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Home My WebLink About290 ESTHER ST - Building Permitsa(��p MFS9 o. , . � h C J 8 °2�,0�, fi CITY OF COSTA MESA BUILDING DIVISION 77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wa✓w costamesaca.qov FOR INSPECTIONS CAIL: (714) 754-5626 , PERMIT NUMBER: E11-00240 � PERMIT TYPE APN: 42628412 JOB ADDRESS: viciniry: SCOPE OF WORK: ELEC STATUS: DATEISSUED: --"_'�--� _ , ISSUED BY: 290=ESTHER ST CM ° Suite/Unit: UPGRADE SERVICE TO 100 AMP. NO RELOCATION OF SERVICE. " OWNER: MALM�UIST,.JOHN C III .�" PHONE: — ,_:'� APPLICANT: GALBAN, MARK � � � � - � � PHONE: 949-735-2720 , . � � - CONTRACTOR: GALBAN ELECTRIC ISSUED 10I24I2011 KJB Address: 1981 SANTA ANA AVE', Unit:, ',' Ciry/State/Zip: ; COSTA MESA, CA-� Address: ��. STIDEWATER �Unit: �,� , � Ciry/Slate/zZip:, t. �.� IRVINE, CA - . , ,,, License No. 961385 : Address: 8 TIDEWATERUniC ' PHONE: 949-735-2720 � �� .' Ciry/State: IRVWE, CA � "' ' � . ZipCode:� 92814 � . . 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 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 (or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all � iequired inspections and £nal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. 'yf UE k, INSPELTION TYPE ORTE IN AL COOEO INSPELTION TYPE Q,pT� INRIIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical -.1266 Pool Spa Final 208 Final Plumbing 20� Final Re-Roof 210 Final Electrical �� ' � 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Appmval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consen� �o 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 ection 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Msurance carrier antl policy number are: �airier: -` �O �5��-c (lliix section n not ee mmpietedrt me perm� is vemee erone nuntlra0 donars (Ev001 orless) P�c,,fN�'�- MR�L2�.9��q .' certiry that in the performance of the work for which this permit is � issLed, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree ihat if I should � become subject to the workers' compensation provisions of Section 3700 of the Labor d, I �all hwit of p e7, th these provision . �. l o ZS I ' IiCdM'S Signalure _ ' d ete' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE, INTEREST, AND AT�ORNEY'S FEES � LICENSED CONTRACTORS DECLARqTION: I hereby affirm that I am licensed under provisions of Chapler 9(commencing with Section 7000) o( Division 3 0( [he Business and Professions Code, and my license is in full force and effect. � C' -/O ic;;s % 3$/ ctass;#�s� �� /D 2 // odVactors SignaWre �. CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that there is a construction lending agency for the peRortnance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lender's Address: SlgnaWre oate OWNER-BUILDER DECLARA710NS: I hereby aKrm [hat under penalry of perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec- 7031.5, Business antl Protessions Code: Any city or counry which requires a Dermit [o constmct, alter, impmve, demolish, 6r repair any stmcWre, pnor ro its issuance, also requires the applicant for such pertnit to file a signed statement that he or she is licensed pursuant to Ihe provisions of the Contrac�ors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempl therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applican� (or a permit subjects the appliCant to a civil penalry of not more Ihan five hundred dollars (8500).): ❑ I, as owner of the property. or my employees with wages as their sole compensation, WILL DO THE WORK, and ihe structure is not intended or oRered for sale (Sec. 7044, Business and Professions Code: The Contracrors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himsa,lf or hersel( or Ihrough his or her own employees, providetl that such impmvemenis are not intended or offered for sale. If, however, lhe building or improvement is soltl 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.). ❑ 1, as owner of the property. am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business and Professions Code: The coniractors License Law does not appty to an ovmer of properry who builds or impmves thereon, and who contracts for such project with a cont2ctor(s) license Dursuant to the ConVactors License Laws.). ❑ I am exempl under sec. Business and Professions Code for this reason: Signawra Date 305]<6 (3/O]) Owner ID verifietl by tlriver's ucense. ❑ Yes ❑ No Driver's License Na. Expires: Verifcatiou of Ownership by (type of document, i.e. - pmperty tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT GERTIFICATION: ❑ I hereby certiry [hat no excavation fve (5) or more fee[ in depth into which a person is required to descend, will be made in connection with vrork authorized by this Dertnit, and that no building strucwre, scaftolding, falsework, or demolition or dismantling thereot, vrill be more Ihan thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administra6ve Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safery, as noted above, unless such person has a pertnit to do such work from the division. $ignaWra Date Division of Industrial Safery Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. WII the applicant or present or tuture building occupant neetl to file and certiry a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Cotle requires, with some ezceptions, thal a Business Plan be Flled with ihe Costa Mesa F.ire Department hy every business which has at any one time during a reportetl year a quantiry of hazardous matenals equal to or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at slandard��emperature and preswre). 2. Does or vrill the applicant or present or fuNre builtling occupant need to file a registration form for acutety hazardous matenals? ❑ Yes ❑ No (Section 25533 0( Ihe Cali(ornia Health and Sa(ety Code. wiM 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 pountls, or a volume of 55 gallons, or 200 cubic (eet of compressetl gas at standard temperaNre and pressure). 3. Does or will the applicant or present or (uture building occupant need lo prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0( [he Cali(omia Health and Safery COde provides Ihal the Costa Mesa Fire Department may require the preparation, certifcation and fling with the Fire Department o/ an RMPP by businesses which are required to register aculely hazardous materials with the Fire Depariment. 4. If an RMPP is presently required, has Section 25534 of the California Healih and Safery Code 6een fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fuNre builtling occupant reqUire fOr the work which is the subjecl of this application a permit for such cons[ruc�ion or modification fmm [he South Coas[ Air Quality Management District or from any other air polNtion control district or agency? ❑ Yes ❑ No (Section 658502 of the Calitomia Govemment Cotle requires lhat ihe requested infortnation be fumished on applications for non-residential building permi�s). 6. Will any part of lhe faciliry to be conStmCted under this permi[ De within 1000 feet from lhe outer bountlaries of a school? ❑ Yes ❑ No Qf "yes', �he faciliry must meet lhe requirement of Sections 25534 and 42303 of the California Health and Sa(ery Code). 7. If a pertnit from ihe South Coast Air Quality Management Disirict or other air pollution control tlistrict or agency is required for the work which is the subjecl of this applicalion, have all of [he tlisclosures prescnbed by Califomia Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. p( "yes", attach certifwte of compliance from the appropnate air polWtion control officer). CERTIFICATE OF COMPLIANCE: I certily iha[ under penalry of perjury [he intormation given above is correcL I agree to comply with all state laws and ciry ordinances regarding Hazardous Materials and Emissions. Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certiry under penalry of perjury that 1 have reatl this application and state that the information given is correcL I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of ihe City oi Costa Mesa to enter upon the above-described property for inspec[ion purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SignaWreolLegalOwner(s) Da�e FAnNorAutMri¢etl'Appl��nh_ �Da�e�-