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1'LOT PLAN 0.~· of lulldlflw I.C.Aaillal Dlrectcr

CrT"f OF

GAIDEN GlOVE I ::L~ /I! /3tJA-I't ~

OIMIHSiCM. !"i.OT PLAN ~y SNOWING Let Trod AU ~. ON THI LOT USE

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&;ilding l.nspktor ~ Office fi'e 13 <>.-•'::'»' By··---·

1

PERM liT

Water Clos.1t (T ollet) ------:-

----~-----------------Shower

~v•_ tory- ___ rN~sh Basin) itthen· Sink ·

---. Garhage DispoSal · ·

j laundry ~u~ 6r Tray

/ ... Water Hea1ow 1'---------------------------"----+--+-1--"'f=-~- New Bldg. 0 Old Bldg; 0 ..

Slop Sink

Floor Sink 1.50

• Floor Drain 1.50

:--+--0-~_;h=W=_:S_h=er=========---l-'' _,_'·"t--~ """ 'orinldng Fountain l.SC · . . -_

--"-+-U_ri_n_al _________ --t 1.-so , --

. G1s System - Outlets

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----~----------------~--~~---+~ lawn Sprinklers (~insl0~1;elling} 2.00

. Swimmil'lg Pool Piping l.SG --~;~---~--~-----~

1.50 Sand Traps ......:... ____ _

lss~&anc:e of Permit

TOTAl !'EE

Permit Authorized By -----------------7A-;----~

1. INSPECTOR

Validation l}Cf 27·71 ' 11 061 U HiU*3.50

IACKWASH

OO WATER LATEIIAL

FINAL

. . . 1tE ~{·OCCUPANCY CITY OF 'GARDEN GR VE ~~- DEVEL.OPM£NT SERVICES DEPT.

I • ;; •

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J'llt .. C.~fl'U';-" iuw:lt htt..,.,.T W T:teiHOCJIIICUurn M ~ so• OfTflf wr;~,O.,. IUl\.01 .. 6 COD( ta•ffll''ft .. TttAT, · AT TIC 'tdlll~ W tS~rtCl:, TNll ~TVttliWAS fit c.-I.IMICI ilft1'M TMt VUIOI./1 oaot•¥«1 Of 'f"[ ClTY -·~UHt;e COfiiU•CTffMI 6-A MC. ,.Ott,._ ,.,,U. .. t:ta! ' • ·· .

JOB AOO~Ess~Nt:. :o:J , ~ PE~MI.T N9 'Jli7 A .. usr cf: -~"a .. Pr1Yttt $Chlo1 ~ aal,,;;,.;,. __ • ....._ __ ·· GRoc~· · c,.1 I _ rvPE v-tt .·

8t.OG. APPROVED ev wt111• Ct. Jtt11W DAl£ 8/Zl(14 _USE ZONE_k ..... :t __

ZOMIWI R£MA1ttCS -·---'..;.;;:''W:-;.:;..,.; .... ~~~-IJI!..-....._. ----------------. l...o.. O...rtt _ 1111t '• •*!.] flt-lll~oott£ss·._ ... -!!!!.l!l!1Ml•r1.01~---S..:It+

... lllfFI I. ..... .. :i,"'- ·. . ,, · · DATE !erp ??t !lelllf ./ a. ... ·~,JIM .. Prt11Cfpa1''-f14t- .,.,.c.. •.

e21:r IN ,A ~SPICUOU$ PLACJ . .. · I~· l' .~'

c~~~s ~· laoV.· ·""""~·•··~ ~ .,._ ~ ~~· ~ ond lliwt my !k:eme ~ in •hli!;

---------------'¥ ~·N<i~ O'ti\I'Nft~ SIGN _~flo;_, ~ ~ ~·~ of Ch. 'J, D;·..-. J, ~ om! 1': t~,·~· c~nJ:··--

~ ~ tiw: ca~ ~"i' and wiii•Fi-!$y Friorm

INPeCtieft ,_...... .... 771

CtTY OF GARDEN GROVE ~. Qwelopment

··-·.. -· .,.....-. . . .-OCCU· ··--:J\- OCC Fl RE ~D...r,=O ADQ,.IUS l PANCY n , TYPE LoAo sPRINK. APPRovAL oATe •N~-. R

1 • ,. . .

USE I'RONT LEFT RH'lHT REAR . 1...., , u .k /I l J.( -1 ,y A c: r. c:·. G. : ZONE . FOUNDATION & LOCATION 1-L -«:.-1P2.. tr ... T ~ ..... ...... • ....... I...,IIMJT ..... . FIRE Ea~PrDJ. I' -~ :U ' / • j , ••• ,. ZONE Sotbocks 11'L. CONCRETE FLOOR,... I 'W • WN " A

REINFORCING U''t! Ut~ 71/Z·JI>~i'"'i ~ ... --""' ,., ~r(l( ~ .. ~ • .s r ft"' 0 I r-. -· "7 ... ___.....,.

PLANNING ROOF SHTG \ 1 f' ,;._, '_;, -.Jtr:: r.~ 6 f! ~ 6. U./1 . ACT'ON PLANS MAILIIOG ADD .. E'<S- IT Zl~

UAII:: ROUGH FRAME

LANDUSE INSULATION ENERGY ..I:C:1 dl.,.,.<r;-,;..._~; - .-.e·'i::--·· O.J~'i APPROVED BY LATH OR DR~WALL I,! ARCH • ..._ REMARKS: 0 ENGR.

