.----------------~--------~---,,--

CIBflriClTI OF iCCUPAitl CrrY Of OAlDIN :'GlOVE

H.A.lt&Y ll. Pi.~J.CI 1 Director 11391 ACACIA , ~961-A

JOB ADDRESS J06~~-8o1SI . PERMIT NO.--...,VreA--

1 USE OF BUILDING 16 Unit Apartment ---_GROUt..---:-:---H~---- TYPE. 3..,2.,2 USE ZONE R·-3 - sfPf62'!_'Jl BY ..... K • M1 ler DATE-__ _ ZONING REMARKS.,_ ___ _

floor lood sign installed per Section 2308 Yes 0 Nu ~ Room capacity sign .instalfed per sectior. 3301 (1) Yes 0 N~ 0

2

The abov& described building has been inspec:ted and found to comply with the provisions of the

Uniform Buil'"luacr&.n.rsh1p 01¥. fndtn. 681 Market St. • San Franc1cco ISSUED TO _ ADDRESS Aprt1 ! , ,!f! , _ -Author~!_8~61ey, Pf'ine1pa1 ft1dg. IM,a!fir . Net1Ctt!!l Pest Ia a ~Ia...,. Plaee .. tile ::Pre..JSes

.

'I: ,.,

CBIIIFICI!B OF OCC:UPAICY 2 JIAitlt a. l'llllCB, Director 11391 ACACIA

J06 ADDRESS i0672 .Jlo...,ls~a._· ____ ........... _ PERMIT NO. M963-A USE Of BUILDING S lbdt Apartrrw?tnt,._ __ :GROUP U _ TYPE __ J&Iol.._i ---USE ZONE R-3 APPROVED BY lib. K. HfJler DATE.. :1:2-72

ZONING REMARK . .:LS -J. ~a.P_1.u0a~2~·7w1L-. -·------------.. ·-· --~· -· --FIOCN" load sign inatelt.<f ptr Section 2308 Yes 0 No tXJ( Room ClpKity sign irtattlled per section 3301 (1) Yes 0 No (j r>-e .hove descrlb.d building h• been Jn~ and found to comply with the provisions of the f.Jniform 8uildirtg Coc». . . · · :: tSSUED TO Mutual Ownersht~ Oev. Fein • ......ADDRESS 681 Market St~:• Sift Franefseo Auth«izect J · · · z:n _.. April 5. 1i72 ~~ . .It: Rtb1ey, Prtn~pa111]1§7~nspectoi' ·· · · lWetlee P..a 1a a Olm81flela•s Plaee ·•• dae P.•e•IIJM

--~--~------------;.._1 -------·

CBITIFICITB or occuPANCY z , ~ =~~;;,::oT an ~~:~::nu~- ~~~~· USE OF BCILDING R@crqn:\;i~S n ;~;d t GROUP 8-3 1YPE_1.i _______ _

USE ZONE R-3 APPROVED BY __ .:.l.H..!.•...:~~)!.!t::'(\:.ut'f~Q------ DATE l{?,j/~t_ __ ZONING REMARkS ~J .. ].!t; ... zl )3 / ~i'"-:t- .. )J7---~--·· Floor Joad sign instaltMI per Section 2308 YesO No 0

,'/

Room cap«ity sign instilled per sec:tion 3301 (1) Yes 0 No 0 The .bov* described building has ~ in~ and found to comply wi.th the provision$ cf the Unifonn 8uilding coc».

5 .,...., ... , ..... ,..n .. ·"'-Jct .. on '"or~-:~ P :1 ~'o· "' .:·,,,.. ·11 n·:lr.~~1"" !"J·'l··<·Jt~ ISSUED TO P• OJ~ ~'"' .; .... ' . J '1.. , •• ..ADDRESS .• · ...• ,.) ,.. (,,,~, ··Oi.lr.;; )'<t ... ""1"'' 'J

A~:m· 8 . . · DATE February 1, 197:~

. · R.:~Ji• ,Pri nei &;~~\, Inspect.Qr.la Ia ·• p---•--" • e. 4181 1a a ,. ... PJ ee •• t e · ~ : , _I

,f '

C:II!IFIC:l!E . OF OCCUPAICY 2 CI1Y OP OAID .. GlOVI

HAU.'i! a. PIIRCI, Di~•etor 11391 ACAt;ll't.

J06 ADDRESS._. JQd52 QAlU -PERMIT N0.44?62•A -·~-u~.,.. ~ BUtLD·I .... G 16 Unit ~rilaent ~"OUP H ac: VN

;ox; vr ' J'll Mli:"'K. M111er -- TYr..:. .. :s .. ~-7r--USE ZONE.. R-~~ROYfD 'Y.__;,.,.-------- DATE "" "--ZONING REMARKS · . S~ lOZ• 7

---~------

Floor load si3n installed per Section 2308 Yes 0 No £! Room capKity sign inst•lled per NCtlort 3301 (1) Yu 0 No B The abov·Jt described building h•s been inspected end found to comply with t~ provision!: of the UnifOttn &uildlt~Q (.ocf.. · · · . .· lSSUED' ·ro MutUal OWMrth1p· Otv. fdn •.. DDRESS 681 Hlrket St. • San Franttsco Authori~':ed li.v . ' . --A~ Apr14 5 t 197~

· u.R. N f1J1~ , ..... ht. 11d;. iOSJ&tOI' . . · · ·· .·· Net.kel P.n ... lil a ·c...p...._. Plaee ... ·tile Pre.._.

CIITIFICI!I ·OF OCCUPAICY 2 ·em a.· OAIDIN OIOYI

... F!oor loed sign instell.cl per Section 2308 v.. 0 No 0 R®m capec:ity sign in•t•lied per section 3301 (1) Y• 0 No 0 The ~. det\'!ribed building has bHn inspected and found to comply with the provisions cf the

Uniform Bui'g~fifitonstructton Corp. P.O. aox 600, Arfahe1m, 92S05 ISSUED TO ~ DDRESS Fi6 1 197·~. -. . ruary • ,.,..

· .. tltfe~. ~1b1ey. Pt1nt11l11 an.~ .. tfll~~-*. ---. _....;_ ___ _ N.Ciul. P.a Ia. a t::w~ ........ Plaee .. Pre•._.

o)

CII!IFICI'E OF OCCUPAIC! z IIN!.tt,..., OiJ1 IUUM CITY Of oAIOIIN OIOYI

, KADY a. ,.lltCEt Dl~e~tor 11391 ACACIA

J'""*' A ... ~~ l0t102 nolsa 'i449ti5 ,-, vu ,.._~fiiOiN- PERMIT NO. ·---

USi OF BUILD~ 12 Wli t ~'1-'art:;:f,mt , GRQUP_H_ T"Pf.. Vn R•J . 1! .. :>fow.~ --- '. ·-1.-1..,.2'"'5 ..... 7 .... 1 .... 3

Ust: 10NE gp ... ,5~~eo IY---------~,.;-, ~~T~-,::::---~· ZONil\:'G RfMARKS 1(.) L '~ ~L..!-.::...::L-.--.

•• .J

Floor w.d sign IW1tta1L.d I*' Section 2308 Yet 0 No 0 Roo"!\ ctpacity sign Installed per Mdion »01 (1) Yes 0 No 0

. Th .. t .-;bove a.scribed building hn beer. fnaptehtd •nd found to comply with the prorvi$ion$ of the

u,,·,·r:-nY' ~~~u~nstructton Corp. P~O. Box S~O, ,rmaheL~t 92005 · !SS\ .. ·"l TO , . OORESS FlbMla" t. 197~ ~~ Sf1b1f1 •. Pt•fnc,pal 81dg. lus~Wto-r------.,.-.------· ~~~ P..t Ia a C::e=spte•••• Plaee •• 6.e~~ Prewl..,. _j

·'

