The URL can be used to link to this page

Home My WebLink About2158 ORANGE AVE - Building Permits� CITY OF CQSTA MESA � ,, BIIILD/NG D/V/SION F � 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 �"°"°'mfi PERMIT NUMBER E08-00008 PERMIT TYPE ELEC STATUS: ISSUED APN: TPN007148 DATE ISSUED: 01/02/2008 , ISSUED BY: SOK _: JOB ADDRESS: 2158 ORANGE AV CM ' Suite/Unit: -. Vicinity: � -� � � � . - . � .� ..,. ._ ., .. _ . , , SCOPE OF WORK: INSTALL NEW 100 AMP SERVICE METER PEDESTAL FOR�"AT,AND T" ; r� OWNER: CITY OF COSTA MESA . ', Address: Unit• . � - �' PHONE: ,' � . .. �City/State/Zip: '" � �� . - APPLICANT: JANAE WILLIS _ . . - �" Address:..- 1921 W 1�iTH ST Unit: �- PHONE: 909-946-0905 - , � . . ' City/State/zZip: ",UPCAND, CA � , CONTRACTOR: VCDTELECOM . License No. 765716 Address: 1921 W 11TH STUniti � , PHONE: "�-; 909-946-0905. � . - . . ' . , City/State: UPLAND, CA �. � . ZipCode: ,91786 � . � � � � CELL: , . �.,. - . ..._ . : ,. .. . . , ....... .-: .. ..�, ; : . .. ' - ...: ,�.` ELECTRICAL PERMIT FEES ' _ Electrical Plan Check Fee: � ' $0.00 Electrical Permit Fee: $54.00 Reinspection Fee $0 00 TOTAL FEES ;'' $54.00 � " NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28. § 1. 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure lo obtain inspections and final approval will result in the expiretion of this permit. LOOEk. INSPECiIONTYPE DATE INTITIALS CODEt INSPELTIONTYPE UATE INTI7IALS 1676 Fixed System Final Fire Prevention 206 Final Mechaniwl 1266 Pool Spa Final . 208 Final Plumbing �� 1 200 � Final Re-Roof 210 Final Elecincal ' 201 Final Block/Retaining Wall 212 Final Fire PreveNion 202 Final Factory Fire Place 220 Final Planning Appmval 1 203 Final Sign 222 Final Site 20a Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSA710N DECLARATION� I here6y aKrm under penalry of perjury one of the following declara[ions: ❑ I have and will maintain a certificate of wnsent ro self-Insure for workers' compensation, as provided tor by section 3700 of the Labor Code, for lhe pedormance of the vrork for which this pertnit is issued. I have and will maintain workers' compensatbn insurance, as required by s tbn 3700 of the Labor Code, tor lhe peAormance of the vrork for which this pertnit is issued. My vrorkers' compensation Insurence carrier and policy numberard:r� Camier: �l� a l� ��,�c.nblre (ThissedionnttNIiro'te,e�m,,mpetetleNe imdsvarue0alonehuneredCdlars(St00)wkss) Policy Number: /"lX..( 2i�" � i�� 2�f/i � I certify that in the pertormance of the vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree ihat if I should become subject to the v.nrkers' compensation provisions of Section 3700 0� th ode, I shall forthvnth comply with these provi ons. O 7� ( ! AO�I¢anf5 SignaWre ale ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS � Ovmer ID verifed by dri� � Dnver's License No. ,ct... _. ❑ Yes ❑ No Expires: Verifcation of Ovmership by (rype of tlocument, i.e. - property tax bill or tleed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certi(y that no excavation frve (5) or more feet in tlepth into which a person is requiretl to descend, will be made in connection with work authonzed by this permit, and thai no building sWcture, scaffdding, falsev.vrk, a demolition or Oismantling thereof, v,ill be more than thirty-sa (36) feet high. (Chap. 32, Grp 2, Fvt 2, Sec. 341, Title 8, Cali(omia Atlminis[rative Code). ❑ As ovmer-builder, I will nol employ anyone to do vrork which would require a permit from the Division of Industnal Safety, as notetl ahove, unless such person has a permit to do such vrork from the division. Appliranl's SgnaWre Division of Intlustrial Safety Permit Number: _ HAZARDOUS MATERIAIS AND EMISSIONS CERTIFICATION: 1. Will ihe applicant or present or future buildinq occupant neetl to file antl certify a Business Plan for emergency response lo release or threatenetl release of a hazardous matenal? ❑ Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Sa(ely Code requires, wilh some PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, INTERES7, AND exceptions, ihat a Business Plan be filetl with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time tluring a reportetl year a quantiry of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under pmvisions of Chapter 9(commencing at stantlartl temperature antl pressure). with Section 7000) o( Division 3 of the Business and Professions Code, and 