- - PLAS. BROWN CT. -- MAILING ADD .. lESS CITY ZIP'

SOUND INSULATION

SMOKE oe TECTOR 'rTL,No. 'STATE LIC. NO ... TYI'C

PARKlNG - --

LANDSCAPING . \ VALIDATION G.G.SANT.DIS.I IO.C.SANT.DIS.I "'~ .. I'"' ..... ' . -FEE REQ'D. 1 IFEE REQ'o. r .. ' '.! :1 ~ ,/, , _•-,!!. r.. --- RI:Q'D P'ROVIDED ~.J_ f \ t --

PARCEL~AP ~ 1\ l 1·~-, [1. .•• , ' FVW DEDICATION ' LJ\NO USE FINAL \"' 7) \ 'i)\V \ \ -- I$ 57 ~ ( - - > I

, \ ~. \ '-. . r'OONTit ACTO" FEES AND BONDS . FINAL . • . J\ ~ .•• ~-1 -. --... -A.·-

UTILITVAELEASE \ \ JJ!:JAFI'~ 11/J- ..._; VL REV. COOlE AMOUNT MAn.ING ADDI'IIESS CITY Zl~ I

IDENTIFICATION CODE I ST. BOND ....

WATER BONO 1/ ( I l T~~'t.5 z t1Gt /'f)s.~AT~ ~:/o~"J~vn o~N.~ WATER ASSMT. FEE IACAG.I /I WORKER'SC;:GNSATION REQUIREMEN~ /. Ci .7-J.I(H'V 'J /94J ~7

/

StawCompensation , -\ ~~<07 • .40 o-~ PRESENT PPOPOSEO

1 WATER ASSMT. FEE (fT.) lneuranc:;aPolicy No.~ '(!1 Expirloti;;\, Oat• ,v BLDG. USE BLDG_ USE ..rr1

II 1---------------jl-----+-.t:----1----1 0 I certify that in the perlormenc• of th• work for which h 1 permit is ~ ..>~ .J PARKWAY TREE FEE v iMu«<, I shall not employ any person lnarynlanner.oasto bec:om• DESCRIBE WOkK •::z .7 ~ tubj..:t to th• Worker's Com.,..,..tlon taws of California. TO BE DONE ~;:;;>~

/

NOTE: If, afur making such c•rtlficate, the spplicant for the permit i PARK 8t REC. FE!' !OIST. ) Jhould bkome subject to the Workar's Compensation provisions / 1 L

1:;.., 1 i. , ,.,,. k -I' J _., 11 J.' 1 • •. _ ·

t--------~-- of this cod•. he shall forthwith comply with th• provisions of Sec:tion • f · .1 I £. .t ..r.li::. ~

V ~700 or h:s pMmit shall b• d"mlld riiYoklld. ~ · f:7

DRAIN ASSMT. FEE IDIST. ) certify that I hlw~ rMd thil "Pt)lication and state that t!'le abova in· NEW IJ!!o..AOD'N 0 ALTER. 0 REPAIR 0 DEMOLISH 0 _.. ormation is correct. I agr" to comply with all CitV ordinanc• end

Stn. 1- raotatlnt to p..xting eonstruction. I further agrM to hold 1--------..... --------..------'~--·==·:..o·=~ th• Citv of Gardan Grove fr .. and harml- from anv liability aril- FLOOR AREA I NO. OF I NO. OF DWELLING

PLAN RETENTION FEE ~~l'w~~i!_ :j~~~~odily d, ... resulting from work performlld (SQ. FT.> .3.32/ STORIES UNITS

''/{'_7_ ,_,-J' "2,, --'-'~ JJ,...; _ If work is not started within 120 days from date of issue or if BLDG. PLAN CHECK '1_....., ~ 4o IJ ~ < ••T """L .. ,... " ufta .. DATo: 0 _.abandonad for_more than_1_20 days, tl'lis perm;t will b4t null-lind_

1-----------~.-..:::o,~~..c-4-:;.~L-F4--...;,p..L..I'-!' ""''~..::Jo-1 B~NESS TAX CERTI FICAT_IO INFORMATION 1-~.:..o•_;;d.,.... __.""'"-:..,......-::-,...,..--:--o-::-::=-::-=::-::=-:-:-:-::::-::-,=~-=c=-=~ , ..,..,_,J_

1 1 lcertifythatthafollowintContractor'sLlcan .. No. AFEE MAY BE CHARGED FOR AE-INSPECTION CUETO

BLDG.PERM.TFEE ~ (I::J {JD andCI-ificatior. llinfullforc•andaff..:t. NEGLIGENCE,INCOMPtETEWORK,ORFAILURETOMAKE CORRECTIONS.