. BUILDING PERr.tiT

~~~~~;=~~~~~~~~;~~~~~:==~~~~ Ja;rtify_~ I he:!~. read 1his oppliccrt,ion

motion is COfl'eCt. I agree to romply to all O~inonces and State laW. ,.lating to building c:onsf1'Uction. I certify that m; the perfo!'TI'Ian~,of lhe' ~ ~J shall rn:>t e!!)ploy O!JY P"'!S<:>I\ .!" vic!lotio~:u,f~j.Qbof' .Code of Cot.fotr.ia rek.tlng to Womnan's COmpenaQfl.:m Insurance. t f-'rther ogr'ee no hold the City of Go~n Grove free an<f· ha:mles:: from aliy lio·

~~:;::.:.:::::~L!-.::~i-~~.:!!:~~::L.f-,.,JJA¢1:::22:::...__,,---.--,~-..J b!Hty a~isii?SJ out of .injury or .bc>dily_ ~m~ _l'f,>JJ!ii<!Sl .~. Y-!.:d; ~-fonned relevant to 1his permit. ' .

CONTRACTORS SIGN &e.OW .· I ·certify that l 0t1t a lle&med contra~ and that imY ~·is in full fora!.

·-"---\j!5''------------l and ~ffect.

... . ~BUILDING PERMIT l't•e .~~!' ....... ,., •. ,.,,. ___ ._:.;?:.:,__...,F-i'-:......4::..::.... ..,;~::.!.:'1~-·.~~--.::.:_--·t.o:=~~~;;.._,.--:-~-":"'

·(-

CITY OF GARDEN GROVE -~ Public-Works & Development BUILDING PERMIT

-· -·· .. ,,. -Inspection R•quests

631-6771 Gener.t lnfot~MtHNt

·08&M1

·_. -\.··~ ...... . 4.e~• ·- INSPECTION RECORD For Apptieant to Fill in

'•/ .\ OCC. FIRE TYPE \if./ LOAD SPRINK. APPROVAL DATE INSPECTOR ADDitESs -tta

FRONT LEFT RIGHT REAR C~~~l,...;;~_t-.;:::::-;;::T-_;_-t--jrt----j---1 FOUNDATION & LOCATION

Eav F!roj,

Setbacks CONCi'iETE i=LooR .. -_-_-t-------t--------f;;w-~ii"'j:~--7~!:..;:r::....!--...l.L~r,t'".,I.....IJ­REINFORCING

.. ------· . -- . . .. - t-::R::o.::b::F~S::.H~T::G:..:.:7-,---,-,--~,_j,--,..--,.----,--+.,..--------1

;. -INSULATiON. ENERGY __ f~(? LS: .a-;_ ./f:g-·-··~ LATH OR DRYWALL ""

AEMA""''" r··c- ---~ ---~ -· -. . .. -- :~~::::u~~~;ON r ~ MAILING ADOUSS

I

CITY

______ ,____ . -- SMOKE DETECTOR TEL. ND. lSTATI: uc. NO •• TYPe

" I 1-P:..;A~R.:.:K:...IN:.;::G~------~_;_--....,...,----t,--,--------L_

LANDSCAPING G.G.SANT. DIS., FEE REQ'O.

.,.CfC.SANT. OtS.-, I- OAT£-----.-----.NITIA~

F,EE REQ'D.

RECO'O I PROVIDED l

VAL.fi:JATION ~-) ~i.

c-

.--=<.;,.,.: I J1 f:~:~ .. , ; :. ::

I

ZIP

- .. :,~

. ~

t::~~-~-~AP ~~--~~- ' .... ::: ::: ... ·-· ~

MVPEDiCATION LAND USE FINAL CONTIUCTD" :: ';:: :· ·- = -:_. FEES AND BONDS FINAL 13 ~t-V. C'-.cNS-r- ~ vC-J?&n-1

REV. CODE AMOUNT UTILITY RELEASE MAlLIN~ AOOitiESS CITY ZIP

Jf.'ARKWAY TREE FEE /

P'ARK & REC. FEE (OUT.

DRAIN ASSMT. FEE (:>1ST.

t!'!--AN RETENTION FEE_

~LOG. PLAN CHECK

I--BLDG. PERMIT FEE

~3;71 .--? !5~'

..i?,£0' v e61 ..171'? (( c-i ISSUANCE

V.AL!JATION

!5lf?J- TOTAL I ?f 16 v FEES :7'r '0

AU"'tNO,.iZED •v

I)J I o.no:

[ f 2d--;; -,~\ ../

.•• INSPECTOR 7

BUSINESS TAX CERTIFICATE INFORMATION I certify that the followinli Contractor's Licansa No ________ _ and Classification is in full force and affect.

(PJUNT~ COHTP.CTOit tB:,~H:~!#:~l~~~~"':t:.r~ ~"-;;--

•usJN~SS TA."'- CIE. .. TI ... ICATE_NO. IEXPitt~TIOH OATE

I certify that i am exempt from Sac<ion 7031.5 of the Bu;inass and Professional Code, Division 3, Chapter 9, Contractors' License Law, under the following Section: Owner: SIIC:tion 70« 0 Minor work under 1_100: Section 7048 0 Employ" working for wages only: Section 7053 0 Other:: ____________________________________ ~-------

C•ti• .. TJ .. WGPII:HTY O'llltNII:ft fs&GNATUftl£) P""OII'tftTY OW""K" bA"t& 0111 AUTHOfUZII:D A& .. NT

FLOOR A~E:A I NO. OF lNO. OF DWELLING

(SQ. FT. STORIES--- UNITS

If work is not started wi~hin 120 days from date of issue or if abandoned lor more than 120 days. this Permit will be null and ~Old. ---A FEE MAY BE CHARGE:D FOR RE-INSPECTION l JE TO NEGLIGENCE,INCOMPLETE WORK.OR FAILURE TO ;.,AKE CORRECTIONS.

PRESENT BLDG. ADDRESS

MOVING CONTRACTO~

ADDRESS

RELOCATION

...... , ... .,.

BUILDING PERMit IC£$1)EP'f;, GARO!~ GROVE

BGILDING PERMIT

OWNER-EIU!LDER SIGN BEtOW f ce-rtify !hot I om exempt from the proi~ision·l· of Ch. 9,, Oiv. :;, 6 ond P. Code (Contractor'~ ticcnse low) bct'>IJS" (check one):

--·--·c·---------·1-"+-'"""=t~..,=---+-=~"'"'-·----------J O l om th~ owner of the obove pro;>erty ondc wm.p.;r.onolly perform the above. w:>rlc.

0 I om th~ ovmer of fhe ab.,ve properly and ! will con trod to hov;, ol: ofrlm above·.wori< performed by lko:--.,ed r.ontroctorc;. final

0 f om 'the ow~er of ~he above proper~/ O";d will empi•)Y p-ors:::t>s lo.per· fonn the above "'crk wi:th wages as their sol~· c~m1pensotion. ! will h•~nd1

------.. ·-·-.,-·--·-····-'...,.--·-'-•-·-----:--,,---'-<lr-----·----•·--1 inw:crice for myem~foym OS require~);; lab~ Co't-~f C~¥~)~.

1 ________ By..,::(, !f. 1:-.J~~---· ~i Own•r's Sign•J!Or6 A!lfilQ•i<ed J~nt · Pm• ·

-..~---------r-::::-:,..~-:--.=::--::~=~·----------~~-t If work b not sfnrted within 60 doy5 fr~lm dale of i>MH> or if cbcmd:>rt<,d

Check BOncf

for moro than doys, 1his permit will:.be and VQid.

-~-~---,----- ------~--~-~-------- ;-------------~----~----~- -~-- --- ------~-~---~------

CITY OF GARDEN GROVE 1 CALIFORNIA •,J, Dovalopmont Sorvlces Dopartmonl

-"--!'-- ~t 11391 ACACIA PAR~WAV, P.O. BOX 307'0, GARDEN GROVE, CALIFOA:JIA 92642

.A •.~· : 10632 80~1] I Suite: PERMIT NO l'i 2797 Pa. 1 No: 10849201 Typa: B33 I Date : 06/29/90 Insp Oist : 020 ___ ..__. ____________________________________ t -------------------·----·----------=~-Owner GARDEN GROVE MANOR INC (CR) I Applicant: SANTA ANA ROOFING INC & WA Address: I Address P 0 BOX 6&6

------------------~--· I SANTA ANA CA 92702 Phone: I Phone:

----------------------------------------l---------------------------------------Arr.hitect: Address

LIC: EXP: PH:

I certify that I am exernpt from Section 7031 ,5 of the Business and P"'­fessional Code, Division 3, Chapter 9, Contractors' License Law, under the following Sectio,_Qi Owner: Section 7044 0 Minor work under $200: Section 7048 w Employee working for waues only: Dection 7053 0 Other: ------------------

(PRINT) PROPERT't OWNER

Planning Final ______ , ____________ __

Bldg Find ?- z, <:"- 'o Utility Notified ______________ __

1.1NSPEGTOR

1 I I I

Engineer: Address

LIC: EXP: PH:

Proposed Work: T-O EX INSTALL 3-PLY BUILT UP ROOF

Value 6000 Floor Area: 5100

Parkway Tree Fee Park & Rec Fee (Dist. Orain Assmt Fee (Dist. ltNSPCT

I B-PER

ISS

15.00 91.50 10.00

':,·

rr.l

11t9262A 6-2f'90

l I I

I l '-

1

106.50

Other~~ Plan Retention Fee Phn Check

16.18

Permit

741-6332 General Information

7 41-6307

81.6t

If work is not ctarted within 180 days from d~te of issue or if abandoned for more than 181 day~. thh permit will be null and void. A FEE MAY BE CHARGED FOR RE­INSPECTION DUE TO NEGLIG~NCE. !NCOMPLETE WORK, OR FAILURE TO MAKE CORRECTIONS.

~------------------------ ----~

PLUMBING PERMIT CITY OF

G A R 0 ft'N G R 0 V E

PERMIT FEES

Water Closet (Toilet)

Bath Tub

Garbage Disposal

Laundry Tub or Tray e. I Water Heater

__ .f_ ... . ------····-··-·---·· Slop Sink

Floor Sink

Floor Drain

Dish Washer

Automatic Waahing Mach.

Water Softeners

Backwash - Trap ·---- ---- ---- ---------------·-··· Water Lateral

Backflow Protective Devices

537 •• m>O

$1.50

I

"'

PLUMBING

J._­]

PERMIT

--------------------------------~------------------------

PLUMBING PERMIT CITY Of

G A r: D E N G R 0 V ~. .. PERMIT FEES .... IACH • •••

Water Closet (Toilet)

l1th Tub

lllu1nce of Permit 2 00

------------ --·-- ..... ____ __:__ ________________ ~ _________ ...

PLUMBING PERMIT CITY OP

G A R D E N. G R 0 VE ....... PERM.IT FEES

.... TYf'l o; reXiU•i oii i11M ~-. ''' ••···u~~··-•·••··~· ' '"""'' <•

W•t•r Closet (Toilet)

Shower

lllu1nce of Permit

TOTAL FEE

,.,,.,if-Authorized ly

'· tHSri!CTOI

IACH

$1.50

1.50

1.50

PLUMBING PERMIT CITY Of

G A R D E N G R 0 V ~.. . ..... PE~MIT flEES

"' '" '"' e~·,., '"" -"'" ,.,,._.,, ""' • • .... IACH • ... Water Cloatt (Toilet) $1.50

" &~th_.!"~ .. - ................... ······· --~~~-0- ... ···-------- .. -~~~~'-.. ~pf1.Q1Jt_ .... ---~~~~~~---·-···------- _________ !.:.~-~ -·· --------~~~~~-~~~~~----- ................. . --- ~;;;Z7si:.,J,-~~~"J_ --- -- ::;~- ---- -~l~mbln~~'!".od__Ot /{wtv;_r:! f f.fli. L ;,;>,£. _ ______ ----·-------·--------.. ----- ---·· -------1--- Coutrador's AddressO/o t.-_ <;; __ ..-.-..... :'i/4.~

Garbage Disposal 1.50 ---·---··---·-·------:~z ...... _.L. .... ....... · -J .... ._,

----- .. -r-- ---------·---.. ------------ --------r------t-·-- Phone~ I-; o ., S ·::::. C1ty Ltc. No. ________ Laund'! Tub or Tray 1.50 !--U~ o;-;l~. L~. :...;;;'_,+ ....... ·· · ........... ··· ·---

Water Heater 1.50 1--------------d.f .. :.S .......... -.- .... ... · -----

--- Slop Sink.. 't 1.50 New Bldg._g _________ ~~~-~~~~:- ... ~-,-:;-----·n"ii"*-i"" OO --·-,-----------.. ------ . 1 Validation ~-~:G -9-71 11 01f3 M 't '•

Floor Sink 1.50 I +' f--:--o----------·------------.. ------............ ___ _ --·- -------------------·- . -----~-- -- I hereby acfo:nowledv- lftet I han read thl1 appllcetlon and ll.te thet

' 1 50 I the above is correct and agrH to comply with all ordinances and St.te S.W. 1 Floor Drain · • i regu .. ting plumbing.

--t-----. ·------r- I hereby certify that I otm prOI*Iy te9lltwed with and/or licented " · 1 0' h W h 0 ' required by the City of Garden Gro,. and/or Stele of California,.~ thet I

IS . as ,er 1.5 am the leVel owner of th~ above described property, and I certifY that 1ft the perf.....,.nce of the work for which this j:)afmlt Is iuuecl I mal not

0 employ any pe.- In violation of 1fte w~'• compenaatlon .... ef the Drinking Fountain 1.5 State of Callfomll,

-~,;nalydem- Outle1s I :~:: ----+----ij.....::~:.:,..:.:==~-;_(~,~~~~;;-;""n·A~d~.A-WCL_r--;;a;.A.L;s __ · --r-Date-.;~iii·iii ·-!f21Fii. ·;:w---

Sewer l 5.00 AI'I'IIOYALS DATI__ _ ~~~----1,la~n Sprinklers (Single Dwelling)i 2.00 SOIL PIPING

----+--------------·---~C~n~ly~--,!~----~----t----~----------------+----·--+---------------l GROUND PlUMBING Swimming Pool Piping 1.50 1 __ -t'---;

___ Sand Traps -+-~--t---; ::~:~P:-:-M_I_IN_G _______ ------·--- -· ·-·-· ___ .. _ .. ___ _

__ r-~~to:natic Washing Mach. 1 ·~0 I 1--G-A_S_V_E-~~--====---_-___ --._-_+--.. _------.-... ·----~=~--.-.-·- __________ _ Water Softeners I.SO SEPTIC TANK or c-pool

---r-- +---~-----r--~-=~~~~-~~~~--

Backwas~ +--l_.s_o-+1----t-----1--SEW_fR _______________ .. ---------· .. ·--· ·-··------··

1. Waterlater r tJOV,. (,0 ~~-o_l_ - ··- ~::~:AIN AND ---· _.___ .. - -· . --.- .. . - -B;clcflo_;--p~~t~~tiv~ D;~ic~s--- 2,0,0 I VACUUM LINES -- 1--------- --.,.--------------- 1----r----· ---------- --~-·--· ___ $.£1jJ..fLQ_ __________ f-----t--t/+-"5"'t-~-'O_=-t__:.:W.::A.:.:TE:::R~H=EA.:.:T=::El_. __ ~~ ---"

PLUMBING PERM IT CITY Ofl

OARD!N OROVI! Pl!ltMIT PEES

nPi o• ;uc'fUitl o• niM' ··-

Water Closet (Toilet)

537 ... 200

IACH

$1.50 • PII

Lot No. Tr1ct No, Ilk. No. "'""'"' '

Both Tub ... .•... .. . '.:50 .. ...... OWner j rJ:::: ,,j. (<1"1'1 , 4>. .. .. .. . .. Sh~~·r ........ --· ......... _ 1_~so ....... _ .......... ::.~~~-e~~-~~-!.~ .... :5c.o _ .. .}/~~, ~~-~,.,~ L:svcto11• (W.uh !cs_ln)_ ..... _ _ ~-~~o .. . ___ --~-~.":'~.'"~ ~~~~~':'-~' __ ... _b_~A .... L:-~ o~;..c J\;rz'!-. ... Kitchen Sink . .. . .... _ .................. ~-:~~- ... ..____ Contractor's Address { ":>·~ o 1 f/.l_~c;·tc;j_~·-fl.~ Garbage Disposal t.so ....... _. _____ ;r·-------- .. · · --·- · --- · ·· ...

. - L•undry Tub -~r Tr~; ... --. - --,.-~~- -------· --+--- ~~~~-~..'{_· 2..-i-~(~j __ ~!_Y __ ~!~:--~~~--.. -------- ---·-··· ....... ---- ---·--·· ... -- --· --· -f------ Use of Bldg.

