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Home My WebLink About2511 FAIRWAY DR - Building Permits� y 1 � • r �t � CITY OF COSTA MESA , , svu��N� o�v►s�oN F . � 77 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 �ro�o rF PERMIT NUMBER: E07-00801 PERMIT TYPE ELEC STATUS: ISSUED DATE ISSUED: 09/13I2007 - - ISSUED BY: BJK ,� , , .. ,; . JOB ADDRESS: 2511 FAIRWAY DR CM SuitelUnit: Vicinity: AT AND T SVS METER PEDESTAL -� _� �,. � SCOPE OF WORK: NEW 100A EIECTRIC SERVICE METER FOR "AT&T." NO OTHER WORK AUTHORIZED WITH THIS PERMIT. REF: PS07-00288 . , . � . " - . OWNER: CITY OF COSTA MESA =: � �� _ � .�Address: �Unit: � � - � � � PHONE: - . � . � � City/StatelZip: , � .- APPLICANT: WILLIS,JANAE . � Address: 1921W-11THST Unit: PHONE: 909-946-0905 . ��. City/State/zZip: UPLAND, CA , CONTRACTOR: VCI TELECOM � - � � � � � . License No. 765716 . Address: 1921 W 71TH STUnit: PHONE: 909-946-0905 �� City/State: UPLAND, CA ZipCode: 91786 . CELL: ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Reinspection Fee $0.00 TOTAL FEES $54.00. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. ' INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must wmply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. ODEk. IN$PECTONTYPE DATE INTI➢qL5 COOEA INSPECTIONTYPE Or1TE INTITIRLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Finai 20B Final Plumbing' 200 Final Re-Roof 210 Final Electncal `J-a.3-Ot �n+�z-� 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 F 1 WORKERS' COMPENSATION DECU, �ON: � � � hereby aKrm untler penalry of perjury one of the following declarations: ❑ I 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 paAormance of the work for v✓hich this permit is issued. � I have antl will maintain workers' compensation insurance; as required by section 3700 of the Labor Code, for the perfortnance o( the work for which Ihis pertnil is issued. My workers' compensation Insurance carrier and policy nUmber are: ��e� �� e�,1�� , 7�.r�K. c� . (IDis s�pn nee� n,ot /be /o�m1p'le/etl n me p7e.mn rs valuea a,i� 1onDe nunotlie'�d,e�onars (Si�) or less ) POIicyNumbec MMI�� L/S��( GJ VV ❑ I certify that in the performance o( the work (or which this permit is isSueA, I shall no[ employ any person in any manner so as to become subject to the vrorkers' compensation laws of Califomia, and agree that if I should become subject to lhe workers' compensation provisions o( Section 3700 of �he L�}�ir C tle, I shall forthwith compty with these provisipqs. (L, -� `% Appiiwnfs Signawre ate 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 (3100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing wlth Section 7000) o( Division 3 of the Business and Professions Code, antl my lica:ns^�e ifs in full force and effect. Li�. Jt ` Class # �� '� Gamrac�or's SignaWre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm that there is a construction lending agency for the pedormance of the work (a wfiich ihis permit is issued. (Sec. 3097, Civil Code). Lpnder's Name: LAnder's Atltlress: Date � r ) �: Owner IDYeriL � driv ise. ❑ Yes ❑ No Driver's License No. Expires: � Veri(cation of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I herehy certify ihat no excavation fve (5) or more feet in depth into which a person is requiretl to descend, will be made in connection vrith work authorized by Ihis permiC and �hat no building strucWre, scaf(dding, /alsewrork, or tlemolition or dismantling thereof, will be more than Ihirty-Six (36) feet high. (Chap. 32, Grp 2, Art 2, SeC 341, Title 8, Cali(ornia Administrative Code). ❑ As ovmer-builder, I wiil not employ anyone to do vrotk which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit ro do such vrork from the division. AOPlicanl'S Signature Date Division of Industrial Safely Permit Number: HAZARDOUS MATERIAIS AND EMISSION$ CERTIFICATION: 1. Will Ihe applicant or present or fuWre 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 Cali(ornia Health and Safety Code requires, with some exceptions, that a Business Plan be filed with Me Cos[a Mesa Fire Department by every business which has at any one time during a reported year a quantity of haz2rdous matenals equal to or grea[er Ihan a weight ot 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperature and pressure). 