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Home My WebLink About2703 ASHWOOD - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DAIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 2703 ASHWOOD TPN00125 Applicant ZIMNICKI,SCOTT Address: 25712 RUSTY ANCHOR � �.. � . � ' - - - ` , ��". � �Phone: (714)240-6294 - DANA POINT, CA� �- ,-�� Zip: 92629 ; ,� � � .� � � Owner�' STANDARD PACIFIC HOMES � � � Address , ' . - ' � - ' . � Phone: . i� ,.. Zip: Contrecror: KRIEGER ELECTRIC Address: 25712 RUSTY ANCHOR DANA POINT, CA- � - ' . ; -Phone: (714)240-6294 � Zip: 92629 License: 607534 Status: ISSUED Applied: OB/0612001 Issued: 08/O6/2001 ISSUED BV: . ; , SCOPE OF PERMIT . 8 LIGHTS, 1 SERVICE UP TO'100 AMP, 1 CONDUIT.AND1'CONDUCTOR.;�' �� ._ _ - _ . ._ <.... . _. � ISSUE FEE Temp:service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool I Spa Li9hting Fixts , � Recept OuHets Switches Non Res Appl' � , � ' Res Appl Service ro 200a � Service to 1000a - � Service over 1000a` ' Motors to 1 hp Motors to 70hp Motors to 50hp Motors to 100hp Motors over 100hp � Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole Quantity ' FEE SUMMARY " � Temp DisJ System /�Lighting Busway /100 ft Standing Section Misc Electrical Equipment Trensformers up to 1 kva/kw `-).....�...-........up to 10 kva/kw .................up to 50 kva/kw ....._..........up to,100 kva/kw ..................over 100 kya/kw _ Low Voltage Equipment �:'" ` Low Volt Wiring System / Ckt Misc. Conduit � Misc. Conductor � Circus ( gen or ride) Cirws (mech ride or lights) Christmas Tree Stand. , Fireworks Stand . Other Electrical Fee $23.50 _ $0.00 $0.00 $o.00 0 $0.00 0 $0.00 0 � $8.80 8 - .. �� S0.00 0 , � � �$0.00 0 . ' $Q00�; '`.,_>�,-,.' . . - $0.00'�� , ' 0 . $3Q50 � , , .1 - $0.00. �'�0� � 50.00 0 $0.00 0 50.00 0 $0.00 � 0 $OAO' 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 Quantity . � $0.00 0 �� $0.00 0 �� $0.00 0 - $0.00 0 . $0 00 0 $0.00 '� 0 -' ; -., $0.00 �- 0 $0.00�� 0 _ 50.00 0 $0.00" 0 � . $0.00 - � 0 $1820 1 $78.20 1' $0.00 0 - � $0.00 0 � -$0.00 � 0 . $0.00 0 50.00 Investigation Fee - � � � $0.00 Plan Check Fee - " $0.00 Reinspection,Fee $0.00 TOTAL CALCULATED FEES $99.20 COMMENTS / SPECIAL CONDITIONS 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: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � 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. FOq INSPECTIONS CALL: (714) 7545626 244fi3fi (6/00) WORKERS' COMPENSATION DECLARA710N: . , — I heraby ettirm under penalty of perjury one of the tollowing declaratians: - . ❑ I heva entl will maintain e certificete ol consent to sel4lnsure for workers' compensation, as provided for by section 3700 of ihe Lebor Cotle, tor Ihe pedormance of the /;c� work tor which Ihis pertnit is issuetl. . i� I have and will meinWin workers' compensafion insurance, es required by section 3700 W the Labor Code, for the pedortnance of the work tor which Ihis pertnit is issuetl. M workers' co%R ensatlo Insurance carder antl olic numIber ere: ,�/ Carder.Y �=Ll I I G �.�n f� �n n C��'.Y / i ion PolicyNumber: lv W C C� I 2 r7 J�'OO (This sectlon need no e com le ed il fhe permif is valued af one hundred dollars ($100) or less.) ❑ I cenity thet in the pertormance of the work for which ihis permit is issued, I shall not employ any parson in any manner so as to become subject to Ihe workers' compensetion laws oi Celifomie, and egrea that H I should beca e suDjact to t�e workers' compensation provisions of Section 3700 of t e Lebor Catle, I shall forthw%h comply with ihesa p%r% isions./� /-[/ �, �7 < , /f. �c f�� G/ ApPlican Sf ignature: r�� /_ /✓l � Date:�[J-�,/ �� I WARNMt G: FAILURE�TO SECURE WORKER$' CO NSATION COVEiiAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLO ER�TO CRIhllNA� PENALTI S AND qVIL FINES UP TOONE HUNDfiED T}IWSANO OOLLARE (5100,OW), IN ADDITION TO THE COST OF COMPENSATION, �AMAGES AS PROVIDED f-0R IN SECiION 3]O60F THE UBOR CAOE, ItJrEREST, AND ATiORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I he�eby efllrm Ihet I'am licensetl untler pmvisions of Chapter 9(commencing with Section 7000) of Division 3 ot Ihe:Business antl Professions Code, entl my license is in tull force and ettect: Llc.'A Class�#J —,�j Contrector's Signamre: _�;� �� ?' . D ta e �� /�2i5 0 2 .