HomeMy WebLinkAbout1412 SHAMROCK LN - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. •
Project Address I LIta SN RAA P
c C ,JG D 2 17 4"3 II � r
•ApPFieht's Mailing.Address .?o?n(n7 n1.•. ,• r�/f'I OK- TYPE OF CONSTRUCTION LJ NEW LI ADD LJ ALTERATION U REPAIR , • 3463 6/12/C7 °✓c'-• 71
• pjp —,p/D ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# � Zone
Owner's Name
p '^'� - d/ r Phone
/(JX��l�LOO DE$CRIPTION OF WORK/USE OF BLDG. Re- rope 1 kr of
v Address 9(// b,E C-Ie GNT //. 8ha ea ei jS Main Building: • Accessory Building:
�j E Z
Arch/Eng. License No. TYPE OF PERMITIli GRADING U FOUNDATION s61 STRUCTURAL T Front - D
Address - 111TENANT ❑�E LECTRICAL ❑ PLUMBING III MECHANICAL • B Rear N
/J Phone . ♦ OTHER KooF/%J6 Rta t Y A I
Contractor's Name -a - 549F7
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N-
Address(mailing)d- 0 - -A y�0 AN` - a / - ..••��p K G
�s2 0 CONSTRUCTION TYPE VALUATION$ U /Q0 S Left R
City License No. TS/ ZONE GRADING CU.YDS. ACRE$
LICENSED CONTRACTOR DECLARA ON Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: _,' • Planning Notes: a
with section 7000) of Division 3 of the Business and Professions Code,and - T
my license is in ful force nd effect.
License lass �- �/' Licene No�sO6 61 hl --_ ---- -- - - S
Date r!i-s•7 Signature •6LID-GUk--. PLUMBING FEES .
WORKERS'COMPENSATION DECLARA I
Bar Sink •
I hereby affirm that I have a certificate of consent to self-insure or a certificate Showers ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section / -..
-
3800, Lab. C.)
Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW •/
Policy No. Company Backflow Irrigation •
Sewer Cap / Construction Pole Sub. 0 SO+KW
BCertified copy is hereby furnished. - -
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps /
Date Applicant a ,
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - Dishwasher - Meter Dover 100 amps •
(This section need not be completed if the permit is for one hundred ($100) or -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
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 t ¢come subject to the Drinking Fountains Solar Tan Fan Motors❑0-1 HP 1%-B
Workers'Wire,Laws of Califocrda.
Date `6 -//-'3 / Signature (( Floor Drains Swim.- ng Pool w/Spa • F.A.U.
•
NOTICE: If,after making this declaration, tr
y. d become subject to the -- - - -
Inc.Solar 15 HP 016-15+
Workers' Compensation provisions off the e .. Code,Code, you must forthwith Floor Sinks mal Fixtures - Micr ave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY •
Gas Service OutletsWater Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance ' Ole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water-Heater Outlets
Lender's Name - / Range
Lender's Address Kitchen Sink Water Service - Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash '
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair LaundryTrays
/ any structure, prior to its issuance, also requires the applicant for such permit i Generator 00-5 05-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions ofRoof s
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/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: I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
.
compensation, will do the work,and the structure is not intended or offered 1 -,--.� Reinspection Fee I $15 Issue Fee $ 3 .
MECHANICAL I FEES
' for sale (Section 7044, Business and Professional Code: The Contractor's
erese Law does not apply to owner if a property who builds or improves _
thereon, and who does such work himself/herself arelf or through ende his or her own DEVELOPMENT SERVICES REQUIREMENTS: .