IssuANce "a..c .,7 JO ~' , ..... NT) C:ONTIItACTo" .... " ..... T'" .. :' coHTJIIACTOft DATa: ~ (..J u OR AUTHO ... IZII:D """'"T RELOCATION

V AL.UA Tl ON --,.:::u:-:s=-:,:::,.-=,.=ss=-=T7A=x-=c=-=,.:-::,.:-:: .. ::-:,,.::-:,-::c-::A:T,.:-:N:-::o:-. -- RX.PIR ATJCN DATE . 00 TOTAL ( • j_ I cartify th111 I am a~.mpt from S«tlon 7031.5 of th• Busin-.s and PRESENT BLDG,

~~ . .0:::.1'7.A ._ FEES I ~ \!7_3 Prof-ional Cod•. Oivleion 3, Chepter 9, Contractors' License Law, ADDRESS I./ 1 'f under th• following Sec:tien: 1--------------------------l

r:-:-==~~::,.~.....!--·----1-----L---=~--.f Own•: S.Ction 7044 0 Minor work unc!M UOO: Section 7048 0 MOVING AuT"-~"'"'"" •v DATE Employ" working for wages only: S.Ction 7053 0 CONTRACTOR

l.- J Oth•:

~- · \.....__ 7 ..l.{ ~ (PRINTI-•-IITY .. ..,, .. ,,. ls••N•t<Tultal ""o"a"n ow""" DAT" ADDRESS ~ "-... Ofl AUft'tOfiiZKD A81ENT

I n .. IC:Dt:I"'Tf"''D -- __ & .. ---...... ,

CITV 0' GAftDIN OftOYE PLOT PLAII

SHOW NORTH ARROW, PROPIEitTV LINIES AND ADJAC:IENT STRI:I:TS,

rT;-:--:-il-~lT1j-IT"'T_ :·:-:·~:_ rr::-J-r--:-;:-,r"-,----;-:; -~r-_ .. ) .. t "liTr::.-.- ·~-~ r· I • ' '.:1 I I • I r 'j •• ' ' ' , .• : j • ·1! l -·• .... '·f I .. , 1 • ' "'' ' • ·r

' ' : • j J I j I ; : ' I ; I ~ ; I : ' I I ! . • ! ' ' ' ' ' I' .. : '·' . : :I ': ' •.. I ' ' ' : I ' ' ' ' i i I ' I t ! ' : . ., 'I l ; ' ' : ; l ' : : l I ~ l ' ~ -l . c I . l .

1-•

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QTV OP GARDIN GROVE ~ic Work• A Development

P.C.tl • 'Occu- occ. FIRE PANCY TYPE LOAD SJIJHNK.

USE I"RONT LEI"T RIGHT ~lEAR Z()NE

f'IAti Eav Prol.

ZONf Setback I

PLANNING ACTION ' PLANS

IJAI t: LAI\!OUSE APPROVED BV ' REMARKS:

·--

G.G. SANT. DIS,I I?·C,SANT.DIS.I '"' " I'"' ..... FEE REQ'O. FEE REQ'D.

REQ'D PROVIDED

I'A.RCEL l\o4AP

Aiw DEDICATION

FEES AND BONDS AEV •. COOIE AMOUNT

ST. BONO /_ WATER BONO ~ WATER ASSMT. FEE (ACRG.) '(

..L

WATER ASSMT. FEE (fT.) ~ PARKWAY TREE FEE c?':.,... PARK t. REC. FEE (OIST. ) ~ v DRAIN ASSMT, FEE (OIST. ) [\.

" PLAN RETENTION FEE

BLDG. PLAN CHECK

BLDG. PERMIT FEE 3~k I~ -ISSUANCE 6s-i7 lo -VALUATION ()0

, TOTAL (J.s-~ -76?--- FEES

AUTNOflll'fZ&O •v OATI:

-~"-, - ;""'.·-:. I

• , ... l!nr__,....,."h

INSPECTION RECORD -------- ------ ~·-

AI'PROVAL DATE INSPECTOR

FOUNDATION & LOCATION f -~-~~ t:'/.Sz.

CONCRETE FLOOR

REINFORCING

ROOFSHTG v / ROUGH FRAME V· INSULATION, ENERGY /(') LATH OR DRYWALL IL/

7 -PLAS. BROIIIIN CT. ... r~ /) . SOUND INSULATlON iJ' ·;

~ /- --~·- ~-1 SMOKE DETECTOR _ ... .., //f./ /I} PARKII~G \.J If"' LANDSCAPING

·' H' {,Ji ... , ~I] t .I\\ '

--. I,_ (.:f' /f,..

/L !!!__!_ LAND USE FINAL. (

FINAL

UTILITY RELEASE

IDENTIFICATION CODE

l I { WORKER'S COMPENSATION REQUIREMENTS

• St•t• Compensation ef2. j e ? !"aur•nc• Polley No._. Expiration Oat• "; ._ _ 0 I certify that in the performenc• of th• work for whl~h this permit Is

Issued, I shall not employ •ny !='•non ln any manner so as to become aubjotc:t tel the Worker's Compensation laws of C511fornla.

NOTE: If, after making such c•nlficala, the applicant for th• permit should bacoma subject to the Worker's Compensation provisions of tt>is cod•, ha shaiiJorthwith comply with the provl1ion~ of Saction

)i('3700 or h;s permit shall be dHmed revoked. I certify that I have read this application and state that the above in· formation Is correct. I agrM to comply with ell City ordlnanc .. and State laws relating to ·pending construction. I furm...- agra• to hold the City of Garden Glove frM and h~rml- from any liability arlt-

~ lng out of i~T bodily damage resulting from work performed

~an~thi .... m~ ~ .. 7 -l_t) _&c., "MIT APr1..1CAH ... IG ... ATURK - - -oA'I'a --

