iiji.ding permit fot .·if s-, ,; .,~1 addren · wo;tk.mt"-'s compensation insurance...
TRANSCRIPT
•
.'IIJI.DING PERMIT Fot Applicant to FiH in
Job .·If s-, ,;_.,"~1 Addren
Owner ------~-=::::~~ .. -.._, _ ___,~...-::..-;_...;___ Own . ..,r's
Address
#4 Owner
·---·----
---------------------------------------PLOT PLAN
' Dep:clc•••.w ., •. c."··- ' Dlredot
I'' ' ; --~"'·!--'+ ._'!')· , •. ""T-·~·· •••. '
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BullciJna CITY OIF
GARDEN GltOVE ·-:;;;;-----~-- -·---1 p;."ffl!ii1::;:~~;;~ ~dre.:_1!_/b:_ 81_. S/IUU:J ft:.~~~~ 8 .
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FouiH:kltion ' and location
~4Nnfcrcing
f:inal
Utir.ty Release
Validation .Arch. or
- Engr.
t-2dres$ · . --.£2c--·--' I hereby &cknciwledge tnot I , avo ro'i'd this opplicotion ond doh• that +h. ebc>Vo is corre~t and oqr&e to cpmply whh all. ordin.!ncen: ond Stato~~ laW$ regulating building .eonstrttdic,n. I harsby certify that I am ptoperly regis.tered with end/or lic:;onsed os t1tquirocl by the City of Garden Grov•l Md/or StatQ of Cnllfc,rnia, o~ thclt I em ffle 1t~qel owr1er, of the obc1vo described property, ,~..,d I c_.rtlf1( .fhot in .the performom:e of th" work for which this pu1r.it is il~u~l I s.hall not employ ony non lro liiol11lion of thll worhnen's eo""p',nsation laws of lha Stat California.
. '
Validation Areh. or
,~ &gr.
Sfatlnles
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rAddress -·--
..,.----·~---~-'-._.....__--------
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#-4 Owner !HI'Itfl:l
~~ .................. --------------------------~--~-------PLOT PLAN
CITY OF
G.UDEN·GIOVE
-11 I
(Use lnl<) l P•'rmlt Mo.
~~~-r~~~~~~~~-r·~~~~~~~~~~~~~~~-~-----~-~~~~:::~3~·c.L··~~~c
@1 •• Blcft. Permit ·If---·-:~·.·--·--· I
----~~~~~------~--~----------~------~--------------~~--------------~·------· ~
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·.· ...., w. •• .,. ' ....;;_----1-fl-.-~. j. !III.OUGH rUR~CE -:;..-.....:.-~1------'--........ --i----..f......:.--+--fH~PTIC TAMj 0, Cor..1pool w.,_ .....,_,Teat. i IF~.......,··wf..;.f""l·/ , ....... ~ .. "*""":---'--.-+. _ __.;...._"'-+---·-----
~--~·--.....:.----------
,.AS TIST I I a.c•w•ll . 1 1 _ ~~.~~lo~::o
I ' i .. •ATilt .... TIIIt -+--·--+------''---·--
........ , ....... : i . • 00 IIACKWAIH' I
r----?'1----:-:----·--------------~-----···
._,-t.-.o,.._.;...-----------+----:--~o...~ Y.L It/e-Lls _________ . _ . ~~r•s A.ddreu 11m Sfitllll t I?L,__ _______ _
--------t----+----tplurr1bing Contra.;totSert!tfd f of .JjHy:''}~_jprd:_ __
--+---r<:_on __ tfGctor•s.Addreu UJ..c .f.J, cfd£S"fK£_~~.t. ___ _ ~~~-+~~~--~~~~~~~~-~~~0-"-~~~~~~~~-~ ~~U~NL--~--~---~r::---::-:-:-~------t---f-:-JU_s_•...;_o_t ~~,~~~· /#i -~-- ---·----·
Hew Bldt• fl ~~d Bldg~. 0 -:-:--:---+-~-r-'------'----+-----i--IYa!idotion J13l to~2 11 z~6~M**.***BO
ROUGH. PLUMBING ---1----""'*-..,_-'-------·
~--~--~·:•:••:•:.~:l:c~W.:.:•~:I:nt~!:M:oc:~:•--~--~~-f~~·~S~P~IP~·~~G~ .. --_...;_ __ -t----~~------------~~---~W::fi:•~S.~h~•~w~e~rs~~~------~~-'l·~f~~~-~~~=·=·A:S:V:E:M:T=···::::--~-r---~--+------------~
'•fide~ I •. '~OUGH FU:::;.::R~H..;.:o/4.,.;-:C~E=------t~--~. --+-'---'----·-_____ ....____ I SEPTIC..T~Hi( or c•••pocill '
W..., Heater T.ut I ~--------+-----+- _,..._ ____ ~------------+--.__.,....__"!": ... _ _,_~---+---+-'-~SEWER , · · · --4-----~--.....;.:..
~;._.·~---------~--~
--------t-~--~------------;-~--1~~~~A~S~T~!S~T~~~-----·+-------~~~---~--------jt---:----,.-:--t----r--1--1~!J. '.t.M''~ri"UIDu!MuJilA.J.~J!I~rJ.iN_D_;_.....;_-4--_:--J._ •. _.,... _____ ~ ~--~----
•2 OHt•• ,lit'
CITY OP' GAIJ)Eif GaOVE
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JIEA'I'IlfG. VENt'ILATIOif, IIUIIIGtliATIOif & .IWl CONDITIONING PERMIT
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t-------------· .. -·--· ...... li ...... ··-·-· ..... ___ ,,.,.,.~ .. , .• ~l
~·-. ~~----------·--~------·------r---~-----~
IGIC. .API'UUCII -..,.-~.l-------------+---t---+---+ .. -11--------·- ----·- ---------·-
'. Q;B&WT ovna:ra I ·---+----·-----~-----+--+--J--t---------- __ __.. ________ , _____ _
aatAVIWft' ZJICBDIIIOOD ---+--·--------..;._...:.,_ __ .__-l-__ .,.1r ........... ----!_... .... ,....._..,_..__ -.. --.................. , ............ .._. _____ ... ....__~-----+-------------+---1-_,;.,+--·-f-""!"'tt-------:::::-::::-:::--t--··--- --------·---
,, COla ltQ Vlf1T cl f£,. ·~---J---~--~~--4--~----------~~==T--------+---------·-·-----
·:•:~m~--::CI~or~:~::::----~·~·----+-~-L---+--~I~·~~~::~:::::Q:~::·-c·~·~~- -------~--IOfAI. I'll ' · • J '/ :p cOIIW'.Ir1DQ mnr ~V:J. r----- -~
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-....rlllaft OF•Iu:tDDfG I Cl1T OP Fo• .JUIPt.~CAH'l' TO Fn.J. 1M (USE l!m) L C. ADAMI • DIIICTOa '7c5BADORESS I PERMIT NO.-...._.,._. OABDEJf QftOVE
//&, ti-SToAeT- bl?,- //,/) ~-,.o JI!'.RMft' PEES . ~..,........,.,.. ........ ~ .. !"~
"U-ft TYPE Of' FIXTURE C~ ITEM I!.AC:H FEE LOT TRACT
- NO. NO.