le. If,employees, provided that such or improvement
are not tor offeyear
of cd for Boiler Hood
ano or Ty 0 ZoningApproved
sale. If, hehowever,wthe building dof pro issold within one yeurrpm- Canopy pe I ❑ pp By Date y.,
pterion, the owner will have the burden of proving he/she did not build or im- • Duct-Under Ground Building Approved By Date nn�( ,I
prove for the purpose of sale). --- ---- - --- - C.l_ i 2 7
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural R geration System Application Issued By Date CJ
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0-100,000 BTU 0100,000 BTU SUMMARYF FEES
builds or improves thereon, and who contracts for such projects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple System Repair/Alteration BUILDING PERMIT $ 4 4- ' O SMIP $ a. SD
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG Fire Dampers PLUMBING $ PERMIT
ISSUANCE $
Date Owner Heating System& cting Registers
PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑0-100,0008 0100,000 BT GRADING $
information is correct. I agree to comply with all city and county ordinances • ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to enter upon the above-mentioned property for'
inspection purprs. N✓ .Date
MECHANICAL $
[ 1?-/747 TOTAL FEE $
Signature ,/ inspection Fee - $15 Issue Fee $ 3 PLAN CHECK 25% $ pp
Drivers' License or SS ,�` Ill
_ 4-S'
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL &SPA
APPROVALS Permit'#' Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
•
2. Soil Pipe-Undrgrnd. ` 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings , 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, E Undrgrnd., Test ' .
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final '
16. Rough Electric Wiring - 67. Fencing Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING •
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i,
20. Rough Factory Fireplace • APPROVALS Permit#
1.9i-
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush •
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil '
25. Roof Sheathing 94447 5'A. 74. Overhead Hydro -
26. T-Bar Ceiling (Structural) & Monocoat / 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe -
28. Lathing & Siding 77. FIXED SYSTEM FINAL .'
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test .
^
36. Hood or Canopy • •.
37. :Final Factory Fireplace
38, Final Plumbing
39:Water Service-Final • ,,
40. Gas Service-Final ..
41. Solar Domestic-Final I -
,42. Backflow Preventer
• i
43. Backflow Irrigation •1' /J
,44: Landscape Irrigation System - • %;+ - ,1
45. Sound Attenuation i.'' •
461' Handicap Regulations - ;! .
'47., FINAL STRUCTURE& BUILDING . + � '
•
48.•Special Requirements Completed ._ 1!
49. Electric Release to Edison '
r
50. Gas Release to Southern California Gas Co
. r
51. CERTIFICATE OF OCCUPANCY
No. Date •
Applicant to fill in all spades within heavy border lines and sign all appropriate declarations. 196 IL.0u/jp
lu/jp i:.u ,
CITY OF COSTA MESA PE,yg�^IIT NO - TRACT NO. LOT NO. BLDG.NO: - - -
CONSTRUCTION PERMIT /f- SRjL� -
Project Address /,Z/,,A 5 -M,4QG7K TYPE OF CONSTRUCTION . ..
Owner A. i ,9-, 0 - Phone 0 NEW 0 ADD 0 ALTERATION - - -.
Address ,-.7.41-4/76- . ❑ REPAIR 0 CONVERSION ❑DEMOLISH, �~
Arch/Eng. - - License No. - 0 OTHER
Address • DESC RIPTION'OF WORK _ -
/ _• ��/
Contractor /(F-7 .PM S7 - :,C-'JP'i6 TYPE OF PERMIT • TO BUT LDI NG -
SETBACK _ ST. PROPERTY LINE -
Address An.: A . .• . k3 7,2/ ❑ GRADING 0 FOUNDATION ❑ STRUCTURAL SIDE YARD . .
LICENSED CONTRACTOR DEC • -AT ON 0 TENANT 0 ELECTRICAL KPLUMBING ❑MECHANICA SIDE VA•
I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT - '
mencing with section 7000) of Division 3 oftheBusiness and ❑ OTHER ' ' -
Professions Cod and my license is In full fort and fje - REAR YARD(TO P/L)' -
PROJECT DESCRIPTION
Licen a dirn,Ease •"— Licenni° N , : PKG.SPACE REQ. - ' - PROVIDED - - -
Date /AI,/9 ffSignature ' Y . M& /1/277,?......)/ SQ.:FT.- - --. - _ ,
WORKERS'COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE. STREET WIDTH ' PARK FEE$
I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BY - , 'I DATE
certificate of Workers' Compensation /I9nsurance,nor aa,,rcertiif d'copy - ,
thereof(Segjjon.3$p0,-1-7--C Company -tom/"s' • .. : •
GRADING CU..YDS. ACRES pp[[/J !F / SPECIAL CONDITIONS: - -- - • - • -
Policy N - ' • - . . - . .