. BUSINESS TAX CERTIFICATe INFORMATION I certi{y thafthe f~wi'J Contr.Ctor's l.lcense N'!¢cf? Df ] 1

bJnd Cl-lfl~n - 'f Is In full f~J~~A}, 7 .J;:j~ 'M J-1-H ~rtiA. 'AA>Ll , - ,. ,_INT) C-TTACTOIO I• .. NATUR:I·.coN"r"A'?~ DATa Cl

... AUT .. O IZKD AG&"T

WUIINCSS TAX CKftTifi'ICATit NO. KKPiftA'f'ION OATIE

I certify that I am ellampt from Section 7031.5 of the Bualn•s and Prof-tonal Code, Division 3, Chapter », Contractors' LicenH Law, under the following Section: _ .. Own•r: Sactlon 7044 0 Minor work under ~00: Section 70.S 0 Employ" working for wages only: Section 70!53

Other:

lPIIIH'r) PIIGPIUIT'Y OWNKN (src:~T:'S~~ .. ,:::":;.~~fll&" DATil

IMplctioft~ 131-1771

a-, ............ ..... , For AppfieMt td FIH itt

ADDII~;;s

12//1 J3vA/2o sl'. 4C, ! 1 ... ., .....

-~· ov.

- ~v 1-·rt-, II It' 0~~ '4~e Si'cA.tdoL ~l j~ YS" ~ .1

l"'~'"m,. ,..,.," .. •• .. , .. ill

1;2.!11 BtJ~t> ~r. cc ¢'.2?A.,., !:::,! ARCH 0 ENGR. MAILING ADDftE51 CITY ztr

. . . , ........... STAft UC NO •• TY'I'Il 1n/~~.M0 I #~--= E ..... L.. ( .~ ~!~.. . •,Jt..,t :. -·

r:or•.~-·~·I:i'· i _1.:: ~-VALIDATION

ISSt··ICE 10.00 CHEC:K *"'"" 25. 00

CONTIIACTOit

s,flf# ~ ffA~~ ~~/.) %dJCt..rl<. I C'c1. I

MAIL-NG ADbJIII:SS .:i:£ , '.2. ClTY 11:1r i (" 0

:J-4 ;J./ E; 8.1Lt ~1) .. Ak~.,F-~ ~:tllo. TIEL, HO, $TA7E UCa NO. l 7 /f- 8/oh- ..,() CJ., 3~i ... PRESENT PROPOSED . BLDG. USE9:'/]{?0L BLDG. USE >4/b.i::-.

I DESCRIBE WORK TO-BE DONE

l,t> 8 ;2~o JC p, tl'J..i &, (.,.. op R~4&& '

NEW 0 ADCI'N 0 ALTER. 0 REPAIR 0 DEMOLISH 0 j

FLOOR AREA I NO. OF

(SQ. FT.I1· ~ STORIES

JNO. OF DWELLING

UNITS

If work is n~:/J:.:rted wit_tiin 120 days from date of issu• or if abandoned fo ore -than ·1o20 days, this permit-will 1>01 null..,d void! _ . . . . .

A FEE MAY BE'CHARGEC FOR RE-INSPECTION DUE TO NEGLIGENCE, INCOMPLETE WORK, OR FAILURE TO MAKE CORFlECTIONS.

RELOCATION

PRESENT BL.OG. ADDRESS

MOVING CONTRACTOR

-

ADDR!::SS . , ............

CITY OF GARDEN GROVE ~ic: Works a. O.Vetopment

aNSP£Cna.. RECORD

UIPftOVAl DATE

·~< ....... ...,.:_,,<J±~~--~~-"-',o?:t.~~!t~~~~~~·~J:- 'o ~~,

l~CTOR

lnspectton Requesu 638-6771

Gtner.e lnforrn~tion 638-61&1

B-PER ISS 10.00

1M2615A 9-29'83 Cf-£CK 36.

ReLOCATION

..• :;1-~-,. ~. _;.·.-~,":- ;..•

CITY OF QARDEN GROVE -·

--·-

I.

:'I

'

....................

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PLOTPW

CITY

MtOW NORTH AltlltOW, PIIOPEIITY LIND -D ADJAC:IENT IITRIEIETS.

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~~-~-D-6-~-G*----zy-~--6-~-D·~---~~-~\.~~.--t~---.. I

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CITY OF GARDEN GROVE Public Wtri:s a Development

rU .. NACE VIENTS

GAS PIPING

DUCTS

liNGLE DUCT ,,AM VIJoiT

KITCHIN HOOD I

HEAniG, VEITI.ADIIC, IEF.EIATIOI &. All CIIID. PE•IT

FEES

LAND USE

Inspection Requests S31-8771

Genc:.e lftforlllllio.ll ..... ,

L'~

(•R~N,.) Ptto~ttTV o-'Nii_R_ (sM::TF::iJ.=:Wa~ --BE CHARGED FOR R1E:·INSP£CTlON- -DUI:-~· l

INCOMPLETE WORI<, OR FAILURE TO ~,1

.. _I

r ' ~

[ t

~

. " CITY OF. GARDEN GROVE Public Works & Development PLUMBING PERMIT

FEES

Inspection Requests 638-6771

Generll lnformetion 638-6661

For Applicant to Fill in INS~ECTION RECORD

APPiaVALS DATE INSPECTOR TYPE OF FIXTURE OR ITE~ NO. leAcH $FEE ""':"-~s . . , ·1.3 I . . . . Water Closer ho•letl I o( I I I L t.l a r 0 I ... " .. "' _ ::::.:;" _ • -~- c.. .. ·c· •· · ·-- .. r T:n 1 ~ o. 1