I I ~ -- - . ·-·-
FUIUfACE Sl..GII OWNE~ jo IJ c , r- 1 .c -A tL..!Y (!LZI.;_ Y ~--~/.JJ
1 WABM ~ OllTLET .zs ~ OWN::'R'l I ·~""'"'''·~''""'"'~--
J FUBifACC vmfU 1.00 0"0 ADDRESS
J - -C•ONTRACTOR 0'1 lZc ,4 .1·1 /J)-tf2L B@- uiic GAS P!Ph~G --OUTLETS ).00 ..
NSC. APP!JAXCES I JIG CONTRACTOR'j; ~ "2. 'i "2 ) A j. A .. ADDRESS " . • j _ fJ •· fl,:t_~~" ~
- J COJOIEBCIJll. HEATING .ua ~NE Ltl., 2- ::s 3&: -'i CITY I
LJC. NO. - L ttL COMMEllCIAI. WAIIM ~OUTLETS .50 USE OF . BUILDING
· COIOIEilCIAL FOJllfACE VEm'S Ul NEW 00 OLD D BUILDING BUILD! NO -Em.AlJST 01J1'LETS 1.00
ff8: -6·62 11 07£1 tu~ ;'I·:.~,.,~ 15 VALIDATION I ..,.,,,._,
ftt~TiiATJOW 01 TO IUATDfG 8l'li'l'DI UIO
I JiwQy cclalowlKp that .I H.• raa thJa GPJzUectloa end elate that Ill• -.n il or;;Q'Kt ..ct ~ 10 ~aaply with orltiaaoc•• -d Still• ............................ ~ ~ lMt 1 - p~rt0 r•;lllterec! with acl/or lic:eot•d • · ],il. 1M City .t 081liola •o"• -df.•r Stm. of CcWon:Ua, M tMt I - 1..-1 o- .. Ill• .. .,.. dH<:rih•d pro~rty. ad 1 c.,rtl:! -... ill 1119 ,......_., • .t 11M work lor which thill p•nail II IIWiued 1 aha
YD'DLATIOlf SYSTEM uo ... ~ .. ~-~ .. t.U _....,. •• C01101'•DHI1-t-' .... tl(
llESTAUBAltt mcHEtf HOOD 3..00 liiiGNATUitE OJI•'lt }~ ~
co..,...amwr :aili.P,' 2.01) o•l.EU ~.,!!!MITTEE ,.. ~ (~)/(~/,-::; OA!!... ~ 6_b~-
CO!IImDJJIG UHlT TO 5.00 I'OCRESS 10 JI.P.
APPROVAL$ C,<~,TE: }l'fJPF.CTOR
COJIDElCIIKG UMT ova. 10.-01 '~: , .... /; -~~.J<il!!:: .. ?t.i If H.P. PUDACI ~.,~~---- -mF- o•lfc~af&TO t.OO I"" , .. 1. r.r IIPJUGDA OM UQJITEI. OOTI.Era .....
EVAPORATIVE COOLEilS 1.110 FUUACEvmml
a.u JIIPDfQ j -IOIC. APPLU'.MCI.:I -EIHAUft. OU'ILITS U'.ftAUJIL ... lll'l'CHD JIOOD
vnmtATJOlf IYftDI ,_.,....._ C01f»a1111GI VIIJT ~ R.P,
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. ~ori'DMft' i
1 .. C~IJIGUJm' 5I H.P •
TOtAl. ftZ j • 3 ?.s c:OJIDatiiiiQ 11Im :lll. ---·---· -M DAT~..-~.r·A:;l ~~---,.,....,., At.ITMOftl:llo:O •v -flltt.L' ~,-~.~ ~~ ' ) -"•-· , llllfUillll• HMI1' IW, ' '
UTILI1'f co~· •o•ll JID. r "Mt\Y i jr) ~~G
···~ •• cw,.c• m.1 flt~oWHM . , •• 1
,I,J I I ' ' , ." -" ......... __ •• < -~~ ............. ....._..__ __________ . ......'. ·--~-~- -- -----· -- ·- .. ..... ..!..._,.~-"'------··· ~ l - L -- --· ----~-- ~-~· -~---
1 ELECTRIC PERMIT o.p.rtnMnt of ·Wdt~ L C. Ad."" Dhctor
CtTY OF GARDEN GROVt:
- .. .;.---.. ---+·---·•~--·-t·-··~--.. --t---~----.,--·------f-.· ______ Pll_t_~ .. --~---··---+--------•!'~P..e.~!~----~--
----.--.,,..-.,.-=--.-·---·-·"'---·· -==~~~-~J::·:: __ :~.~~=~:: 1
. -~T;~ .. ~-·-~~--:·-:·~- ·. ""$::~~-)~---~:~ .. ,/l:;;>:~;-~;.:;··;~.r .~ -··---·i-~---f--,-·;1--·--··i-·---··-·---+·---J-;Si;-::·::--·-F,:·-~:ti;: . 1 ,_ ..... , ..................... -"·'·-···-j"'":; ,,, .............. . ........................... ..
_ _;._ ...... ~-~ • .:J-~-----·----~-- o~~~~:~~~r~~~~~ ~-:~~,:1~~--~~--- ~ I ' "
Wire
--· -----·--i-.. --------·1-··-··--·~--1----1··-·-·--'-1
·;:~:T-··
.:.~:1 .. · ... ,o.~ . . . ~Ol ..
lnaptdor ·-----·--·---·il .... ·-··-·--··--·-··-1--------·----·-.. ·· -· ........ _.. .......
_ ....... ____ ·--·---·---·-·'"'"'-·-·r-------~-·-+-----l----·----1·---.. i~~~.!.~. ------""'---'-----·t--+-·t--l----~----1-~~~~--··--· .... -11/- "2 .~4 t._ _____ .. j .. J.l' ............ -_ ............... __ . _____ , .. ,. .. ..
... -. 1 ELECTRIC PERMIT
Tot•lm Inspector 1---------·--·-- ----------- ··-···-····-··-·----·······-· _, ___ _
'~IIIW!II"W~III:
llUJLDfNG PERMIT
Street Address
lNSPECliON RECOiO
·-------- A~Y._~~-------·------_Q~T~ .. fCKJndotion
a..~~-!:.~9.!'.0.-~ --··-··--·----~------
~!.!!!!~~--~~-?.b!~L.___ .. ------ -- --· ~C:.IJ9~ _from~-----·---------'------- .
t.c.J.~--~ E?,r~-~~ .. - ..... -- -Plos. Brown Ct.
Other ~ --··---··- ··~·.,· ... .., ...
land Use r• • .-o~. "'•"'•'• •• •••
Fino! .. "" ' ..... --··· .