❑ Sett—Med copy is hereby furnished. _REMARKS: '
emitted copy is filed with the city Building Division. - - - __ - - ' - - - .- •
•
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - -- • -
(This section need not be completed if the permit is for one hundred
($100) or lessj. . - .- - - _
I certify that in the performance of the work for which this permit I5
Issued, I shall not employ any person In any manner so as to become PLUMBING . - PLAN CHECK - - - ' ELECTRICAL PLAN CHECK- -• .
subject to the Workers'CompensLaws of California.
• BATHTUBS SHOWERS - - uCUG CLN -- GARAGE
Date Signatures' I -
NOTICE: If after making this declaration, you should become subject TOILETS -. URINALS I • GENERATOR 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must . TRANSFORMER - -
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAVS . APPLIANCE 10-50 KW=50+KW. ._
r¢voked. - KIT.SINKS - - 'DISHWASHERS MOTORS.
CONSTRUCTION LENDING AGENCY ` 0-1 HP 1-30 HP .
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - \I (INC.SOLAR) ,10-50.HP 50+HP +•
formance of the work for which this permit is issued (Section 3097 - -- -
Civ.-C.). - ' - FLOOR SINKS . FLOOR DRAINS -� 'FIXTURES. "' OUTLETS- SWITCHES. - ' •
Lender's Name - +
Lender's Address DRINKING FOUNTAINS - • . GAS TUBE SIGNS - - - ._ .
OWNER BUILDER DECLARATION - - • - INTERCEPTORS - CLARIFIERS' POLE LIGHTS -
I hereby affirm that I am exempt from.the Contractor's License Law for I -
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL - - P TRAP - - LUNSI Hut.I rury -
Any city or county which requires a permit to construct, alter, POLES METERED SUB •- - - - -
improve,-demolish or repair any structure, priortoits issuance,also re- WATER-SERV ICE ALTERATION PANELS - - MAIN - SUB•
quires the applicant for such permit.to file a signed statement that he - -
Is-licensed pursuant to the provisions of the Contractor's License Law G1 -VICE - - - OUTLETS \ SERVICE _ _ . -AMP- _ _
(Chapter -9 (commencing with Section 7000) of Division 3 of the -
Business and Professions-Code) or that he is exempt therefrom and the WATER HEATERS } BTU OUTPUT / - -- - .-• -
basis for the alleged exemption. Any violation of Section 7031.5 by 0 -
any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - J . . •. - . . _
of not more than five hundred dollars ($500). -
❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS; -' - - -
%..... . ..
sole compensation, will do the work,and the structure is not Intended _ -
or.offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE- - . . ' .
Contractors License Law does not apply to an owner of a property - APPLICATION APPROVED BY .
who builds or improves thereon, and who does such work himself or ' ISSUE FEE - DATE. -
through his own employees, provided that such improvements are not
Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK - SUMMARY OF FEES' - - '
Is sold within one year of completion,the owner will have the burden •
of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTUBUILDING
❑ I;•as owner of the property, art exclusively contracting with -PERMIT $ • SMIP - $
AND DUCTING licensed contractors ford to construct the project e(Section 7044, lness 100,000 +BTU PLAN CHECK $ PERMIT _ •and Professions Professions Code: Tho builds
or S License Law does not apply to _ ISSUANCE •$ -i
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING $ - - •
tracts from such- projects with a contractor(s) licesnetl pursuant to SYSTEM . GRADING $•°" '
