HomeMy WebLinkAbout2913 BAKER ST - Building Permits •
CITY OF COSTA MESA
BUILDING DIVISION
F• I' , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
!Lr PERMIT
J 064.
Ran
M03-00238
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 2913 BAKER ST Status: ISSUED
Suite No Applied: 05/20/2003
Issued: 05/20/2003
Vicinity:
Parcel Number: 13926212 ISSUED BY:
Applicant: WETTSTEIN, DAN
Address: 2913 BAKER ST
Phone: 714-360-0458
COSTA MESA,CA Zip: 92626
•
Owner WETTSTEIN, DANIEL AND KALMA, LYNN
Address: 2913 BAKER ST •
Phone:
COSTA MESA,CA Zip: 92626
Contractor:
Address:
Phone:
Zip:
• License:
SCOPE OF PERMIT
CONVERT EXISTING 454 S.F.GARAGE INTO EXPANSION OF THE MASTER BEDROOM
(HABITABLE SPACE)AND CONSTRUCT NEW 665 S.F.ATTACHED GARAGE.
1 VENT FAN/SINGLE DUCT
REF:B02-02072
• FEE SUMMARY
Quantity - Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit 50.00 0
Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0
Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0
Inst/Rep. Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0 • Domestic Incinerator $0.00 0
Refrig Sys>100 k BTU $0.00 0 - Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace 50.00 0 3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0
VAV Box $0.00. 0 30 To 50 hp/1,750 k BTU $0.00 0
Vent Fan/Single Duct - $7.25 1 Over 50 hp/Over 1,750 BTU $0.00 0
Appliance - $0.00 0 Boilers
Fire Dampers $0.00 0 Up to 3 hp $0.00 0
Smoke Dampers $0.00 0 3 To 15 hp $0.00 0
Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0
Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0
Floor Furnace $0.00 0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
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 it 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 / )
2446.48(8/00) /l/
DECLARATIONS
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 Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: I r Policy Number:
(F+is section need not be Mmplefed if the permit Is valued at one hundred dollars($100)or less.)
1 e I certify the t in Ir. "--, Nance of the work for whi• this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
-" compens. '• aws of C:'omia,and agr:e that I shout•become subject to the workers'compensation provisions of Section 3700 the Labo e,I shall forthwith
comply 1 these pr• ' Ions „ ' A/
APPll gr "�% - / :27.,.#2....-e_.,
.,.." pato Q5 Lf/ 03
WARM •. •".E TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER CRIMINAL P ALTIES AN CIVIL RNES UP TO ONE HUNDRED
THOUSAND Dol I-RE I$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 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.a Class IS
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 tile 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 fora permit
(s cts the applicant to a civil penalty of not more than fNe hundred dollars($500).):
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
himself or herself or through his or her own employees.provided that such improvements are not intended or offered for sale.IL however,the building or improvement is
sold 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.). •
as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
"' CCC ode:The contractors License Lew doe-not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pu the Contractors Lic. se La s.).
❑ lam ext e• /� !I�.>/� l: ...Professions Code for this reason:
Signature: L n. S A/..2 __ _
E.apires: C.-09.OY
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: i
❑ 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.talsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 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:
1 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? 0 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? 0 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 California Health end Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished an applications for non-residential building permits).
8 Will any pan 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 II a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Ts the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). V
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:
•
CERTLFIC• ' •F COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is
correct. agree • comply with tate laws nd city ordina es relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-•.scribed •rope r cti pu ryc es. ccuPy or allow occupancy of any building authorized by thi rnit until fi inspection.
�,, 0 - fL S2 _off ,
'Signature Of.Legal Owner(s) — Ti_ Date/
And/Or Authorized Applicant Date
900E I I$SPECTIONTYPE Mk INTITIALS 909E1 INSPECTION TYPE 2M
1616 Fixed System Final Fire Prevention 206 Final Mechanical 1 -a3-ori
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final 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
`• F CITY OF COSTA MESA
t BUILDING DIVISION
„ ,I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
tSIPPIKia PERMIT
Itt+„Rmofi' 1 P03-00315
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 2913 BAKER ST Status: ISSUED
Suite No Applied: 05/20/2003
Issued: 05/20/2003
Vicinity:
Parcel Nunmber: 13926212 ISSUED BY: ��
Applicant: WETTSTEIN, DAN
Address: 2913 BAKER ST
Phone: 714-360-0458
COSTA MESA,CA Zip: 92626
Owner: WETTSTEIN, DANIEL AND KALMA, LYNN
Address 2913 BAKER ST
Phone:
COSTA MESA,CA Zip: 92626
•
Contractor:
Address:
Phone:
Zip:
License:
Arch / Eng: .