Pion Chock Borsd
.Perm if
FEES Bu,ld~~:; Psrrn,r
validation JU'-1 29-65 1l 075 U ** • ••5.00 OfSCRiBf'Wc~,;, .... l____ -- ------ -----r--------·-----·-·-- ~-~?)------
~~-~~--~-~- _(!_ ~-fttc..EL-~---<'_r..;J_h oi.,r._ •. ~~-P- ~ -L~ .. _____ e~~rt-~t~"':: .w.,&.J.L ________ -·· _ OWNE:?-BU!LOP: PERMIT RESTRICTIONS: An owner-builder mus1 r•Ji«<. within lhe buildi.-.q f,,. ><hich this permit is i~ued. (accessory buildings !'U<t~t""'l: So;d boild·~"'· mcy "o' conloin more than 3 dwelling units, Otherwi~fl, this oe-rmit con b-e: ~sued oniy to a <:ontrodor licensed in the Stc.,te of California ~nd a b·_,~;, ~~·;; ],.t~'"" mo•t b.. procured from the City ol Garden Grove.
WO;tK.Mt"-'S COMPENSATION INSURANCE REQUIREMENTS, A certificate o; duplicate t!-.r,rec! of workmen's compensation insurance rnu•t be on flle with the City of Go•de., Grove prior to th., issuonce of thi; permit unless, 1. This permit is fer less rhon $100 valuation or, 2. The cJpplicanl qualifies o! 011 c.wner-hu;ff:kr cr,-,d >'9"' the $lr.1temr.nt below •
! r.:ertify rhat "' the perlo• monr.e of the work for which li1ls permit is l$$U~d, ; shall nc·• ""'F"!oy anv ;.oci'>On in any mann-er so as to become sublt'<:.! to the wcrk.men~s com?'..ensation law~ cf California.
:_orl CERTIFIC~:,TE ON FILE. __
APPLIC.-'.Nf·S CHTIF 1CATION, I hnve carefully reod ond exqmln<'d t~e c.d'lOVo noplicutlon rJf'"d f.nd th,. 'iC::tnW to be 1rue and correct. All provi~io11, of thtl bws 1111d ·~·ci,r-u!lr!'l of thE< City c)f Gorden Grtwc and Stole d Cnlik..rnio wiil bo ccmc,l·~d with whr-lh!!r specified hert~in or not.
Signature of p,ermittH
Addrett
"·~isi:Nr ~to(; ADDRESS MOVING CONTRACiO~
~ELOCATION
... Dote. .
1 fjlJ'~, li'::
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CtTV OF GARDEN GROVE ·Public Works & Otvttopment
.. BUILDING PERMIT Inspection Requests
638·(i'l71 Gerreral Information
638-61161
APPROVAL
INSPECTION RECORD
[ . .,.-, ~· t&-f:'/ ~..~-t-No. o~~; N().
- .... . ....... ·- ~'iH ~-- .... - ·-··
P C .. -·-· " ·- (>OC. ""' NK, --· •• , , ~ ""
_____ .v!~--r·~a~~IAD.:••• •··~·T~~~· r·~.? __ ~·i!_j~-·----_- .. --c.·-----.. _ -- - .j-J I ct7/c' . ...... -· l: {,((.!. . ." ~ t; ' " .... :f~::-- · ___ __:~- --~:~~ · "1:·z~~91·'"' ~f<t,JA ;'" cc:.; -F 1
ZON< ~-C- -,/.J ___ -----
For Armlicant to Fill lo
40CRl~tiS
INSPECTOR DATE
__ ;:;: i fJ ~~rC(., ·-·~rJ ·-:y,,. ~t 'i.t~ 1 J U. fr.j' I~(), ---·--·--- ------ I
NG
PLANS ARCH
Pl.ANNI ACTION
LANO USt APPROVED BY
~~.~~.:........: .. ·...:::.. _________ ' --· ------· INSULATION. ENE AC:,v J --------··-~ ..... , __ ,_ ..... ···~-~ ·---·--4-. "' -1~-----LATH OR DRYWALL -------~
tiP
~TA""rJo: LIC r•l(), & 1'YI•C , __ --·-
:£c;:~~o~'5L_~_J[~~~~;E~J
1' .. 1'~f~-·~:"'"
I"AMEL MAP_ ....... -~·--·-----~-- -~-~~:- :=:.:EO -·-·---......... _ftpff•r.-,_; ffl F.=} --r- I "/WO£DtCATION LANou-----··· 1 '1 •• 1
--=:t . ····"""··-~·- - -·- ···--- -~·,...~=....... . -·· ·-~.._.~-~
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FEES APJD BONDS /)£(/ f"( 1 /v' (,... .... ·--·-···-·--·--·-c:it.TY. IUV. COOl: ---- AMOU~v••-••' nk~k~~~ J J• I
tl""\r! .. l"'""lei,.A.,.Inft..l ,.l"'t.l"\e ZIP
__ , _ L 5'"1 , -r'-1 '- ell q_~~r;_ · , ·· ; ~'rArE. LIC, NO.
ST. BOND
WATER BONO
-'J·--·~-.-1
WORKER'S COMPENSATION REQUIREMEI'JTS State Compen .. tion lntllr•me Polley No, -EKplratlon Oat•--·------~-0 I certify that in ttl• p•rformanc• of the work for which this permit Is
'L::Ls-q<:; M r ez i 7''1 25:... :!_~.---'PRESENT B;-/JrS' . PROPO!>EIJ ,4_ /'r·<~ f.ILDG. USE 7~ [lLDLl. USE /f/" .) '"r •=>·=~-- --···-··" ~ .. ·- -•• • ·""" •-•~~-~~~~ ... .J, -~•• • • -- • •· • • • ~- •-•·-"·- •-~ ... ~.. • - -
1'1.!11(WA Y T'fiEE FEE
I'A"'I( & l'lEC:. F CE IDIST.
Oft AIN ASS'.IIT. FE f !Of ST.
l'lAN "'£1ENriCJN FH
I
I : . i ! I
lstu.cJ, I stlall not employ any P&flon In any m1nner 10 •• to b1ccom1 tub]Kt to the Wor~er'• Comp•nutlon laws of California,
NOTE: II, nit•• mok ing 111ch cerllfi<<Bio, the ni>PIIemH for the purrn 11 oh,,ulcl t>....:on"'' ouhjocl to klr'l Conoplttlltlllon provlllom of this <.od~. he 1h11ll fo wlllo r.ornp y with the provi!IOtll o1 Stotlon :1100 or t<;, permit 1 I ht dw~Jmltd r oker;l.
(] I c•tlfy ttoat I hav eftd thi' applica on 1nd •tattl thlt the above 1'1· form1tlon 11 corr t. I egrH 10 co IV with ell City ordtnan.:t1 and Stall '"""• r-'atl n ruction. I further agri!l tCJ hold ttl• City ol Clar rov f •n h~rmlu11 from any ll8bllitV arll·
DE!lCiliOic. WOHK ,(,1, y.r,, . rouE I lONE 1 I'J s T/J-" '- r' ...