the Contractor's License Law). 300,000,+BTU PLAN CHECK $ - // -
❑ I am exempt under Section B.'& P.C.for this BOILERS BTU -ELECTRICAL $ ( ' — • - $ •
reason - 'PLAN CHECK $
MICROFILM $
Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE$
I hereby certify[hal I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ -
Information is correct. I agree to'complywith all city and county • PLAN CHECK $ LESS AD-
ordinances and state laws relating to construction,and hereby authorize . 'VANCE PC $ •
-
representatives f this •ity t. - ter upon' the above m nti ed' •
$��property for, pecti. • P p• -- ,�
Signature at - S • ���/
- ISSUE FEE ..-_- -_ - - -
CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL&SPA -- ,. . - • .i- I.C. 4..7)::
Date Inspector 'Date - Inspector
APPROVALS Permit P58y y APPROVALS '' Permit# __ - _ _ _ __
.. 1. Temporary Electrical Service or Pole _ ."_ _43. Pool & Equipment Location " - -- - ' - - -
2. Soil-Pipe-Undrgrn . . 44. Steel_Reinforcement"
- 3. Electrical Conduit-Utility-Undrgrn - --- -_- . . _ - 45:0 'Forms, -
-4. Electrical Conduit-Undrgrn- . _ _ - - _- - - - - - - _- -46.- Electrical Bonding . ' -
5. __Steel.Reinforce- .__.c_ _ 47.- Rough Plumbing'& Pressure Test:- -- ' - • - -- • • - - -
' 6: Electrical UFER Grn- _ __ _ - -.- - , 48. APPROVAL TO COVER-GUNITE
-
-7. Footings _ - _ _. _ _. _ _ -. _ . ..__ __ . 49. Electrical Conduit-Undrgrn - - - - - . -
8.- -Foundation • -- - - -- - -- _ ' • 50.r,. Gas Pipe, ❑:Undrgrn,Test - e
' -9. Water Pipe-Undrgrn - - - - -- - 1 - -• • 51. Backwash Lines.P-Trap. ❑Undfgm - '•" _ "'
10. Structural-Floor System _ _ -_ - 52: . APPROVAL TO DECK _ -` - . ., .. ..'
.-11:--Property Sewer Line& House Connection- - " - - _ - 53. - Backwash &'Receptor-Final '. .
r12:- Street Sewer Connection- - -.-- _ _ " --- 2 - -- -- 54: Heater& Vent-Final. • '
' 73.- Rough•Plumbing_ --- _ _ - _ _ . .-- _ - _ _ - 55. Plumbing System-Final - - _
, t4._ Rough Electric-Conduit - - "-- -- -- ' -56."-Electrical-Final - - c .
15. Rough Electric-Wiring -- -' " - --- _ 57.- Solar System-Final - -' -, '_-
16.,-Rough'Heating &Air Conditioning-- -_= - -- --i- - ,- - r== - _ ba.-- Fencing.&Access Approval - •'
59._ APP.ROVED'FOR PLASTERING " •D
17+' buds;-in-Structure - - - -- - . . ,..- '- - • •- -- - -- „
18: - Ducts;-Ventilating - �-.'. - - -- . - - -- - -..._ - - - -- - - - - - - -- - - - -
19.. Gas Pipe-Rough &Test - ., i - t - - - .. . -- - - - -- 60. - POOL/SPA.SYSTEMS FINAL - - • - ,
'-20.. "Roof Framing ;- -- - - - - --- - i --1 - - .-.. - ---. - - --- - - -
21., Roof Sheathing, -! --- -. --- - - - - - - - - cia
22' Frame and Flashing.. NOTES: =. ._ ,
•
i 23.` -Insulation - - - _ .- - - - - - -'._ __. - - - - .. _ _.. - ---- - _ - -- - -- - . • ,
` 241 - Lathing&Siding -- --- -- • - : .-- - '-- f---- .- --- - - -- - - - . - --- - -
' 25:r- Drywall Nailing -
r 26.1. Plaster-Brown Coat - -• - ., - _ _ _ -- ._ -_ . _ . _.__ _ -- -- -- -.,,, . - _ .
27: -Electrical Power Meter-Final " - ---- - -- - ---- - ---- - - - - • - - .• ,
-- - - --- .. . - - - - - -
r -29. "Final Heating'&Air Conditioning-- -- . -- -t--- f-- - -- - - -- - - - - , ,• .: =% - -
! 30. Final Gas Pipe-Test --- -- - -- -- - - - - - - - - - - ._ - - -
31.- Final Plumbing -- - - . . - /,2%x'712-- -��8%/-�- --
32:- Water'Service-final - -- _ - - - - '
-33.- -Gas-Service:Final-- ---- -- - - - - - _ - _ - - - . . o r
34. Solar DomesticFinal . _ __-__ _ . _
35. - Landscape Sprinkling System - ! - - - ' - - ' - ' ` .. - ' " " ' _
..
