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Home My WebLink About1982 POMONA AVE - Building Permits e.601Mac v CITY OF COSTA MESA ►'D - BUILDING DIVISION o a-;�.A i- 1 Ea/if 1 DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER P .1 PERMIT 04-00389 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1982 POMONA AV Status: ISSUED Suite No Applied: 04/16/2004 Vicinity: Issued: 04/16/2004 Parcel Nunmber: 42223427 Applicant: MODIC, WILLIAM L TR ISSUED BY: Address: 1822 ORIOLE DR Phone: 949-642-4252 COSTA MESA,CA Zip: 92626 Owner: ' MODIC, WILLIAML TR Address 1822 ORIOLE DR Phone: COSTA MESA,CA Zip: 92626 Contractor: OWNER BUILDER t Address: • r Phone: Zip: License: 000000 SCOPE OF PERMIT SERVICE UPGRADE TO 200 AMP SERVICE AND ADD 100 AMP SUBPANEL. • FEE SUMMARY Quantity - Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 - up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $30.50 1 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) , $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 - Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $30.50 1 Plan Check Fee , $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $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, 12-21-92) 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. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS I I • F• WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty 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 performance of the work for which this permit Is issued. ❑ I have and will maintain workers'compensation in urance,as required by section 3700 oche Labor Code,for the performance of the work for which this permit Is Issued. My workers'compe satlo I st1Sn�a carrier o number are: Carrier: Policy Number: (This section need not be completed if the permit valued at one hundred dollars($100)or less.) �I certify that 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 California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I sh I forthwith comply with these provisions. Cf Applicant Signature: l . ' .4.- .P ca.-er Date: r �CO /U WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO E HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR 000E,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: _ Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file 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 the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended 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 thereon,and who does such work him or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If.however,the building or improvement is d 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.). I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ tam exempt under sec. Business and Professions Code for this reason: - f(_ r O•�-1 Signature: KM -lmnu /�noal e..� Date: SIL• I/�!/ Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2.Sec, 341,Tale 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with 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 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Celifomia Health and Safety Code been fully complied with? 0 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency'? Yes P No (Section 65850.2 of the California Govemment Code requires that the requested information be fumished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the-South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescnbed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). 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: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection pu oses.I agree not to occupy or allow occupancy of any building authorized by this permit/until final i cti . Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE r INSPECTION TYPE DATE INTTALS CODE INSPECTION TYPE all 1NTIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing p 200 Final Re-Roof 210 Final Electrical /L'7, i f LI 201 Final Block/Retaining Wall 212 Final Fire Prevention ll •. i7/. -1•• 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy OWNER EDrAtARD NARTIN0 ' DATE 5/21/80 JOB ADDRESS 1982 Panona Ave. BUILDING PERMIT NO. 50131 . GENERAL CONTRACTOR Owner/BuilclPr DESCRIPTION of WORK 4 Car Garage AP No. 115-330-54LOT Por G TRACT 612 FIRE ZONE VALUE $ 15,000.00 INSPECTIONS Signature Dote TYPE GROUP ZONE R2 _ SOIL PERMITS ISSL ED GAS SUBCONTRACTOR J Dote I Number Signature WATER Plumbing _ `ROUGH PLUMBING V'ROP. SWR. LINE f•] HOUSE CON. El SPRINKLING SYSTEM MISCELLANEOUS ,ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE JNDERGROUNO 0 POWER ❑ I l OUCH WIRING �y Heating and Vent. TRENCHES (2"-- FORMS IJ STEEL REINF. [lar e S to-l447 07LOOR SYSTEM 4OND BEAM [J STEEL REINFORCE f[ QV"'`SSSHEATHING NFRAME AND FLASHING (( r LATHING — IN t i OUT D} —e FLASHING J�PLASTER, BROWN COAT 4, tr/S// T STRUCTURAL, FINAL , )S .4q gy Electric HEATING. VENT., REFRIG. AND A.C., FINAL _ PLUMBING. FINAL AND GAS TEST fl ELECTRIC, FINAL BUILDING. FINAL OWNER HEBERT, Walter A. DATE 14-15-54 JOB ADDRESS 19gZ-Pomona Ave. BUILDING PERMIT NO. 183 GENERAL CONTRACTOR Owner-Builder VALUE $ 5,500.00 LOT 23 BLOCK 0 TRACT 612 Dwelling GROUP I TYPE V // E' ZONE R-4 FIRE DISTRICT #185 INSPECTIONS TSUBCONTRACTOR PERMITS ISSUED /" DATE NUMBER Footing Trench f�� 1474/ 7Ay Foundation Forms and`Grrade to Garage / / Rough Framing ns--z ' s�j�j,/{/{17 �q �L `'( Plumbing,Rough to Slab `�LG`S 'S`/" i21-V. (,(/..Qjj —T �-.7 T 03 Plumbing,Rough Complete )'ii'L. S// /,s `] �r f - � V Wiring,Te rary P ringRough hle •)1 U� Sffl /filial.'" T / /817 P Heating,Rough Heating, Final _ Sewer r� .,a'' S _ Septic Tank or Fgsspo Cf6 G .7 ' /Ar�r24 ,\, l��}(' S t 6 Lathing//V d��) eis, .1 , Plastering go--g Plumbing,Final,Fixtures Complete sra }J-1' O.&7' Plumbing,Final Gas Test IS/L-P-71-16"7-S__. 8-1 t j{SY�'acs to S2 _ 7::: - 1�"_ zH____ _g_____ Wiring, Final -71-16"7-S__� 7// 4t y I c� __— Occupancy c c Ev..e_t<enr =_.-�r-t 2-SO (tL'6,- Form 210 GH IM 12-63 I COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR[STRI CIII AL PERMIT!G9e05 "IC P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 B 'PERMIT /3/ For ApplicantQto Fill inCompletely —/U�s[e Ink Only 1■ ADDRESS I98oz P2iO/JA �J UE, rLDlNG ,V NO. /i s - 3 30 CR./ 7ornolu'AOWNER ORp DREl7^� � �� /�` T OR MAILING7f6s. MM# /fes CE NO. ADD RE55/gig iQ�//s-// fT /�� r��r TEL TR.NO.4LOT /� U /t BLK. CITY(,J7 . /% c,5' NO. 420 [O D en REPAIR lT NEW ADD ALTER MOVING DEMOLISH CONSTRUCTION LENDER BRANCH OWNER E.DW 4R.D /77/9127/^/0 , ADDRESS VALUE ARCHITECT TEL. USE S OR ENGINEER NO ADDRESS i/L//T r/4 Q �ZZOOONEE)C 2-- (TYPE GROUP /S 4:54"CONTRACTOR a/IA/a , "' 'V . DATE ..2/ 'I1 RO ADDRESS TEL. CITY NO. moi , STATE CITY APPROVED SETBACKS LIC. NO. LIC.NO. {,y SIZE /� �1 C- NO OF BLOGS. �•' (FROM C/L STREET) / ,, //�I/f tY OF LOT/5,5" /vv INOW ON LOT (/!`E FRONT ,JD FT. 0 � /24-4r..-e&V G Q USE OF OY RI EXISTING BLDG. /PfS./,Dri3/CE EL SIDE 0 FT. rn N Separate permits are required for L.SIDE 3 / FT. 5- electric,plumbing and heating work. REAR -- IV FT. USt./JF�IILDING AN$�ORI4 TOrPERFORMED PLANNING ACTION /,[ CC�11dTOICK//1/l6/J,�G DATE 'CI. p7IC APPROVED 7 APPROVED// ,n /gyp } —BYC�rS DATE .S/2I! O CCW O I hereby acknowledge that I have read this application and state n g4 that the above information Is correct and agree to comply with L all laws regulating building construction, and I shall not employ si Z any person In violation of the workman's compensation laws of o n] the State of California. /�/� I hereby certify that I am properly licensed as a contractor under ��vU SO. FT. m`+ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California usineu VALUATION PERMIT FEE Ssr and Professlo Divisionn3,Chapter 9r 72/ CJarn PLAN o PI mitt e�... (4-latter 5 000 TAX CHECK S 3�e� u. e ✓ Permittee i $ v' or / V Authorized Agent Date N / TOTAL PAID $loge as