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Home My WebLink About2260 CANYON DR - Building Permits! � . � ! • - S � CITY OF COSTA MESA �` "'FS, BUILDING DIVISION i�� 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us r ` °��b�� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: E09-00261 PERMIT TYPE ELEC APN: TPN009024 JOB ADDRESS: 2260 CANYON DR CM Vicinity: STATUS: ISSUED DATE ISSUED: 1 011 6/2 0 0 9 ISSUED BY: BJK Suite/Unit: SCOPE OF WORK: POWER SUPPLY PLACEMENT AND ACTIVATION FOR CABLE COM. 1 SVS TO 200A OWNER: CITY OF COSTA MESA . PHONE: APPLICANT: AUS71N, RAYMOND PHONE: 714-639•3032 CONTRACTOR: A C H E INDUSTRIES Address: 24872 WELLS FARGO DRUnit: City/Slale: IAGUNA HILLS CA ZipCode: 92653 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Reinspection Fea $0.00 TOTAL FEES $54.00 Address: 77 FAIR DR' Unit: City/SWte/Zip: COSTA MESA, CA Address: Unit: City/State/zZip: License No. 789314 PHONE: 949-770-9676 � CELL: NOTICE: The work authorized by Ihis permit shall comply with all applicable handicap access requirements under Califomia statutes antl related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed under Ihis permit to be considered legal, such work must comply with all applicable codes, and all required inspectionS and £nal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration o( this permit. CODE t. INSPELTONTYPE 1818 Fixed System Final Fire Prevention 1268 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire place 203 Final Sign 20a Final Demolition OA7 INPTIALS COOEO INSPECPONME 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 FinalPlanningApDroval 222 Final Site 250 Fnal Building/Occupancy OpT �NTITIpLS mL�l � � (� � ! • 1 � WORKERS' COMPENSATION DECLARATION: I hereDy aKrm under penalty ol perjury one of the following declarations: ❑ I have and will maintain a certifcate o( consent to self-Insure (or vrorkers' compensation, as pmvided tor by section 3700 of the Labor Code, for the peAormance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the pedormance of the work (or wfiich this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier: (Tnis section need �wf 6e rompefetl Alne perm! is vy��¢y at one nunOreO �llars (Sf 00) w less ) Policy um6er: G� I certify [hat in lhe peAormance of Ihe work for which this permit is issued, I shall not employ any person in any manner so as lo become subject �o [he workers' compensalion laws of Califnmia, and agree that if I should becoma subject to pe vrorkers' compe hon provisions of Section 3700 of the Labor Code, I Sall (orth ' com 'th lhese provision ' � lF,b9 Appli Ps'SignaNre �Dat WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE F{UNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing wilh Section 7000) of Division 3 of Ihe Business antl Professions Code, and my license is in full force and ef(ect. q n `Cic'. #�' Class.# ` �Q . C-�� ' 0 / 09 omraarn's SignaWre ate �_J CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a constn�cibn lending agency for the peAormance of the v.ork fa wfiich this permit i� issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre Da�e OW NER-BUILDER DECLARATIONS: I heraby aKrm lhat under penalty of perjury ihal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7037.5, Business antl Professions CoOe: Any city or county which requires a permil to consWct, alter, improve, Cemolish, or repair any slrucWre, prior [o its issuance, also requires the