G""" """"'"' r. _I AL/ ~:;:::·s:::~"'""' , /Jj" I ) / I li:i'l ,!JI I Ro:~gh Plumbing /"'2-- '2,...//"6' 7~ v~~,. _ Garbil•'l" O:spo~t __ __ 1..._[1({ (" feS Vtf {lQ/1 Q f1 W{ff..(}Y/1

' L.:JUndry Tub or Tray OWNE,. s ADD,.ES~ / J -. Y

1 Gas P•ping --1 W:1ter H~atl!' 1&~6 7 JitCfOR;if :sf. {!_I!J C}c)f.t, -Ft.oar $1rik -~- £-/ ! ~":>..!::!.... ')Ut~ •LH\.Ot"'(,. o" t:XH~oTtNG uu•Lo•NG .loc:cu•ANICY 1usa ~ •u•Lo•"'""""

Gas Vent ~, . AODt'r-oN .. " .. "' :[t!Mooc"' -. .. 11!:,.. Gftou~ 101t.......,.... Qlll uNIT• 1 Floor D'a'"

D1sh \Nasher so~ FT. SQ. FT. ;~ ••. ;:'~~-. 1 1 fLPn

S.W!lr VALID .. -,-ION -1 ... ·· Onnk~n(l !Ounta•n _

Main Drain and Vacuum Line,

ur~qal

~ G.;.s. Svstem - Qy!let£ I .S._~o

ISS UO.OO ~EFL~'Ilt

ISS 1.10.0Ct f Su1 t.~ 1ng Se""~' IF<Ut tOO fU · .,...;uJi~tiTitAI:Tolt 1STA~o~

I Wllter Heater J"&;ildtilgSe'M!• !Add"l :.OO!U ·- 1)3

•Ji 11 1

,.., /1 1~5821A12-2' ~83 CHECK 20.00 ' Bwtaong SeWH (N. adt!; dfaon) . u'u 'It 1t-' .J"....

l!lllckwwsh ADOttlt•ll; Cl \' ~~ PltOIU: 1 R•onW(I!er D•••n

Swim«""'! PoOl I"•P""9 Water l.atefl\l, 1 Sand Tr~;'Rtt~to<~ - --

Aut~;>ma!<c Wash!tig ~l"llt I I I • I ~~~ Soft~nen

·klo.....,$!1-Tr~

~--------·~---4---------------f--------------il~w~a~t~~,~~l~~~~er~•~'- 1 1 B.xkftow Ptot..:t111e Oe"oces

1-

~•pon9 (N. lOOft .I --+--1---- ~SJM•nklcr§ tS.F 0, O"lv\ ~ --1

la.'Ml Sprmkter~ !othN_I __ ·-t-·-·--.1----j~

WOfUCIIIl'l COMPENSATION RIQUiftiMINTS ·

---~--iOn , __ P.otiey 1M. . Er.Pir•tlon D•te-.~--:-:-0 ! CW!HV m.t.., '1M ~.nc• ottht worl\ ,.,. whit~~ 1hlil """'" Ia

-.....I !lllllll ftet-....., env ~ tn tf'IY mtf'!Mr to • te ~ ~ te th4l Woftlet'a Co~tl~n •- of Call~

NOTE: If. af- mM<int such certlfiett•. th~ IPPIIctf'lt fOt_•tht IHI'f'lltt -uk! ~- IIUbjtct to m• Worker's C~tlon proyleioM ot 1hilt o;odo, ho 'lh.tl forthwith comply with the provisions of S.Ctlon

0 3701) OJ hit v . .lrmlt thllll be ed revoked. I ~. tftet I 111M1 relld , It iclltlot\ tnd Nte 'Itt« '1M elK ... .., •. •-ten t. cot...ct. 1 ..,.. comply wlm ell CitY ordlnenc• •nd s- ,...ttlnt to pending Oolttr tlon. I furm..- .., .. to .hold !he C Or • fr ml- from ony llebNitY ..-II-

II ewltlfll r,om WCwk ..., ...... _,

'*~··""' JMrmtll~ ~C-~C~-- -t l -b----- I ..• L l . ~~--

1

.l J[o;

•'

2

l

-1 ·~ .__ . Lc,LL~J-~ _ _ s. t'f£M 000£ f'EES -~ ~ ~-~1 e_...., .. C.n•" (otitr.NA~-ufital-CeNTWAcTiHt --DATa --~~

0" AUT"Oittae• Ae.NY

~~.- •uSKttiESil '!A. CK.IItTWICATIE .. o. &XNIIAT10N DA~ I c.tt;fy mat I am ol'Cempt from Sect!on 7031.5 of the llutl,.. and !"tofi!Miollel Coo.. Division 3, CheptM' 9, Contrtcton• Lie- L-.

~ - !he fOIIOWintl Section: .. -!If Cloimr: S.Ction 7044 0 Minor wotk undet t:iOO: S.Ctlon ?048 0 ~-.. - Ernploy .. wotki09f09'W09"0nly: Section 7053 0 ~~· . Ott>er:

~ · ... ,..,..,..T) ~iJI'1E'~TY ow"£" t•u•HATURRt ~RoP&JtTY ....-.. ---;;;

·~ ··;,_· .,

~

if'- LANO U'SE ON ~~T"ORrZK• AC.ff'l'

~-. - Ia -...! wlttlln 120 deys fiiOo"f> da .. of ....... o.- if l A FEE MAY BE CHARGED FOR RE-INSP£CTION OU£ :t'O · 'J ~ •• lftOfe tbon 120 devs, IN& -mit will M<w.IJ and I NEGLIGENCE, INCOMPLETE WORK, OR FAILURE TO 'MAK£ .;

,' wek\. COP.P.ECTIQNS. ---

.... ~t,~- ·--.-....-. ;. - .... ~ ...

