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Home My WebLink About3453 SMALLEY RD - Building Permitsn pia� �sa-s2�s • Fvc (�ia� �sa-aess CITY OF COSTA MESA BUILD/NG DIV/SION DEVELOPMENT SEAVICES DEPARTMENT PERMIT ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant Address: Owner: 3453 SMALLEY RD MEDIA ONE CABLE T.V. BOX TPN990237 THOMPSON,TOM 1835 WHITTIER COSTA MESA,CA SUITE A-12 CITY OF COSTA MESA Address , . , Contractor: THONIPSON AND THOMPSON Address: 1835 WHITTIER , COSTA MESA, CA ' , SUITE A-12 , ' , ISSUE FEE . Temp service test . Res. a/c package New Res (1-2 unitsJ New Res (3+units) � Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t000a � Service over i00oa Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Phone: (949)548-1735 Zip: 92627 Phone: Zip: Phone: (949) 548-1735 , Zip: 92627 . License: 550936 PERMIT NUMBER E00-00187 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: SCOPE OF PERMIT INSTALL ELECTRICAL METER FOR NEW;CABLE T.V. POWER SUPPLY FOR -MEDIA ONE-. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0:00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 �Quantity FEE SUMMARY , , Temp Dist System / Lighting Busway /100 ft � Standing Section Misc Electrical Equipment Transformers 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 Low Volt Wiring System / Ckt Misc. Conduit �Misa Condudor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 03/07/2000 Issued: 03/07/2000 Quantity $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 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $o.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, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspanded or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this parmit to be considered legal, such work must comply with all applicable codes, and all required inapectlona and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARATION: , , I hereby aflirtn untler penalty ot peryury one of the following declarations: � � ❑ I have and will maintain e cartilicate of conseN to self-Insure for workers' compensation, as providetl for by section 3700 ot the Lebor Cotle, for the pertormance oi the work for which ihis permit is issuetl. � - ❑ I have and wiil maintain workers' compensetion insurance, as required by section 3700 of the Labor Code, for Ihe pedormanca of the work for which this permit is issued. My workers' compensation Insura�n�c�e,(�/a rrier /a9'd policy numb�are: / /� / Carner: � ��✓v� t dw�—J �S PolicyNumber. ! �`� 37�0 � Uv (This section neetl no( be camp/eted i/ the permif is velued f one hundred tlallers ($100) or IessJ ❑ I certity ihat in lhe pertormance of the work for which this permit is issueQ I shall not employ eny per5on in any manner 5o a5 to become subject Io the workers' wmpensation laws of California, and agree thal if 1 should become subject to ihe workers' compensation provisions oi Seciion 3700 ot the Labor Code, 1 shall fotlhwith wmpty with these pr ions. Applicant Signature: ��Ct� �- Date: � - �' �U WARNING: FAILURE TO SECURE WORKERS' COMPENSAiION COVEfiAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYEP TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDPED THOUSAND DOLIARE �5100,000), IN A�DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN $EGTION 3]O6 OF THE L4BOF CO�E, INiEiiEST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm Ihat I am licens y �der�j ovisi°J�s of Chapter 9(commencing with Section 7000) of Division 3 of the Business�d 7 fessions Code, and my license is in full lorce and ettect. Lic. # �S U Z 3b Class a Contractor's Signature: � �.,��Q - Date: .`2 — 7 - CONSTRUCTION LENDING AGENCV: ❑ I hereby aflirm ihat Ihere is a consiruction lending agency tor the perfortnance ot the work tor which Ihis permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lendefs Address: SignaWra: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm that under penalry of periury ihat I am EXEMPT FROM THE CONTRAC70R5 LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or coun�y which requires a permi� to construct, altar, improve, demoiish, or repair any stmcture, prior to its issuance, also requiras ihe applicant for such permit to file e signetl statement that he or s�e is licensed pursuant to the provisions ol the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Prolessions Cotle) or that he or she is exempt theretrom and ihe basis tor ihe alleged e:emption. Any violation oi Section 7031.5 by any apPlicant tor e permit subjects �he applicant to a civil penalry of not more �han five hundred dollars ($500).): ❑ I, as owner ot the property, or my employees with wages as their sole compensation, WILL DO TME WORK, and the swcwre is not intentle0 or oReretl tor sala (Sec. 7044, Business antl Professions Cotla: The Coniractors License Law tloes not apply to an owner of property who builds or improves thereon, antl who does such work himself or hersefl or thmugh his or her own employees, provitled that such improvements are not intended or oftered for sale. If, however, ihe builtling or improvement is soltl within one year of completion, ihe ownerbuiltler will have ihe burden of proving that he or she tlitl not builtl or improve for purpose oi sale.). ❑ I, as owner of ihe property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tha proiect (Sec. 7044, Business antl Professions Code: Tlie contrectors License Law does not aDP�Y to an owner ot propeny who builds or improves thereon, and who contrects tor such project with a coniractor(s) license pursuant to the Coniractors License Laws.). ❑ I am exempt untler sec. Business and Professions Code tor ihis reason: Signature: Date: Ownar ID venfied by tlrivers license. ❑ Yes ❑ No Dnver's License No. Ezpires: Verification of Ownership by (type of document, i.a. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby certity that no ezcavation five (5) or more teet in depth into which a person is requiretl to tlescentl, will be matle in conneclion wi�h work authorizetl by ihis pertnit, antl Ihat no builaing sirucNre, scaffoltling, falsework, or demolition or dismantling thereof, will be more than t�iny-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, California Administrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from the Division of Intlusirial Safety, as notetl above, unless such person has a permit to do such work from the division. Signature: Date: Division ot Industrial Safery Pertnit Number. CEPTFICA7E OF COMPLIANCE AND AUTTIORIZA710N OF ENTRY: I certity untler penal�y of perjury that 1 have read this application and s�ate �hat ihe intormation given is correct. I agree to comply with all state laws and ciry ortlinances relating ro building consimction, and amhorize representatives of ihe City of Costa Mesa to enter upon the above-tlescribed pmpeny for inspection purposes. I agree noi to occupy or allow occupancy oi any building authorizetl by this permit uniil tinal inspection. ��Y Signature Of Le9a� �� O Date U Antl/(�r Authonzed Apphcant Data 40oE �. INSGECTIONTYGE 1616 Fixotl System Final Fire Prevention 1266 Pool Spa Final 200 Final Ra-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Damolition 24a&a8 pATE INTRIALS CODE� INSPECTIONTVPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy UpTE �NiIT1AL5 3 ro ao R� 0�/07/00 10:24 �$714 895 0188 ORANCE COAST DIS � 001 . . . : : �'. . . � FAX COVER SHEET ��'�q uwn�tu� c.�uroa�i.� ��-�- � D� S� N �.� i'lii>D� h?'!"R.�.t7RA.tl." C.�npar. H[TNTINGTON BEACH SERVICE CENTER TO: Burt Morgan City of Costa Mesa FAX M1MIiER: 714-754-4856 FROM: Edison Planning Department PHONE NLJMBER: (714j 895-0363 Edison Site Releases For Media One Cable TV Sqots P1S # Address �� ..� /U��a�C — .• N n 3-7-�ia �C NUNIBF.R OF PAGES INCLUDING COV�R SHEET _;� Please notify sender if arry pages aze missing (714) 895-0244 -_ PAX 54244 SOUTI�RN CALIFORNIA EDISON COMPANY 7333 Bolsa Avenue, Wtstminster, CA 92683 - FAX: (714) 895-0188 - PA:C FAX: 54188