.. . ... _W•!!~_!f•~!-~-- .. - ... _- ----- · -L~~- - -----~--- New Bld~~-ig_ ---- . -. OldBid~.- ... 0 ........ -- ---- ---Slop Sink l.S~ ------------------,--;.·:--::--;--1T ________ lf****3Z 00 · · ·· T-- - -- ------- -----·---- · -- -- --- Validation ; ... 1 0 1t. l Hl •

~ Flo.:..r Sink 1.50 ____________ . ---------------··---------- -- -- -- I h b 1c led that I haft read thla application and state that - .. - . ............. - - .. , .... _ ····- ___ .. ____ -- r--,--S-O - . J . -- the ~be:. h c':~ ~agree to comply with all ordinancas and St~te laWI

1 Floor Drain · regulating plumbing. --·-··- ,~- ····---···-~--· ····-- ·---· -·--··---------------- ---· -·--- ------- ·------- 1 hereby certify th•t I •m properly ~l...,..d with •nd/or licensed u

D·Jsh Washer 1 50 · I raquii'H by the City of Gardetl Groft and/or State of California, or that I • : I am the laval owner of tha above dc~ibecl property, and I certify that in .................... ___________ .. ____ --·-- ____ ,____________ i the performance of th. work for which thlo permit Is issuad I shall not

Drinking fountain I 1.50 l I r,:~c!:H~~son In Yiolatlon of 1M worlunen'a companHtion &.ws of the

---··-- Urinal ------~ uO! ! ~"':"'..':~ 7J~ --::rfi(,L- ..,. '/cb'-----~asSyste~-=-Outlets rl.SO I ~~ --·--~-- I I t-:.Ad=dre.=--=:=::o=':":'""----r--;u:;;.---,--"'iiH<iii=ifti.-------- _ f--~~~~ Se_we_r_ . ·--~- ~-~~ -~ APPIOYALS +-DA_TI ___ ---4

1

___ 1NSPKTO ___ I ___ _

! lawn Sprinklen (Si~tgle0~1;elli"g)l. 2.00 I SOILPIPING ' t GROUND PLUMBING . I

Swimming Pool Piping 1.50 1--------·---·---;-·---.. --------------f--------· ----+----t----l ROUGH PlUMBING ;

Sand Traps 1.50 ::::::~-----+1 -----t------------ ----------------- --.. ·--f--··--·-t---it-=G=A=S~P::_IP_::IN:.:.:G:_ ____ -+l -----1'-----·-----

Automatic Washing Mach. 1.50 GAS VENT i ---- ,_ ---------------.. -- -----+----- +----+---1 -------------+------ ----------------___ --~-at_er_~-~-ft~~·~--------t- ~--·5_0_+--i---j.__:S::EPT_::::IC:_:l_::A:::N.:.K.=:or:_:C=-~pool::.-_.:_ i __ f---·---------

Backwash - Trap ' 1.50 SEWER I

;;. {;~~~~;.tf~~~~-~,D-~ v--+--;:-~-~i-~-!-~--~-~~~-:~s __ N~-0~~~~~--~--~· ----r-_~+-1;-_--_-~---··-~~: =~~-~--,-~- .. -~----_-_-

PLUMBING PERMIT

--~F ___ Io __ o_r_S __ in __ k ______________ --·----~~~.-~5~0~-·--::--~·~--tT~~~~~~!..-~~~~~C[]~":~~:::-~~1::~~ -- ·- '2 ~..n !t,. ~~ r~--comct-end "::..' t!'·:m~.dwi:lsan... '~~~ ~:::: 1~!!

Floor Drain 1.50 ! 0 ~ regulatang plu•nbing. --=::..+··--·-·-··· ··· ·--------- -+--· ···· · I lwreby certify tMt I am ..,._,1y reolstet.d with and/or licensed as

D·lsh Washer i 1.5"' re~i-.d by ft. City of Garden Grewe anci/:ll' State of CalifOfnia, or that I " - the legal -• of tha ahoY. dMail>.d pr-rfy. and I certify that In --l-------·--·---·-----··-----+-·-- +. --+---i !be l'erfllfllllnce of !he worit for which this ~if Is iss~ecl I shall not 0 empfoy any person Itt YiolatkH! vf 1he worltMeri 1 compen~~t1011 laws vf the Drinking Fountain l.S State oF eatifom4 //

urinal -..:__:_:.----+--1.-s-o-t--+:J---;/;,.. =:;:r;jJ.Aff~oUuAM Dale "-'3-?1 Gas S)'5fem - Outlets ~.I~ l.SO Ji.J i"7V Add,.. 0 House Sewer s.oo t:::. looj..-:==.-r.;; -rnou;wo;, . .,rn;....a.---_:_---,-'"iDimA-,.r--r--iiiiii,_ .. m; .... ,,FOi".,.-------------+-·-2-.-oo··-·-r-V.. .so•t ., .. NG / .Jn -·~ 1 ;"} 1 .. lawn Sprinklers (Single Dwelting) .... , t:' 'I" . r I y_:,r__~

' Only 7

7

Sand Traps

-g' Automatic Washing Mach.

Water Softeners ---------~------~--------------

----·------Backwash -Trap

--.--4---v' ?J'" Wa~er Lateral

Backflow Protective Devices --+----·---·-----·---·- ------1--+---t---{_.:..:...:.:..:=:..:.::.:=.. ... ________ +---·-··--· -·····- -··-·-···----·------·-·" __ _

WATER HEATER ---1------ -----------------+---l----+·--1-" . .::::.:.:::::..:.:.-:-::~::----- ·---4--------··-+---··· - .... ·--·· ------- ··"·

-..-l.------------t--1f--:-+-::::i.JIA~C~KW~A~S~H--------+------··--f·-.. ····-··-----· --···--luulnc• of Permit 2 OO WATEit LATERAL -=TO::,::TA:.:.:::L:::..F.:.:EE_:_::;:.:.:.:.:..... ___ ~---1-~$-t~-~d~'J:-~~ 0--t..:f~INA.L~-~··~~-----~=:-t-~-L-:--q:-,;1·-:;;-, ~-:--+./.-#-~-#-r----·- .. -· .. ·~ ,.,It Authorlzeclly •7-- Date ~ • ,3 .• ?/ UTILITY co. ~1w..u __ l V :..=:~=:.:..::.:..::.:....::........:. ___ !::__ ____ ~.---··-···-~~~~ .. ..!....-• ...1-. .::::.:..:.:::.:.~~~=.:.:=-~Bidg~ Permit It ~ J;flj--~

1. INSPICTOI

PLUMBING PERMIT ~11AuSTJ2~~. u:: :J:tW."~~~,~~~·~N~0~PI:~ ([) ~aOIB~\u,J•w.rtr'rsTih•'Pib .. \1"~1'1-iilii'T "'11 1

C. I T y O f 527-4200 'i , It No G A R D E N G R oy ~- . . !lor Appllcent :Pill In . . trm . •

l

... n .... .,.,:.:•_:~~Es .... ; ,, · ~!d,.,.s;.fUSJ.k.[ 041UJA .;2~ WotorCiom_{!~n!'> •........ 11.so __ .£i?..l€(l L•_t_~•: _ , .. , ~~ctNo. . .1J. z.:~· .. /b. _Bath_Tub .. ·····-· ... __ l_._so --~ ~.Q . .. O.YI.~-~'.t?r~. l.D't'r'\.¥'i\~t·,.-~~· • ~

Shower 1.50 Owner's Address ;:; /' · ·· ·

,:)( L~·~i (~·~ ~~~~>_ ---- 1-1 :s~· ,_l.fQ !oO 'Pi~.;b;;.;c.;;,;,..... ::.:./>,{~ IJ1;d .a.£. , 7 b Kitch·~-~~~-~ --------------~--~-0 a41~ C~ntr•ctor'~ Add~~ 9/9' £_?¥_ ~1-t .. s.hfA~ ... ~ -~:·td~"r:t;~-- --~ ~~~ ~'II&:J 1M; !f.?f~~ ~lty_LI:._~··/130{ __

}k_ Water.Heater 1•50 Jt//I;S!O New Bldg. ~ t __o."'_Bida.:._ Q= ·==-----

Slop Smk 1.so 1---~ • . .. !'J:;-3-71 11 011 rf*~*ffi.IIO --- ··--------- Val1dation ·

- _____ J~F~I~oo~r-.~S~in~k~------·------------f-~1.~:5~0+---+---h•C--~ •hfti.~Y"~~~~ 1h··t ·-,--h-.v-....-~~e~-~1h'""t.-.pp--::-liC11...,,::-Jon- ;;;;d ..... 1h .. the ~· I'; corr.ct ·:nd agree to comply wJtb all ordinancet and Stefe lows Floor Drain 1.50 •eo•llatiol!ll pounKung. __ _.

--~~---·------- -----+--+----t-----1 I herwby cwtify thet I am properly l'elllsleNd wl1h a~/ or. licen .... •• requi...! by the City of Gorden GroYe end/or Stale of Ca'•forn••: or ltlat

11 Dish Washer 1.50 ..,. the legal olol-ner of the ebove clescrib.d property, a11cl I certrfy tt.at n

- ___ _J_ ________________ -+--+--t-1 the J>erforinance of the work for which· tt.ls permit Is inued I shall ~~ _,.roy •ny person In Ylol.tion of the wortm.n's competMetion Jews of "'"' Drinking Fountain 1.50 State of Califon!A. :---;}·

--t.:U=-:.r.:.:.:in=al _____ -=_-=_-=_-=_-=_~~~~=~=l~.s=o:=~~~;;~ -... ~fi?ii}L~{j jJn,~ Date (, --8 ../) ( <6 Gas System- Outletsb~ 1•50 )L{ WO Add.... I

_J-~[___--l--H __ o_use_Se_w_er _________ -t __ 5_._o_o~J__~5~e~·~a~_::._=_=_=j~~~:!l~"i!"_-_-::.~-T~---:-,~DA~'-::;;1TirE;_-;.i~~;-;~~-~~~r:_-:_-:_-=: lawn Sprinklers ( Sing:0~1~e:l ing) 2.00-L--L---l-~SO~I~L~PI~P~ING~---:-:::-----1~,~~~9_.!_ ··?':____/~~~ ..... ·,__ ___ _

'!!!!~·-}----------- L~G«<U~~N~D~~~U~M~B~IN~G~-~~~-~~~·~~~----··-----Swimming Pool Piping 1.50 Ul /77 ~, ; ./ / ________ ~--=-·-----1----f----+--1_~ RO~UGH~~DI,,~ .. ,,.~"'!!"''"'~--,,Li 7~'":z_,/;._.:_.-./ /_,!_ ,/-1F.t'~ _/l'.,~~~-------

--1--Sa_n_d Traps !.50 cG:::AS:::.:.P.::IP_:ING=-------l------+--""'·--------Automatic Washing Mach. l.SO , GAS VENT

- ------------·-------Water Softeners 1•50 SEPTIC TANK or c-......t --t---:---..:.. ______________ j--------+---1----l ~":.:.:~=-:::::.:::..=::=!:~""'":=._+-----t-------- ------Backwash - Trap 1.50 SEWEI

~..-1f---

~ Water l•teral I -/#r:Jz,_- -l~¥.'~ -...-:. _________ _ Backflow Protective Devices

------1,------------------ -·--

WATER HEATER ---!--------- -------+--+----j'----J_ _ _:_:_-::::.=_:...:.:: _____________ ,

--L------------i---i-----:--t--::::t...!IA~C~KW~A~SH -·-----··----+ .. -·-····---··· --· .. ___ ,,_

IPu•nce of Permit 2 00

WAiEit LATEitAL _ .... -~-·----·---TOTAL FEE $ l;lj 3 lll0 FINAL /1"~-' b-·~~ --·----·--~

~ ~ ..... . ~

!P~tr~m~lt~A~utho~rl~z~~td~ly~-~F~:__-~D~Ite~-~~~-·~ 3. ~:·?7_L/ __ _l__!!UT!!!JILLI~TY' C;f)O~··~~ """1,.'!r~~~Q;;I·d~~~~. ;:p.::,m:;,:t~---,;L_ "4tffi;7A_:-:_ 1 • INSPI!CTOI

v

PLUMBING PERMIT CITY Of

GARDEN GROVE PERMIT FEES .... n;. OF .. xniRI Oil ITIM

.. - ' ·- ..... ··- --· ,.

Water Closet (Toilet) ·~~ ••• --• ov,• -, •

Bath Tub

Shower

Livatory (Wash Ba~Jin)

Slop Sink

Floor Sink

.!137·4200

IACH

$1.50

1.50

1.50

1.50 ···+----------·· -··-·· ··------··· ·-- ----- --··--t-·---· --t----···- ·-t---r

1.50

Dish Washer

Gas System - Outlets b

Lawn Sprinklers

Swimming Pool Piping

Sand Traps

----·+···--···· ... -·-· ---·-----·------

llluance of Permit

1 . INSPECTOR

PLUMBING PERMIT INITIIIUCTION1 un TVP'IW,.,TI,. o" 141..1. P'OIN1' P'IN, I"IUII 1"1"1•4L.Y, It~ IU"I AL.r ~8t:lfi.1r"Nr 'rli~I·'J{~

C IT y O pr ~~0-~~'j,u,Js /cf.''.t''fl 11h"'fiD \l',olf{•p{tiflirT II(!> G A R DE N G R 0 V E

537·.il00 Jfoobr App'it/~ .·.· Permft No. , ., _

PERMIT FEES "" .., .. - j .... ,.,,. oti ;ixwlti ORIYIM ... :·. ~ACif ... ·'· _· Pii .·:: ----~~~r~ ........ · ... 1.23~ ... . 0411J-I_a

:::;.~~ ... (Tolloti _ I::~ Cf I~ ~:;;·--- _ 71 _ _ ;~ct ~: ~ .~- ~~~~~-iJL .. .. ..... -~- . ~ ~iJ''lJ. -:•

J~ ~~~:;(W •• hB~.i~i~-~-~~- ~:_L~ ::~~;;~~~7~:~---:~~:~~~~i:-~ --= :~:::f 9 00· ~::::;~j;,'"ffjlf;;f!f--j3~i_a__· ~~:;:~:;·~':'~Y. _ ---><::: q btJ Use of Bldg:~-----------------------------

... ---- ---- · --- ----- New Bldg. ~ Old Bldg. 0 -- ··-- _S.I~~-Sin~ --- -------- ----- 1.so Validation ''':l-3-71 ---..1~1-0_l_O_lJ *** tt88.90

Floo~~~~k-- ·---- __________ ······-----+-1_•

5_0_-+------t----J 1 hereby ocknowl•.-fhat 1 hove rue! this opplic.tl~-- ond state that

tho obove is corroct ancf agree to comply with all ordinanc11 ond State laWI 1. 50 .-.gulating plumbing. · ---t-- ---+---1 I hereby certify that 1 am proper·!y registered with and/or licensed as

requlr.cl by the City of Garden Gr-. ancf/or St1te of Californi•, or that I 1.50 am th• leg.l ow111r of the above described property, and I certify thot in

1-------- ------------------------------- --------+--+-----;----; the c::',«m•nce of the work for which this permit Is Issued I shall not Drinking Fountain 1.50 ;"~ ~ C"f;~ In violation of the woru.n•s compenution laws of the

Urinal ---1-.5--o+----+-----i ~~ii?!lfLOJ/..u. ..... tl.-3 -11 3 Gas S~stem- Outlets6-'~-..i\ 1.50 S__ (iQ LAdd..:..:.:,....:...:..AiiiiiiO:vii:S-0_

1·_Di ·iE

1 __ 1iiimiOi:--

_(. __ r--~~~~~~_':___________ 5.0~-L--5~~~~~·-fl _________ ___j~-:D--ATE __ ---:-f-7"J-r..----·-lawn Sprinklers (Singl~~~<>lling) 2.00 SOIL PIPING ~ lj,-1 / 1..e~-{f

Floor Drain --- -- -.. -·· .......... -·------------------------

Dish Washer

~ GROUND PLUMBING --.,..-1.----··----~-+..-----;.;--------f ~ Swimmi~~ !~~- Piping l. 5-0--+-------t-----tl--=-: ROU:...=_GH•..:..:::.::. PLU~MIIIIN_::_:G _ ____,(J.F-i~i-'--;~·7,_· j_j'_ li,.-1/

S~md Traps 1.50 ---+---···· ·· · ·· · · ···----------------------+-- ---+------f-----1 GAS PIPING

l.SO ~G::.:_AS::_:_V:.:_EN:.:_T~------+-----·i--------------·----:--·t--·---t---t-=:.=_:_::_:_: ________ -----+---- -·

------t--W-~ate r ~-~_*.!~~ers --------- ---------t-_1 __ • S_O-t------r---t-.:.S.:::.:EPT...:..::IC:_:_TANK or Cesspool

Automatic Washing Mach.

--·--+-----------Barkwasn - Trap 1.50 SEWER

--+··---·-1----~=- --.,---t-------- . ·--·--!-~ ./ 3-~--------+-~·""·-·· ..... ,~-;iat~r~--~---:~~~~~:----~~=-. 1.50 'f ~ =~~:~:AINAND----~f-"-·-1~ --~----------·-

Sackflow Protective Devices 2.00 VACUUM LINES . -------------"· f--------- . ... -· -+--------·1 ----- ---------- -------

-----If-·-·-- --- WATER HEATER -- .......... -----·--+--- -...... ,____ ___ -----r--1--:.:.:..:.:..:::.:.~ . .:.:..::.:.:.. _________________ +--- ···--- -------- t-·· -·--- -·--·- ----···-------