�' . .s . � CONSTRUCTION LENDING AGENCY: ❑ I hereby e(firm that there is a construction lentling agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Code). Lenders Name: Signeture: _ Lender's Atldress: Date: OWNER-BUILDER DECLARATIONS: I hereby attirtn thet under penelry of perjury ihet I am E%EMP7 FROM TME CONTRACTORS LICENSE LAW for iha tollowing reason (Sec. 7031.5, Business end Professlons Code: Any ciry or counry which requires a permit to construct alter, improve, tlemolish, or repeir any stmcture, prior to its issuance, also requiras the applicant for such permit ta file e signed stetement ihat he or she Is Iicensed pursuant m the provisions of the Contradors Llcense Lew (Ghapter 9(commencing wi[h Seclion 7000) of DiWsion 3 of the Business end Professions Cotle) or thet he or sha is exempt thereirom and the basis for the allegetl exemption. Any violation of Sectlon 7037.5 by any applicant for a pem:: subjeds ihe applicant to a civil penalry of not more than tive hundred dollers ($500).): ❑ I, as owner of the properry, or my employees wlih wages as ihelr sole compensation, WILL DO THE WORK, antl the structure is not iritenCetl or oHered for sale (Sec. 7044, Business and Frofessions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himselt or herself or�ttimugh��his o\her own employees, provided that such improvements are not Intentled or otfered for sala. tl, however, ihe building or improvement is sold within one yea� of�completion,4he ownervbuilder will have the 6urden of proving ihat he or she did not build or improve tor Durpose ot sale.). ❑ I, as owner of the proparry amfiEXCLUSIVECKCONTRAC7ING WITH LICENSED CONTRACTORS to constmct the projact (SecJ044, Business and Protessions Cotle: The contrectors License Lew'does not a`pply to an owner of property who builds or impmves iheraon, antl who contrads tor such project wit� a contrector(s) license pursuant to tha Contractors License Laws.)! v ❑ I em e:empt untler sea � Business end Professions Code for this reason: Signature: '''��- Date: Owner ID verifietl by tlnvers license. ❑ Ves ❑ No Drivers License No. Expires: Veriticetian of Ownership by (type ot document, i.e. - proparty tax bill or daed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICA710N: ❑ I hareby certity ihet no excevetion five (5) or more teet in depih in�o which e person is required to descend, will be made in connec�ion wi�h work authonzetl by ihis permit, and that no building structure, scalloltling, talsework, or demolition or dismantling thereot will be more than thirty-six (36) teet high. (Chap. 32, Gry 2, Ar12, Sec. 341, Ttle B, Calitomia Administrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from the Division of Indusiriel Safery, as noted ebove, unless such person has e pertnit to do such work from ihe division. Signature: Date: Division oi Industrial Salery Permit Number: CERTFICATE OF COMPLIANCE ANU AUTHORIZATION OP EMRY: I certify under penalty of perjury that 1 have read this epplication and state tha� the informa�ion given is correct I agree to comply with all state laws end ciry ordinances retating to building consiruction, and euthodze representatives of the Ciry of Costa Mesa to enter upon Iha above-descnbatl property for inspection Ouryoses. I agree not to occupy or allow occupancy of eny building authorized by this permit until final inspection. CQOE 1. INSPECTION TYPE re Of Lega wnar(s) t . � Authorized'App4cant P� UiIIIJ9Lfl 1616 Fixed System Final Fire Prevantion 7266 Pool Spa Final 200 Final fie-Roof 201 Finel Block/Retaining we11 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition COOEI INSPECTIONTYPE 206 Final Mechanical 208 Finel Plumbing 210 Final Elechical 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final BuildincyOccupency 2g 1t�Lfl