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Home My WebLink About1000 MISSION DR - Building PermitsCITY OF COSTA MESA BUILDING DIVISION f77 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 / PERMIT NUMBED E08-00250 PERMIT TYPE ELEC STATUS: ISSUED APN: TPNO07219 DATE ISSUED: 06/25/2008 `:.=:ISSUED BY: RMD JOB ADDRESS: 1000 MISSION DR CM Suite/Unit Vicinity: &BE-WAtKA//e4, SCOPE OF WORK: NEW 100 AMP SERVICE METER FOR PEDESTAL LOCATED IN ALLEY (NORTH,OF_MISSION DR). OWNER: CITY OF COSTA MESA` - Address: ; Unit - , PHONE: _ -City/State/Zip: APPLICANT: WILLIS, JANAE M Address: .1921 W 11TH ST Unn.,..,, PHONE: 909-946-0905 City/State/z2ip: UPLAND,,CA t; CONTRACTOR. VCITE LECOM ..... -. .. - License No. 765716 r. Address: 1921.W 11TH ST,Unit: PHONE. "909-946-0905 City/State: UPLAND, CA - ZipCdde: 91786' - 'CELL: ELECTRICAL PERMIT FEES Electrical Plan Check Fee $0.00 Electrical Permit Fee: `,..$54.00 Reinspection Fee $0.00 TOTAL FEES ,$54.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. D f INSPECTION TYPE DATE INTITIALS CODEC IN$PECTIONTYPE DATE INTITIALs 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing iro0 Final Re -Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION* I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section,3700 of the Labor Code, for the performance of the work for which this permit Is issued. I have and will maintain workers' compensation insurance, as required by tion 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' mpensation Insurance carrier and policy number are: %' n Carrier: ' Tre / �1o12/ 1 (This seciion need ca/ndelted �t permat a valued at one hundred mitars(5100)or less.) Policy Number: � l Li/ f ;/ S- -/ /) � /) 0 ❑ I certify that in the performance of the work 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 California, and agree that if I should become subject t th r. ' compensation provisions of Section 3700 of the Labor Code, to omply with these provisions. Appli is SiAture Date WARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full ^force and effect. ul/(x P Lic. # l.J ,eaClass # (pr's Sigju Dile CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature Date OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($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 offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold w4thin one year of completion, the ovmer-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: . Signature - - Date 3057-06 (3/07) � t Owner ID verified by do , (cense. []Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property,tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, Wi11 be more than thirty-six (36) feel high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tide 8, California Administrative Code). ❑ As ovmer-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Applicant's Signature Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, With some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safely Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons. or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No Of "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (if "yes", attach certificate of compliance from the appropriate air pollution control officer). - ' . CERTIFICATE OF COMPLIANCE: I certify that under penalty of -perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding, Hazardous Materials and Emissions. Signature CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ij►=�� AuRT5-n7V1!!ATphcant i rAnd/or Date CITY OF COSTA MESA BUILDING DIVISION i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.00sta-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: E08-00250 PERMIT TYPE ELEC Final Block/Retaining Wall STATUS: ISSUED APN: TPNO07219 Final Sign DATE ISSUED: 06/25/2008 220 Final Planning Approval JSSUED BY: RMD JOB ADDRESS: 974 MISSION DR CM-,Suite/Unit ':; Vicinity: SIDE WALK -- - - SCOPE OF WORK: NEW 100 AMP SERVICE -METER FOR PEDESTAL LOCATED ON WALK: - r _ - OWNER: CITY OF COSTA MESA. -Address: Unit - -- PHONE: City/State/Zip: APPLICANT: WILLIS, JANAE M -` , _- -Address:_ . 1921 W 1 1T ST Un_it:,. PHONE: 909-946-0905 �, City/State/zZip. UPLAND;,CA :+t CONTRACTOR: VCI TELECOM License No. 765716 Address: 1921,W 11TH STUnil: - PHONE: '909-946-0905 City/State: UPLAND, _CA -�-_ ZipCodei 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 comply with all applicable handicap access requirements under California 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 authorized 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 to obtain inspections and final approval will result in the expiration of this permit. ODER INSPECTION TYPE DATE 11MUL CODE/ INSPECTION TYPE 1 IN AL 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re -Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATIONS I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and vnll maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 'E3ahave and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier: Q�--PU ,Q C (� This son neeCl net be wmp'etM Othe permit rs valuetl of one hunOred dollars ($100) orlecs.) PolisOlicy Number: Mi Oi��(ri �C� certify that in the performance of the work 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 California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of th abo ode, 5h forthvrith comply with these provisio s. ca �� `ApdKanrs Signature Date_ ___r WARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. 1:1,Licr#. ClC as-s#—I Gp actors Signature -Date— CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($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 offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such,work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as•owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: .f Owner ID verified by dnVE .cense. ❑ Yes '❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation We (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building stmcture, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Appltmnt's Signature Date Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safely Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California 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 quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does of will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school?- ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code), 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency.is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATEOF.COMPLIANCE: I'certify: that under penalty of perjury the information given above is correct. I.agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature ' Date ' CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and stale that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 'ignatur of g I Ov.er(s) Date Signature Date Cd a �- W5716 (3V7) ♦AnNor Authorized'Appt¢ant 'ff + "C I J1 ISI. i I � AVL e I H I\ Y 1, 'ff + "C I J1 ISI. i I � AVL e I City of Costa Mesa 77 Fair Drive Costa Mesa, CA 92626 RE: Letter of Authorization To Whom It May Concern: Angelica Ramirez is an authorized representation of VCI Telcom, Inc. d/b/a VCI Telcom, Inc. Please accept this as written verification for Angelica Ramirez to process any necessary applications for permits regarding VCI Telcom, Inc. Should you have any questions please feel free to contact me directly at (909) 946-0905. Sincerely, Ro9'arof Vice President 1921 W. 11th Street, Upland, CA 91786 (909) 946-0905 • Fax (909) 946-0924 California Stale License 765716