2. Does or vnll the applicant or present or future building occupant neetl to fle my licen�se7is/ i�n, fuCll�f'orce an/d�e,Hect. ''7 /! ^ a registration form for acutely hazartlous matenals? ❑ Yes ❑ No [ IILJ �� `-� Class # —/ (_ 1.,� (Section 25533 of lhe Califomia Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantiry of acutely ConVacmr'sSignaWre aie hazardous matenals equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at standard CONS7RUCTION LENDING AGENCY: [emperature and pressure). ❑ I hereby affirm that there is a constmction lending agency for the 3. Does or will the applicant or present or fuWre building occupant neetl co peRormance o! the v.ork for wfiich this pertnit is issued. (Sec. 3097, Gvil Code�. prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazartlous materials)? ❑ Yes ❑ No (Section 25534 of the CaliFomia Health antl Safety Code provides that the Lentler's Address: Cos[a Mesa Fire Department may require the preparation, certification antl filing with the Fire Department of an RMPP by businesses which are requiretl ro register acutely hazardous materials with the Fire Department. Slgnalure Date 4. If an RMPP is presently reqmretl, has Sechon 25534 of the Caldorma OWNER-BUILDER DECLARATIONS: Health antl Safety Code been fully complied with? ❑ Yes ❑ No I hereby aKrm that untler penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or the (ollowing fea5on (Set. 7031.5, Business and Professions Code: Any city or counry which requires a permit to cons[ruct, alter, improve, demolish, or repair any sVucNre, pnor to its issuance, also requires Ihe applicant for such permit lo file a signed statement that he or she is licensed pursuam to the provisions o( the Conlraclors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the Business anG Professions Cotle) or that he or she is exempt therefrom and Ihe basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit suhjects the applican� to a civil penalry of not more Ihan five hundred tlollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or oKered tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves thereon, and who does such vrork himself or herself or through his or her own employees, provitled that such impmvements are not intended or oftered for sale. If, however, the building or improvement is sold within one year of completion, Ihe ovmer-builder will have lhe burtlen of proving tha[ he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct the project (Sea 7044, Business and Professbns Code: The contractors License Law dces not apply to an ovmer of propeRy who builtls or improves thereon, antl who contracts for such pmject with a contracta(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business antl Professions Cotle for this reason: 305]<6 (10i) 5. Does or will the applicant or present or future builtling occupant require for me work which is me subject of Ihis applicalion a permit for such construction or modifcation from lhe South Coast Air Qualily Managemem District or from any other air pollution control tlistrict or agency? ❑ Ves ❑ No (Section 65850.2 of the Califomia Govemmen[ Code requires that the requestetl infotmation be fumished on applications fa rao-resitlential building permits). 6. Will any part of the facility to be wnstructed under this permit be within 1000 feet from ihe outer bountlanes of a school? ❑ Yes ❑ No Qf 'yes", Ihe facility musl meet Ihe requirement o( Seclions 25534 and 42303 o( Ihe California Health and Safety Code). 7. If a permit fmm the Soulh Coast Air �ualiry Management Dislnct or other air polWtion control dislrict or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Satety Code Section 42303 been made? ❑ Yes ❑ No 8. Q( yes", attach certifcate of compliance (rom the appmpnate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws antl city ordinances regarding Hazartlous Materials and Emissions. Signawre CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and state that the intormation given is wrrecL I agree to comply with all state laws antl city ordinances relating to building construction, and authonze representatives of the City of Costa Mesa to enter upon the above-describetl property for inspection purposes. I agree not to occupy or allow occupancy o( any building aulhorized by this permit until final inspection. Signalureo! IOvmer(s) Oale / - � 1 �-�- Og ; An0/o�Au�honeetlA001iUn1 Oa �'