1 o..v ~J 1t·
. _t l!.r::J~ y '- I ( tJ ,:.: L !C ..... NEW I'J 1\IJO'rJ I I 1\i.'ff I< ' ~EPIIIH ~ Iii V<'L 1 '•' 1 :
f7,o~)l;·:\;;,··~,-·· T No. c• ,;:-, --1 rc.o. 1H rw,;J_J,• lrJJ • to~),.-' ~. ~ I t .T
{!HI, F'f'.)ZU.Q l !.Hlllt~S ~'".:~ ., • 1/rltl~.-----~
-~~~~:C=~bA~ CHtCfi
l._ C. PU!Mt'f rf:" E ·-;? · .• C'J(, l - ("• II I~ ~--4 ((j L ~-<'::
ing out of intu• IIV d11m r .. ult1n11 from work ~•rfo~
rtlevtnt to tho& p ..... ,. ..••• ~~-·~~~ ..... ~.l...J ....... J:, t 1 tf•T'uJJ";; t~· o• rc
BUSINESS Y. C I !CATE IN O'llMAl'JQIII7 f_ :' {j I c•rtlfv that tht folio reo . actor' I Lie an" ~.o .... .,:::Z 7. ..... 0~~~--·"
~nc:..p.tR~~~/22 "1<:-z:;:J~.f~~-~~~~~~-~~~-'~-~~-t~. ~~--~~~
If work 1~ nut 'itMtfirJ .... ..,,,h,~, HHJ d.Pr'\l fr(.tttt r"J;i!~i ot 1H•1r tH '' abnnlloncU lv1 n,nrn tti,ir, '~~~; -fJyi. thi'i Pr:rrrnd ~ ... ,dip,;,.,,:: ;u;d vnld
'1\ Pl.l: M/\V Ill· r;JII\Ht.lL- !IJn IH IN:~f'FLf•<•f·J [I'll ll) Nfi(il_I(;('Nr;l·, INCr>'.1Pll~ !c WOHil:, (Jf~rr.:t t••<t ''' \1.'\>:l c:ormt,r.:-rJoN~;
1f.1.1'_it?J~:-~!SUMJCl ! VALUAO;;(J~! ~-~- --
l I : .. 1.-.a.g--.J , C0 ~ ,-.... ·'7
,,,. :~Bit"""t:"o" h-~ll.r:uv:::;l.~~r:T:tft!:" f.l.a.'rfl
~k .,, .... ifiliikfij • 1 .. A· c; ..c H.TI;..~;cA~, .• ;;~__.. --- ... &~·, iHATICttoiUAn:===-·~ I certify that I 1m l>llmpt irom Slt(ltlon '1031.5 of th• ButlniU •tntJ "roftttlon•l COdl, Olvltlon ;>, Ch•mo~r £1, ContrBctort' l.lclnll l.aw, under th• 1oflowlng Section: Owntr; S~tiOt't 7o.t4 fJ Minor work utldtr $:1,00: !ltcrlon 7040 lJ EmpletVH wettklng for WIUfi only: l:liiC!IM '/0!l3 0 Othtr:~-----------·· ....
flf(l'.'d N I lJt LH•. /\(H.Ifd ~t':1
M(.lVINO t:OII:l 111\\:"t<Hl
'"(riliiH1T ,_,.;,,;a-,;_,-;-·;;;,;.,·.,.· "iti~'N,t."·u;,-,-.-~;,;-o-;;;;t;;¥t;;,;;.ttW L ~~ ;:;; t 1_/ \..i~-? 1 ___ a• AU·tHt;ftiiAU AtillH1
"'"~~~~~~.:: jl\tJI.HlE~>;
RELOCATION
---------~1-alM.l rl.·, l:nlli •l !''
Cl
III~OW NORTN ARROW, l'fiCll'r.tfiTV L.INF.%1 ANO AD,IAt:F.NT 5TREF.T!i.
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lit! llulldirtll lrtttl,/j:l 1\UI!Um/j;j I'NttnltlHH/<1.1 ... l'tht I c~rrtllv thlllrtftlttnlllluu hlluttlrt 11 ~lltnltlwt• Mtult:cmtwL HI'.
______ .._ ______ ....,. _______ ..._ ______ ....... _______ "':.:..' :."·='"'41_ __ :'!:._ -
,., ·••,.,
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IUitDING PERMM''
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PLOT PLAN .,...,...,. ... of lulldlnt LC.AthnM
CITY Of GAII:nEN GlOVIi
J\)b Address
.,
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G.l.l!lllti!~N OIOVI!
P'tlf.MBI N G PER MIT
CONIIII.CI'IJI•• .• •.WARM AIR OUTLETS .so USE OF ~ .. I BUILDING~
COliiMlf:liCW. FUJUUCE VEl!fiS
COJIDEJmriiG OBIT
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GAIPIPIKG
EXHAUST OUTLZTI
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1 • ILECTRIC PERMIT
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n•ture d1' '· . ,. ,
Inspector
... ' . ... . ' . ' . '•" ' .. --··~---~~~~':C'~~~~ ' CIIIIFICifB .OF OCCUPANCY 2 ,. < ·
·OIPAlfMIMt• OP .udtNO 8, C. ADAMS, DillldOr .
(:I!Y OF CARDEN GR4)VE
11391 ACACIA
.JOB ADORES$ . l1MI.......... PERMIT NO ......J.(ijl)J I use a: auttbtNG--8-U.a ,.. ·. ·. ,.GROUP·_ ... a.,_ __ -_" . TYP~-~ _._-_--_-- I.· USE ZoNE ... , . . . . ......APPROVED &'t---L ....... DM-...---·---- DATL .. ;U-£6-62"·-·- I !C;)NJNG REMARK~S.,.._.:-a.i~IU!JQ:IIIK-IINIIM_..MNI.NIC------_:_---·----
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CrrY OF ~RDEN GR<.M! ~t Servlcet~rtment BUILOING PERMIT
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I CITY OF GARDEN ,GROVE, CALIFORNIA Ouvolopmont ~1orvloos Dapmtrnant
•• 11391 ACACIA PARKWAY, P.O. GARDEN GROVE:: CALIFORNIA 82642
Parcol No: 1 :t 6 13 ? ~-.; ·r u 11 f{ 1 l01obG ;J~~9
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LIC: EXP: PH:
State Compensation InsurancE' Polloy. No . .,--,...,.,..=--Expiration Do to___,..,..,....,..,.---, 0 I certlly that In the performance of the work for which this permit
Is lsaued, I shall not employ any person In ony manner so as to becon111 subject to the Worker's CompenMtion laws ot Cnllfomlo.
NOTE: If, after making such certlrlcate, the r ;;plloanl for tho permit should become subject to the Worker's Compensation pro 1islons of this code, he shall forthwith comply with tho provisions of S!lotlon 3700 or his permit shall be deemed revoked.