~ CITY OF GARDEN GROVE

.... Public Works & Development ,

Soil Piping

J~,s P1P1ng

Gas V~nt

Silwer

Main Orain and V~~~:uum Line~

W.ter Hf!at•t

lac:kwWI

INSPECTION RECORD

DATE INSPECTOR

'PLUMBING PERMIT FEES

lr.spection Requests 638·6771

General hformation 638-6661

For Applicant to Fill in

St•te Compensation •-.nee l"olicy No. Expiration uaw--,,..,----:--:-0 I cwtify thet in the pt~rformanca of the work for which this,. · •

iwued, I thell nat employ any parson In •nv man,_ 10 ... to IUI.>tect to the Work•r·a Compal'llatlon I•WI of C.llfornie.

NOTE: II, after making such r•rtific•t•. the applicant for the ~-· .... should become subject to the Worker's Compenutlon provi.;ona· of this code, he shall forthwith comply with the provisions of S.Ctlon 3700 or his permlt shQII be dHmed revoked.

0 I certify tha~ t h11v• rMd this •PPiic•tion and stat•th•nhe ---~­form•tion is correct. I •ar• to comply with •II CitY ordl- end St~te taws r .. ating to p•ndfng connrucl:on. I furthr. ..,.. .. to ttoiG the Citv of Garden Grov• fr• •nd harml- from any liability «ie-

resultilll from WOI'k ~

C•:,~":~¥::~l.~::T::.r-.::" ... _

ausJtrtG!l* T'\X CER71f"fCATE NO. 1UlP1ftATI0ft DATa

J certify that I am •x•mpt fro.n Section 7031.5 of th• llusin.. llftd , Prof-ional Code. Divi•ion 3, Chapter 9, Contrac1on' Ln:an. L-. 'J

Employee working for waga1 only: ~ectil)n 7053 0 , · Other:

f~tUNT) PRO,.~RTV OWN£ft fsiG~:T:~~~O';..~~:::"..."''C:.~~NIE!. DA:r•

under tile following S~~<otion: I Own•r: Section 7~ 0 Minor work undar t!tOO: Section 7048 0

If-· 0.--- within 120 days from dc.l't of~ .. or 1r , '\A .. IB A FEE MAY BE CHARGED FOR RE-INSPECT ION DUE TO 81M1ftoi11MIIMI..,- tNtn 120 day._ this -m<t will be-~~ al"d c:;fC/ Q NEGLIGENCE, INCOMPLETE WOJ'. K, OR FI'IUIRE TO MAKE J

, \'aid. -~=-JLC~O:R:R::E:C:T:I:O~N::S~. :.:-:-:-:-.::::::::::::::::::::::::::::::::::~~;;;~ 1 IWSP£CI OR _, DS_ .. _, c

.;:_ - -, -~

.. , CITY OF GARDEN GROVE ELECTRICAL PERMIT Inspection Requests General Information .. .. Public Works & Development 638-&771 638-6631 .. .

' INSPECTION RECORD FEES For Applicant to Fill in t ,, SINGLE PHASE SERVICE SIZE 0 UG DoH I IF NOT LISTEn BELOW NO. ! EA. I FEE AOD~Ess

! SEE CODE

LL~li.J . .b.g~EUCTOOO •• MOTHO. -AM?S VOLTS RIG. CONDUIT --r--

THAEEPHASESERVICESIZEU3W~re 04W•re [JuG [jOH RClsidential (R-1 & R-3) SQ. ft.

t Garage, Resid. (Ml sq. ft.

i AMPS VOLTS RIG. CONDUIT

-~SPECTOR --- Service Meter~ Sing!:! Phase r .. L ·~32101 I

APPROVAL DATE Service Meter, Three P~a.e

' --~=+=-Underground .<'.dd'l Meter, Three Phdse

.w:~4L~? \]{l~~M1C{~~-o~l I Tempora•'>' Power Pole

$"+= Conduit Pole, Power. Light, etc.

l. Sub-Panel" 1 ¢1 Co5. 7 lJ1-~An,\ CL-1

~+. ~>S+n N~1 ~1/U,i) J Sub-Panel$ J $

Wiring ·- Rough I'\ j;----t "" ~~~~:~~~~t~;E~ ~~::~~NEG\. SA~~::~ING o~c:;:pNC ~ :;.:~:~ Outl<>ts

~" Fixtures :;,. d?~----- I 15 {./ SQ. FT. SQ, FT. i>-F·~~ ltt50

,--~ Heaier --

I Fixtures~ Marc. Quartz. ~tc. j---- VALIDATION .. ::;:~ lJiliTv--i f-

f

Fixtures•& Trim Heater-Not Over 1650 W .1g'5~)?6~\i2-Zl ~83 c~··;tcr~ 11.::\0i

_/} Washer

-7 Dryer Motors f4LECTRICAL. CONT~ACTOR STATE LIC, NO, & TYPE

Hot Water Hea!ers In LlJ \'\ e:c ·-· ( Dishwasher

Oom&Sitic Range or Oven ADD RIESS t:l"T.'Y !'"HONE

' " Oitf)OMI

Powe: Apparatus H.P., K.W. or .'\ K.V.A. Motors, Transfor-mers, etc. WORKER'S COMPICNSATION REQUIREMENTS ..--:- State Coml)<lnsation

i Not Ove<1 e;och Insurance Policy No. .E><plratlon Date

' ) Over 1, Not Over 10 aech 0 I c:enlfy that in the performan~e of the work for which 'this permit Is

' issued, I shall not employ any perso·~ In any manner so as to blt~ome Over 1 0, Not Over 30 each subject to the Worker's C•>mpenstJtion laws of California.

