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Home My WebLink About2995 MESA VERDE DR - Building Permits_J ` CITY OF COSTA MESA . � B(/IID/NG D/V/S/ON / 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us -,,/ FOR INSPECTIONS CALL: (714) 754-5626 /Y PERMIT TYPE ELEC APN: TPN007231 JOB ADDRESS: 2995 MESA VERDE DR E CM Vicinity: SIDE WALK PERMIT NUMBER: E08-00359 STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: ISSUED 09I12I2008 �fl�� SCOPE OF WORK: INSTALLATION OF A 200A SVC PANEL FOR A NEW PEDESTAL LOCATED IN PUBLIC RIGNT OF WAY, REFN: PS07-00192. " - � OWNER: CITY OF COSTA MESA PHONE: APPLICANT: HARPER, BART _ , . PHONE: 951-520-0434 CONTRACTOR: HARPER ELECTRICAL CONTRACTORS INC Address: 704 DRY GULCH PLACEUnit City/Slate: NORCO, CA ZipCode: 92660 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Refnspection Fee $0.00 TOTAL FEES $54.00 Address: Unit: Ciry/State/Zip: Address: 704 DRY GUICH PLACE Unit: City/State/zZip: NORCO, CA � � a License No. 779882 PHONE: 951-520-0434 CELL: . . ..f j a j? �iZ . ;i NOTICE: The work authorized by this pertnil shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 1B0 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . INSPECTIONS: In order for the vrork authorized under this pertnit to be wnsidered legal, such work must comply wiN all applicable codes, and all required inspeetions and final approval must be obtained. Failure to obtain inspections and final approval vrill result in the expiralion of this permit. cooe� iNsrecnoxrrve � x17RIRL5 �Et �nsrecnoxTrve o�re R�m_��LS 1816 Fixed Syslem Final Fire Prevention ZO6 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 270 Final Electncal �/� �� 201 Final Block/Retaining Wall 212 Final Fire Prevention ' 202 Final Factory Fire Place 220 Final Planning A➢Oroval 203 Final Sign 222 Final Site 204 Final Demolition _. 250 Final Builtlincy0aupancy WORKERS' COMPENSATION DECLARATION: I �ereby aKrtn under penalry of perjury one of the following tleclarations: ❑� I have and will maintair� a Certifica(e O( con5ent to 5e1(-InSure tor vrorkers' compensation, as provided for by section 3700 of the Labor Code, for tha performance ol lhe work for which this pertnit is issued. �I have and will maintain �wrkers' compensation insu2nce, as requi2d by sectbn 3700 0l the Labor Code, fa the peRormance of the v.ork (w which this pertnit is issued. My workers' compensation Insurance cartie/r� nd policy numberare:!"/t��y<.1/WY`�� .�(,.��/�/ Carrier: (Ttusseabnr�eednmoemn+de�eCtNeP�k a� OalarsfSi00)«kss) Polity Number: (-(J2�� li �� ❑ I certily thal in the p¢Kortnance ol the work for which this permit is issue0, I shall nol e loy any person in any manner so as to become subject to Ihe work pe tion laws ol Calitomia, antl agree that il I should become bject the rker ' mpensation provisions of Section 3700 of lhe L or Co6 shall fo�h ' om th these provisi s. / - 2-oz� Opican�'�pnaWre Date WARNI : FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S ($100,000), IN ADDITION TO �1'IE CAST OF CAMPENSATION, DAMl�GES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTOR$ DECLARATION: I hereby atfrm that I am licensed untler provisions ot Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Cotle, and my license is in full torce2 tjgffect. � Lic. # � Class # / � i ,� onlmclor' a�ure Da1e CONSTRUCTION LENDING AGENCY: ❑ I hereby aHtrm that tdere is a crosWctbn lending agency for the perfwmance W lhe v.ork for xt�ich this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: lender's AOdress: Sigrolure OWNER-BUILDER DECLARATIONS: I hereby affirm Ihat under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the lollowin9 reason (Sec. 7031.5, eusinass antl Professions Ctltla: Any city or counry whith requires a permit [o cons�rucl, aller, improve, demolish, or repair any structure, prior to its issuance, also �equires Ihe app�iwnt !or such permit to file a signetl statement tha� he or she is licensed pursuaM to the provisions of the Contractors LiCensa Law (Chapter 9(wmmencing with Section 7000) of Division 3 0l the Business and Professions Cale) or that he or she is exempt therefrom and �he basis for the alleged exemption. Any violation ol Section 7037.5 by any applitant for a permit subjec�5 lhe applicant to a civil penalry of no� more than frve huntlretl tlollare �$500)J: ❑ I. as ovmer of tha property, or my employees with vrdges as their sole compensation, WILL DO THE WORK, and the slructure is nol intentletl or offered lor sale (Sec. 7044, 6usiness and Professions Cotle: The Contractors License Law dces not apDly to an owner of properry who builds or improves thereon; and who dces such work himself or herself or Ihrough his or her ovm employees, provided that suG� improvements are not intentletl or oHered for sale. If, �owever, the building or improvement is sold within