0 I certify that I have read thiR application an':i · the Information Is correct. I agree to compll' with State laws relatlr.g to pending construction. the City of Garden Grove free and harmless from out of · oi!Jbf;dily d ma e resuh lng from leva o ths p ·mi
BUSINESS lAX CEATIFICATC NO --.-i!Xf'llfATION om--I certify that I am exempt from Section 708 i .5 of the Business ond Pro· fesslonal Code, Division 3, Chapter 9, Contractors' License L.nw, under tho fol!Qwlng Section· Owner: Section 7044 D Minor work under $200: Section 7048 0 Employee working for wages only: Section 7063 0 Other:-------
/PAINT) PROF>EffiV 0'1/t.I!R -::;:(~O;;;::N,-;;:JlJ~fU:"lli:,::Cnu:r.'!t'i:rn"fif;r:V O;::l'Mm;~l!l~l - ~-,.. on AUTitOfl!lCO ftOt't'fT
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Pre Inspection Fe~
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CITY OF' GARDEN GROVE, CALIFORNIA Dovolopmonl Smvlcos Dopnrtmonl
11 I ACACI/\ PMI\WIW P 0 BOX 30i' GARDE'N GROVE CALIFOII~JIA 9264 2
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REQUIREMENTS
~~\:~)o~gom~gljg~' 1~~. ·------Expiration Onto---·----0 I em ;;~y thnt In thn porfonnnnc.:o of tho work for wll1ch thl9 purmll
~a~~~~~d~l~b1~1gt11 t1~0\h~m~gr,~,~r~ gg~gt~~~~i11i~~ ~~~~~11 ~r 2~~~,~~~nl~~ NOTE: II, oltor moklng such corllllc:uto, tho applicant lor ttJCI ponnlt
should bocorno subject to tho Worker's Cornpunsolion provisions ol ltliS codo, ho ol,oll forthwith comply w1111 1t1o proviston" of Soct1on 3700 or hiG permit st1oll bo dvomed rovol~ocr.
r:ll cmtlfy thnt I hovo rearJ this G!1Piico11on nncJ slnto lhvt tho abovo informution is corrocl. I ogroo t() t:(Jmply wrth all City on.ilrmncns nnd State laws rotating to porvJing connhuct1on I furttwr nomo to hold tho I Go or rc ' oe a. ld t1armlor;u lrorn nny llr1biLty mlolng out of I ury o o y t.l ~·rJ~,ultlno from worl~ rmrlormocJ ro~
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BUSINESS TAX CERTIFIC,t\TE INFORMATION I corllfy lhul lho lottowino Contrnclor·.s L., 0<•11<1e No ______ .. ond {.lauslflcatton _____ iu in full I: lr~:r- ami olf(lct
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I cor!lfy that I nrn oxompl !rom Soclian 70:\ I !':.. of lim 8ut:Jrnmm uncl ProfomJotonol Code. Orvi!;10n a. Chaptor e Contr;l(·tcrn~ l.1cnn~.u Law, undor tho followJJl" Soctiun· Ownor: Sor:trrm 704•t D Mw.or work ondor $200: SocUon 704U d Employuo •:mrt~in(j for WiHJUH only: Sotllon nJ53 0 Other: --------------------------------- --------· ·-~----· --·----11111'•' l'fl•ol'[lll> (IV/lUII ,H,ijl,llifii>IOO,oi1HI' oN/Iii II IO.o.!(
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Contractor's A.dd~ __ j! b,£;z ___ ik!.~ ..... l.;L<n':../JL~..rJ/...
~--J_Z~. r;·.J...1/ -~~~:_~~· _____ q_:4'?~L ... . Use of lldg. .ft J:Z.L~ .. · ---------~:].=E~~.S_T_ -J- .... . ~w ~ 0 Old BlcJv. [21. vlli~·-·- ------------,;s~-----,r-oTfllu"ifuJ.50
t. ..... ,. ~~ ,;;_,-T-;;;..;;- r;M~-ilii- ~!)PiiC.riOi-i ·ind··;;•- --r.;.,-..a.o.o. 0. ~,..,c; and .._. to <"OCI'Iply wfth all ordinanc.s and StaN- law.
N9ut.fillv· ~ill9. .. .;~...-... .... :----~,~.-------l l ~ ~ "'•' 1 em properly reol•illred with and/or ll••mecl ·•• · )' 50 ' reqvinod lrr the City of Garclttn C#-o\le and/ot· Slo'- of CalifO<nia, 0< l'ft•t I · ,
1• l :' - flttt ltvaf owner of tiMt wbove <Mt.erlbttd .,...oper~y, •"d I certify that In
·· ···~- .. .., .•. , ..... "~""'"1~---. ------,> ·· tlw '"""'.-- cf the """""' for which thle permH '• iuuad I 1111•11 n<>t ',, )'l.~l'l ·.· ' ~- ,....,. 'l>ti- lto •lof.tlon of !h. worlcme~t's COIT•P"ffHiion ilaWll of li!e ' """ S..te ol •C:.aj;~. ·.--·----- -.···.: ---~~ .. rso·:-~---1~-.
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DEP.l,RTMEN1' OF BUILDING AND SAFETY
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PLUMBING PERMIT FEES
INSPECTOR S FEE
lnspllction Rcquens 638-6771
General lnforr t«tion 638-661)1
For Applicant to Fill in
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1 ~ t:'l ..:...,_' .t -·'-'
Plg & Htg
Crenshaw Blvd - L.A., 213-759 I - I I . . Ql ('\, .~an~ Tr;~nco_ ·~~r-llrJlfH.;. : ~ I - ·-%94-J.-·----____.,;t-..1....';./_ . ..._ __
WORKER'S COMPENSATION REQUIREMENTS
~ . ..' ··- -· -1 .... ._. ~~"""·~----+--+---+---+----i St•t• CompensatiOn 686987 85 5 186 l".surance Policy No. ______ _:: __ Exptratlon Dare .. ---~·----··-0 I certify that in the per1orl"'""ance of the work tor w""11C'h ·h·s oer1"""11t tS
issued. I shall not emPloy anv person in anv manner so l.!S to tt'!come subject to the Worker's CornpenJatJOn laws o1 Cal don,·a
-..,... """""' 1:?0 c•v• from d•t• of iuue or ,1 t.t ~~~ tfl4ltl 120 dey1, thll .,.,m,f Nillt•• r,.;ll ar-'J ~/;2/J
-~---
NOTE: 11, after mtJkmg su~h .cert1f1CJtt~. the at.H'!t.:,1r:! •ur tr"i··~ ;.;e;·•·,~ shoulr..1 become sut.•Ject to the 1..-\lvr!HH s CorntH~nsat•on ·~"'ro~·S•( ·'r.
ot th1s codrl. htl' shall torth\'\llth comply ,.·~·•th :ht• t·,ro\'IS·~"1'1S c• "3r• • ""'" 3700 1.)r h•s por mit shall !'Je deer·noct rt>vO-_ t!d I cerufy that I have read ~his appticat•on and ~Hate that the J~c· . .e r.
