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Home My WebLink About2811 PINECREEK DR - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa•mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applitant Address: 2811 PINECREEK DR ADAMS AND PINECREEK DR 14136205 MICHAEL ECHAVE 463 N. SMITH AV - CORONA,CA Phone: 909-371-4202 Zip 91720 Ownerr COAST COMMUNITY COLLEGE Address DIST " COSTA MESA, CA Phone: 2701 FAIRVIEW RD Zip: 92626 Contractor. MOORE ELECTRICAL CONTRACTING Address: 463 N. SMITH AV ISSUE FEE Temp service test Res. alc package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts . Recept OutleLs Switches Non Res Appl Res Appl Service l0 200a Service to 7000a Service over t000a Molors to thp Motors to 10hp Motors to SOhp Motars ta 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Lighl Pkg Si9n Circuits Temp Pwr Pole CORONA,CA Phone: 909371-4202 Zip: 91720 License: 610382 SCOPE OF PERMIT SERVICE UP TO 200 AMPS FOR CITY TRAFFIC SIGNAL. $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 30.00 50.00 $30.50 50.00 50.00 50.00 $0.00 50.00 $O.oO 50.00 50.00 so.00 50.00 $0.00 50.00 Quantiry FEE SUMMARY . Temp Dist System / Lighting Buswayl100ft Slanding Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw ..........::...:.up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Voll Wiring System I Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee . Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES status: ISSUED Applied: 03/31/2005 Issued: 03/31/2005 ISSUED BY: Quantity 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 50.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 9248, § 7, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized undar this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons end final approval must be obtained. Failure to obtain inspections and final approval vrill result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 �anwo �aw� WORKERS'COMPENSAnON DECLARATON: I hareby eMirm under Penalry oi perjury one of the tollowing declaretlons: ❑ I heve end will maintein e cetlilicele ot consent to self-Inswe for workers' campensetlon, es prwidetl for 6y section 3700 of t�e Labor Code, for the pedormence ot �he work for which this permit Is issued. ❑ I heve end will maintain warkers' crompensation insurence, es requlretl by section 3700 of ��e Lebor Code, for the pedormance ot the work for which ��is pertnit is issued. My workers' compensetlCoP I�sur� Vg cerrler end po�cy n,um e re: I�� Cartier. J�iT \ b }"�'� Policy Number. (Thls settlon need no� be complafed i1 the Oertnit is velued et one hundred dollars ($700) or IessJ ❑ I certity that in 1he pertortyenC6'OM e work lor which thls permit Is issued, I shell not employ eny person in any manner so as to becoma subject to the workers' compensetion laws of alifamis, ei yro@j et 1 � ultl becoma sublac� �o Ihe workers' compansaiion pmvl5ions ot Section 3700 ot �he Lebor Coda, 1 shell forthwith campry wit� these pm sions. ` 2 .{ '1 Applicant Signature: � Date: !'✓ I_ v� WARNING: FAILURE TO SECURE WORP S' CqAPENSATIpJ COVEfiAOE IS UMAWFUL AND SHP1L SU6IECT AN EMPLOYER TO CRIMINAI PENPLTIES AND CML FlNES UP TOONE HUNDFED T1KK15AND DOLURE (5100.000). IN ADDITIqJ TO THE WST OF CqAPENSATION, OAMAGES AS PROVIDED FOR IN SECiION 3/O60F THE LABOq CODE, INrEfiEST, AND A'ffORNEYS FEES. LICENSED CONTAACTORS DECLARA710N: 1 hareby aflirtn that I am licensed upder Ctoyi�io�c(�C �er 9(commencing with Seclion 7000) ol Division 3 of the Business force and elfect. lic. k V� V � Class w Contractor s SignaN/e: � � . Dete: _ and my license is in full CONSTRUC710N LENDING AGENCV: ❑ I hereby attirtn thal there is e consiruction lending egency br ihe De�ormanca ol lhe work tor which ihis permit is issued. (Sea 