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Home My WebLink About828 CORTEZ ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Ownec 828 CORTEZ ST REAR SFD 14130216 HOLLIBAUGH, KIMBERLY B 828 CORTEZ ST COSTA MESA, CA HOLLIBAUGH, KIMBERLY B Address 828 CORTEZ ST COSTA MESA, CA Contractor: OW N ER-BU I LDE R Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting FixGs Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 'I OOOa Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Molors over 100hp Communicafion drops Sub panel to 200a Pole Light Pkg Phone: 714-641-6919 Zip: 92626-5823 Phane: Zip: 92626-5823 Phone: Zip: license: 000000 SCOPE OF PERMIT CHANGE-OUT OF AN ELECTRICAL SERVICE IN AN EXISTING SFD. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. -� $23.50 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System ! Lighting Busway /100 R Standing Seclion Misc Electrical Equipment Transfortners 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 Law Volt Wiring System / Ckt Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigafion Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 04/15/2003 Issued: 04/15/2003 ISSUED BY: Quantity $0.00 0 $0.00 0 $0.00 0 $o.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandonetl for a period of 1 BO days. INSPECTIONS: In orde� for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectlons and final approval must be obtained. Failure to obiain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (774) 7545626 zaaerslvoo) WORKERS' COMPENSATION DECLARATION: I hereby aFtirtn untler penalry oi pefury one of the following tleclarations: ❑ I heve antl wiil mainta(n a certifcate of consent to selt-Insure br workers' compensetion, as provided �or by section 3700 of Iha LaDor Code, tor the pedormance of ihe work for which this pe�mit is Issued. ❑;� I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for Ihe perfortnance of the work for which ihis pertnil Is issued. My workers' compensatlon Insurance wrner and policy number are: Carnar. Policy Number: (This secfion need not be completed il the permit is valued at one huntlretl tlollers ($f 00) or less.) [) I certify that in iha peAorrt�,an� ot the work for which this permit is issuetl, I shall not employ any person in any manner so as to become subject to the workers' " compensetlon laws oi Cell�o a� e thet If 1 should become subject to ihe workers' compensaGon provisions ot Section 370ggg of ihe Labor Cotle, I shall lotlhwith compty with these pro�isi � � /�� Applicant Signeture: � Data: � WARNING: FAILLIRE TO SECUqE W ENSATION COVEPAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMIN L PENALT14 AND CIVIL FINES UP TOONE HUNDRED TFIOUSANDDOLURE(5100,000)• DRIONTO ECOSTOFC/JMPENSATIQY,DAMAGESASPROVIDEDFORINSEGTION31O60FTHELABORCODE,IMEREST,ANDATTORNEV'SFEES. LICENSED CON7RAC70RS DECLARATION: I hereby aflirm ihat I am licensed under provisions of Chap�er 9(commencing with Section 7000) of Division 3 of Ihe Business antl Professions Coda, antl my license is in full torce and eHacL Lic. N Cless x ContractoYs Signeture: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that ths�e is a consimction lentling agency for ihe pedormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lender's Address: Signeture: Date: OWNER•BUILDER DECLAAAT�ONS: I hereby eNirm that under pUnalty ot perjury ihat 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions Code: Any city or county wMch requires a pertnit to consiruct, alter, improve, demolish, or repair any strucNre, prior to its issuance, also requires the appliceN for such pertnit to file a signed statement that he or she Is licensetl pursuam m the provisions of the Contrectors License Law (Chapier 9(commencing with Section 7000) of Division 3 of tha Business end Protessions Code) or thet he or she is eaempt ihereirom and the basis tor Me allegetl eaemption. Any violetion oi Section 7031.5 by eny applicant for a permit subjects the applicant to e civil penalty ot not more then five hundred doliars ($500).): ❑ I, as owner ol the pmperty, or my employees with wages as their sole compensation, WILL DO 7HE WORK, antl the sirucwre is no� intended or ottered for sale (Sec. 7044, Business and Professions Code: The Contracbrs License Law does nof apply to an owner of property who builtls or improves ihereon, antl who does such work himself or herself or ihrough his or her own employees, provided Ihat such improvemenis ara not intendetl or oflered for sale. If, however, Ihe Guiltling or improvement is sold � m one year of completioq Ihe owner-builder will heve the burden of proving that he or she did not build or improve tor purpose