form~tnon •'i corrttc~ I agree to cornt'IY w•th nil C !V O'dln,, .... .;:,.•, ,H' ~ St•re laws rLllatmg to cendtng <:on~•ruct•o•. J furl''t'lr .lgr.J(> r~v "'O ,1
th• CitY or G.ltl11!hl Grove froe Jl1 hatiT'lless fror-n ,Jny 1 lj)t)dlTY ,.r ~
mg out ot ~ or .. ~.o o~dj'J. 9~'' re~ulting from ~·~orlo. O@t4
·;; .. r ... ,~·:d ••levant !07T/)J?'t{~f ..-- 6/11/85
(_ff'....J. _____ .. __ ----- --·-··--~--~- -IT "PI"'L.IC ... ...,T ~l.oNATUUt:: .::I•Tt: ---- ·- .. __ .......... -·
I ceft•"Y that the foll~f)j Contt ctor's LJc,n e o ~~~ T,, • __
BUSINESS TAX CERTIFICA't~tr.,. 1Yl~.ll8'186
xacJassi-ffcatiOn ___ ~-~Q_- 'f ~ ;ect. _I ,_ ~~---------- ---·-~~~. - .. --·----·- ~-'.11 ~~~ l,.l'fiNTI CQ~TqAC:T~)I.f ~~tGNAT'-'Yi•:) ro~ ~IACf'OR r:.~o,•-
OU "UTttO~IlfO _.,~F.:;"'T
_ _2_2.0.3.5_4 ____ ·-~·---- ---· 10./.3_1...~_85 lfU~I~l:.S!. 'rA~ Cto;JTJf'ICATf. l'o/0, 1.'1.•-lflA.!i_, ... tl"'~'
I c;trtify that I <JTT" ex~l'nPt from Sec110n 7031 £i of th~ Bus,ness .'!r.j
ProfehiOnltl Code, o.·•ision 3, ChJDMr n. Con~f3C\Ots' LICtH'"-1~ L,l•'• unde,· the following S1H_Ct1on: Owr.er Section 7044 lJ Minor work un(Jer $.100. StH.'~q)rl :-o~;:, Employee work1ng Tor wages only: Sactton 10!)3 ;~1
Other·-··--·-··-·-·-------------- __ -·----···-·
1-;;;=:TT ;.·;;;.-~:·~; .;-;-·dw-;;~·;;- T~~~·~~-~-ck--;-,---;-;;~ p;_ ;;;~-;;;;.-:--;:--;; l1" T£ ort AllTHO"fllt~O "'-ht AtT
~T--~~~-
~ • r ' ~--;:;-7\~f~ ~~;-·:~:-;;-~i;7;TI7~ ~j~ .. -i ~~·.hI I ;-~~:~r'-1
Nf:l',tlitr'-4tf', j,-..H_,rlf-.ll•tfiF. '/.'t'J~r\. ,,,~ 1,\!• •h't • t-(, ~
~l.fJ.!.L!!;!L.-~ ~·~·- .. ~·----.... -.. -.--
CITY bF GAR.DEN GROVE', CALIFORNIA • Dovalopment Sarvloes Department
DEN GROVE CALIFORNIA 92642
11'101 STLlAHT on I ~;uite: P E r~ IH T N 0 .. : Parcel No: 100b6223 Type: 833 I Date : 11/01/90 Insp Oist : 013
o:;~;-;·-··:·--~o c·i:; ;.~;;;I'; .. :··,;;·~~:~~;~~~--;~- .. <.;;;~~;··· .. ·- ·- ·- ....... 1 ....... ~ ~-~1 J.· ~ =·~; ·t:~- ~ ~~;E ;~ .. --- ·- ... -- ------------------'.Address : -····-···-·--.-·--··-····--.. -·-·------........................ -........................ I 1-1 d d r e r" r:; ll 7 01 sTu f~ H T D r-1
---·--···-.. ·--· ... ~" ................. " .. _········-.. "r'h~;-;;·;;_; .. ·"·::::::~.::·~·~·~:::.:.::::~:~~=~~~.~: I "h on 0 :
----------------------------------------1---------------------------------------· , A r c h J t e c t : " ......................................... " ...... « .......................... ~ ........ - ..... -·-·· .. ••• l
I I I
En IJ I nnE: r ; ...................................... _ .................................... - ... ----------·--. 1'1ddr·ess
LIC: t::XP: PH:
COMPENSATION REQUIREMENTS State Compensation Insurance Policy No.===..,.._Explratlon Data~~=--= 0 I certify that In the performance of the work lor which this permit
Is_ IHUBd, I shall not employ -any person In any m&nner so 1111 to . become eub]ect to the Worker's compensation laws of Call!ornlu. · NOTE: If, alter making sucll certlfloate, the applicant lor tho permit
should become subJect to the Worker's Compensation provisions of this code, he shall forthwith comply with the provisions of Section 3700 or his permit shall be deemed revoked.
0 I certify that I have read this application and state that the otJove Information Is correct. I agree to comply wltn 1111 City ordinances and State illws relating to pending construction. I further agree to hold
. the City of Garden Grove free and harmless from any liability arising out of I r damage resulting from work performed re· ~ant r it. \ \-\J2Q
eiGNA ~ ~0~
(SIGWITUAEI CONTAACTOfl OR AUTHORIZl!D AGENT
OATC
IUSMN TA>C CERTIFICATE NO. E~PirfATION OATC
I certify that I am exempt from Section 7031.5 ol the Business and Pro· lessional Code, Division 3, Chapter 9, Contractors' License Law, under the following Section· Owner: Section 7044 0 Minor wor~ under $200: Section 7048 El Employee working for wages only• Section 7053 0
. Other:-----------------
!PRINT) PROPERTY aNNER t&IGN"TUfUtl PHOfltlJUV OWN!!JI OR 1\U'UIOAIZI!ll AODNT
. . . lNSP-~C.i RECORD : A P. P R 0 VA L A : ...4tN Sf EC T 0 H -. P r e Ins p e c t __ -J 'Z- Q_.;J~----·-·-·-- F o u n d a t i o n ·---·-···--··-·-w··-· .. ··· .... -..................................... ~ Concrete Floor
.. --~: !_:_ ~;' c I: g __ ~==-::.:;::::__-: . . y ---··--·- •. ~- • -~~;::j--·-··"ffl"'~-~ : Roof S h t g _ .. ·/~····"--··~-··· . _ Rough Frame---·-·---.. --·-····-.... - ... --... -~ · Ins u 1 I En e r g y -------····---··-··---·------
0 r y w n 11 .. ---------------.. ·-···-·-.. ··-·-La t ~ ----·-----·-·---..... _. ·p 1 as. Brown Ct.. -·---·-------.Lands ca. pi 1'1 9_,._,_ .. _____ ...... - ................ ,.,_,.;_., .. Pre G_.uni.tv ___ ~ ___ .. ._.,_ •• ,.~ .•. ~re Deck - · ·
---....... _, __ ~_, .... .,.,,,...,.,,...,,.., • .,,., .. \•lifiiii~Nif.I'I•Ji .... ,...,ll\l¥Ji\Uo
.Pr·e Plaster • • .' .,. • ..w,u .. ..,, ...... .,..,.tUW>;.W"'"''•"'""·'''"''"'"" ""'""'~ 1·~~ '"'' lhi,YI>•~eJ0\••1 WIV;\WI)
1. INSPECTOR •. ' '
AddJ"(H>5:
LI C ~ EXP~
PropoGed Work: REROOF
V•lue 5000 Floor /~rtli~: 6000
Pre Inspection Fee POI"Ill.it I s I!;IJ iH1 c e1
3200 3225 BLDG PEf~M & 3617 ISSUANCE FEE
llf5358A11
15.00 7~?.tHi
1.0.00
TOTAL FEES
1 1. 1
PH:
INSPCT B-PER
ISS ~90
15.00 72.86 10.00
15.00 72.86 :1.0.00
97.96
97.86
7ll1- S~! O.ntrtl lnform1tlon
74J.-:o·G30/"
If work ln n~t ~t~rted within ta~ dayo fro~ d~to of ie•u• ~r if ~b~ndun~d for mora than 1a0 d tt .Y r.; , t II J. ~> fHH' m l t: w .i .l1 b tl n u l.1 l!ltHI vold. · 1. • •
A FEB MAV ~E CHARGED fOR RF~ INSP.f!CTION Dl.Hl TO NEill I. ICH:tH:Il ~ l: 'tH: 0 M P L t: n: WO B K • 0 t~ F.A r.L U fH( 1'0 MAK~ CDRAECT~ONS.