applicant for such permit to file a signed statement Nal he or she is Iicense0 pursuant b[he provisions of the Conlractors License Law (Chapter 9(commencing with $ection 7000) o/ Division 3 0( the Business and Professions Code) or that he or she is exempt lherefrom antl the basis for the alleged exemption. Any violation of Section 7037.5 by any applicant for a permit subjects �he applicant to a civil penalty o! not more ihan five huntlretl dollars ($500�.): ❑ I, as ovmer of the property, or my employees with vrages as their sole compensation, WILL DO THE WORK, and the sWCNre is not intended or offered for sale (Sec. 7044, Business and Professions Cotle: The Contrectors License Law does not apply to an owner ot property who builds or improves thereon, and who does such vrork himself or herself or through his or her ovm employees, provided that such improvemen[s are not iNended or o(tered for sale. If, however, the builtling or improvement is soltl vrithin one year ot completion, the ovmer-builtler will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer o( lhe propeAy, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct lhe prqect (Sec. 7044, Business and Professions Code: The contractors License Law dces not appy m an owner of property who builds or improves thereon, and who cont2cts for such pmject with a contracta(s) license pursuant to the Contractors License Laws.�. ❑ I am exemp[ under sec. Business and Professions Code for this reason: 305]-0fi (3I01) / . . � Owner ID verifed 6y dnver s license. � Yes ❑ No Driver's License No. Expires: Verification of Ownership by (rype o( documenl, i.e. - properly taa bill or dee0): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certAy that no excavation fve (5) or more feet in depth into wfiich a person is required to tlescentl, will be matle in connection with work authorized by Ihis permit, and �hat no building strucWre, scaFfdtling, falsework, ar demolition or dismantling ihereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, M 2, Sec. 341, Ttle 8, Califomia Administrative Code). ❑ As owner-builder, I will nol employ anyone to do�vrork which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such vrork /rom the tlivision. Appl¢anfSSlgnaWre I Dale Division of Intlustrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file anC certify a Business Plan for emergency response to release or threatened release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the Califomia Heallh and Safety Code requires, vn[h some exceptions, that a Business Plan be filed with Ihe Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazartlous materials equal to or greater than a weigh[ of 500 pounds, or a volume of 55 gallons, or 200 cubic feet oF compressed gas at standard lemperature and pressure). � 2. Does or will [he applicant or present or future building occupant need to fle a registration fortn for acutely hazardous materials? ❑ Yes ❑ No (Seclion 25533 of the Califomia Health and Safety-Code, with some exceptions, requires registration with the Costa Mesa Fire Department Dy each business which at any one time has on hand a quantity of acutely hazardous materials equal lo or grealer [han 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 wi0 lhe applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Brogram for acutely hazardous matenals)7 ❑ Yes ❑ No ' (Section 25534 of the Califomia Health and Safery Code pmvides Ihat Ihe Costa Mesa Fire Department may require the preparatioq certification and filing with the Fire Department of an RMPP by businesses which are requi�ed m register acutely hazardous materials with the Fire Deparlment. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fulty complied with? ❑ Ves ❑ No 5. Does or vnll the applicant or present or future building occupant require (or the work which is the subject ot this application a permit for such construction or modification from [he South Coast Air Quality Management District or from any other air pollution wmml disMct or agency? ❑ Ves � ❑ No (Section 658502 of the Califomia Govemment Cotle requires that the requested information be fumished on applications For rwn-residential builaing permits). i 6. Will any part o( the facility to be constructetl unaer this pertnit be within 1000 feet from the outer boundanes of a school? ❑ Ves ❑ No (If "yes", the facility must meel lhe requiremenl of Sectionls 25534 and 42303 of lhe California Health antl Safery Code). 7. If a permit from Ihe South Coast Air Quality Managemlent District or other air pollution contml district or agency is required for Ihe work which is the subject of this applicatioq have all of the disclosures prescribed by Calitomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (I!'yes", attach certificate of compliance from the appropriate air pollution control OKcer). CERTIFICATE OF COMPLIANCE: I certify that untler 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. 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 antl city ordinances relating to building consWction, and authorize representa[ives of the Ciry of Costa Mesa to enter upon the above-described propeAy for inspeclion purposes. I agree nol to occupy or allow occupancy of any building authorized by this permil until fnal inspection. : 5' Wrearl (s) ate D - o �4 �F Mg�AuOwrizeE Applicant _ Dal � 1 a.��w...., , - — . . .. . ...'..1 - � ... . �v �� f �: �i i� R6�"'r'-� ' + .�,. .�.�C� �.,x�� , ,,,�„„«.. � f,..l`—�y� �� j....:error._fi.: , � , .�--, � . ..'^��'� � 1 i �"=''3- � `` � , r � 5 j � '-�'' E �� : , Q ' 1 � ��'�'a * �, s � � �. , t� � ��-^f • �` 1f 'yy�l�� `�Il�_ ..�'1�}'��. � �� I �I ♦ 1 � ^` '�''�� ' � � � � , � r .. _ . . � � '� _ - �. ,.K'� `.�-�-� _ �� , _` - . � `""^�,*^"-�-� ,, 2260 Canyon �Do Casla Mesa' CQ 9263�7 ' �, � +�� , � - � � � , � ~��'� � ,' '� �� ' i � � �� 1�~�. r, ��\,�� ` • � . �-� . .' ' (�_ 7. � 4vf ,s,r��— �•�_ rt r . {� � l Oi ^- YM1 � � �! '� � i ' ' t �. w � _�: � � X ^ t � � � � x�+w ._ ) .+r� `'r�Or�!'��1�� .. ��C'AI�� *� � t,,..- - . _ _ _ . - � . > - _- ^ _. ..., ..... . .,._ .. .� �W�w�libniSU « n, ,.- f ..w.. :..%4'i.-+*."""'r-`. T�". _ . . « �-� � . r ,,�, . ,�%` , � � _ , I �y ��` �� '�`' �� r ' .�. � '�'� o. ti � � �� .-s S. � .\ q,. ♦ ...v t �r- . �t � ! � � � i . � S � � . �� rK4C. ! �� x�fir�„,.LL f f r .. � _�_� 6. r � . M� . � �'�{�J � �� ` ��.,� � � � � \ � J ' �` . - o �`�„ �� ` � ' � j' � „ � "� �5. �• �; J� �,;T T �� 1 e *_,�1. u` ._.�i �,,� � � �' �fi'�i � •I� 3 ' ,�}'n � ' '`` . r,•,l < ` , , _ '�} . �-- �._� ; � , �= �. �r�� , �.:, )) � � �049.Te�e Atla� � .}f t e..�_yn�,.�� 1. T� � r.xe ��.►�j a��'�, r - � � " z� ... � y.7� X.