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Home My WebLink About2603 FAIRWAY DR - Building PermitsCITY OF, COSTi�, MESA � " BUILDING DIVIS/ON F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754�856 • v-nvw.ci.costa-mesa.ra.us I �. �` fi FOR INSPECTIONS CALL: (114) 7%-5626 � A �'"'"' � PERMIT NUMBER:� E08-00005 PERMIT TYP� ELEC APN: TPN007104 JOB ADDRESS: 2603 FAIRWAY DR CIIII vicinity: � � . STATUS: ISSUED DATE ISSUED: 01/0212008 ISSUED BY: SOK Suite/Unit: , � SCOPE OF WORK: INSTALL NEW 100 AMP SERVICE METER PEDESTAL FOR "AT AND T"� �" . OWNER: CITY OF COSTA MESA Address: 77 FAIR DR Unit: PHONE: �- - � City/State/Zip: � COSTA MESA, CA APPLICANT: JANAE WILLIS . . PHONE: 9b9-946-0905 - . CONTRACTOR; VCITELECOM Address: 1921 W 11TH STUniY.� City/State: UPLAND, CA Address: 79Z7 W 11TN ST Unit: � City/State/zZip: -"'-UPLAND, CA . PHONE: 909-946-0905 ZipCode: 91786 ELECTRICAL PERMtT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Reinspection Fee $0.00 TOTAL FEES $54.00 License No. 765716 CELL: 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: PERMIT EXPIRES 780 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 comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will resWt in the expiration of this permit. G OEM. INSPECTIONTYPE DATE INlI71AL5 COUEY INSPECTIONTYPE ORTE INiITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final . 208 Final Plumbing � 200 Final Re-Roqf 210 Finai Electrical � 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 WORKERS' COMPENSATION DECLARATION� I hereby aKrm under penalty of perjury one of the following declarations: `� ❑ I have and will maintain a certifcate of consent lo self•Insure for vrorkers' compensation, as provided tor by section 3700 of the Labor Code, for the peRormance of the vrork for which this permit is issued. I have and will maintain v,�rkers' compensation insurance, as required by ection 3700 of the Labor Code, for the peAortnance of lhe work for which [his permit is issued. My vrorker� compensation Insurance carrier and policy Carner: ! �-'v�/ l�l �J -5 }—� lJ <J � v/ r�w �c.r,U�e (ThissecY.bnneeAp rro/i�e�co�md�ef/e�tl+rlt�epertc�nrt—avalvetlatare�undretlCWlars(E100�) PolicyNumber./"VCI�/l�� y >�fi��C% ❑ I certify Ihat in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree that if I should becon bjecl lo lhe workers' compensation provisions o( Section 3700 of t abor C de, I shall torthwi[h compty with these provi 'ons. Applicanl's SignaNre D e NING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing with Seclion 7000) o� Division 3 of the Business and Professions Code, and my license is in full lorce and effec[. "�/� . � � Class # �_ / l= � 2 Conlrac�or's SignaWre Dale CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn ihat there is a constmctbn lending agency for the performance o( �he �wrk for wfiich this pertni� is issued. (Sec. 3097, Civil Code). Lender's Name: Lendeis Address: OW NER-BUILDER DECLARATIONS: I hereby affrm that under penalry o/ perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Pmfessions Code: Any city or county which requires a permit to constmct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to fle a signetl stalemenl 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 the Business and Professions Cotle) or that he or she is exempt there(rom and ihe basis for the alleged exemption. Any violation of Section 7031.5 by any applicant tor a permit subjects ihe appliwnt to a civil penalty of not more than five hundretl tlollars (5500�.�: ❑ I, as owner of the property, or my employees with wages as their sole compensalion, WILL DO THE WORK, and �he slmclure is not in[ended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves [hereon, antl who does such work himself or herself or through his or her own employees, provided ihat such improvements are not intended or offered for sale. If, however, lhe building or improvement is sold vnthin one year of completion, ihe ovmer-builder will have ihe burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRAC7ING WI7H LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business and Pro(essions Code: The contractors License Law does not apply to an owner o/ property who builds or improves [hereon, and who conlracts (or such project with a cont2ctor(s) license pursuant tothe Contractors License Laws.). ❑ I am exempl under sec. Business and Professions Code for Ihis reason: SgnaWre Dale 309-46 (3/0]) Owner ID verified by drie,. . lic, Diiver's License No. ❑ Yes ❑ No Expires: Verifcation of Ownership by (type of document, i.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certify tha� no excavation frve (5) a more feet in tlepth into which a person is requiretl to descend, will be made in connection with work au�trorizetl ,4y Ihis pertnil, and ihat no building structure, scaf(dding, (alsewnrk, v demolition 6cdismantling thereof, vnll be more than thirty-su (36) feet high. (Chap. 32, Grp 2. Art 2, Sec. 341, Ttle 8, Cali(omia Administ2tive Code). ❑ As owner-builder, I will not employ anyone to do vrork which would require a permit from the Division of IndusMal Safety, as noted above, unless such person has a permit to do such work (rom Ihe division. Ap0licanCs SignaWre �ale Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS 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 Ihreatenetl release of a hazartlous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Cotle requires, wilh some exceptions, ihat a Business Plan be filed vnth lhe Costa Mesa Fire Department by every business which has at any one lime during a reported year a quantity of hazardous matenals equal to or greater than a weight o( 500 pounds, or a volume o! 55 gallons, or 200 cubic (eet of compiessed gas at standard temperature antl pressure). 2. Does or will the applicant or present or future builtling occupanl need to file a registration form for acutely hazardous materials? ❑ Ves ❑ No (Section 25533 of the Cali(omia Health and Safety Code, wilh some exceptions, requires regis[ralion with ihe 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 feet of compressed gas at standard temperature and pressure). 3. Does or will ihe applicant or present or fuWre building occupant need to prepare an RMPP (Risk Management and Prevention Pmgram for acutely hazardous matenals)? ❑ Yes ❑ No (Section 25534 of Ihe Califomia Health and Safety Cotle provides that the Costa Mesa Fire Department may require lhe preparation, certification and filing with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous ma[erials with [he Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Cali(ornia Health and Sa(ety Code been fully complied with? ❑ Yes ❑ No 5. Does or will [he applicant or present or future building occupanl require for the work which is lhe subjeci of [his applica[ion a permil for such constmclion or modification from the South Coast Air Qualily Management District or from any other air polWtion control tlistrict or agency? ❑ Yes ❑ No (Section 658502 of the Cali(omia Govemment Cotle requires that the requested information be fumished on applications fa non-residential building pertnits). 6. Will any part of the facility to be consVucted under this permit be within 1000 fee[ from the ouler boun0aries of a school? ❑ Yes ❑ No Qf'yes", the facility must meet the requirement o( Sections 25534 and 42303 of the California Healih and Safefy Code). 7. If a pertnit from the Soulh Coast Air Quality Management District or other air pollution control tlistrict or agency is required (or Ihe work which is the subject ot this application, have all of the disclosures prescribed by Califomia Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certificate o( compliance from the appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correcL I agree to comply with all state laws and city ordinances relating to building construc[ion, and aWhorize representatives o( the City of Costa Mesa to enter upon Ihe above-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspeclion. Signa re of egal Ovmeqs) ate f` � ntllor AWhOrizetl Appliwnl Oat