3097, Civil Coda). LenCer's Neme: Lender's Aadress: Signeture: Dete: OWNER-BUILDER �ECLARA710NS: I hereby attirtn that uPtler penelty ol perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW br the follawing reason (Sec. 7031.5, Busi�ess aad Protesslons Cotle: Any ciry or counry which reQuires a pertnit to construct, elter, improve, tlemolish, or repair eny strucWre, pnor lo its issuance, also requires the applicant br such pertnit to file e signeE stelement ihet ha or she is licensed pursuent to the proNsions oi the Conlrectors lJcense Law (Cheptar 9(commencing wiih Section 7000J of DlvlSion 3 ot Ihe Busineu antl Prof8s5�ons Code) or ihet he or sha is exompt Iheralrom entl the besis for the elleged ezemption. Any violation ot Section 7031.5 6y any ap0�icant for a permit subjects Iha epplicanl to e civil penalry ol not more than Ilve hundred dollers (5500)J: ❑ I, as owner ot tpe property, or my employees with weges es Ihair sole compenselion, WILL DO THE WORK, and Ihe strudure is not imentletl or oHered for sale (Sec. 7044, Business and Pmfessions Code: Tha Contrecbrs Ucense Law tloes not epply to an owner ot property who builtls or im0�ove5lhereon, and w�o does such work �imself or hers�� or through his or her own empioyees, provided lhet such impmvements ere not intentled or oflered for sale. If, however, the huiltling or improvement is soltl wilhin one yeer of complotion, the owner-builder will heve ihe burtlen ol proving t�et he or she tlitl not huild or impmve for Ourpose o1 sala.). ❑ I, as owner of tbe pmperry, em E%CWSIVELV CONTRACTING WITH LICENSED CONTPACTORS to wnstmct Ihe project (Sec. 7044, Business antl Professions Code: The conPactors License Lew �oes not apply to en owner ot pmperty w�o bulltls or improves thereon, antl who contracts for such pmject with a coniraaor(s) license pursuan� �o the Comrectors License Laws.). ❑ I em erempt under sec. Business and Professions Code for Ihis reason: Siqneiura: Daie: Owner ID venfiad by d��efs license. ❑ Yes ❑ No Drivefs License No. Verification ot OwnerShip by (type ol0aument, i.e. - property tex Dill or deed): DIVISION OF INDUS7F71AL SAFETY PERMIT CERTIFICATION: Expires: ❑ I here�y certify [het no axcevetion five (5) or more feet in tlepth into which a person Is requlred to descend, will De mede in connection wit� work authodzed hy �his pertnit, end that no huiltling sWCWre, scaHolding, lalsework, or Oemolition or dismantling Ihereot, will be more than t�irty-six (36) feet higR (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Atlministretive Code). ❑ As ownerbuilder, I will not employ anyona to do work which woultl require e pertnit fmm Ihe Division of Indusirial Safery, as noted above, unleu such parson has a pertnit to tlo suG� wa�k trom ihe division. Signature: Date: Division of Industrial 5afery Permit Number: CER71FlCA7E OF COMPLIANCE 1WD AUTHORIZATON OF ENTRV: I cenity under penelly ol perjury that I heva reetl t�is apPlication antl stata t�at ihe inbrmation given is wrrecL I agrea b comply with all stele laws and city ordinances releling to bullding conslrucllon, end eut�odze representetives of �ha Cily ol Costa Mesa to enter upon Ihe ebove-described proparty br inspe �tion purposes. 1 agree not to occupy or etlow occupency ol eny buildi� authorizetl by tNs Dermit uatil tinal inspection. �OUE �. IMSPECTIONTYVE 161fi Fixed Systert� Flnal Fire Pievention 7266 Pool Spa Final 200 Finel Re�Roa� 201 Fin01 BlocWfletaining Well 202 203 204 Final Factory Flre Place Final Sign Finel Demolil�o� p�TE INIIIJdLi 3 • 3 VC'= 0 � Date COOE 1 INSPECTION TYPE 206 Final Mechanicel 20B Flnel Plumbing 210 Finel Eleclricel 212 Flnal Flre Prevantion 220 Final Planninq Approval 222 Final Sile 250 Finel BuiltlinglOccupency QSjF IHIIMLS e•_