36. Sound Attenuation - - - r... - _ - - -
37. Handicap Regulations - - - - - - _- -
38. FINAL STRUCTURE&BUILDING ' - ' _ -
39. Special Requirements Completed - _ _ . I _ - -. --. - ... • - - - - - --- '
{ 40. . Electric'Release to Edison -
i 41. Gas Release to Southern California Gas Co. _ - - • .
42. CERTIFICATE OF OCCUPANCY -
No- - Date -t - - - - - - - . . . ._ , - - -' ----- . . . •_ -- -
OWNER r01.p480j J!"145 DATE 6-13-58 ._
JOB ADDRESS 11412 Shamrock Lane BUILDING PERMIT NO. 69116
GENERAL CONTRACTOR ^., z .q,.a eor.ctr VALUE $ 598 no
AP. No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK 4.t _,w ca4
GROUP TYPE ZONE PLAN NO. 6946
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel &'E-t (. '/6-t$r
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing
Lathing, In Out
Plaster, brown coat
Underground soil W/G Pipe Test
Top Out
Furnace
Gas Vents
Rough Plumbing
Cesspool Septic Tank
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating Final
Plumbing Fixtures, Final
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Fixtures, Final
OCCUPANCY £.-E--E -/?4-i
*Form 210-5M-1-57 6946
/ COSTA MESA BUILDING DEPARTMENT I 6946
P. 0. BOX 317
. r-i- COSTA MESA CALIFORNIA 'EE I��E E �
Eo FOR APPLICANT TO FILL IN
C.L. OF STREET----- 448 SI trey n
• FINANrE DEE , I UILDING ADDRESS /'"�,2 (.5747/77/1",r/( /Or//,
_ , M_ __ PROP LINE CITY OF OSTA; ['ESA' Owner .Lit ' ,I .e
,c — =
10 FT. FOR 60 FT. STREET 12 FT. Ti6li FOR i I Mail Addresq /9/.Z % tom oc Line
I 650 FT. STREET //�J ✓✓
I I City /Ar`G'1 ltieret Ph. No At j9v''4/
I I Contractor QUOi_(t J
i%Ph. No. WC 77A`0
I . Address �� /a576 CatnRnave %/ CC_
50 Fll IF FRON City Lic. No. 10.27 7 State Lic. No17012S
4 10F PROP. 1- / SC _ �j
150 FT , atu
it Size of LotAX ° AP No. //3— a a a -
I- Lai 1 f' Setbacks: C/L Street 5 -1 Rear 4'
ta co /
ta El t a Side Yard - Right i� Left <� �/
wr—'-- _ _ a. Type of Fence techs-•tip
t �._...... 1 t� 0 s/,X",,y s%,
o. I ALLEY OR P 1�N� � S� al ci r1` y/d�� L3'Y 1 fl '
i=": x.� ` 1
' --1 U I hereby acknowledge that I have read this application and state
C• Ji m� LL Z , =11 r d 1 '`/ I that the above is correct and agree to comply with all City Ord-
d‘ G 3 / Ey'I^''=� < n• o . � inances and State Laws regulating building construction.
\ 0 — C / 5 L` _M`Y Q d ' � ' Signature A ,p
7 �Otc,i ,... .
, 10I of Permittee -� 'j . Ali • _,1- x,,52FT I Agent r: '!o44'1CfliII3T s IN. �' w z FOR OFFICE USE ONLY
t ..
FT. � w a 40 I
W y jG U_. w'. a F T 1 i
Z ` 8/ r I I ,_,I Permit No.
oJ. .� I I '' ,Ep rte` S . c ,,,s I
o IC. ' — 60 FT ST. 'e dived by Da - Re.-iv_ed/ Date Issutd
d - I ��`" �/7rY
Ip2 F T. ST. ! ties I V'A ION ��
_ �/PRO_P_LINE __ _- - - Weir'_ _ — _ � 9�\; Permit Fee $
J ` !
