' _ ._' . , . . . .. .. � , . . . , � , . � .. i . . . � . . , .. • . . . , . , ' n'r!i'i f� .. f i . i... . i � , . � � � . .. .�.-n •.. . c. �.�?