/ lndv. Circuits NOTE: If, aftor making such certifi•;ate, the applicant for th• pa1mit

>hould become subje<'t to the Worker's Compe.,sation provisions ' ··- of this code, he shall fo:thwlth comply with the provisions of Section ;

Time Clock

I < :noo or hi• oarmit shall.,. daem8G revoked.

Sign 0 I certify that I hav~ read \'hi& n;:~plication an1ttata that 'the ebove~in-

' 1----'-------------- - formation Is correct. I agre.t •.o comply with eli City ordlnanc.., end

1--· Sign Hookup State laws relating to pcndi.t:.g construction. I further agree to hold

~--- the City of Gardan GroJe k• and llarrnlaN from any lillbilltV aris-

~· Ufer I ""-in!f out oi injury:;;~ damage resulting from work jHrformecl

··;m;-l'}: ,., ~ 1£. ~ )

' · • I ..,.E.,...M-tr"'~P~:c:A·~ s.~~E DATil:

Service ,k~us:!'foss TAX CERTit'lCATE INFORMA';-tON

'l--lt.t~~"i I certify ll't the ollowlnrJ Contractor's Llcano= No.

~ ~ttlMAL~~ """~~~, ~'~" "" ~ and Cl-lfieation _____ ;,sln full fer~:• end eti;;::t-

----- -~ ~~ ITEM CODE FEES (•RtMT) CONTIIt.-.CTOR C•b~,.:J~::A.~~:T::f~~" ':II AT£

/ Utility Notified

i'lan Retention FM ~

•usnrn::ss TAx c:~RT'imA'i£'""Nci.-- IE:XPIRATION l'l~TE

Plan Check - I certify that I am >><empt frorn Section 7031.5 of t.':e Buslnllt'.s and

U)ENTIF!CATION CODE Permit J I ::; v Prof&R;onal Code, Division 3, Chapter 9, Contractors' License L•w,

+ -r under the toll owing Section:

I tss.uance Jl? Db Owner: Saction 7044 0 Minor work under ~00: Section 7048 0

15"-c Employee working for wages only: Section 7053 ·

l to--/• Jl i ~~ti!/llJ ............. uo. IVIENT. MEAT. A:;;;:=

TOTAL FEES Other:

_ ~ COMO. ~IE:ftMlT PliO~ - -(PRINT) P' .. OPitRTV OWNER (SIGNATURts} ~f\DPE .. TY l"'WNII:fl ----

AUTMflrt E.O aY DATE

I Oft AUTHOftiZ&D AGENT

' t..ANO USE

}Jfl CA'r£

r;::'tt wwtl Ia not Matted within 120 daya from date of issue or if ljp. -:~£~ A FEE MAY BE CHARGED FOR RE·INSPC:(.fr(5,;;-Qij'"ETQ

~ ... 1001,... for moo• then 120 ClaYS. 'this permit will be null and NEGLIGeNCE, INCOMPLETE WORK, OR FAIL 'f,RE i'O MAKE

If vokl. !;;QBBJ;;~TIQNlj, -u:_: /!'ISPE~TOR If (/ o ..... , ..... n

I

FEES NO. EA. FEE

VOl.TS

lnttNCti?n Requtttt ell-l7n

0..11 ..,.,,.tioft ..... , For Applie~nt to Fill in

ADD RIESS

\Z..tll ~u~a.o S+­NI&i

DATE

BLK-NO.---TRACT NOT ____ IE __ _

,."___ -,\ ~- ~ ~~WfVI\OB'IVliBIIfr IIUt=trrlliS:M: I 1/' ~- . i--towNER -~- ------INSPECTOR

~1\J\.£-Ii V.qUC/17,} ss

' \JK.~K.U'\ '

c...cstx.

SQ, F'T,

--·--· - ---· ------· ---- I -I VALIDATION E-PER 52.50 ISS 10.00

1#9014A 7-30'84 CHEG( ACTOR STATE LIC. NO.&: TYPE

1----~··~----~-IUJCC.f.'l~ I •-- -~.

KER'S COMPENSATION REQUIREMENTS State Compensation

- /: J I ~ C) l'~ul vvcr • c~u 1 1 1 ~• ~s nee Policy No.--· ------. Expiration Date --f ~ /1 I . /7 . _ _ t ,~q._.. <:::: ~-- I certify that 1n the performance of th• work for which this permit ts

ued~ i shall not •mploy any person in any manner so •5 to become subject to thu \.'Vorker't Compensation laws of California.