--AIR HANDLING UNIT

EVAPORATIVE COOLER

;2.2.1 SINGLE DUCT FAN VENT I

1 MULTIPLE DUCT FNI VENT

KITCHEll HOOD IRESIDENTIAIJ

KITCHEN HOOD (C()MMERCIAIJ

I BOILER OR COMPRESSOR 3 H.P. 01 I LESS

I • BOILER OR COMPRESSOR 4 H.P. TO a I INCL. 15 H.P.

I BOILER OR COMPRESSOR 115 H.P. TO a INCL. 311 IU'.

I BOllER OR COMPRESSOR

I BOILER OR COMPRESSOR OYER 50 H.P. i ' '

- ·----.-.~--·· -· ---ISSUANCE Of PERMJT

lOYAL FE£

,.£RMI1' AUTHORIZED BY

1 ROUTING:

#I INS,.IECTOR #a 8TATISTIC:• #IJtiNMITTU •• ,.u

i 1.50

.-- ---

' ! s... 1M

2.10 J.f'/1 3M

3M 4z~ .10.01 I

I

-

•• I 7.SO_j_

\10.. I : 15.00

125.18

I I

2

$

IIIILDINI PIRWIT NO.

44WA

VALIDAT!ON MJC -2·71

r hereby acknowledce that 1 have read this appi'"Uon and ~tate that 1111 lbwa II correct and agree to COI'IIIII1 with all ordinances and state Jaws rqiJJatlll pllllbiJIIo I hfireby certify that J • praperly rqfstertd with lltd/or lictllald • ,..._ ., tile City of Garden crcve tate of Callfomll, or that I • till llpl 11111111' of the above clescr certify thlt in U. perf~ of till WOil for Which this not employ any pei'SOII II Vlolltloll of ..

if Ia.

SIGNATURE <OF PERMITTEE

ADDRESS

INSPECTOR

FUIIIPICE

fU!DIACE VEffTS

GAS PIPING

DUCTS

SINGLE DUCT FAN VENT

KITCHEJf HOOD

Alii IWIDLIIIC UNIT

EYAI'OIATIVE COOl.Eit

IOIW 01 COMPitESIOII

.... ...., .......

.. ------------------------------------------------------------------~--------------- -----,

---t--------------7---

ADDRESS

BOILER OR COMI"1lESSOR 3 H.P. 01 4 .•• DATE

LESS J_ ___

~ER OR CO;;ESSOR

FIJIIMCE 4 H.P. TO a 7.50 l INCl. 15 tf.P. l fUIIfVICE VENTS

! BOllER OR COMPRESSOR 15 H.P. TO a l1uol CAS I'II'ING INCL 30 H.P.

: I BOILER illi COMPRESSOR 31 H.P. TO I I

I!!!<L. H H.l!. ! 15.110 DUCTS 1

125.111 I SINGLE DUCT FAN VENT BOILER OR COMPRESSOR Ovr..R 50 H.P.

lltTCHD HOOD

Alit twllllfCG UNIT

lVAI'OIATIYE COOLER

IOIUI 01 COMPIIESIOtl

' ----~---·-

ISSUANCE OF PERMIT

TOTAl. FEE

FE"'MIT AUTHOI'IIZ£1:! BY

1 ftOUTING: .... #I INSPI:CTOft #1 aTATIITtCa .,,,~ ..,.., ..... #I I"INMinll 414 PI&.&

- ·----~·--

USE OF f-+---------------l------l------l---1 BUIL.OING

AIR HANDLING UNIT

EVAPORATIVE COOLER

NEW BUILDING

SINGLE DUCT FAN VENT I hereby acknowledce that I have read this appllcatlc.n and state that till .... 11 :=:~~--r-------=----=-:.::..:..--=-=~------t---!~C+!~=:::_-J.--J correct and acree to comply with all ordinanc:u 111d state hlwl rtlfllltilll.........,

MUlTIPLE DUCT FAN VENT I hereby certify that I am properly realstered with ltld/or licensed 11 .......... 111 ----t------__.:..:.:..:._.::.=::_:_ _____ L..:=:::+----c___,~ the City of Garden Greve and/or State of California, or tllat I .. tile IIIII ......

KITCHEN HOOD (RESJDENTIAU of the above described property, and I certify that In tilt perfonaMCa of tile wen ...:-...3!!!!:::._-f-_______ _.:.__.:.__~----~==~Lfl~.;.--1 for which this not employ any perS0111tl1tolltlall of Ull

KITCHEN HOOD !COMMERCIAIJ '*'~ _ _..,._. californl&.

BOILER OR COMPRESSOR

BOILER OR COMPRESSOR ---...!!!~~!!!.!..!_..;_ ~------1 FURNACE VENTS

BOILER OR COMPRESSOR GAS PIPING

BOILER OR COMPRESSOR DUCTS

SINGLE DUCT FAN VENT

KITCHEN HOOD

AIR HANDLING UNIT

EVAPORATIVE COOLER ________________ j! ____ , ___ t-t::::-:::-::--::::::::::::----1----t-------

IOtlEit 011 COMPIIESSOit

ISSUANCE OF PE::MIT

1 #1 INSPECTOR #:J ,_EI'IMI'f'!'f:l

#a STATISTICS #4 fi'ILI

Alit HANDLING UNIT AUG -z-E'IAPORATM COOL£R

SINGLE DUCT FAN VENT I hereby ar.knowlecfce tlllt I hava reid this appll"tfOII IRCI state tllat U. ._. II ---+--------;._-------t--=::=-1-4''--""---L--1 correct and il&ree to compl)' w1t11 ~:II ordlnancn and State laws Nlillallllllllll!abllllo

MULTIPlE DUCT FAN VENT I llereby certify that 1 z!ll JIJOPCrl}' recfstered wltllllld/« ilcealcl • ,..._ 11J ---t-----:.:.-:~;.::....:.:::..:.:.. ______ +__.::::::::_1-----r---1 'the City of Garden Grove rttd/or State of talifomla, or t111t I • tile IIIII ...

KITCHEN HOOD (RESIDENTIAU of the abo'le descrjlled and I certify that In the perf~ of tile work _..:.._;::;.._t-------------··-__:___.::=.:~,.,L-~.:----1 for which this not emploY any persoa Ia Ylalltloll of Ill

KITCHEN HOOD (COMMERCIAl.)

BOILER OR COMPRESSOR 3 4.01 ----+-----------~~--~~~:~------+-~~£

BOILER OR rOMPRESSOR -----~~~~~

BOILER OR COMPRESSOR

BOILER OR COMPRESSOR

ISSUANCE OF PERMIT

1 :/11 INS~EC:TOJt ,.,.MITTII8

:#a STATI.TICS .... Plio£

GAS PIPING

DUCTS

SINGLE DUCT FAll VENT

KllCHEM HOOD

AIR HANDLING UNIT

EYAPOIATIVE COOlER

IOIL£1 011 COMI'IIESSOII

.

1

QAS SYSTEM 1.50 ~-------------------4-~~-l--

AIR HANDUNG UNIT

EVAPORATIVE COOtER

NEW BUILDING

VALIDATION

SINGLE DUCT FAN VENT I bereby acknowlqe t11at I bave read this appilcatloll MCf sbltt tllat tile lbGIM Is ....=....:::.._-;-------_:__.:......:...._~:__ ____ ---t--:::.:::':' l=---"----"---1 correct and 3il'H to comply with ail onlinMc:ti IIICl State laWs rtlidltiC ......,...

MULTIPLE DUCT FAiM VENT I her~ certify tllat I wltll lltd/flt liclllsld 11 ftlCIIInd W -·----+----,------------:....:..:..-_______ ..;.....::::=:..J------+--1 tile City of Garden or t111t 1 • tile IIIII o...r

KITCHEN HOOD (RES'!DENTIAI.:l of the above tile perfOfiUICI fill 11e Wldt -=-~'--t-----------------------~:.::..:::_r;~~-.,.--1 for whicll - PlfiGa 111 Ylolltkll of tile

KITCHEN HOOD tCOM'MERCI.AlJ'.

BOILER OR COMPRESSOR

BOILER OR COMPRESSOR

BOILER OR COMPRESSOR'

BOILER OR COMPRESSOR

SII'IGLE DUCT FAN VENT

KITCHEN HOOD

AIR HAHOLINC UNIT

EVAPOIIATIVE COOLER

IOILER 011 COMI'IIESSOit

ISSUANCE Of PERMIT 2 00

TOTAL f£E

MIT AUTHORIZED BY

I',OUTING:

#I INSPIECTOJII #a 8TATI.-TICS /I:J HfltMjT'I"JI :/t-4 I'ILIE

FURNACE UP TO 100,000 BTU's

f'URNACE OVER 100,000 BTU's ------1----- ........ -----·- ··--------·-.

AIR HANDLING UNIT

EVAPORATIVE COOLER

SINGlE DUCT fAN VENT 1 hereby acltnowledee that I lave rud this IJiplleatlon and tt.ate tllat till IIICIIIt II -=-st-=--t-----------------+-= -1J"'-----<f-1--J ~orrect and acree to comply with all ordlnlnces and state Jaws n&Watlltl ~

MUlTIPLE DUCT FJ.N VENT I hereby certity that 1 a properly rqlstered with and/Of( lk:lnsld a J'lllllirlll 1iJ ---+-------...:..:.... . ...:..:....:_:..=.:.:. _______ .L.:==----l------:-1 the City of Garde!! GrOVII rltd/tJI( State of California, Of( tllat l - Ole llpl Cllllllt

KITCHEN HOOD (RESIDENTIAl} of the a~ove described I certify that in the perform.a llf t11e wwt foe wh:=tt tltis not . any per'oa Ia violation tf tlla

KITCHEN HOOD !COMMERCIAl) : li.DII workmen's com·pen,c!ian

AIR HANDLING UNIT rm'!?f: i.~•- s• EVAPORATIVE COOLER ! Ul

US£ 01" J'l~ _. BUILDING NP'./

NEW r7l _,-BUILDING ~

VALIDATION 4UC ·2·71

-1147221.

OLD D BUILDING

11 110 ll .. •l'Ul'JIJ

· .:J""'-~B'--·t-S_INGLE __ DU_CT __ FAN_VENT __________ L~ !5b ~ llleraby ICknowle~,. Halt I have read this application Mil state IIIII tiNt -..1c ~ : correct llld qree to compJJ wltll all ordm.ces and State llws l'lli*till......._,

MULnPL£ DUCT FAll VENT ! 3. ~ I llertbJ' certify t111t 1 1111 properly J'lllltlnd w1t11 Md/tJil llciMid • l'llllllnd llJ ---i-----___:_-~_::;_-=--------'---=.::-t----..,.---l tile Cit)' fit '"-dell Gron ~- sute of Califonlla, t1l 1llat I • llle IIIII .....

/ / KITCtiEff HOOD IRESIDENTIAU _; l.IIG IJ b ;~ of the abcve described property, nd I ::ertlfy tllat in tile ~ of tile w.t '~ .,l"J for wllidl this ~..: .. .:.: -~·-"not emplllf any...,_ Ia vlalatioa flf 1111

KITCHEN HOOO (COMMERCIAIJ 1.. 1 worm.•s ~ laws~~ Lifomll.

-·---·---+---i-;---1 ~~';,':,~!·~:.::~- ~ - DATE ~.2h ./ ---+---------------·-,, 1//7 , ,

ADDRESS ~r (/

BOILER OR COMPRESSChl 3 ~Ss c : 4. ; ------~----------~~~L----,~.---r-----~~E

L::A- BOILER OR COMPRESSOR 11.JtPiJ0HJ. :'-l __ SG __ +--!----It:ru:::mu.c==E:-::V:::Em=-----;;~~'4-::;7/;A:"h:=~::-t/-~-;;-:H;~---~ ---.r<---''---8-0-ILER--OR-C_ot.ft __ ESSOR __ _,tNCL~. :=H.~P3o~TO...!CH.!:!.~.!---; 11:. I ! us PIPIK

BOILER OR COMPRESSOR llici -~-~: j i5.DO !1-DUCTS----------t----+-------

BOILER OR COMPRESSOR OYER 50 H.P. ! 25.00

I

i ISSUANCE Of PERMIT

TITAL FEE

IT AUTHOIU:Zl:D BY

1 JlOUTINOt

¥1 INSPECTOR •• HIIMITTH

#I ftAT18TICS #4 ......

z 00

. DATE ... ~~ ---

SI,.GLE lltJCT FAN VENT

KllCtD HOOD

Alii IWIIllftG UNIT

EVAI'OIIATIVE COOL£11

BOILO 01 COMPIIEISOII •

... ~LECTRICAL PERMIT DEPAIIItTMENT OF DEVELOPMENT SERVICES

PHONE: !537•4200

ISSUANCE OF PERMIT

11 068 u .... •22.00 "EAD THE AI!IO\It:: APPLICATION AND KNOW

THE SAME TO I!E TI'IUI£ AND CO!'fRECT. ALL PROVISIONS Of' STATE A"'O LOCAL L.r.WSCOVEI'tiNG THIS TYI"f OF CONSTIIIUCTION 'MILL BE COMPLIED WITH WHE THE. A SPECIFIED HEIIIEIN 0111 NOT NO PE ON SHALL 8E EMPLOYED 11'1 VIOL.r.TIO,.. OF THE" LABOlt CODE THE STATF OF CALI"FOIIINIA. SIGN OF EE •

IUO, C:ONOYII~

• nECTIICAL PERMIT DI .. A .. TMIINT OF DI:VI:L.OI'MINT SI: .. VICI:S

PHONE: !537•4200

ISSUANCE OF PERMIT

I HAVE CAREFULLY READ THE ABOVE APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS Orr STATE AND LOCAL LAWS COVERING THIS TYPE OF CONSTRUCTION WILL. BE COMPLIED WITH WHETHER SPECIFIED HEREIN 0" NOT. NO PERSON SI~ALL BE EMPLOYED IN VIOLA YION OF THE LA 80" CODE OF THE STATE OF CALIFORNIA. SIGNATURE OF PERMITTEE DATE

X

WlltE

3 l\ I R E 0 4 ~· t R E

WUtl

WATTS WATT! L2. L3

SIO N lltEitMI T NO. lf!IIT. !CAT, Altt -· NttMtT ...

nECTRICAL PERMIT DI!PAftTMENT OF DEVELOPMENT SERVICES

PHONE: !537•-4200

ISSUANCE OF PERMIT

eM IAI.I. ltOtNY ltiN, H&tt Alit l.f OIIU, NO IIWA~Utllt L II CHUIID " WOU •

11 056 ...... *1 0.00 I HAVE CAREFULLY REAO THE ABOVE APPI...ICATION o\ND KNOW THE SAME TO BE TRUE o\ND CORRECT. ALL PROVISIONS 01' STATE AND LOCAL LAWS COVERING THIS TYPE OF CONS TRUC Tl ON WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. NO PERSON SHALL BE EMPLOYED IN VIOLATION OF THE LABO" CODE OF ~HE STATE OF" C LIFORNIA. SIGNA OF PE OA TE

WATTS W.ATU LZ L3

--------· ----INIT.UCTIINt. Ull T'I'II'UIIITI~ 011 I ALl. II'OIIIIf ,.,;, , .....

• nECTRICAL PERMIT I'I .. MI.'r', U tUIIIi Al.l. C:OI'I.:S' .UII! LfGIII.I!, NO lll.IUGIMII III!I'IMITTI!o. A. OOUILI 1'1ft WILL H CHA.IIItiD lfl' WOII If ST.UTID III'Oitl l'lltMIT" ISUIO •

DEPARTMENT OF DEVEL.OPMENT SERVICES .JOB AOOI'II!IS fi.ICfiiiC: ltiiiMif liO.

GARDEN GROVE, CAL.IFORNIA PHONE: 537•4200 / bf4.)./2 ALIL.s.~ fll~l~«• .. .. - I"JWN£1111 De v rca •. diJ onttr:~N 1"1-10..,;; ~~ LOT NO. &- -~~ TRACT NO. .

kl l , 1 o ' · /11. t... d')UJ N·ct?. ,s,i 1 L::J qg :J, /,).., 7 _!1" NOT LISTEO aE OW SEE COOE NUMIEII EACH P'EE

R•s identia I ~I & H) sg. ft. .01 OWNII::I'I'S ACDI'I!SS C'l T T

G~rage, Resid. (J) sq. ft. 1/..1;0 .005 s:r· lA1 t:tJ~/ tUJJex-er ~AN F~ NEW IUILDINQ Oil EXISTINI IUILDINI I OCCUI'ANC'I' I USE 0' IUI~OIJII A~

Service, Single Phase $1.0(1 ADDITION - Aif£4 II!;MOCEl. AI'IE.~ I '!"IH>"

&::·;;.::~ Service, Three Phose 1.00 j ~plf' so."I'T. SC.I'"T.ir '

Meters, Single Phase 1.00 ELECTI'IICAL CONTRACTOR V

j?Jj,§-~ Meters, Three Phase l.OO RovA J-2tNI ..G'.4xf.Qtc /NC. Pole. Power. light, etc. 2.00 ~OORESS '~:a~~l'\,lt-~ STATE L.lt!:JISI ....

Sub-Pa-ls 1 ~ LOO /69~tJ' 5 g~tJ4JO{.P- as-Jz.JS Suit-Pe-ls 3 q, 1.00 YALfDA TION

Outlets 1st 20 .20 JUN 30·71 11 065 y *** *1 0.00 Outlets Over 20 .10 I HAVE CAREFULLY READ THE ABOVE APPLICATION AND KNOW

Fixtures lst 20 .20 THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS 01" STATE AND LOCAL LAWS COVERING THIS TYPE OF CONSTRUCTION

