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Home My WebLink About5 MARK LN - Building Permits. ; � r i CITY OF COSTA MESA BI/ILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 •�wew.ci.costa-mesa.ca.us FOR IMSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. E08-00019 PERMIT TYpE ELEC APN: 42001214 JOB ADDRESS: 5 MARK LN CM Vicinity: LIVING ROOM AND ENTRY STATUS: ISSUED DATE ISSUED: 01/10I2008 ISSUED BY: BJK Suite/Unit: SCOPE OF WORK: INSTALLATION OF A NEW FIRE ALARM PULL STATION WITH BELL IN AN EXISTING RESIDENTIAL CARE HOME. OWNER: STATE OF CALIFORNIA % FAIRVIEW DEV CNTR PHONE: APPLICANT: MAROIS, NICK PHONE: 774-235-2601 CONTRACTOR: MAKO ELECTRIC Address: 2035 WAVERLY ORUnit: PHONE: 714-235-2601 City/State: ANAHEIM, CA ZipCode: 92802 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $41.70 Reinspection Fee $0.00 TOTAL FEES $41.70 Address: DEPT OF DEV SERV Unit:COSTA MESA, CA City/State/Zip: 2501 HARBOR BLVD Address: 2035 WAVERLY DR Unit: City/State/zZip: ANAHEIM, CA License No. 836183 CELL: —:i �i� � Q = �;-,nr[s. `��":;+ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Cali(ornia 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 lo be considered legal, such work must rqmply with all applicable codes, and all required inspections and £nal approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this,permil. OG pE�, INSPECPONTYPE OATE IN7ITIALS CODE� INSiECTIONTYVE DRTE INTITIr1L5 1618 Fixed Sy6tem Pinal Fire Prevention 206 Final Merhanical 1268 Pool Spa Final . 208 Final Plumbing l^/ �,-�� 200 Final Re-Roof 270 ✓Final Electnral��QC �� g �i 201 Final BIo�WRetaining Wall 212 Final Fire Prevention 202 Final Pactory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Sile �'� � 204 Final Demoli�ion 250 Final BuildinglOccupancy r '� WORKERS' COMPENSATION DECLARATION:� I hereby aKrm under penalty o! perjury one o( the following declarations: ❑ I have antl will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the peAormance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insu2nce, as required by seclbn 3700 of the Labor Code, for the peAormance of the work fw which this permit is issuetl. My vrorkers' compensation Insurance carrier antl policy number are: Carner. (TN5 seclion naM rpl pe mmp'eled Jfhe peiml B ralueCaf ine nu�MrM Wlars (5100) a/euJ Policy Number: n � �I certify Ihat in the peAortnance of the work for which this permit is iss , I shall not employ any person in any manner so as to become subject to Ihe workers' compensation laws of Califomia, antl agree that if I should becom ubj the vrorkers' compensation provisions of Section 3700 of Lab od II forihwith comply with these provisions. 'ApPiwnl's.5i9wWre\1 Dab 7 �.-- WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT 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, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrtn thal I am licensetl unaer provisions of Chapter 9(commencing with Section 7000) of Division 3 0( Ihe Business and Pro(essions Code, and my license is in full force and effect. j Cic. #. �Class # 3 I �� \ � `ior's Signalure ! ` e � � CONSTRUCTION LENDING AGENCY: ❑ I hereby aHtrm that Ihere is a construction lending agency for the perfortnance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lender's Adtlress: SignaWre Date OWNER-BUILDER DECLARATIONS: I heroby a(frm that untler penalty of perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the follovnng reason (Sec. 7031.5, Business and Prolessions Code: Any city or county which requires a permit to conslruct, alter, improve, demolish, or repair any struclure, prior lo its issuance, also requires Ihe applicant for such permit to fle a signed statement [hat he or she is licensetl pursuant to tha provisions of the Contraclors License Law (Chapter 9(commencing with Section 7000) o( Division 3 0( the Business and Professions Code) or Ihat he or she is exempt Iherefrom and the basis for Ihe alleged exemplion. Any violation of Section 7031.5 by any applir.ant for a permit subjects Ihe applicant to a civil penalty o( 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 oHered for sale (Sec. 7044, Business and Professions Code: The Contraclors License Law tloes not apply to an owner o( property who builds or improves thereon, and who does such work himself or herself or Ihrough his or her ovm employees, provided ihat such improvements are not iniended or oRered for sale. If, however, the building or improvement is sold within one year of completion, the ownervbuilder will have the burtlen of provinq that he or she did not build or improve for purpose o( sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and Professbns Cotle: The contractors License Law dces not appty to an ovmer of property who builds or improves thereon, and who contracts fw such project with a cmtracla(s) license pursuant tothe Contraciors License Laws.