�—�."' ilev NBflI� �� ^" f • Oct_3.:00➢ IR � �; � ;ooql ��u 58B �. ��,* • y''''•_� �' � :: .::� ; ; �, (»a) �sa-s2�a • Fex (��a� �sn-aass Job Address: Suite No Vicinity: � CITY OF COSTA MESA BUILpING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 2260 CANYON DR SIDEWALK Parcel Nunmber: TPN99045 Applicant: Address: ELECTRICAL PERMIT THOMPSON,TOM 1835 WHITTIER ' �� ^ � "� ` �� ' NUMBER E99-00698 77 FAIR DFIVE, CASTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 07/2711999 Issued: 07/27/1999 � i ' i . COSTA MESA, CA ' � / � ' `� � ; Phone: (949) 548-1735 � - � ,,�.�,/� ,-.� , ! - SUITE A-12 , � Zip: 92627 �� _ . � � /�l�%�� _ _ �_ � � � �..�� A� / , . \ %, / \ � / \ �_/i. / t � ' - � - . ownec CITY.OF'COSTA MESA �- ' _ � ; �;A� � � / „ . , Address j��77�FAIR DR. �} �' ; < < � � � - � . � /��/� . �� '_ A� .��. ! , i �.A:�� / Phone. �.��\ _� ��/\\, � �CM, CA/ � �� Zip: 92626 � �� C /.� , � �� / //�.. ��\\\ � � ��', % ��" � ��\�� ,/ ` i,/ �� i/�% �� ,� � ��`, �'o,'ntractor: � THOMPSON AND THOMPSON /`� �� ,. ,. i i, , / � . ''�'� ��-Address.-, 1835WHITTIER ' � - '�� - ,',�r�, � � COSTA MESA, CA , Phone: � �(949) 548-1735 � � � �, , , ' , �SUITE A-12 � ` ' .�Zip: 92627. .. � :. . . � , _ ��; ,, . , . . __ , , '. j r .. � ; � . � ��.License: 550936 , . . , / _ A �, f %� . ..,�� . � A.. . . 1' . .} ; i� ";i � :. //�_ - A � ' �� . , , � SCOPE OF PERMIT '� � '� � ECECTRICAL SERVICE FOR CAN POWER SUPPLY. �� ' �� . , r , �;l _ . . - ,. � : _. � � . t �- . , . ��-FEESUMMARY� �� , �`. Quantity .. , Quantity , � ` ISSUE FEE $22.00 - -. r`�,- , `�-�, t � �Temp service test , ~ 30.00 - - � ,Fies.�a/cpaGcage , 50.00 New Res (1-2�units) , � -. $0.00 New Res (3+units) � � , $0.00 Pooll,Spa � � $0.00 Lighting�Fixts�, , �� $0.00 ReceplOutlets. , � \ _� � $0.00 Switches��, � � . ' V�;,' �$0.00 Non Res�Appl ' ;� $0.00 ResAppl ' `\ , �-�$0.00 Service to 200a , �$0.00 Service to 1000� $0.00;,, Service over t000a� �j � $0.00 � Motorslolhp � `�� - $0.00 Motorstol0hp ��` � ,$0.00 _ Motors l0 50hp � � � �'�� $0.00 Motors to 100hp � � ` _ $0.00 ' Motors over 100hp � '$0.00 Communication drops '� $0.00 Sub panel to 200a $0.00 � Pole Light Pkg $0.00 � Sign Circuits $0.00 Temp Pwr Pole $0.00 Intermed Pole 50.00 0 - 0 0 0 _- _. 0 �� ' 0 � . 0 0 �� Or.. .. , 0 - 0. . ' 0 =`' � • _ � 0 i � 0 ; , 0 � 0 0 0 . � 0 Temp Dist System / Cighting ,, $0.00 0 � �- �" Busway I100 ft% � - � _ $0.00 0 , � = Standing.Section' - $0.00 0 ,�. � Misc Electrical Equipment $1625 1 ; .' Transfortners up to 1 kva/kw $0.00 0;��. � - .._.....,....:up to.l0kva/kw . $0.00 0'. - - , .................up to 50 kva/kw i$0.00 �' 0�"- : � . ..................up to 100 kva/kw $0.00 : � ". 0. .' � � � : ` ..:.:.........over 100 kvalkw ' $0.00 .'', �� 0 '� � Low Vollage Equipment $0.00 ;:�� 0 � � � Low Volt Wiring System / Ckt • $0.00'� � 0 � - �- � Misc..Conduit" . $0.00' 0' � - Misc, Conductor ` . $0:00 . � 0 , , - Circus ( gen or ride) � _ � � � $0.00 � � � 0 �-. ' , Circus (mech ride or Iights) $0.00 -'0 ; % „ � Christmas Tree Stand , $0.00 . 0 , - . Fireworks Stand $0.00�' �0 "i Other Electrical Fee . $0.00 Investigation Fee . .$0.00 .Plan Check Fee• : $0.00 � Reinspection Fee , � $0.00 TOTAL CALCULATED FEES 538.25 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 1241•92) EXPIRATION: This permit shell automatically expire and become void if work is not commenced within 780 days, or i( work is suspended or abandoned for a penod ot 180 days. . INSPECTIONS: In order for ihe work authonzed under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inepeetlona end flnel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS' COMPENSATION UECLARATION: I I hereby afllrm under