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT •
CONVERT EXISTING 454 S.F.GARAGE INTO EXPANSION OF THE MASTER BEDROOM(HABITABLE
SPACE)AND CONSTRUCT NEW 665 S.F.ATTACHED GARAGE.
1 BATHTUB, 1 GAS OUTLET(1-4), 1 SHOWER, 1 WASH BASIN SETS, 1 WATER CLOSET, 1 WATER
HEATERNENT. •
REF:B02-02072
FEE SUMMARY
AMT QM' _ AMT QTY AMT QTY
ISSUE FEE $23.50 , Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $9.80 1 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $9.80 1
Drain,Floor $0.00 0 Sewer Connect - " $0.00 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $9.80 1
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
• regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2448.46(8/00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued,
My workers'compensation Insurance carrier and policy number are:
Carrier: V Policy Number:
(This section need not be completed if the permit Is valued at one hundred dollars($I00)or less.)
(T`
I certify that in the•s••r ance of the work for which thi-permit Is Issued,I shall not employ any person in any manner so as to become subject to the workers'
compensatio• aws of Ca I•;#00Fi 'e t t if I sh• Id be o s • : to the workers'compensation provisions of Section 3 00 of th Labor Code,I shall forthwith
t_ comply with hese previs o '''jam' §
Applicant Signatur- �sn/� �� Date: • "u IE 7
WARNING:FAILU-E SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALT S AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,0110),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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.Lk.q, Classif
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 penally 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(commenting 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
subjectsec( the applicant to a civil penalty of not more than five hundred dollars($500).):
/`-'�/ 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
himself 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
sold 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 purs s•t to the Contractors Licen Laws.).
❑ I am ex: pt und,r sec. 55�iL' LsinessProfessions Code for this reason:
'Signature: -y Date:// - �3
Owner ID ve'fled by driver's license. 0 Yes 0 No Driver's Ucense No. / xpires: QG,—D9'—�
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,wit 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,Title 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:
1 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? 0 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 ❑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).
_._ __..noon_ oal
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 Califomia 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.
0 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any parrof 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(Duality 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 prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 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 at state laws and dty ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
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
correc. to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the Cit of Costa Mesa to enter upon the
abov -describe roperty 1 sp tion prpos I agree not to occupy or allow occupancy of any building authorized by this per ' until ' al inspection.
Signature Of Legal Owner(s) • , Date
And/Or Authorized Applicant Date
CODE# INSPECTION TYPE BATE Iw'mALS BODE! EISPFCTION TYPE PATF 1TI0ALE
1616 Fixed System Final Fire Prevention 206 Final Mechanical rY
1286 Pool Spa Final 208 Final Plumbing ' '09
RN
200 Final Re-Roof 210 Final 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 i
204 Final Demolition 250 Final Building/Occupancy
`, ' 4 CITY OF COSTA MESA
4 •
BUILDING DIVISION
Y .� ,4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT E03-0 3
%Ammo le
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 2913 BAKER ST Status: ISSUED
Suite No Applied: 05/20/2003
Vicinity: Issued: 05/20/2003
Parcel Nunmber: 13926212
Applicant: WETTSTEIN, DAN ISSUED BY:
Address: 2913 BAKER ST
Phone: 714-360-0458
COSTA MESA,CA Zip: 92626 ,
Owner: WETTSTEIN,•DANIEL AND KALMA, LYNN - . -
Address 2913 BAKER ST
Phone: .
COSTA MESA,CA Zip: 92626
Contractor: - -
Address: • - .. .
--Phone: , , - .
. Zip: -
License:
SCOPE OF PERMIT
CONVERT EXISTING 454 S.F.GARAGE INTO EXPANSION OF THE MASTER BEDROOM(HABITABLE
SPACE)AND CONSTRUCT NEW 665S.F.ATTACHED GARAGE.