one year of completion, the owner-builder will have Ihe burden of proving that he or she tlid not build or improve fonpurpose of sale.). ❑ I, as ownerbf the property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law Cces nol apply to an ovmer of propeny who Cuilds or impioves thereon, and v.fio contracts fa such project wiih a cont2cta(s) license pursuant [o the Cont2ctors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: SiBnalure Date 3057�a6(3/0]) f '-7 Owner.iD verifed by ddve� _..cense. ❑ Yes ❑ No � . Driver's;License No. Expires: Venfication of OwnerShip by (lype of document, i.e. - property tax bill or tleeC): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby certify thal no excavatbn frve (5) w more feet v� tlepth mto which a person is required to descend, will be matle in connection with xork authorved by Ihis permil, and �hal no building structure, scaffdding, (alse�wrk, v demolition w tlismanUing Ihereof, will be more than thiny-s& (36) (eet hgh. (Chap. 32, Grp 2. M 2, Sec. 341. Ttle 8, Cali(omia Atlministrative Code). ❑ As ovmer-builder, I vrill not employ anyone �o tlo work which would require a permil Irom lhe Division oF Industrial Safety, as notetl above, unless such person has a permit to Oo such work from the division. Appliwnl's SignaWre Division of Induslnal Safety Permit Numbe[ _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will the applicaN or present or future building occupaM neetl to file antl cenify a Business Plan for emergency response to release or threatenetl release ol a hazardou5 material7 ❑ Yes ❑ NO (Seciion 25505 oi the Califomia Heaflh and Safety Cotle reqoires, with some exceptions, that a Business Plan be (letl vrith the CosW Mesa Fire Department by every business which has at any one time dunng a reportetl year a quantity of hazartlous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet ot wmpressetl gas at slantlard IemperaNre antl pressure). 2. Does or will the applicaN or present or fuNre buil0ing occupant need to file a registration form for acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health antl Safety Code, with some exceptions, requires registration with the Costa Mesa Fire DepanmeN by each business which at any one time has on hantl a quantity of acutely hazardous matenals equal to or greater than a weighl of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compresseG gas at standard tempereNre and pressure). 3. Does or vri6 the appficant w present or tuture buiWirn� occupant neetl to prepare an RMPP (Risk Managemen[ and Prevention Program for acutely hazardous materials)� ❑ Yes ❑ No (Section 25534 of the Califomia Health and Satery Cotle provides that the Costa Mesa Fire Departmenl may require ihe preparation, certification antl filing vrith the Fire Department of an RMPP by businesses whic� are required ro register acutely haza�dous materials vrith the Fire Department. 4. I( an RMPP is presenlly reQuired, has Section 25534 0l the Califomia Health and Safety Code been (ully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future builtling occu0ant require for Ihe work which is lhe subjact ol this appliCation a p¢rmit fof Suth wns[NctiOn or modifcation from the South Coast Air Quality Managemenl District or from any other air pollution control distncl or agency7 ❑ Ves ❑ No (Sectbn 65850.2 of Ihe Calilomia Govemment Code requires that the requested infortnation be lumished on applications fa roo-residential buiMiig pertnils). 6. Will any pan of the �acilily lo be conslructetl untler lhis permit be within t0001ee1 from ihe outer boundaries of a school? ❑ Yes ❑ No (It yes', the facility must meet the requirement of Sections 25534 and 42303 of the Cali(omia Health and Salety Code). 7. If a permit (rom the South Coast Air Quality Management Dislrict or alher air pollution control disMct or agency is required !or the v,ork which is the subject of this application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made7 ❑ Yes ❑ No 8. Qf'yes", attach cedificate of compliance trom the appropdate air pollution Gon[ml o(fceq. � ' � ' -CERTIFICATE OF COMPLIANCE: bcerti(y Ihat under penalty�of peryury�the information given above is correct. I agree.to wmply vrith all state laws and cily ordinances regarding Hazartlous Malerials and Emissions. �, �. � - SignaWre ' Date � CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury lhat I have read this application and state that the information given is correct. I agree to wmply with all sla�e laws and city ordinances relalinq to building wnstruction, and authorize representatives�of the City of Costa Mesa to enter upon Ne above-describetl property for inspection purposes. I agree not to cecupy or allow occupancyof any builtling authorizetl b th' permit until f al inspection. . 5 g Wre b( Le wneqs� ate G� / — Maror o a /wv��nt oatc