Fixtures Over 20 .1 0 WILL BE COMPLIED WITH WHETHE!R SPECIFIED HEREIN OR NOT. NOi~N SHALL BE EMPLOYED IN VIOLATION 01" THE LABO ..

Fixtures, MER C. , 0 U A R 'l' Z • ETc. 1.00 CODE 0 THE STATE OF CALIFORNIA.

SIG. . E OF YM:~ ... DATE~/.:: /~ H .. ter 1.00 X -:A_.A rr-tf...,..-·~ ·- ",3(7 '2L Washer LDO

BRANCH CIRCUIT PANEL: CIRCUITRY Dryer l.OO

!:11'-I8111UI. WilliE NOMENCLATURE NO.OF' W•TTS WAT"!'S WATTS Hot Water H .. ters 1.00 NO. $1U SIZE OUTLET I. I , Ll 1.3

Dishwasher 1.00' 1

Domestic Range or Over? 1.00 2

Motors Not Over 1 HP l.OO 3

Motors Over 1 Not Over 3 HP 1.50 ..

I I s I 6 i

rHSPECTION RECORD . APPROVAL DATE INSPECTOR

Underground

I Conduit

Wiring

Heater

Fixtures

Time Clock 1.00 Sign, 1 Tran. or 1 Ballast 2.00 Eoch Additional Tran. or Ballast 1.00 Service .A ~ ... '(/ Sign Hoolcup 1.00 FINAL ld' -7--:6 _ .. 7 .IJ,_ P~/'/

Utility Notifi"d , .,.

" .. r

SINGLE I"HASE SERVICE SIZE l:j LIG Oo1-1 ISSUANCE OF PERMIT 2 00 APioii"S. WlftE ._IG. CONDUIT.

/~ I~ THftEE I"HASE SE:"'VICE SIZIE 03WIRE 0.011 R£ cl!G CoM·

-"Of A L ,., e ~ AMI"S . :.wi"'E IUO. CONOUt,.1

• .. ICI'OIJ ,.l!ftfM~T~Y 1°2~7/ • UILDING ,.Eftlii.!.!...NO. SIGN "'UMI't1 NO • YIIIT. llllt't, -.111 C ....

·~~9.!;;5A " ......... , ......

J ~ :.L7/ II II

~ .'!"': 'I .. II ...... !1181

nECTIICAL PERMIT ENT OF CEV!LOPMI!NT S!RVICI!S

PHONE: 537·4ii!OO

.WJIItl

liON "IIUIIIIT NO.

~-~-~--........---___,-----:--------..... -----­INIT .. UCTIONI. Ull UI'IWitiU~it Olt U'-1. I'OINT f'U, I'HII

£LECTRICAL PERMIT DI!PARTMDIT OF' DI!:VELOIIMI!:NT SIRVICI!S

GARDEN GROVt::, CALIFORNIA PHONE: !537•-4200

LOT MO. {..- ....... .L TRACT NO.

l'lltMI.'\1, II: .,.lllfl' o\1.1. l:OII'IUi Altl': l.iGIIC. •• N~ l'ltA:li.Hirj(f IIUMIT H.D. A DOUILI ,II W~I.L II CHAIMD I, WO.I M ST.UTIO llf'ORI ftUMIT II IIIU5D.

Outlets 1st 20 .20 wrno-71 11 063 fA****lO.OO Outlets Over 20 .1 0

Fixtures 1st 20 .20 Fixtures Over 20 . 1 0

Fixtures, MER C., 0 UA R 7 "Z .• ETC. 1.00

Heater 1.00

Washer 1.00

I HAVE CAREFULLY READ THE ABOVE APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AL.I. PROVISIONS 01'" STAT£ AND LOCAL LAWS COVERING THIS TYPF- OF CONST!q'UC TION Wii.L BE COMPLIF" WITH WHETHER SPE;CIFIED HEREIN OR NOT. N;I~O PERSON SHAL 1.. BE EMPL.OYED IN '1101.1\ TION OF THE LA BOA

SIGN RE OF 1"TEE - DATE:: /" ./.., /- ~ CODE THE~STATE OF CALIFORNIA.

X _ _.. ~-· -~-· t-/.~0/7/ -rl/

BRANCH 'CfRtUIT PANEL: CIRCUITRY Dryer 1.00

t:lll. IIIKII. WillE "'O!oo!EHCLATURE NO.OF OUT I.E T

WATTS Ll

WATTS WATT

Hot Water Heaters 1.00 NO. SIZE SIZE LZ U

Dishwasher 1 .00 1

Domestic fL •ge or Oven 1.00 2

Motors Not Over 1 HP 1.00 3

Motors Over l Not Over 3 HP 1.50 .. 5 6

INSPECTION RECORD

APPROVAL. DATE INSPECTOR

I Underground

Conduit

Wiring

Heater Fixtures

Time Clock i .00

Sign, 1 Tran. or 1 Ballast 2.00

Each Additional Tron. or Bollost l.OO Service ,.•·' J)

~H_o_o_k~vp~--------------L-----~~1.~00~-----t--4~f~IN~A~L~~~----~~~--~-'+)'~·L-J'~ ... _··~7_-e:·~.l+-~j2~·~'·'f~~~L~~~ .. ::~~,~-'~----Uti lity Notified ~ rc·

SING I.£ PHASE SE,RVIC E SIZE t:J V •:l C 0 H

lSSUANCE OF PERMIT 2 00 AMPS. WilliE IlliG. COIIIOUt'

J ......... ., ......

ELECTRICAL PERMIT D!PAIItl'MIINT OF DI!V!LOIIMIINT SIRVICI!S

GARDEN GROVE, CAL. I FORNI A PHONE: !537~4200

NCE OF PERMIT

;m; 30-71 11 062 Ll ·U·-t **6.00 I HAVE CAREFULLY READ THE ABOVE APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF STATE AND LOCAL LAWS COVERING THIS TYPE OF CONSTRUCTION WILL. BE COMPLIED WITH WHETHER SPECIFIED HE.RE!N. OR NOT. NO PERSON SHALL. BE EMPLOY.EO IN VIOLATION. OF THE LABOR CODE THE STATE OF CAUFORNIA. 51 OF •

Wilt IE

~lilT, MIU, AI. eMit. I'IIUIIIT lit.

nECTRICAL PERMIT DEPARTMENT OF DIEVI!L.OPMI!NT SI!RVICI!S

'flllf. MIU, Ala~.

""*'' ... '

,., ',._ ¥$ I TUUIIIIU~ ~ Ul.l. ltOIHT ltiH, , .... • INaTIUCTIONt llll

ElECTRICAL PERMIT I'II'IMI."'', If. iV"I A&.l. CO,Il-IJ' A"l: l.t:Oitl.l', NO '-"A~U'IIt

• ,.I',.MITTfi.D. A DO~IILI '1ft W.ILL II CHAIUSID , WOIIK • STAIIITID II'OU " liMIT IS JSLiiD.

DEPARTMENT OF DEVELOPMENT SIERVICIS JO!I Ar.J01tEU U«CfiiiC I'UMif 110,

GARDEN GROVf., CALIFORNIA PHONE: 153? ... 200 //lh ()2 lt..d/i'At 841411 A - OWNER 0€ V 1JgiJ4J(/Jj_f"ltJI\I ,.HONE "ft'J' LOT NO. er-- :~ TRACT NO. Ill' NOT ~IST.Jill .EL.OW SEE CODE NUMSEII EAC:H ~u: Jk tJ rU ilt.t-1- OWNia.Jf4.tf!' 'I:Z. l.,z. 7'7 Residential ~I & H) ss, ft. .01

OWNER'S A-oORESS I; T T

G•rage, Ruid. (J) IQ, h. ~&t? .005 .)J. ~ & g; 111.4-/2 1-r< f S4'L/\l r~ Service, Sinile Phase '

NIEW IUILDINI Oil I:XIInHI IUIL.DINO OCCU~A NI;Y USE Or' IU1L01114 A-

$1.00 AIIIUTION - AIIU af!'1.4I>Of!. Al!t::: ,r "" ,.., ... ,. or- ""'"' --- g--,~ SO .. FT. ~A--.,~ S.rvice, Three Phase 1.00 50.P'T.

Met1rs, Single Phaae 1.00 ~CT,.ICAL CONTiilACTO" PHJ'III'ff. tl.,/, M.ters, Three Phose 1.00 "il ~2./AJi £/&c...r //\) t!- 3J...::J9...l~JV

...!.!!.e, Power, light, etc:. 2.00 ot.DORESS aA~~"'~y ,.,~,,. Lr<Or.llar. ltV·

Sub-Po-ts 1 ~ 1.00 I/& PtYt? 5 ~.1!04/JfAJ.A _1 ..,

Sub-Pan.'i!!s 3! 1.00 VALIDATIOPf" --Outlets 1st 20 .20

JUN 30-71 11 060 t~ *** ••6.00 Outlets Over 20 .10 I HAVE CAREFULLY READ THE ABOVE APPLICATION AND I<NOW

Fixtures lst 20 .20 THE SAME TO BE TRUE AND cORRECT. ALL PROVISIONS Of' STATE AND LOCAL LAWS COVERING THIS TYPE OF CONSTRUCTION

Fixtures Over 20 .10 WILL BE COMPLIED WITH WHETHER SPECII'"IED HEFIEIN OR NOT. N!~~ SHALL BE EMPLOYED IN VIOLA TiO~ OF THE LAeOR

Fixtures, MER C., 0 UA f?T Z • ETC. l.OO CODE 0 HE ST~~F CALtFO.RNIA. SIG E 7ER TEE DATE ~~

HHter 1.00 X ~ ... ~ .r.uo~"?""'Y .-::::: • ? 'JtJ/~ / Washer 1.00

BRANCH CIRtt:IIT PANEL: CIRCUITRY Dryer 1.00 cut. IIIKI'I. WillE NOMENCLATURE NO.OF W ... TTS WA.T'1'S WATTI

Hot Water Heaters 1.00 110. SIZE SIZE OUTLET L1 i.Z L3

~-Dishwasher 1.00 l . Oomestic§Range or Oven LOO 2

' , Motors ~t Over 1 HP 1.00 3

1,;, , Motors Over l Not Over 3 H P 1.50 " - 5 6

INSPECTION RECORD APPROVAL DATE INSPECTOR

Underground Conduit

Wiring

Heater Fixtures

Time Clock 1.00 Sign, 1 Tron. ·;~r 1 Ballast 2.00 Each Additional Tron. or .Ballast 1.00 Service -·1 /"" ~'? Sitn Hookup 1.00 FINAL IL- J /. :_ ?tt~j_ .kd- ~·::;,, """ .. ,,..,,.'

Utility Notified r ~ r

C u-:; OoH -SINGL.E I"HASE SERVICE SIZE '

ISSUANCE OF PERMIT 2 00 AM,.S. WlltE ltlG. CO..,Dut't l

h ~ THitEE .. HASE SERVICE SIZii 03WIRE O.u 1u OuG Oo~· 1 . '

'I'OTAL Pll A M.-s. .IIU lttO. CCHtOU!t.

:''' INSP&CTOR J ,.E"MJ::!..IJ~ IY ~~--71~ 1

1;0

'1}9~6~ SIGN IIIEtU<iiiTlfNO. VfliiT. !CAT, ....... ,

II .. I .. MIT .... ...rJ.r- :II

·' .. ,, . .f il.

., .• tlECTRICAL PERMIT DEPARTMENT Otr DEVI:L.OPMI!NT SI!RVICI!S

PHONE: !537·-4200

I HAVE CA~EFULLY READ THE ABOVE APPLICATION AND KNOW THE SAME TO BE TltUE AND CORRECT. ALL PROVISIONS Of' STATE AND LOCAL LAWS COVERING THIS TYPE OF CONSTRUCTION WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. NO PERSON SHALL !!IE EMPLOYED IN VIOLATIO"' OF THE LA!!IOit CODE OF THE STATE OF CALIFORNIA.

TURE OF EE

WATTS WATTS •. z 1.1

• .. , ·ElECTRICAL PERMIT . '· DI!:PARTMI!NT OF DEVI!LOPMI!NT SERVICES

Mill

IUILDJNO llaii!MjT NO.

t./4. '~ 2,.

..... ···ELECTRICAL PERMIT DI:PARTMIINT OF DEVELOPMENT SERVICES

WATTS .. .r.TTl L2 U

itECTIICAL PERMIT DEPARTMENT OF DEVELOJ'MENT SERVICES

PHONE: !537·<4200

WA 'tTS WATTl LZ 1.3

E OF PERMIT

------------~----------~-----

• £LECTRICAL PERMIT DIIPARTMI!NT OF DEVELOPMENT SERVICES

PHONE: 537•4200

I HAVE CAREFULLY READ THE ABOVE APPLICATION AND KNOW THE Sj>ME TO BE TRUE AND CORRECT. ALL PROVISiONS Of' STATE AND LOCAL LAWS COVERING THIS TYPE OF CONSTRUCTION WILL BE COMPi..IEO WITH WHETHER SPECIFIED HEREIN OR ~OT. NO f'ERSON SHALl BE EMPLOYED. IN VIOLATION OF THE LABOlt CODE 0 THE STATF OF' CALIFORNIA. SIG E OF

WATTS WATTI LZ L.3

IIGN ~l:ltMit NO.

ELECTRICAL PERMIT DllptARTMENT OF DI!VILOII'MI!NT SIIRVICI!S

mt -1·71 I HAVE CAREFULLY READ THE A80VE APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL P"OVISIONS Ofl' STATE AND LOCAL LAWS COVERING THIS TYPE OF CONSTRUCTION WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. NO P'ERSON SHALL BE EMPLOYED IN VIOLATION 01" THE LABOR CODE OF THE STATE OF CALIFORNIA. SJGtqATU"E OF PERMITTEE , DATE

·• ·. : · ~ ·t l E C T RIC A L PERMIT DEPARTMENT OF DEVELOPMENT SERVICES

NCE OF PERMIT

U L I. ,OINT IIJIN, ~t•ltt IU l.t Olel.l', NO I!!IU:iUIIII

II CHAI 01 D " WOII tl

.BUILDING PERMIT . DIVrLOPMIMT URVICE$ Dll'T:, GAR

r • 1:' ~ . . , ,

OWNat4!1~Jtll>at' SIGN NLOW · . . --...:...-----,---if'·"---..,..,-,---...,.;j,.o,...,--..,...,...,..,_.,...,.._,..,...,.,..,.....,.,.,,_.,.J-.t -'+*¥ thot ·• - •-..pt from. ~. ,.t~ of. Ch. 9, !iiv. 3. a _, P. Loth r>r Drywall Code (Contractor'• ~.,..Low) bKauM'(eMclt OM)t .. .

-------..,---t---.:.-....,--f--,-------·---1 0 I. am the owner of the Obove ~ ond wlil-·~o:.lly ~l.ftlot ··~-tt.·· · .. ···:li: .. ,, •.•. ,:.·

---·-----+------l---------·-1 0 I am tt.. DWMf of~ abow ~ one! t wlfl conti"'ICf t~ hove .. Other.. . of the obow ~ p.rfonMd by lic:eneed .con~ ______ ___,......__,r-·--·---+---7':-'"-------t 0 I CIM thtt owner"' tM obOv. .. Oll4f wll employ penoN ... ,.e.:. .· Ftnof fonn the above WOfk wl1h .... comp..,_lofl, t w1M f-.~ '' ______ _...._.,._.,_,_..,......,....,.'\.,.....,_.-...._.,.,......,.....,.....,._ • .....:..,..._.._ INi.nonce .for. my- . .mplo)lellt • ~ 1h* Lobor ~ ef till..._~ ... ..._.

1 BUILDING PERMIT PLOT PLAN l:ioii"'-:AoDiiiE'ii""""----:--:;­Dnalop .. llt Serwlces uet~tme11t

CITY OF GAIDE:N

. UIWC'i.UR~S ON t."~~;~~;ND TH£11' UU. ~ .,.z-:-:. ·' <'i-.,

-· :.._,~.;..,;../..:;.,.;_£., .... ·- ~ . G :._:·

11. -. ~/.~)'~·

C .. 'f·'!f .. t.#·~( I - ff I )~ • • ! ·.·· .. · J)

. 17~~-

-- .·- ~:.~ .. ;.,""

---- -

... ~ ......... ., if' '.... ~· •. ' ~~ IJ~" "f' / l ' ~

. . ' '~ ,_ , .. •;.

BUilDING PERMIT

Other

Final

USE ZONE

Rough Fr(]m~. --·--·----------------+-----------~---------~---------··-1~~~

loth or Drywall OWNE~·IIUILDER S'GN BEtOW

I ceni~ that I am exe.mpt from the pr.,vl5ions of Ch. 9, Div. 3, 8 and P. P•cr • Btown Ct. Code (Contractor's license low) becousc~ (check one): -"-L--er.-· -. -. -~ ·----...-,.----1-·-·---··-----j-------·------1 0 J. am t.he ownar of the above propeny and will p•monall•f perform ""'

""I " above work.

final

Utility ~eleose --·----- ··-· --~-",-...,.,----,--'---..--,.....~~--· VAlUATJON NOn, lt~LUOE lABOR, MAT. $

\ WiltiNG, ~LUMB., HEAT., ETC.

FEES

0 f am th,, c>wner cf the .o:~bovw prop~rtY ond I will contract to hov~t otl of ~ obow work p!!rfomwtd b~· lice~sed cm~troetors.

0 I om the owrwr of the above. prop~rty and will empiC>y p~;-sons to P'el" forrn the above work wilh wogC!s as thelr.1ole compei:sotion. I will f11mi8h

far my ernployel!t as i~tjuired l~::cibOr Code of Co~. __:;_ _______ .· ..:. &~ /$. .. t::...u }~ OWI'Hit'1o Slor.~tur• . Au~!\ot•nd AO'I<'It' . - -t;;,t If work is not ltart~ within 60 days dote of falt.Ht or if obundof<..J fOt moN tho1 120 day,, thl• permit· null and \I'Old.

ECTRICA(. PERMIT" IN5Titi.I<:TIONI USI! lltfiiMl.~ lll: ~VJtf· 1"1·11' d'l' f u ST

IJ~ NAi.l. .. OINY .. ~~. "'"tU ANt· l.f·\>IIH,f. 'i'' •·''"' ,I.JM~ft t. Bf CHAP Cif.: D " WORt&: ~~

BUILDING PERM I.T

BUILDING PERMIT

BUILDING PERMIT ...... :·;:, .. ,, ... ,._,,_,-,

BUILDING PERMIT : •. :..:.::.::::.:.'··"" '"-'~·;::·.:· ... :.c:,. ~-· . ".'.' :.: ~.-.~. '""";·,-,~::.~:;:,:::::.~:·;:~. ·:::.::,:· ·::;··:;;;;;~:;;;:;;·.c.:;;;;:~::;;;;t