26 LIGHT FIXTURES,20 OUTLETS, 16 SWITCHES, 1 SERVICETO 200A
REF:B02-02072
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 $26.38 . 26 up to 50 kva/kw $0.00' 0
Recept Outlets $22.00 20 up to 100 kva/kw $0.00 0
Switches - , -"/ $17.60 16 over 100 kva/kw, $0.00- 0
Non Res Appl - $0.00 , 0 f 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 50.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 0
Communication drops $0.00 0 Investigation 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)
7)i
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: '
I hereby affirm under penally 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
❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number:
(ml section need not be completed If the permit is valued et one hundred dollars($100)or less.)
_ 'certify that in t : •edormance of the work for which this•ermit is issued,I shall not employ any person in any manner so as to become subject to the workers'
co nsation aws o . mita,and =gree that I I shout, become ect to the workers compensation provisions of Section 00 of the r Code,I shall forthwith
comply with th• e provisio
Applicant Signa re: :.1- /"ear 7irearami.. Date: 2C?lt 63
WARNING:FAILURE TO S- URE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,0001,IN ADDITION TOTHE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR WOE,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.a Class x
Contractors 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:
1 hereby affirm that under penally of perjury that 1 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($500).): 1
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
himself 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
,.[Gold 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
A>_f".I,as owner of the property,ant EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
1 'Cate:The contractors License Law does not apply to:n owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
livens: :. . :nt to the Contractors License Laws.
❑ I am.•empt un•:r sec. .r i _ .r V' a - : d Professions Code for this reason:
Signature: �.'r,aliir '
��"f1/ Date: '
--Owner ID ve•'ted by driverC
s license. 0 Yes 0 No Drivers License No. � . u _ Expires: O6.0 -O 7/
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,felsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 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:
1 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? 0 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? 0 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 Califomia Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or presenc or future building occupant require for the work which is the subject of this Application apermit far such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 8 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished 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? ❑Yes 0 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 prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 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:
CERTIFI . • COMPLIANCE AND A ORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correc. I agree to c•.•pl all state -ws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
abov: •escribed pr• 6em .:ctl• purpos:s.I e•ree not to occupy or allow occupancy of any building authorized by this rmit uni' nal inspection.
Si! aturii 0 Legal Owner Date
And/Or Authorized Applicant Date
CODE 1 INSPECTION TYPE DAA INB71A1.$ ;ODES INSPECTION TYPE - DSIE IHTTMts
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing f� ./
200 Final Re-Roof 210 Final Electrical 0-4 CH • 6 t,
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site i
204 Final Demolition 250 Final Building/Occupancy
,O°' ' CITY OF COSTA MESA
BUILDING DIVISION
F � DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER
PERMIT
ec 802-02072 tbbosTmo
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2913 BAKER ST Status: ISSUED
Suite: Applied: 12/27/2002
Vicinity: Issued: 05/20/2003
Parcel Number: 13926212 Zoning: R1 R1
Applicant: WETTSTEIN, DAN ISSUED BY: _
Address: 2913 BAKER ST ,
Phone: 714-360-0458
COSTA MESA,CA Zip: 92626 EXTENSIO
Owner: WETTSTEIN, DANIEL AND KALMA, LYNN ALLOWED
Address 2913.BAKER ST
icri
COSTA MESA,CA Phone:Zip: 92626 PER
Contractor: OWNER-BUILDER EXPIRES c/s//os
Address:
Phone:
Zip: License: 000000
Arch. : Eng: VALENZUELA, CARLOS
Address: - Address:
- Phone: - Phone: 949-548-2300
Zip: License: License:
SCOPE OF PERMIT- -
CONVERT EXISTING 454 S.F.GARAGE INTO HABITABLE SPACE AND CONSTRUCT NEW 665 S.F.ATTACHED GARAGE.WORK TO INCLUDE:
EXPAND EXISTING MASTER BEDROOM,ADD AMASTER BATHROOM WALK-IN CLOSET,AND ALTER ENTRANCE TO EXISTING BATHROOM.
BLDG.AREA-39%
DRIVEWAY-8%
OPEN SPACE-53% -- : - -
FEE SUMMARY
Plan Check: $459.39 Calc Valuation: $58,109.10
Permit: $706.75 Claim Valuation: $0.00
SMIP Res: $5.81
SMIP Com: $0.00 •
Other: $0.00
Inspection: $0.00
Total: $1,171.95 ,
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 20-0- Rear 22-0 Left 7-0 Right 5-6
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
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
2446-48(WOO)
•
u
,
DECLARATIONS car ' 4.