penalry of pehury one ol the tollowing deGarations: � , ❑ I have end will maintain e ceNticete of consent to self-Insure for workers' comDensetion, as provided for by sectlon 3700 of the Lebor Code, tor the pertormence ot the work for which lhl9 permit ig issued. � have and will malntain workers' compensation insurence, as required �y sectlon 3700 ot ihe Labor Code, for Ihe peAortnance of ��e work for which Ihis pertnit is issueC. My w ers' crompensaHon I surence carner antl polity nu er ere: /� ` �—f pt� Carrier. �� j%�Q �✓�-_C �//L/i� Policy Number: // /� / �� / I — ! 7 (ThIs sect/on need nat be canp/etetll! fh perm/f /s ve/ued et one hundreG tlollers ($100) or less.) � ❑ I cently thet in Ihe peAortnance of ihe work tor which this permlt is issued, I shell not employ eny Oerson in eny manner so es to bacome subject to the warkers' wmpensation laws ot Celilomia, end agree that If I shaultl become subject to the workers' compensation provisions oi Sectlon 3700 of the Lebor Code, I shell forthwith h lons. '— A � ��,�R�� —(/v�t a: � 2�- �'i � W�O SECURE WORKERS' CW.IPEfJ5AT10N COVEMGE IS UMAW FUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALilES AND CNIL FlNES UP TO ONE HUN�RED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED f-0R IN SECTIIXJ 3]O60F THE IABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: � I hereby attirm ihat I am Iicensed untler provisions ot Chapter 9(commencing with Section 7000) of Division 3 of the Business anC Professions CoCa, and my license is In full force e . a x Cla # � Co a ofs Sgna r� � � Dat . "�.7 i � COlTSTRUCTON LENOING AGENCV: � ❑ I hereby attirtn that there Is d consWclion lending egency for iha perfortnence of ihe work tor which this permlt Is iuued. (Sec. 3097, Civll Code). �� Lentlefs Neme: Lentler's Address: � Signature: Data: � OWNER-BUILDER DECLARA71tlN5: i I hereby aHirm that untler penalty oi perjury thet I am E7(EMPT FROM THE CONTRACTORS LICENSE I.AW for the following reason (Sec. 7031.5, Business and Protessions Cotle: Any ciry or counry which requires a pertnll to consiruct, elter, improve, demolish, or repair any structura, pnor to its issuance, also requires tha epplicant for such permit �o tile a signed stetement thet he o� she Is Ilcensed pursuent ta ihe provlslons of ihe Contrectors License Law (Chapter 9(commencing wit� Section 7000) of Dlvislon 3 of ihe Business and Protesslons Code) ar that he or sha is eaempt Iheretrom antl the besis for the alleged e:emption. Any vlolatlon of Section 7031.5 by eny epplicant for a permlt suhjacis the appllcant to e civll pePalry ot nat mare than flve huntlred dollars ($500).): ❑ I, as owner oi ihe property, or my employees wlth weges as ihelr sole compensetion, WILL DO THE WORK, end ihe stmcture Is not inlandetl or offerad �or sale (Sec. 7044, Business antl Professio�s Code: The Contractors License Law tloes not apply to an owner of property who builds or improves Ihereon, end who tloes such work himsetl or herself or ihrough his or her own employees, provided ihat such improvemenis are not intended or ottered for sale. Ii, however, iha 6ulliling or improvement is sold within one year of completlon, the owner-bullder will heve the burden af proving �het he or she did not builC or improva tor purpose ot sale.). , ❑ I, as owner of the properry, am E%CWSIVELV CON7fiACT1NG WITH LICENSED CONTRACTORS to construa Ihe proJect (Sec. 7044, Business end Professlons Code: The contrectors