~~~~~t~. . '. ~:~- ........ J~!l~r-.. ~I·~·· Q'f''LJ:~~ ... -.. ~tg,!);.,_, __ · ..,;;0.:;..~·-·~··"··••··~"':-.:

~;:.".!.::!!;.:~J!~.S...:!!W~f:!~J.l'i:;~~a:_..:.....:;::~:&;~!:!::::::.._-I··L~ ...... thcrtJ hove read this opplicojlon_ond_sto~e tlv.ot the obp1.1eo infQf'· motion ii ~ect. I ogru to e<;>mply tel .all City Ordinances and Stote 1o,., reloting to building construction. I certify that in the perfonnunee of the

.. obo.Ye WO~ f th~fl nl)t employ O!l)' P.e:~tlld!'l 1{iolation f:lf th•.la~ 4:;99e ~;;;::;:r.:;;i;::;""-:~~--jj-;"'L.:':::/.;;-;;--j'?.:;fj;r--..;_~;..::..."'""-:"--..-'1 of California relating 1o WOfkmon's Com;>enlation lnsvronce. I fv~

ogr" fo hold the City of Garden Gro•(e free ond homtless froM any li<;· l-·-'-.,.,-...,....,..,.--,..,..._.-,-+-#-"";h~.,..,-{--,,P::ot:.!e+-~--~-..,...,....-..,.--J biUty or!Si!l;9_ out of iniury or ~ily):Qo~e. fJW,IIfirtg. f~ ¥o'Oric. ~·