' ' _ .............. _ ...... .., ......... --. .. _,_,_, __ ._._. __ , ... _____ ... ,,,_.,. ___ .. .__ ... ---------------
··Fino!
P.LOT. PLAN .,. ............ "' lurkllng I.C.~ . Director
I'
CITY OF GARDIN GIOVI
I
l I I
.! i l . l I I
,., .•. . .,
: .... ~' f
-PLUMBING PERMIT
Floor Drain --·---+·---·-~---- ... ~ ..... ~ ....... """""' .....................
Dlah Wuher
Drln~lng 'Fountain ____ ......... _. _..,_, ___ . __ ..... ,., .............. _ ... ~-,..,-Urinal
I ) .... Gu Sy.;;iJO;i;;~-
Hou .. S.wer
"_L_ ~~tHtatlc w •• ~.i~~~·-c_h_. -+ Water Soft.ner.
Fum•:•
Water Hec.ter T••• ------+---------------------~---
---·--+ ~ackwo1h
;1::.:~,=-·=.~~~.~:~~·::~.:·~"= ":~:,:::.~:.:·.·~::f.::=:~.:::=~::•::····~··:·.~~=·~.~ "' UTtLITV CO, HOTII'Il!D --L------~--
IY3 Owner (II'J, licit• Permit W •• -J..1~!,.:1.J_ .. _,,.,
1·. COK'.a11CIAL WJUIM Am OU1'LETS .50
COIOIERCIAL FUJUCACE VENT~ Z.OO
... Of'"'" ,, ....
HU.'nNO, VEN'J'ILATION, IEFRIG!RATION & AD\ CONDmON1NG PERMIT r ~.~.:.~~ I CITY OP •to• APPLICAJCT TO PILL Ill lUI!!: l!f'X)
.......... 'P-41100 CAilDEH CaOV! Jon ADDIUflll
Jl'lll I, S1v A 1}~7- D /~
i•
':
~~~--~---------~----------------~----·-----·--· -----·~~~·~--------~-----------~--+----r----~----~-~-+"_,.,._rm __ DJI._TJ_o ..... x_•_~,_'fDI~·---\-', uo ___ -·· . ......:......-..f'-UIT--A-UUMT_'---m~CHBif-,.---H.::::0-:::0:-:D~~-I-I.-00_-I---I--li IIIGNATUIU: 01" ('! ~· . . ·- ,·'l1 rl_l/
COMDt:!fiDfO viG'I' Ill H.P. uo P'!I'IM ITT I! I:! J.~-· D~_'t.lf1A111!.. .. L't ~ O!ltEM
----+-C-O_JmDIDI ____ ....,.C_UIGT ___ ----':=TO-::---+-, ,-r-..oo·· -I·.....-: IIQDI'IIes • ·' ---...,...---.,.--~----10 K.P. ,
.-......;-+CO-Jellnl---llfC--UJIJT---·--O~VD~-:-, -1"-.. -· APPI'IO'·,i,l..ll ~ ___ lN_II_P_f:t~!£f.' ____ ~
10 lf,P, lO.OO rtJIJIACI
,', ~--=~--=~-r:~=---UOM--~=~==!s=~=·_:coo=ii-:="r.a_':o=l·=--~=--~=-.. ~~=-_,:=-::=--::::~::~~~~~~:r-~=~~~:~-::~_:~-~~:.-.~~.-~ .... c~_::=;-ro __ --~~-··'1'1~~==--==-~-·----i--------~.~-------·-----1·---·--· ·--··-··----···~·--·--
----1---------------,-l~--· ---- ··---·-·-···--- -----··-.. ~---~----IIUTAUI.IIIn' IITCHD HOOD ----1---------------'-' -1---1---1-·· .. _ ..... __ ..... .., ......... - ........ ~~ .... ,---··~ ______ ......._ -.................... -----·-
--~~~~~_!W~AilM~.ADl OUTLETS .SO 8UILOING
COIIIOIUCIJU. FUUrACE VENTS 2.00 IOUILCIN~ [QJ BUILDING D
............ ~ ,;;., ..
J 1
MJIC, ........ _ .. __
IXJIAUI\' OUTLITI
- ••' mciii:K HOOD 1
-I
1 GO
• 3 f-1~ .. #0
DA-rr._2,...,tJr"-... ' . JJ ·~. ~h :6 t_ .I hi'. - ••. ,,
fOTJU. nz . NIIMIT A.r-:""':::::: aY /'M~ /U.I
:~·· .. ··-.. I~IIOT'Otl •• Oflll'ICI 1'1'-l •• OWNI"
,ILICTRIC PIRMIT DllllolftMYM M. lulkJin41
__..__.._ ......... - .. _.,_ .... _ ......... ~.~ ............ -..,.., ... .
',:.r::::."LL. ... .L!6Ui':.~.L""22-
~--...;......!u::::.:&:.c.:..;- :r ,.::._.~,:~~- 2.eL'Iz<:?.": ... :r.Li~z • .:.~-
Foundation
. O'M'-Iflt-i!oiJi'•OER :?ERMIT RESTRICTiONS< An ~ner.OUIIder must reside within
~~~~~;;;~~~~~~~~g~~~~~;;;;~~~~ the building for ~which this perm•t Is i :ued, (ac<essory bulldings excapted). :-aid bu,ld.~~g me~y not cootaln more than 3 clwelllng units. Oiherwls,., thl; permit con be iss>ed ·only to a controctor lice~ilod in the Stole of California o.nd o lwsoneS$ i;<.e~se mu>l be procured from the City of Garden Grove.
and ~~ ------.--..:...----------·-··-··-·-········-···· .... Reinfon:ing ---·- ............... ~------'--·----------.. --.. ······· ........ . Roof Shtg, -·- ... ____ , __ .. _____ .. _____ ... _________ ------ -- ........
'~~~!!:~.-=}~(;~i~--~-~~~~~ .. ·-··_; __ ·:· ... ~~--~~--Cf.:
$ s
.. it"''
WORKMEN'S CCMPENSATION. INSURANCE ~EQUIREMENTS: A certificate or duplocate thereof of workmen's compemotlon .fns~ronce must be on We with the City rs1 GcmJ.>r~ Grow> prior to the l .. uonC<> of this permit unlesa: l. This permit is for ~~~ thdn S 100 voluolion or, 2. The applicant qualifies as an owner...bu.Jdeor <:n~l s•gns the statement below
I certily rl>ot in ihe !'erformance of the work ior which thlo .permit i> l,.ued, I >hall I'!Qt emplql any person in any manner so as to become subie<.t Ia the 'Mlrkmen'$ ex>mp~nsation low~ at California .