License Lew tloes not epply to an owner of property who builds or improves thereon, and wha contrecls far such project with a conirector(s) license pursuent to the Contractors License Lews.). , ❑ I am eaempt under sec. Business and Professions Code for Ihis reason: � SignaNre: Date: Owner ID venfied by drivers license. ❑ Yes ❑ No Dnver's License No. Expires: Venfication ot Ownership by (type a� tlocumem, i.e. - property tau blll or deed): DIVISION OF INDUSTRIAL SAF6TY PERMIT CERTFICATON: � ❑ I hereby cenity ihet no eace�ation five (5) or more teet In depih into which a person is requiretl to tlescend, will be made In wnnection with work euthodzetl by this permit, entl that no Duiltling 4lructure, scattolding, falsework, or tlemolition or dismantling thereof, wlll be more t�an �hirry-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 347, Title B, Califomla Administretive Code). � ❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit From ihe Division of Inaustnal Safery, as noted above, unless such person hes e pertnit to do such work from Ihe divisloa i Signeture: Date: Division ot IndusMel Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CEfinFICA710N: 1 W ill the appllcent or present o� lutura 6ullding xcupant need to file end certity e Business Plan for emergency resDonse �o release or Ihreatenetl release oi e hezardous metenell ❑ Yes ❑ No � (Seciion 25505 of ihe Calilornia Heelih and Salery Code requires, with some exceptions, ihat a Business Plan be filetl with the Casta Mese Flre Department by every business which has at eny one time tluring a reportetl year e quantity of herardous matenals eQual to or greater Ihan a weight of 500 pounds, or a volume ot 55 gallons, or 2W cubic teet ot wmpressed gas at stendard temperaWre antl pressure). 2 Does or will the appllcant or present or future bullding occupant neetl ro file a registration form br acutely hezardous meterlals7 ❑ Ves ❑ No (Section 25533 of ihe California Health end Safety Cotle, with some exceptions, requiras registration with the Cwte Mese Fire Department by each business whicn at eny one time has on hend e quantily ol ecutely hazardous meteAals equal to or greater than e weigM oi 500 pounds, or e volume of 55 Bflllons, or 200 cubic �eet of compressed ges et standard tempereture end pressure). I 3 Does or will ihe apD�lcant or p�esenl or future building occupent need to prepare en RMPP (Risk Management antl Prevention Program for acutely hazartlous meterlals)7 (Section 25534 of Ihe California Haalth and Sefery Code provitles that the Costa Mesa Fire Department may reQuire ihe preperetion, certl Depenment ol en fiMPP by businesses which ere requlred to register acutely hazardous materlals with the Fire Depanment. „ , .._.....,, . , ....... . ............ ................ ... . ..._._ . ......_._ '___....__ _ _...— 4 If an RMPP is presantly required, has Section 25534 oi t�e Cehfomla Health and Safery Code been fully complied witM ❑ Ves ❑ N 5 Does or will the eppllcent or present or fuWre Dullding occupan� require tor Ihe wotic which is �he 5ubjeC� of this e plicatlon e germit fOr 5w trom the South Coast Air �uel%y Menegement Disttict or from eny other elr pollutlon conirol tllsttict or agency7 � Ves ❑ No (Sectian 658502 ot the Celilomie Govemment Coda requires Ihat Ihe repueste0 intortnation be fumished on applicelions for non-resldential 6 WIII any pen of the fecillry to be constmctetl under thls permit be wllhin 1000 feet from the outer bounaanes of a school7 ❑ Yes ❑ 1 pf yes', the taclliry must meet the requlrement ot Sectlons 25534 end 42303 ot the Califomia Health an0 Safery Code). 