formed relevant to this pennit. · :. . · CONTRACTORS SIGN aelOW

I Qftify that. I om a lker.~ contrridor anc:Hntli' my tteenSI!' is in iull ·foro! ---"'""-:"-------,---J~'::::i-_:..,H~-1+--~c,.L:,A----------I and effect. Rough Fror:ne . Si'£arL r ..at<t; ~. B~~~~:.L..!~~z:L:~U ---------~---------4-----~---+-------------·--·---l c&;~aa~ ~ ~ loth or Drywall . OWNER-BUILDER SI~N BflOW

i certify ;nat ! om exempt from fhe p~vialons of en: 9,. Oi;,. 3, 8 and P. Plos. Brown Ct. cod .... (Contractor's license tow) becOUifl! (check one): -0·-th--e·--r-'---·~---:----+--------!--------------t. 0 I am tbe .owner of the above prope~ and will pM&OOOIIy perform t*"t

above work. 0 I om the owner of the above propt'rty and I wm contract to have all

Final of the above work performl!d by H.:ensed contract~. " D I om tiW! owner of the ohove prOperty and wlil employ person• to per· forrn the obove work with wages os thl!ir sole compensation. I will fvmisk

--.. -- ---'-'------.,.~-'-:-:.,-.,...----...,.---=--·----~,·---...---;...-f iri'luiQfate fOr. ·my· emptoyees· ·os fequi~~. by· the·labcr COde '

Own~• Sign~t.,re

~-------~--·-""'!.•-::"""':':""::----------·-~"'1 If work is not 'tarted w:~in 60 d.l'fs for more than 120 doV1i thl• permit

BUILDING PERMIT nfFAIIHm..ir Of lUilDIHO 6 WITY, 'MIIDEN OltOVI!

·~Pm"ft4j'l'7 . ~ ... ~ ~ 1, . .... .• ····~ ............ ., .... . Tract N0. f' ( . ! ~ ) '~

,opp!i•ro.tli~ ond ~~te .. thot riw oboye in~ot·

;;~;~~;~;;~~~~~~~~~~~;~~;;;;;~ City Ordinances. and Stme lows Telating . fo building <onstruction. thot in ·the pedor,w::rice of tJ-e'

. above wori:: l ~Hno.t f!rnp!oy ·any· .. ~~. irl viol¢i<:!!:' of ~ LQbor of. California relating to Warkmon's Coinf)enaotlon l""t'Tanc.e· I 1:1gree to hold the Ci~ of Gorden Grove f,_ and t.ormlt!n from any li<:»-

f-,-.·-,-,--,-.,.,.,.,_..,.,---,-J:-4+:--1-C:L--+-,~+::...oli<-.;:_..::,;.~-.,.,..,...,;,·· ,-----,·--1. b:lity orisjng out . of iniury .0! i,:lodijy ~ ,i:famog~ ~!llt1~ frqm •... w.,rk ~r· fenmed relevant to11:is permit. · · CONTRACTORS SIGN &ROW

h~~rtify that J om o li~contractor:ond #-tot my·llcemce i:S in full fo~ and effect. .·. •. . . t':.- 3l~~·

/ }_ . /.1 • " (· ' . Rqugh Frar:ne . By~·pu a ~ .... ....,... . .._ • '/ -------~----f--"'"--.Jc----=+------------1 Controctor . A.uth:>rizad Agant · .. D<~ta ·

loth or Drywall· OWNER-BUILDER :SIGN mow Plos. Brown Ct. f certify that I cun exempt from the pr~vis10n~ of ch. 9:''o<v. 3, I ond P.

Code (Contractor's license Low) bec:au:ae (Cheek one):

Other 0 I am the owner of the above property and wU! .,.n::.not;i'·'P*:ic.nn th. obovework. . ·

Finol 0 I om the owner of tiJe above property and I will c~!roct to have o.ll· ofthlt above we!+. performed by liof'rrsl!'d tontTOctm·s. '"

0 I am th~ owner of the aboveproper~ and \~·m employ peucm3 to pe~ fotm tM above work with woges o•1h"::r sole cx>mp.~l,!SOtiO"- fwill furniah

,---.-~·"· ' ..... ··~··-·-·-,.··--·-'-·----..,----·---.:._--..,---·-.,--~-----·-1 in~ui"anee for my employees as reqvirE>~· by rh 'labor .Code .IC!f Cal~"·

!.:.:!:~~~~::~~~!!;~!:.:J:!!~l::..~::......!.=:::=====:!!==i::l ewr~r-r. s1gn~rvr• · B·iS~;r!~;tiJ~~~·~;.~&J!/ I~ war!~ Is not started w~thin 60 day• .from dote of fuufi 'C'r i'' ohondon~d for mot'e than 120 duy.•, this permit will be n!lll Ct"f'~ .,.oid;

BUILDING PERMIT

BUILDittG PERMIT Dfi'AitTMINr Of liJUDIHO & &,1\l'fTY, CiAltDEN GROVE

fllfl! !,~ .. f'-.---··-···-·--~~=:._.._;:::.~--'-'·:.;:· .. _.~;):..! ·--.2:.~~-_:;:.: __ ,_,.::~ •• :7::-";:;._,,~ ... ----···;..,.-