�. ❑ I am exempt untler sec. Business and Pro(essions Cotle for this reason: 518^aWre 305]�a6�]IO]) Owner ID verified by drivc .,ce�._�. ❑ Ves ❑ No Driver's License No. Expires: Veri(cation of Ownership by (lype o( document, i.e. - property taz bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cetldy that no excavation frve (5) or more feet in depth into wfiich a person is required to descend, will be made in connection v,ith work authonzed by Ihis permit, an0 that no building structure, sc�fdding, false�wrk, a tlemolition or dismantling thereof, will be more than thi�y-six (36) feet high (Chap. 32, Grp 2, M 2, Sec. 341, Ttle 8, Califomia Atlminist2tive Code). ❑ As owner-builder, I will not employ anyone to do vrork which woultl require a permit from the Division o! Industrial Safery, as notetl above, unless such person has a permit to tlo such work from the division. Appliwm's SignaWre Division of Industrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: t. will the applicant or present or future builtling occupant need to file and certify a Business Plan for emergency response ro release or threatenetl release of a hazartlous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, lhat a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reportetl year a quantity of hazardous matenals equal lo or greater than a weight o( 500 pountls, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at standard lemperature and pressure). 2. Does or will the applicant or present or future builtling occupant need to Ne a registration fortn (or awtely hazartlous matenals? ❑ Yes ❑ No (Section 25533 of lhe Cali(omia Health ana Safety Code, with some exceplion5, requires fegi5tratiOn with the Co5[a MeSa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or grea[er than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet o! compressed gas at stan0ard temperaWre anC pressure). 3. DoeS or will the applicant or present or (uture building occupant need to prepare an RMPP (Risk Management and Prevention Program !or acutely hazartlous materials)? ❑ Yes ❑ No (Section 25534 of the Cali/omia Health and Safety Cotle pmvides that the Cosla Mesa Fire Department may require ihe preparatioq certification and filing with the Fire Department of an RMPP 6y 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 Califomia Health and Safety Cotle been fully complied wilh7 ❑ Yes ❑ No 5. Does or will the appliwnt or present or future building occupam require for Ihe work which is the subjecl of ihis applicalion a permil for such construction or modification fmm the South Coasl Air Oualiry Management DisMct or from any other air polWtion control dislrict or agency? ❑ Yes ❑ No (Section 65850.2 of the Califomia Govemmenl Cotle requires that the requestetl infortnation be fumished on applications for non-residential builtling permits). 6. Will any part of the faciliry to be consWcted under Ihis permit be within 1000 feet from the outer boundanes ot a school? ❑ Yes ❑ No (If'yes", the faciliry must meet the requirement of Sections 25534 antl 42303 of Ihe California Health antl Safety Code). 7. If a permit from the South Coast Air Qualiry Management District or other air polWtion control district or agency is required for the vrork which is the subject of Ihis application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (I�'yes", attach cenifwre of compliance lrom the appropriate air pollution control offlcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury Ihe information given above is correct. I agree to comply with all state lavrs antl city ordinances regarding Hazardous Matenals antl Emissions. SlgnaWre CERTIFICATE OF COMPLIANCE AND AUTHORI2ATION OF ENTRY: I certify untler penalty o! perjury that I have read this application and state thal Ihe information given is correcL I agree to compty with all state laws and city ortlinances relating to building construction, and authorize representatives of ihe City of Costa Mesa to enter upon the above-described propetly for inspection purposes. I agree not to occupy or aliow occupancy of any building authorized by Ihis permit unlil final inspection. Si aW Q L al Ownerp (s) Da e� �n .� V �rt– �� An�d/j Or Au .Oriz tl Applicanl.. __^ } , � e__� L�— _ CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENTSERVICES DEPARTMENT �o � - oo� �9 � �n� �� C�� . . � � I �� nc�,�� ; z J Building Division (714) 754-5273 • Coae Entorcemen�(714) 754-5623 • Planning Division (714)754-52a5 FAX (714) 754-4856 • TDD (774) 754-5244 • www.ci.costa-mesa.ca.us