2. Does or will the applicant or present or fu[ure builtling occupant need to fle a registration form for acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Cotle, with some exceptions, requires regis[ration with [he Costa Mesa Fire Department by � each business which af any one time has on hand a quantity of acutety hazardous materials equal to or grealer than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at slandard temperaWre and pressure�. OWNER-BUILDER DECLARATIONS: � hereby affrm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 703t.5. Business antl Professions Code: Any city or county which requires a permit to conswct, alter, improve, tlemolish, or repair any strucWre, prior to its issuance, also requires the applicant /or such permit to frle 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 lhe Business and Professions Code) or that he or she is exempt theretrom and �he basis for [he allegetl exemption. Any violation o( Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than fVe hundred tlollars ($500).): ❑ I, as owner of the pmperty, or my employees with wages as their sole cbmpensation, WILL DO THE WORK, and the strucWre is not intended or oftered for sale (Sec. 7044, Business and Pro(essions Cotle: The Contractors license Law does not apply to an owner of property who builds or improves Ihereon, and who does Such work himself or herself�or through his or her owrc employees, provided that such improvements are not intended or offered (or sale. II, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden ot proving that he or she did not build or improve for purpose,of sale.). �. . , [] �I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro construc[ the project (Sec. 7044, Business and Protessbns Code: The contractors License Law dces no[ apply to an owner of property who builds or improves thereon, and who conlracts for such prqeCt vnth a contrec[or(s) license pursuan[ to the Contractors License Laws.). ❑ I am exempt under sec. � 6usiness and Professions Code for this reason: SignaWre ' Date 305]-06 (3IOl) 3. Does or will the applicant or present or fuWre builtling occupant need to prepare an RMPP (Risk Managemen[ and Prevention Program for aculely hazardous materials�? ❑ Yes ❑ No (Section 25534 0/ the Califomia Heal(h and Safety Cotle pmvides Ihat Ihe Costa Mesa Fire Department may require Ihe preparation, certifcation and fling with the Fire Department of an RMPP by businesses which are required to register awtely hazardous ma�erials 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 Qualiry Management District or from any other air pollution control tlistrict or agency? ❑ Ves ❑ No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be fumishetl on applications for non-resitlential builtling permils�. 6. Will any part o( Ihe facility to be constructed untler this permil be within 1000 feet (rom the outer bountlaries o( a school? ❑ Ves ❑ No Qf "yes", the (acility mus[ meet the requirement of Sec[ions 25534 and 42303 of the Califomia Health and Sa(ety Code). 7. If a permit from the South Coas[ Air Quality Management District or other air polWtion control disirict or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by Calitornia Health antl Safery Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", attach certifcate of compliance from the appropnate air polNtion control officer). - � CERTIFlCATE OF COMPLIANCE: I certify thai under penalty�of�perjury tfie information given above is correcL hagree to comply with all��state laws and city ordinances regarding Hazardous Materials and Emissions. - 5ignaWre Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that . the intormation given is correcL I agree to comply veth all state laws and city ordinances relating to building construction, and authonze 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 buitding authorizetl by [his permil until inal inspection. SignaWre ol Legal pwner�s) ale U - AnClo�Aulhonze0Ap01icanl �ale � :,. _ Public Services: (714) 754-5323 • Fax: (714) 754-5028 • TDD: (714) 754-5244 Call (714) 754-5025 by 3:00 p.m. for next business day inspection DATE: 06-26-2007 Encroachment PERMIT NO. PS07-00288 Original Permit No. Zsl � BY: CHIRA M LECi�) sfo�z��f�v Address of Work: �S�PAIRWAY DR � J�� Suite or Unit N : ' � � ' Location: Description of Work: ENCROACHMENT PERMIT TO EXCAVATE IN SIDEWALK TO PLACE CONDUIT AND AN ABOVE GROUND CABINET "ALP-248C". AT&T SHALL RE THE EXCAVATION5 PER CIN OF COSTA MESA STANDARD 813, REMOVE AND REPLACE SIEWALK PER CITY OF COSTA MESA STANDARDS � CITY INSPECTOR'S SATISFACTION. TR4FFIC CONTROL PER WATCH MANUAL FROM 8:30 AM TO 3:30 PM. MANDATORY PREGONSTRUCTION MEETING REQUIRED 2 WORKING DAYS PRIOR TO START OF WORK. FAILURE TO DO SO WILL VOID THIS PERMIT. Star[ Daie: 06/2612007 Building Reference No:19-5672946 Planning Reference No. (Project No.): N/A Contractors Name: AT&T CALIFORNIA Address: 3939 E. CORONADO 1 ST FLOOR ANAHEIM, CA State License No.....: Insurance Company: Insuance Certificate No.: 24-Hour Emergency Conracr. LESLIE MONTY UG Service Alert ID No: WILLCALL Applicam's Name: AT&T VRAD Developer'S Name: Telephone No.: FEES: Permit Fees: DEPOSIT: TOTAL: SIGNATURE OF APPLICANT`_ �1 � $415.00 $0.00 $0.00 Permit Exoiration Date: O6/26/2008 Phone No: 714-666-5749 Ciry Business License No.: 24-Hr Telephone No.: (714) 666-5467 BOND AMOUNT: $0.00 __—��L� , � PERMIT APPROVED FOR CITY ENGINEER By: �YC Date: �-.L��—o7 NO'�� .�pp��ant shall reference the a[tached Conditions, and Municipal Code Sec[ions applicable to Ihis permit. !�',- n... .. . 'I�.