I to
I I $ \ Plan Check $
C.L. OF STREETS ���
TOTAL FEE $v
• MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES —— — ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS
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ADDRESS OF UNBIND 1412 SHAMROCK LN WIT: CITY OF COSTA MESA — BUILDING PERMIT
OWNER'S NAME IF KNOWN: GALASSO THERESA A PERM NO: P 078068
,ADDRESS 1412 SHAMROCK LN
COSTA MESA,CA 92626 .Z( q PERMIT NO: P 078068 PLAN CHECK NO: N GOVT: N SUPP : N
•
APPL.MEMOADDRESS • CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT OR ENGINEER: MHO.: JOB DESCRIPTION : C/O WATER HEATER SQ FT:
ARCH.OR ENG.'S ADDRESS: UNT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
caNRACTan NAME NOCK PLUMBING ( 714 ) 895-1246
CONTRACTORS RARING 11610 SEABOARD CIR COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT
ADDRESS: STANTON CA tomb.: 511971 *+A***x'x'*4***** *****iEitititit*x*iFit*****fEitit*+E*i[*EE+E+Ei ******iEft*iter***+Eit****************
90680 UNIT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby aflrm under penalty of perjury Matt am[tensed under provisions 01C er g SETB ACK S
(commencing with c+tion 7000)of Division 3 of the Business and Professions Code,and my' rise is in fu
llWed.
C • C.NO.: 050386 UC.CLASS: C-36 LIG.NO.: 51197 17 MAIN BUILDING ACCESSORY BUILDING
/�J511 FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
— - Contractor /!V ` � LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
BUILDER DECLARATION:I hereby affirm under penalty d perjury that I am exempt from t Contractors License law the
Ir wing reason(Section T031.5 Business and PMeesions Code:Any city a count', Penni( mneted. laamrprwa, PARKING REQ; PROV: PARCEL : 41814301 ZNE: REF NO:
:moleh,or repair any structure.prior to its issuance,also requires the applicant for such pests to fib a signed statement that he a she
PLANNING N V T ES>
o licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 d the
Business and Professions Code)or that he or she is exempt therefrom and the bade for the alleged exemption.My violation of Section >
7031.5 by any applicant for a permit subjects the applicant to a dl penalty of not more then five hundred dollars MOOR. *************3*******************3********#*'IE********************if********'******
❑ L as ovmar of the property C.my employees with wages as their mile conpensetion.wil do the work,and the structure is not intended DEVELOPMENT S E R V I C E S — R E Q U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not appy to en owner of precedy
who builds or improves thereon,and who does such work Nmself or herself or through his or her own employees,provided that such
improvements ere rot intended of offered for sale.If,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ Las owner d the property,amavidly*oentreditgwith Seemed eanaaam"to°ons°In the proMd(Se°°"7D44.Business and BUILDING APPROVED BY
Profeaeoro Code:The Contractors License Law does not appy to an owner of property*tic brim a imprand oves thereon aw �1 DAT E
contracts for midi projects with a mv111[10°)licensed pursuant to the Contractors License Law). /�—p
APPLICATION ISSUED BY: k/_ %'/ /�1•
❑ Ism saempr under Section: B.AP.C.,ler this reason: ********************** •,3 - ****D***** J*�s
Dale: Owner: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: N
I do hereby certify OWI am aware of and understand the requirements of California Health end Safety Code Sections 25505,25533.and
zss3o.ed hal loamy Mare building occupant winlwelrM(dmk one)need to comply with said date codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
e permit forconetruction or modification from IMAs udty ana0emeni District.Residential mm
rnaion appiWare e exempt p these
provision. PERMIT 11 ,00
Date: Applicant: 25% S M I P/NON—RES
PLAN �l
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: ISSUE FEE 22 . 00 1i
o Ihave end wiImaintain atariffless dconsent to self-insure for workers'compensatiognprovdedfor byRadice 3700of the Leber BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code,for the perfro
amee o the work for which this permit o issued. I
TOTALS----> 11 . 00 22 . 00d �O./ 0 . 00 33 . 00 33 . 00 . 00
I have aw workers'kers'compensation insurance.as required by Section 3703 d the Lebon Code,for theMod pmence IM
//)rl work far
%Nth this panne®'issued.My wakens coat sation insurance anter end policy number me:
Carrier: STATE EXPIRES REVENUE DIVISION TOTALS > COLL'ECTED ; 33 . 00 OVER/SHORT: . 00
policy Number: VUUVVVUUUUUUVUU 01 /01 /01 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
�Q
(This section need not be competed iI the
penal is for one hundred dollars 151001 or lese.) 33 . 00 i
I candy that in he perfonnnce d the work la which this permit o issued.I Meg not any.... ill, so n to
compensation wectho provisionsod5ers'comction DOd the taws of Cafilomia.andbor Cab.l shell tat rise that comply d those •it.