use ZONE

~~~~~~~~U~~~:!,~~il;~~~!.~~~~~~~~ cm!fy ·!hot_! hove. read . . and st~;~te. ihot th~ ~bove infor· - mC>tiQn ~~- .ronitt. ( ogree to · to .:~11 City Ocdirn>nces and Stote _((,~<n ____ ..._ _______ ....;;..... ___ ....;...._;. __________ ;........;.._-1 ..-kiting to building ccnstructlon. I certify- that in the pe; fonnonce of"~

-:;;;;;~~~~~:..:..:..--:"'-f?.~;;;~'?;+.;_j~~~~~~--:-:~·· ~!:iQ~ ~.I ~~~ not employ .(Jny pe~O!'I .in. vit>lotioo t>f 1h4! l.obQJ- Code F of California r~l.:rting ·to Workman's Compensation lnwrant1!. 1 further

Q9fft to ho_ld the City of Garden Grovt fret! and harrn!e~r. from any lio--t-·,-----,,-,-:'-',J-::'-:+-:7t,..,.,.l~~~~.;ICII~..:..,.,.,.., . .,....,.,..:;..,.__,.~..,.,........,___,,-:-! ~!,lit)' .?ri$ir19 .. out. of. injUrf or .. bodil~· o;fomuge !"'~W!ting __ frq,-n WQrk per~

rormea.relevant· tu this pennlt. : . . CONTRACTORS' SIGN BROW

ftrtifv thot 1 em o licensed·cot'ltroctor•and that my·ii<:e~'<se b in.full force -----j.!.!lii~r::!::::....:::..:.-~:-::::::::=::...:=:.......:._ ___ .:_'"'--l ri!"id -~·-

OWNER-BUILDER 'siGN BELOW I cMiifY that· 1 ain· exempt frcm lh~ prcivi1lon' of Clot. ;; Div. 3, 8 c.nd P.

Ptas. Brown Cod" (Contractor'' License L<:.w) bocau_ae (theck one): .Other -----t------+--'----..;._--------1 .Q .I om 1he owner of the obove prope~lv ond will per'IQOOIIy perform tlw ·

t~buve worlt. · . . , 0 I am the owner of thi!! above property and I will controct to have oil

~! .. :h~l_:.,, ____ ---·- · of 1M obove work ·:x~ed by lici-med <.'Ontru('"orl. 0 I am tt~e ciwner of the abow properly and will employ J:Httsol'll to po!r­

. -·-.. ----.,--i--,--...._-,_,..,....,...,..:.._.,..........,.._ ...... __ .,_..,_ _ __,,_,a fonn th_ • ob<->w work with Wogoea tn thalr · . c~_ensatkm. I .will furr ;sh '-~·-=----' .... insui"'ftCe for my employees oj ·..-qu~~ tt.e labOr Code ,t:lf Colifc.mi~.

BUILDING PERMIT

-~ ---,---------~, ..... ~ _ _, __________ _... _ _... _ _... ... ..,. ___ ""'""" ... __..-,

CITY OF GARDEN GROVE, CALIFORNIA Dovolopmont StlrVIooa Dopnrlmunt

11391 ACACIA PA WAY P.O. BOX 3070, GARDEN Of!OVE CALIFOHN

A~dres& :1lj6~~~BOLSA AVE I Suite: PERMIT NO.: 12624 Parcel No: 18849201 Type: 833 I Date : 04/02/92 Inep D!st : 021 ----------------------------------------l---------------------------------------Ow~er : GARDEN GROVE MANOR Address:

1 I I

App lioan t: Address

ACADEMY ROOFING 1833 E 17TH ST 1308 SANTA ANA CA 92786

Phone: -----I Phone: 973-1261

.----------------------------------------l---------------------------------------Architect: Address

LIC: EXP: PH:

WORKER'S COMPENSATION REQUIREMENTS State Compensation J/J1"'7~/?] d' / 0'1 Insurance Policy No.'"' "T~"LJE.xpiration Date ,?J-" -/--<. 0 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 to become subject to the Worker's Compensation iaws of California.

NOTE: II, after making such certificate, the applicant for the permit should become subject to the Worker's Compensation provisions of this code, he shall forthwith comply with the provisions of Section 3'(oo or his permit shall be deemed revoked.

Ja1 certify that I have read this application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating to pending construction. I further agree to hold the City of G en rove free and harmless from any liability arising out of inj or b ily damage resulting from work performed re-levan s per 11.

'!' 'f-J..-11---0ATE

SVS~'tESS TAX CERTIFICATE NO EXPIRATJOr~ DATE

I certify that I am exempt from Section 7031.5 of the Business and Pro­fessional Corle, Division 3, Chapter 9, Contractors· License Law, under the following Sv;tiodn· Owner: Section 7044 D Minor work under $200: Section 7048 Employee working for wages only: Section 7053 D Other:------------------

{PRINT) PROPERTY QIIINER !SIGNATURE\ PROPERT f OWNER OR AUTHORIZED AGENT

INSPECTION RECORD

DATE

APPROVAL DATE INSPE~JOR Pre Inspect 1'/- 2 4-5 ·L f. Hr

F·ou nd a tl o "--------------Concrete Floor ___________ _ Reinforcing _____________ _ Masonry ________________________ __ Roof Shtg ____________ _ Rough Frame ___________________ __ Ins u 1 I Energy _________________ _ Drywall ______________________________ __

Lath _____ ------------Plas.Brown Ct. ______________ __ Landscaping ___________________ __

Pre Gun 1 te __ -----------Pre Deck _________________________ _ Pre Plaster __________ __

Planning Final ___________ _

Bldg Final ~~~·~·~/P~·~S~·~L-------~'-~--) __ i· Utility Notified ________________ _

1. INSPECTOR

1 Engineer: Address I

I I --------------------------·--------------------LIC: ·---- EXP: __ PH:

Proposed Work: .~EROOF q CARPOR REPLACE BU ILT!UP ROOFING

/ -;i~;----~;-~t;;;-------------Floor Arav· 1.000

Pre inspecti n fee Permit Genl plan/cult art Issuance

3200 3226 BLDG PERM & 3617 ISSUANCE FEE

Olt4·57'~A

34.S0 118.29

10.00

TOTAL FEES

1 1 1 1

INSF'CT B PER MISC.

ISS

1&.11 118.29 19.51 10.80

:1.5.00 118.29 .19.50 10.00

.162.79

162.79

Inspection nt:uu•tnn.:::;

741-5332 General Information

741-5307

f work is not started within 180 days from date of iasue or if abandoned for more than 181 days, this permit will be null and void. A FEE MAV BE CHARGED FOR RE­INSPECTION DUE TO NEGLIGENCE. INCOMPLETE WORK. OR FAILURE TO MAKE CORRECTIONS.

-·------------------'"-~--~~~----~--~-----··--' . - _.. - - - - ..

..,...,. -. ---·~ ' -.,.----__......,.._.. - ----- --- :~,-, -· .. .,'"1 , I -~~~~~~~ CITY OF GARDEN GROVE, CALIFORNIA

\ Onvelopmant S11rvloea Oepftrlmenl t:lliol ... ,., ,.,~ ..., -~

11391 ACACIA PARKWAV~_E.O. BOX 3070, GARDEN GROVE, CAL.IFORNIA 92642

Addqu;s : 1064? aot..sA AVE I Sul.te: PI:RMIT NO.: \.~ae Parc;~el No: 10849201 Type: B33 I Date ; 04/04/91 In ~lip Diet : J 021

---~---~--------------------------------1------------------~---~----------------Owner . GARDEN GROVE MANOR I Appli,1antl OWNt;R . Addrftss: I 1\ddr@GS . 10642 aoLSA AVE ' . --:.-----··----=--~~~~~_:-----~-~------~--~-£.±~~L::_~·!.~_;_(;~H.r:~~~~~.:_7~:L:~~-~:(!?;'2. __ 'Architect: - I Engineer:

--------~.,....---·· --· Address : ---- ~-

' Address : ---......-----·-w--- - I _ ... __ ,

.. --· LIC: --- EXP: ----- PH: I LIC: EXP: --- PH: - -· -

··-··· '" .... . -·

-··-··--·- -·· ·-·-···-· -------__________ WORKER'S·t.'OMPi:."NSATION REQUIREMENTS Proposed Work: REPAIR PATIO CO\ ER IN COMMON A

..... -- ··· Stale Compensation qfA Insurance Polley No. exgtratlon Dat~ D I certify that tn tr<J performance of he 11vrk for which this permit

is Issued, I shall not employ any person In any manner so as to ------------------------------- ------ --------become subject to the Worker's Compensatir : laws of California. NOTE: If, after making such certlllcate, the ap;:>:ioant for lhe permit ll'alue : 4000 should become subject to the Worker's Compensation provisions of

lhls· code, he shall forthwith comply with the provisions of Section Floor Area: 0 3700 or his J,Jermlt shall be deemed revoked. 0 I certify that I have read this application and state that the above

Information Is correct. I agree to comply with all City ordinances and Permit 1 63.82 State laws relating to pending construction. I further agree lo hold

the City of Garden Grove free and harmless from any liability arising ~ssuance 1 10.00 ~~~~lly damage resulting from work performed re-lev n to hls;,pe it(.. - 4. - (::!- cr t

PERMIT APPLICANT SIGNATURE DATE

BUSINESS TAX CERTIFICATE INFORMATION I certify that the following Contractor's License No. and Classification Is In full force and effect. (PRINT) CONTRACTOR (SIGNATURE) <.;ONTRACTOR OATE

OR AUTHORIZED AGENT

BUSINESS TA.:t CEA'ftFJCATE NO. EXPIRATION DATE

I certify I hat I am exempt from Section 7 03 1.5 of the Business and Pro· fessional Code, Division 3, Chapter 9, Contractors' License Law, under the following Sectlor:i Owner: Section 7044 D Minor work under $200: Section 7048 Employee working for wages only: Section 7053 D Other: f::: ::~Ef~ 63~82

!PRINT) PROPERTY OWNER (SIGNATURE) PROPERTY CWJNER OR AUTHORfztD AGENT

DATE ·rt~a ...... / ... 1 :!.O..ClD

-· INSPECTION RECORD jj( .:1..21/l '!··{ t:.:t\11 r r.~tcl-{ 73~82

APPROVAL DATE INSPECTOR Pre Inspect Foundation 5-l~-C) ,. :r. r-7 Concrete Floor Reinforcing ___

Masonry 3226 BLDG PERM & 63.82 Roof Shtg 3617 ISSUANCE FEE 10.00 Rough Frame Insul I Energy Drywall Lath Plas.Brown ct. ·-- Authorized by: tl.k TOTAL FEES I t;,.tsz Landscaping X Pre Guni r:e Inspection ~~ ue~~ Pre Deck -- 741-533' ~f worl< is not started within -Pre Plaster_ - General Information 1'-80 days from date of issue or

741-5307 f abandoned for more than 181 Planning Final ----- ~ . .... .. :lays • this permit Will be null

~ ~nd void.

Bldg Fin~ l. ___ :7, 2. ".,..~ .!:_--·-;:y::;-;;_z ~ FEE MAV liE CHARGED FOR RE-

t ~~· .. •• NSPECTION DUE TO NEGLIGENCE, ___ .. ot .. ·- ..... , ) Utility Notified ______ t~. NCOMPLI!TE WORK, OR FAILURE TO _..,. __

"' -- . ~AKE CORRECTIONS. ~ -·-·· •• I

l ..__) : lhj~.;f'[CTOI:

I I ·I

eoil ... i

. BUILDING PERMIT !llP ... ltlMt~(T Of IUILDINO I WI!YY, OAIOEN oC;.OVE PH. -'31·4200

.-~~!!!!!,:~.j~s;_~..Jj~k,J.~~~·-~~.:_!!..:!:..l:J:zl~~~--f. r. ~rtifr t~~ r have. ~ad tf,is CJJ:IplJc6ti~ ~ilcl. ~tote. thot;1f,e ,IJb:~ve Wor--matlor\ is ccrreet. I agree ~o .::omply to all City Or"'inonces aMI SJote low• .

··~;;;;~~~~~~;~~;~~~~~;~;~~~[!===~ ro!ating to buikiing construction. I ctirtify that in thtt perfonnom:e of tM .a~ w1nic .l.~oll not employ ony . .P,~"onJf! ylolotiQrl ~if.tfie.l.ail\Of CO!M. of Colifomia relat;ng 1'<) WO(Icmon•s;; Compiln1ation ln:•urance. I further ogre. to hold the City of. Garde':" Grov~ free, an& ltarmleu from nny lia-

f-:-.~;.....,-,.,.,...-,.~:+-'..,..,..;,.,.,..-_,....,+-.-...,-~-..,~.,--:.;.,...,_.,_,...,...._,.,,.,....f.b.i!ity arl~fng . ou:t of injury ~r. ~iiY. lfo!'n9~, '""uhit!9 from wofk ,_-. formed relevant to this PtJrmit. :· ·

CONTRACTORS SIGN .BElOW 1-cwtify that I om o li~ contra~ and t'not my liceme is in fult 'farce and ~ffect. · . .,. ;.-. .3/.1

I c;;;;;;;;;,;---------:-~"~L II. ..<..~ AYil -----'--'-------#-;.....,---!:.....;-!..o..:.....,.-h!h'-..::..;;,------·--1.1 ::Authoriz-.f ;.gent F Dot>~

OWNER-BUILDER f-IGN BELOW 1. ~ify tlicit l cini exem.pt from the Rroviaicns of Ch. 9, Oiv. 3, 8 ol1<i P. Code (Contractor's License Law) because (check one):

-,.....:.....,.-. ________ 1+:L..f~--''i-'F,ii-.,;1£....r.;-~-----.. ·-... -l Q. I om .. the. ow~er of the above ProPenv and will ~-lly .,..-form the

abov11 work. ' 0 I am th<' owner of the obove PI'OPctly and I will controd to hav-. aU ··... of the obovu worlt performed by lke:o~atd contrac1ors. 0 I om the owner of the above ~ anJ will ~rnpi-Y; ptttaons to p..-.. for-m the obcve work with woges o1 thl!lir aoltt co~PIJnsotiott. 4 will hm.,la .. !.

--.,--~-;----,.--,..-'-~,----'----....:...;.,_,_~-"'"-·----.,-·--1 iriiuranc::e fOt' my empfoyeel oa iequi~ by the Labor Code of California.

~~~~~~===~~~ -----.,.---". _-·--~:'./; 1-# /~. f:;~, .. ~'!'#!! OWn•f'& $(ljri~tiJI~ ~~~en I :::_~-;:

-=-------~~-r--:-"::::11,.....':'""-::-'":':""--.... ------;--t If wort.: '* not alorteod within 60 doya ' date of illtte 0t if obondunccl for mont thon 120 day1, this '• nvll and voit'i. ·

~~~~~~:~;~~~~~~~~~~~~::::~::~! f c•rtify t_h:-Jt 1 .. ~ve rec1d th.l~ r.i;.·::c;;f' ''~ un<l stat~ .:that. 1hei a~ve infOI'·. motion is t:Om!!ct. I agree tt.1 comply 21"'_ 'lll Cay Q,dinct!\CH aNI State lows relating to building construction. I certify that in the performance of tt... a~ ~ ( shall not .t!fnplo; any pe~ jn .. yi()la,:c>r~ of :tilt l.ll~ eo• of California rek:.ting to Workman's c:~_. .. ,.-,,;.-.;0\it ·Insurance. l t.,rthM agree to hold the City of Garden Grove free and harn-!;tu frum a•'Y .Jia.

~~~~~~~~.J.,.£.t...:.~L..~.:.!-..;r;~~~L:J.~~.,..--,.,-..,.........,....,-1 bllity ori$lng out .. of injury~ bo<:{Hy ,il,;:,;:~:Je. ·•·· )!lr:, fi':QI'O ,.,o:}, ~-forr1'1ed rele.'lant to this permit. . ., ._ · : :

. CONTRACTOitS SJGN MlOW . 1 cerlify-~t I am a I~ c:ontroctor:..,ncl that m·· .;c.nse l1l m -futl ~

-,~__,----,----+:.-.......,;--"-''-'--t#ilk--------1 and effect. ··~ 1 . 1/J . Rc.ugh frq;pe ~-----·-----By~· t"/. ,..,,.-:·•==~--=:-1-.L..! -·---.;..__,.-----+-'=-------=~---lfl&......,..._,__..;. _____ ..,----1 Ce:1troctCM' Authorized fo; :..·.;:

l~Jth or Drywall OWNER-BUILOER,:stGN BaOW

Plas. 'Grown Ct. l certify their lam exempt from ttie pri>viaions of 0,.· 9, 'Jiv. ; • a and P. Code (CQntractor'5 license law) becodse (check one):

Oth-.. --r---·-----t---'--'---...,."+-----.....;..-----1_0 I om the.ownerof 1M above ptopel:..,•.anclwill peracmnlly perform~ "' above work. '

. Final 0. I om the owner of 1he above property ond I wiH c~ntroct to h(f111> oil · of tile obow work performed by licensee tontractcrs. tJ 1. om the owmtr of 1he al:love pl'('f)er~ and will empiay p.raons to ptor-

:...----~'c-:----··-·---_,.!.---=----..-!--..,..--------. .;._.~ form t_he above w_ ark with wo~e• os th¢ir sole compensotiol'l. I wilt fvrnis_ h lnauronr.1 for my employtts as require<~ the labor of Co•lifQf11!7•.).

.. . BUILDING PERMIT . '

Flf.~

!,ONE __ .::-_____ !!!!~-~~·-·-.!~~ ..... .:'.!I:IIl\jl-~~:..----··-h-:7..-i:·------------·'--·