of sele.). - , es owner ot the properry, em E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the pmject (Sec. 7044, Business and Professions Cotle: The contrecmrs �cense Law does not apply to an owner of property who bullds or improves Ihereon, and who coniracts tor such proiect with a coniractor(s) license pur5uant to ihe Comractors License Laws.). ❑ I am exempt under seC. Signature: Owner ID verifiad �y driveY E eusiness end Protessions Code for ihis reason: ❑ No Drivers License No. Venfication ol Ownership b�y (�ype ot document, i.e. - properry tax bill or deetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavation five (5) or more feet in tlepth into which e person Is required to descend, will be made in connection with work authonzed by this permit, and that no bullding structure, scaffoldinq, falsework, or demolition or dismantling thereof, will be more than ihirty-six (36) teet high. (Ghap. 32, Gry 2, Art 2, Sec. 341, TM1Ie B, Cafitomia Atlminisirativa Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from the Division of Industnal Satety, as noted above, unless such person has e permit ro tlo such worK �rom the tlivision. SignaWre: Date: Division of Indusinal Satery Partnit Number. CERTIFlCATE OF CO(�7PL1 ICE AUTHORIZATON OF ENTRY: I certify under penalty of perjury ihat I have read Ihis application end state that Ihe iniormation given is correct. I agree t cqfhply w h ell a I ws and ciry ordinances relating to 6uiltling consiruction, and euthorize representativ s of the Ciry of CoSta Mesa ro enter upon the above-descnbed r(>e f ins ti n rposes. I aqree not to occupy or allow occupency of any builtling authonzed by t is ermit u lil final inspection. Si aj re Legal Owner(s) Date CODE N. 1616 12fi6 200 207 202 203 Fized System Final Fire Prevention Pool Spe Final Finai Ra-Roof Final BIocWRetaining Well Final Factory Fire Place Final Sign 204 Flnal Demolition OATE IMR COpEII INSPEGTIONTYPE � 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Pravention 220 Final Planning Approval 222 Final Si�e 250 Final BuildingiOccupancy INfITIALS UWNi�:lt TF.4N�,_EAL� .TR_ DATE $-1Fi-� JO$ ADDRESS R?R Corf:Po Street BUILDING PEI�SIT NO. 7(i(YJ3 GENERAL CONTRACTOR Air Verrt Awnin¢ DEscx.iPTiOtv OF WORK SylT1A}lA(jP R+,,,r+„m VALUE TYPE �SUBCONTRACTOR I Date Final � 260?_3 � � COSTA MESA BUILDING-SAFE�Y DEPARTMEPlr P.O. BOX 12M COSTA ME5.4. CALIFORNIA 92E2B For AppllmM ro Fi11.In ComplNdy _ TYPE OR PRINT e �ocneoe' r�,�,� �'Dt 'fe L � CO3TA MESA. CALIFORNIA z r, +��" — 5. r� 0 BETPACK LIN! PqON DESCRIPTiON OF WORK I X6R60Y ACkNOWL[DOt 1NAT�1 /�ND BTAT6 TMI1T }M[ ApOV{,�B PLY WITH ALL CITY ORDI GUILDINO CONBTRYGTON.� y. 8I6NATUR6 OP PeRM1TTH AUTHORIZ[D A08N1' AUG 17-66 OD 7754�***°*3.00 MPLICATION FOR PERMfT BUILDINO For OHIc� Uq Only nicnrtno. I �� ZONING � I Ha.e. �.� ruH� y, sun teaqt i .. �—'/7 '1 A. P. NO. � .S � � � C� � NOTE: NO EAVE OVERHANO SXALL B8 LlBB THAN � ��6 � 90'T061DE4REAR .L oPe�oa�. ,4�� ALLOWBD (U.B.C.RHQUIRBMRNT7 ONIAT up YARDHAPPROVED YARG9APPROVHD ��u• MAINBUILDIN6 ACCfi880RYBU1LDiN6 vwre. # DATB � AP�UGTON TM[ AYOYM /HOWN YNOtfl VALUATION IB POR TH8 116[ M COY• '11R'Ooi O! �IiAGL16HIN0 A PeAY1T !6H ONLY. �L� T��ti VALUATION (y�j � � �L�� PERMITPEB s ��d �� 12308 CpSTA MESA BUILDING.SAFETY DEPARTMENT P. O. BOX 9f7 COBTA MEBA. CALIFORNIA For Applicanf to Fill In Complefely TYPE OR PRINT COSTA MESA. CALIFORNIA OWNER Mesa Del Mar Developmant co. ao��wra� Su1te 1� 3800 E. Coast Hi FEE �,Ec��v�Q � J 17 1960 `� FINAfvCE DEPT. APPLICATION�QR�P�ERMl7'�A MESA Lot � 73 gU1LDING Plan R 1D For Office Use Only RECEIPT NO. PERMIT NO. ae�ev il �re yQi BUILDING ___ APPROVED GOSTA MESA. CALIFORNIA v ADDRE6S 3HOO E� CO$SC H�gI1W8Y ZONING Corona del Mar ICNE � I NO.OF I UeE OP N8W Q�Ty PLANB BUILDIN6 �cTNo. 98808 No: � 34220 eBCRIPTION ot 73 Tract � 3745 SIZE I NO. OF BLpGB. O OF LOT 65 x 93 NOW oN LOi q, p, NO. USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED BHTBACK LINB FROM pt IC6NT6R LINC BTJ ceNi6R oP BTf6ci 42 REAR YARD � FRONT T/ FT. 81DE YARD ILEFY S RIGHT 5 R.SIDE � FT. DESCRIPTION OF WORK c— REPAIR I IIMOVING I IIDEMOLISN I BYPROVED fi ZE DING 54 X 4(� ROOMS f) ST�RIES 1 EXTERIOR W LL C CCO I ROOF COVERING d COVERING USE OF BUILDINa AND WORK TO BE PERFORMED _ with attached garage I X¢qHBY ACKNOWLL'�QE AT 1 HAVB RBAD iH18 ANO eTATH THAT YXH AB ¢ I6 GORREGT AND AGI PLY WITH ALL CITY ORD ANC AND BTATE lAWB BUILDINO GONBTRVmO ///f 61GNATURE OF I .. /' .. .I IAUTHORIZED AGENT' P:O,'0CC s TXH AMOUM BXOWN UNOER VALf1ATION IB POR THE PUPP088 OP ESTABLI6HING A PERMIT FEE ONLY. VALUATION 3Z.�� PERMIT FEE $ c $ 13,395�00 pLAN CHECK $ lV•oo TOTAL FEE $ 4S.00