to Tickers' **********************************dE********************************************
Or
'" I N D I V I D U A " FEE BREAKDOWN
Date: (1....? Applkant. r„ / // 5
Warning:Failure to secre workers'compensation coverage Is unlawful,and shall subject employer to admin(p as end TYPE QTY D E S C R I P T I O2N UNIT COST TOTAL COST
civil"Ms up to one hundred thousand dollars(5106000A In addition to the cost of compensation,damages as Provided ler In
Section 3706oldsLabor Code,Interest,and attOmerefees. PLU 1WATER HEATER AND/OR VENT 11 . 00 11 . 00 •
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a constnnion lending agency for the END OF FEES
performance of the work for which this permi is issued(Section 3097.CM.C).
LENDER'S NAME: "Th
LENDER'S ADDRESS:
v N
I certify that I have reed this application and dale that the above information is correct.I agree le comply with all my and county ordinances1 •
and M
state lava relating to Mildig conebudon and hereby authorize representatives of this cryto enter upon the above-mentioned popery AJ '...yf, ,•, -
totM°edUnpr ' RON CK////2r
`�
Pint Na / I ell 7'
Date:
Signature A med., •. ✓ or
(5151,x8 WPI Were-Buildig 8 Safely:Gran-Pile:Canary-Malcom;Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING' POOL & SPA
APPROVALS Permit#_ Date Inspector APPROVALS Permit # - Date Inspector
1. Temporary Electrical Service or,Pgle 52. Pool & Equipment Location ' i'
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. : 55. Electrical Bonding 1 .
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. ;;�'.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 U,ndrgrnd. •'
10. Structural Floor System - . . 61. APPROVAL TO DECK
11, Property Sewer Line & House Connection 62. Backwash & Receptor-Final"-
12. Sewer Cap / i 63. Heater & Vent-Final
13. Roof Drains , 64. Plumbing System - Final .
14. Rough Plumbing 65. Electrical-Final i•-/
15. Rough Electrical-Conduit -.-' 66. Solar System-Final - -�
16. Rough Electric Wiring • 67. Fencing & Access Approval '
17, Rough Wiring Sign s - . 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 9 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating - - 71. Product Piping GGas 0 Oil
23. Gas Pipe-Rough&Test 72. Underground Flush
24. Roof Framing' 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical
27. Frame and Flashing - 76. Dry Standpipe
28. Lathing& Siding • - 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY, FINAL
30. Drywall Nailing 4 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: /
34. Final Heating & Air Conditioning - -
35. Final Gas Pipe-Test, • 1
36. Hood or Canopy - !!
37. Final Factory Fireplace
38. Final Plumbing - V_ / moi 1-14_
11L (// ---
39. Water Service-Final �t�� L( `7`-M/�_
40. Gas Service-Final
41. Solar Domestic-Final -
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation - -
•
46. Handicap Regulations -
47, FINAL STRUCTURE & BUILDING
48. FINAL PLANNING - --
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date -
OWNER College Mesa -Company DATE 4-18-56
JOB ADDRESS 1)02 Shamrock Tang BUILDING PERMIT NO. 2785
GENERAL CONTRACTOR The Halp Company VALUE $ 10,248.00
LOT 26 BLOCK TRACT 2132 Single Res. w/det gar
GROUP I & 'J TYPE V ZONE Rh FIRE DISTRICT 2814
` PERMITS ISSUED
INSPECTIONS a_An�-S��,E.^'� SUBCONTRACTOR
T/ ; DATE NUMBER
Footing Trench rt.A✓t t ✓r•`i- r..