--------------- -·------·+---

NOTE: If, afttu t"~1lo.. ing such certificatu, tha applicant for the pe,.mit should becomrt subJeCt to the Worker's Cornpensation provisions of this codo, h~ '$hall for:hwith com~ly with the proVi5ion'io of Sec:t1on 3700 or his ''Ort1li! shall he deemed rovokod. I certify tht'lt t hnva rend this upplicotiou and stato tha~ th• 11bova in formation is correct. I agroo to (;omply with Bll City ordinan•::es ""nd State laws raiAtln\Ji to pending constnH.tlo.n. I funhur agree to hold the City ot Garden Grove free and harrnluts frorn any liability afl!t· ing out of injury or bodily damaoo rn5ul~ing from work performed rel...,ant to this permit.

Pc"MM'f"'TA";·.;L,C ~~ATl.ift i~- DATl:

•u~Ur,.t!S5 TAX CE.RTIF ICATE NO, £)(PifH~.TIOr4 CATL

I certify that I am exempt from Section 7031.5 of the Business a"d Professional CaCe, Division 3, Chapter 9, Contractors' License Law~ under the following Section: Owner: Section 7044 ~l Minor work under ~JOO: Section 7048 0 Employee working lor w11ges only: Section 7053 U

{ .. lltiNT) ~l'tQ~P:"TY ·o;;~e.:-.;t- (stGri:T~l~\EH)o'"R~~:~ttATJ.~VNF.H

A FEE MA_Y_ BE CHARGE-D FOR HE-INSPECTION DUE TO NEGLIGENCE, INCOMPLETE WORK, OR FAILURE: TO MAKE .c.o.RR.EC :r I 0 N S.

IIKJCTS

IINOLf DUCT 'fi', .. N VINT

IUnlll, .VEIITUTIII, REFIIIGaATIOI & All CIIIID. PERMIT

IMPtdion A...-.. tl38-e771

Genetlli l..tc.r.-tieft ~1

For AppliC8nt to FHI in

City of Garden Grove

u• 011' •ULONtJ ~ 0111~~......,..

S .... ..,TE UC. NO. 8c TYPK

UOilt!U Of t.""OftlPre"UO" tO e. lO<CI 1 :> MD. J 6 ~ ( '[)N(r*? _ AD.,RESS ---·---·--· I -·-.... 1 .... ,.,..,_. -1

L_

TOTAL FEES

----~ : ,.r-· .-/ ~.)

/, I {;' ,_..,.,

S'\nto Cornpensation ln'luranc• Policy No.~-~--- ____ EMpiratlon Dete---,-----:---:-0 t corti1y that in the portormntu~n o1the V\IO:k tor wMich this permit ia

issued, I shell not employ ony pnr;Otl in any mann•r so •• to t.scome sub,ect to the Worker's CotnptHl5n\lon low• of California.

NOTE: 'f. aftor making such (UJtifit·nto. tho lHHllicant for the pwrmft shoullt becorno subioct tu 1hn \.\101 kor's Conlpm1S8tion provisions of this ''Ode, he $hnll forthwllh t nn1ply with tho provisions of Section 3700 O'" his perrT~it shiJII bn ~llmtHfl!f revoked.

0 I certify thl!it I hnvt., roatl Utili hPllllt:fttlon end sun• th•t the abo\·• ln­formetiot' ls cor teet I our m• to 1 nmply with ~til City ordin•m:ea .nd State IG~ r•lating 1 pundfuu 1 nn•trucllcn. I further •gree to hold th• Ci~V ~ f GardCJrl' rove fnu• and harmless from •nv liability aria­ing odt f Injury r bodily tlntn~gu rl!sulting frorn work performed

••'""" to.- · p rnit. <":···;C . ! !./ · r , 't:!"-- . _ ~-~-~· ~ ,, - 't- 1 --- ~ii"MtT 1\t•PuCANl .. ~~;-;.,; ... ~"~~ ~..a o""• .~ -

1, USINESS TAX~PiiiTf:ICATE !NFORM1T1f~ z-1 u~~·f'. ~t the toiF,/·i"g.~r• •~:t.or'a)/icenH No. • I . ,.S __ ·~<f~J!J,t~lion ___ ;... .. • i - ~ ln)\•}J'jorce end effwct~. /'' /\ .... ~, ~~~ :-,;tJ, {/JY/LLJ,·--/-'-, / --!-- .. -- c ' ,,. ........ ,, CONYIIIIAC'I'DR --· ·.J- It A.l~~~.~~~~~~~::r:cr!'~" 0,;,-.;-.--

/; .. • ----~:Ji""t~~i"~;~ATt. Nn: -'"·- I!:JII.PI,.ATION PAl~

I certify thot 1 am oYOrllpt trorn Sttction 7031.5 of the SusinMJ 1nd Professional Code, Oivision 3, Chnpter 9, Contractors' Licens.e L•w. undwr the tollowlng Ssc.tion: Owner: Section 7044 U Minm work undM $.100: Section 7048 0 Employoo working for wugos only. Section 7053 0 Other:. __ _

OAT& """""(;;.-;;;-,-;~~~~-,-r. I-ll T'V OWNt. H ·~~ lh;:.;; ~ IJ;; ~Ho~ ~-;;-.;N-.;-; (lh AUTHORI~I'.O A~·~NT

A FEE MA\:-BE~Eu Fcm NEGLIGE~C~-. INC:OMPLETE WORK, CORRECTIONS, ----~-

RE"-INSP£Cl"ICN 0L'~ TO OH rAILURE TO MAKE

o•-o"t .. -1'1