SIGNA fURL . · ~-/~~/.~ .~~~..::::;./ . ../. -..-,:::1~~-~~. i
'or) CE~T'fiCAT~ ON filE.
_ .. _.,.._, _ _...;., ... ~--.··•·«> ....... _..._.. .... _ ....... _ ........ _, __ ,.. __ ~·~-·-·,.---.. --·~-·----·-
:------ ----~--~~......._._··-----......... - .......... ~~· ... •"-·,......_,,._, ........... _ ........ _ .. _~-·· .. ~ ...
---·-------·-----·-
' BUILDING PERMIT ' '
f1Cl31·6'l --'----·------·--·-------- Valldation
Arch. or · -~ Addr.ess -·
Engr. ·----...-------- ------Contractor Ph.<:_~
~~!~~~~~~~~~~F~~~;;_;~~;. ~:~:l>aekn~wledge that I have read :hh ~;(:; a~-d-s~·::~hot J the above i> correct end agree to comply with <:~li orcl!noncttt .~nd
St~ttit laW$ ntguleting bui:ding eon5truction. l hentby certify that I am pl'iJperly registered with ur•d/or Jicensed liS
required by th• City of Garden Grove Md/br Stato of Ct~lifO'rnia, or that l em the legal own~tr of fh~t above described properly. l'lnd ! ceriify that in the performe nee o o . V(ork ~M which this p!lrmit is issued I shc~ll nol employ any, 11 in viola,':;on of the wo.~:nen's cQmpenseiin f • S;~~~il, f ·.elifornie. /.
hl'll!llft"-~ii::::...L.~r;...:~~·i,;!· .. ·::.__..· ~ll:l..<tl~::::···=-~· Oolte / lJ jk . , r· --~~------+------~~~~---------~~---------~Ra~~~x~Trnlo~w~,
. PRESENT BLDG. ADDRESS MOVING .-------~-~---·-·-·-·----·.
CONTRACTOR L:.ndUse
~~~ Own•r'
i t
PLOT ~LAN Dop~ of lulkllng 1 .. C. AdaMI
Director
.. +, ~
·f.- .....
. '
·i. ·-
''
CITY OF GARDIN GROVI
Job /J7()y Address
Lot
": :'it'
lri '~ i
1
L ~----· · ..... -· _-...... t--. ._··_· -.... ·-~····-..... ·..;,_,..-h-~--~-:....~!---o~~~..o..t-~~~~..t.+.,.·-iL=~..!. . ...;._~~·_;.-·:·-4_;·~~-~ i ... t ~ • -~:.:
i : ~-
Is CICIIr.,1 ... cznd c:ornM:f.
12 Offlc» Fllr, 13 Ownlt
1 ~
ELECTRIC PERMIT Electric: Permit No.
..-------q----.. ----·---·----·--------------. 1/., .·=>-·
I.
t,,' ,,
o., ......... .,~ I. C. MIMI Dire« or
$
.. ,,
MOVING CON\'ItAClOR --------1 ·----------···•<'•··---.. ----·--·--·-· . ADDIIE£6
iNSPECTION fEE
.·, ,,
:1.··: '·. " ··. ' .
~~
I ""'"""1r·------·-·--·-· .. -'1t}; II)! II ---+-
"'" ~I~~ :r ' r .. ('
'. 1
Final ) I ( ;; '/ l .-,•f·[~:~i
-------i'-----....:--t ----Utility RelfJaM
Remarks: ..
' ' '
'·' '
. ' .. :
t. r, ! j ...
n. ..... L\ -.-r:- '
1
, .. ·,.,
• CITY OF GARDEN GROVE Public Works Sa Development BUILDING PERMIT
INSPECTION_ RECORD
APPROVAL DATE
Inspection Reque1t1 638·6771
G ... ncral lnfom•ation 638-6£tl1
...,._..,.u:o&. INSUI..ATION, ENERGY ~~ "(. ~lf.J 19. I /0;6,___d:7i:rJ.IJ?-~-- {:;,:•, /\~ ~ovEoav ~- ----·--"·-- -
LATH OR ORV'tNALL ~ ARCH M:MARKS:~ · ""---- 0 E:NGR.
(PIIINT) CONTIIACTOI!
sttte thet the 8bOYe In· _ --.. ·~·. --·-·ell City ordlnence& end comtru~n. I further liii'H to hald
_________ , and e from eny liability erl• ....... u..-.r~-!'!!l! "• "ft from work performed
aU.IN•t• TAX. CaltTafl'-tC-AT4--NO. .JUtiNATION DAT.
I otirtlfy thet I em exllmpt from S.Ctlon ?031.11 of the Sualn- 1nd .. ,of..,oMI CocM, Dlvlllon 3, C"~IIPter 8, Contr110tor1' Lie- Law,
• ·- - " -····•OF'.'l'Jfl' ", .. ., 1 I I under the followl,.lt!Uion: y{l - m, 'L?W f''J -!.. OWner: S.OtiOft 71Mt 0 Minor WOI'Ic Under lJOO: fttctlon 70018 0 I MOVING · -·-- lmpfoyH worklftt for w..- only: ltcdon 7013 D
om-=----------------------------·---------
--------·-·CITy-----~ 1.1r
STII.TII: UC. NO. 6 TYPe:
'71> 2 .)__..J'V
y,.t, 6 I> Q
REPAIR 0 DEMOLISH[]
NO. OF
Sl'ORIES 'J._
RELOCATION
NO. OF DWELLING
UNITS
";;J ., . ' ~"· _,. o-ifr- I""''"'""-"'_ ... , .... u ... :.MI.?.IU'I.Va~fN•• DATI ADDRtsS -,J !fp ... -w. . 1> ...... ~
CITY OF GARDEN GROVE Public Works & Development
INSPECTION RECORD
VOLTS
DATE INSPECTOR
,!:.~ •• ,;·
ELECTRICAL PERMIT FEES
NO. I EA.
Inspection Requests 638-6771 ,_ ..
General lnformatif'n 638-6661
For Applicant to Fill in
ESS
170~ BL.K ,.,0, TRACT NOJ E~E(irlnll>;l&tttriNIJ~
ISS 10.00 - 1ft5604A 2-29'84 CHECK 24
LIC. NO. & TYPE
tiiU.INat•• TAX c•MTtP'tC:ATK NO. &JCPiltATION DATC
I c.,tlfy that I em vJC•mpt frorn Section 7031.5 of the BusiMss and Prof•••lonll Codl, Olvltlon 3, ChiPter 9, Contractors' Llc•nse Law, under the following Sfl:tlon: owner: Section 70414 0 Minor work under ltOO: Section 7048 0 Employ" working for WllftS onlv: Section 701S3 0
Othlt: --·---------· .. --····---·-~~--... ---...
Ul'\'1'1!1: "[PNiij~ti,.tlP•WTY owNER- Tiiii~~TFj,iU:w,f:~"ATJ.a~~N- ..
A FE'E MAv aE"cHA'Ril£o Fol'i R~·•NsiSEcTJoN-ouE:-1-cr NI::QLIQENCE, INCOMPLETE Wont<, OR FAILUil~ TO MAK!::: Co.B.BECllONS.... ~--"--
t1\1•tt\Jto-u .. Jl't