Foundation Forms and Grade to Gara g
Rough Framing `d .1- -3r/C
Plumbing,RougISab `f1'1
Plumbing, Rough Complete /lt//Cb U J. ,. .py,/�� .cc y ' 9•1G-it t/( cr.--
Temporary Pole fa
'� � ,o p
Wiring, Rough fr2 7115•,t'6 l,..,, .,.J As. ! p 7-/9-47- 6 P
Heating,Rough —7—�7
Heating,Final ��� r,,,, /. ip-.zee-Cr' 3 3 ,rte
viewer, House.t9.ex, Sewer,St. rp-a-0,4.) /f., at2 - .r< !/GjS,? —
4ep4 n7c ool .oe f—,--I
-
Lathing, In)/ Out g"&" 8/,j
Plastering if 119"/rs -.f~l:
Plumbing,Final,Fixtures Complete/t�tr,`, /� _ ar
,,
Plumbing, Final Gas Test Ira '✓�'� /r/'S �C��C...r/ .v //Af ' —i, &
Wiring,Final /�/�j-
Occupancy tO� //_yf.c
FORM 210 3M 10.55 ,
LL Costa Mesa Building Department APPLICATION FOR PERMIT
281
111 EAST 20th STREET BUILDING
.- COSTA MESA, CALIFORNIA
\. FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN 4 Receipt No. IP e(97-.5—.-Building O
Address. 1412 Shamrock Lane
Costa Mesa, California Received by Date Redd Date rlxssue(d
Nearest ��" �`��
Cross St Watson Avenue Building
Address
Owner College Mesa Company Costa Mesa, California
Mall
Address 8002 Central Avenue Nearest
Tel. Cross St., / r
City Garden Grove No. LE 9-2158 Zone 1J No.of I Type/ Oroup� //j
l,ly
Architect or Lie. Plans �//
Engineer Davis & Quigley No. C-1790 Approve v
by Date
Address 43 Malaga Cove Plaze.Palos Verdes CORRECTIONS
City Lie.
Contractor The Hale Company No. 3422
`
Address 8002 Central arden Grove
Ave.„
Legal I Lot I _ -_
Description I No. 26 I Block I Tract 2432 yy r
( l 1 /A\\ IT; 1 _s
(Attach Metes and Bounds) I 11 \ `I, Y•
size of Lot 65 x 95 I Now.onLot None ' ii
0
Use ofNo.of No.of ii jr x
R 1 R tor
Existing Bldg. I Families I Rooms ..vv B
Setback Line from Rear Yard 60' -
Center ofStreet 50' Side Yard 51 PITY n,- y
DESCRIPTION OF WORK ✓•. i - / r
New I X I Alteration I I Addition I V! � ` � ��A
Repair I I Moving I I Demolish I
Building 1181 No.of
Size Rooms 5 Stories 1
Exterior Wall I Roof —
Covering Stucco Covering Shake APPROVALS
Use of New
Building Single family dwelling with Foundation Location Inspector Date
Forms,Materials,
datached garage. Under-Pinning
Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath.Int.
with all City Ordinances and State Laws regulating
building construction. Lath.Ext
Signature of THE HALE COMPA c
Permittee Plaster,Int
Authorized Agt. Plaster,Ext
SILVIA LARDNER
Valuation Permit Fee $ )1`2” Masonry Reinforced
Plan Check$ r 3
$ / e f �7 Total
�w� Bond Beam
�,
Fee $ )7/
. FINAL
rnnM 904 c_nn 2M 6.55
C Y
•
J C
603J
0 d.
a 0
a
A 1 I Diaes;, :13� a• :,:30.n r
Street
PLOT PLAN
Show location and distances from
property line and between buildings.