7 It a permit irom Ihe Sou�h COast Alr Quelliy Mena9ement Distdct or other air polWtion control tlistrict or egency is requiretl for the woi applicatlon, have all ot the dlsG�asures prescnbed by Celifomle Health and Safery Code Section 42303 been made7 ❑ Yes ❑ No B pf yes", atlac� certiticate of compnence rrom tne eppn CERTIFICATE OF COMPLIANCE: I caniy ihet under regarding Harerdous MateAal4 entl Emlulons. Signature: pe�ury the iniortnalion given above is correct. I egree to comply with all state Date: end filing with the Fire Imctlon or modification 7 pertnits). i is ihe subfett of lhis vs antl ciry ordinances CERTIFlCATE OF COMPLIANCE AND AUTHORPJITON OF ENTRV: I certity under penalry of perjury that I have reatl ihis eppliwtion antl state thal the intortnation given is correct. I egree to comply with all s�ate laws enC ciry ortlinances relating to building conshuction, end authonze representetives of the Ciry of Costa�iMese lo enter upon the flbove-tlascrthetl propeRy iw inspe�tion puryases. I agree not to accupy ar aUaw occupancy oi any huGding auttwrizetl by �hLs pemUt unUl tinal Inspection. Lepel CODE t. INSVECTONTYPE 1616 Fised System Finel Fire Preventlon 1266 Pool Spa Final 200 Pinal Re-Rooi 207 Flnal Block/Retaining Wall 202 Flnel FeMory Flre Place 203 FInelSign 20d Final Demolition 2A46d8 PA7E 27- �$ �Q.Q[e INSPECfIONTYGE 206 Finel Mechanical 208 Flnal Plumbing ' 210 Finel Electdcal 272 Finel Fira Preventian 220 Final Planning Approval 222 FinalSite 250 Final Building/Occupency +� 4387.�1 COSTA MESA BUILDING-SAFETV DEPARTMEN P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING ADDRESS Q OWNER _ , ¢ �•1�{2.7 � MAIL P ADORESS � � � �i /J TEL. CITV �� c o'�d �¢S-/� C.A7 NO. BRANCH �j(��Y �Y"CC ADDRESS % `jtJ!(_,S�y-jB� ARCHITECT A. ._ /�._ _ _ CONTfiACTOR ADDRESS �j � g� �G 4 [k CITV � ��- TE c�te "F�zs-�;L;,•:.QOlaeoN �:,�u36.5G APPLICATION FOR STRUCI'URAL PERMIT RECEIVEOBY DATERECEIVEO D TEISSUEC t�-�s ' 0 OF USE OF N NS BUILDIN ► STATE �^- CITY �'ARDSAPPpOVED VARDSAPPROVED � LIC. NO. Sv - LIC. NO.� MAIN BUILDING ACCESSORV BUILDI {ra SI2E NO.OF BLDGS. (FROM C/LSTREET) L OF l0T NOW ON LOT ONT FT. a USE OF � EXISTING BLDG. E � FSeparate permits are required for �, F � . electric, plumbing and heating work. qEAR Fr. W VSE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BEf. BET. MAIN & QMAIN BLDGS. ACCESS. BLOG VAF. TE '� C.U.P. � APPROVED � � APPROVE 'P � W HOLD FOR SPEC L REQI pI hereby acknowledpa thac I �eva read this application antl rtate y� that the ebova Infarmatlon la corract end a0�ea to comply wlth 4 ell laws regulatinB bulltling consvuction, entl I shall noi employ {Z any parmn in violatlon of Me workmen'z compansation laws of x Me State of Califotnla. 3 1 heraby certify ihet I am prope�ly Iicensetl es e<ontractor under SQ. FT. Me Sum of Cellfornie Businen and Profassions Cotle, Dlvislon 3, THE AMOUNT SHOWN UNDER VALU� Chapte� 9, ontl thet suc� Iicanws ere in full torce entl affact, or I THE PURPOSE OF ESTABLISHING A PERb am exempt from tha pr� ons f the Stet of Californle Business VALUATION PERMIT FEE $' antl Professiona Co e, DI sion 3, hep SIO�eturo Of ` PLAN CHECK E Parmlttee __ � 5 ��0 TAX $ AUShorizetl Apent TOTAL PAID S n w i m m N 1/S FOR y� [ ONLV: � a r0 m ID� m 0 LL � U