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
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number:
(This section need not be completed If the permit is valued at one hundred dollars($100)or less.)
/ "a I certify that in th. .: . ..once 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 I: s of Call.rnla,and agree that if I shoul become bject to the workers'compensation provisions of Section 3700 f the Labor ode,I shall forthwith
comply with the•• provision
Applicant Signature: __... /L/ Date: h ��� �3
WARNING:FAILURE TO` CURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE(S100.000),IN ADDMON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SEC ION 3706 OF THE LABOR CODE,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.5 Class k
Contractors 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).
Lenders Name: Lenders 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($500).):
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
himself 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
���/// sold 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.).
,{q 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.).
❑ I am exe uncle's Business and Professions Code for this reason:
Signature: 1/x./ �/
Expires: 64-09-Ov/
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,Title 8,Callfomia 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:
1 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? 0 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 lime 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 end 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 California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the sublect of INS-Application aaermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 prescribed by California Health and Safety Code Section 42303 been made? 0 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 COMPLIANCE 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 :. ee to comply with all st.to laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above .- d pro.: . •r i pact'.n pu ..--s.I a.ree not to occupy or allow occupancy of any building authorized by thi permit unt' royal inspection.
Signature Of Legal Owner(s) Date j
And/Or Authorized Applicant Date
BODE 1 INSPECTIONTYPF PATE PALE SODS( W$PELTION TYPE 26Th INIITIAId
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final 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 7 or_/
25 8 11136 bI.- !AMY.* �—Li
'
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPTCIT .
101? APPLICANT TO FILL IN COMPLETELY APPLICATION FOR�PERnMIT�
TYPE OR PRINT .. BUILDING •
BUILDING 2913 SMce
ADDRESS G a- FOR �t
COSTA MESA, CALIFORNIA OFFICE (ISE ONLY
L.Kt /�I 5-t Co. I RECEIPT NO. I 7`"
OWNER V /�/i // 7 0
MAIL /✓, I t n RECEIVE I DA RECEIVED/. A EHSBUED•
ADDRESS /��J �"cI L�'V ' �� I DATE
— 7���//- 77) -1-g
CITY „eV • TEL.NO, ADILDING •r• //� i4 6
ADDRESS
ARCHITECT LIC.
OR ENGINEER NO. COSTA MESA, CALIFORNIA
FIRE
)� n (((���
ADDRESS �/� ,A/`1 ZONE TYPE //GROUP , J/ `y/
/[1.AVO �� LIC.Nt /19 5 APPROVED 4
CONTRACTOR BY DATE
ADDRESSq +� % ZONING
LEGAL LOT 1 / -i 1 ZONE NO.OF I USE OF NEW Single Fain. Res.
DESCRIPTION ICO. I OS IBLOCK (TRACT R-1 (PLANS 2 BUILDING w/ att. gr:Tage
A.P.NO. NON$ BYPROVE YY
1) I-i 1� .PATE I (• 6; C
SIZE .•r7 C L/ I NO.OF NOW ON LOTH REQUIRED l �AL'LOWED
OF LOT �/ 7 /�
USE OF (CENTER LINE ST.) ` ` I
EXISTING BLDG, FRONT Lf g, Y'FT. IN.
SETBACK LINE FROM D REAR YARD7 "`!!!”'
CENTER of SERE `LC R.SIDE FT. IN.
SIDE YARD I LEFT 7• I RIGHT 5 L.SIDE ?',9 FT. IN.
DESCRIPTIONJOF WORK .� // - •
NEW / \II ALTERATION I II ADDITION I REAR ) /. .7 FT. IN.
/
REPAIR I II MOVING I II DEMOLISH I �'f
BUILDING NO.OF
SIZE hr 0 0 ROOMS STORIES
COVEXTERIORERING WAL�,�,LC LIIROOOERING SHI 0G1E
USE OF BUILDING AtID WORK TO E PERFORMED
l .. am ES
a-r -r. c---a 2 A Z=-E
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE .-•VE IS CORRECT AND AGREE TO COM.
PLY WITH ALL CI •R•0 NCES AND ST T- -EGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CON -UCTIO SO. VALUATION
I •
SIGNATURE 0 .. PERMIT FEE $ __Wt.--
PERMITTEE , 77 _ q
$ // ]��//J-1 PLAN CHECK $ /
AUTHORIZED AGENT TOTAL FEE $ �7eft 7—