c~-------~- · st. bono """tea bono """tea assmt. fee (acrg i wi\ter assmt fee 1ft i parkwi\y tree...

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  • -- c~-------~-___,.,- --"----~---

    an·c.auta•llii.uM ...... __... ~----- lniiii:Cilaft ...... .......... -11 .... -7 ~ ServicM Depertment ,;, ~lf,"z.-

    838-e771 ..... 1 INSPECT10N RECORD For Applicant to Fil in

    OCCU- lt'z. m'f.:irtJ ~ F1AE APPROVAL DATE INSPECTOR AIJOOES!I I'N«:V ~-~a AlA-r-USE FRONT LEFT RIGHT REAR PRE INSPeCTlON l\'52.' ZONE r Eav. Pro). FOUNDATION ~ LOCATION I WT NO ... "' NO '"""' WJ ~~ --

    Setbacl. REINFORCING PlANNING -~ - """"'n 1 ,.._,..,.., •• ,. ACTION MASONRY !.iATE AOOFSHTG

    lAND USE IMIUNGAOOReSS ;:;:,,. '" A."'PROVED BY ROUGH FRAME

    REMARKS· INSULATION, ENERGY • ·-----=~ 6roe. 1\E.J,

    DRYif.II\LL -LATH

    O.WUOOAOOReSS -~ ~.4.~ -·-PLAS. BRONN CT

    LANDSCAPING j~OO -to\. Gt.s"(· IStMwctn~ -··

    't-?0~2.~"2. I E:-PLAN 7G.OCl G.G.SANT.D!S. I I~CSANT.DIS. I I ,.,. -FEEAEQ'D FEEREQ'D REO'D PROVIDED WJOATION B-PER 146.00

    I'NlCEL MAP ISS D.m rvw DEDICATIO.,; PREGUNITE

    fi:-IM~ (Jlff!£7~ :fZJ~. 226.00

    FEES AND BONDS PRE DECK REV. CODE AMOUNT PRE PLASTER CONTRACTOR

    ST. EIOND l/SZJ/ £, 61-..PALMA fo.JAHiexA 9z8:J, PLANNING MAIUNG ADDRESS CITY Z>'

    --W'ITER EIOND 4/r-t;~~

    FINAL

    V.II\TER ASSMT. FEE IACAG I

    TEct?o~7tf STA.'!"E UC NO & 1~ - WORKER'S C~¥,PENSATIOrfREOUCREMENTS IJ-Z2tJGG 2-V.II\TER ASSMl FEE i'T.) State Compensation ~ ' J3 _ J g Insurance Policy No. IOI'!i I- Expiration Date P - PRESENT ,J 4 PROPOSED PARKWAY TREE FEE 0 t certify that in the performance of the work for which th1s permit is issued. I BLDG. USE / ,..... I BlDG. USE shall not employ any person 1n any manner so as to become subjecl to the Worker's Compensatoon l>'ws ol Cal1torma. DESCf11BE WORK

    f.'ARK & REG FEE (C'IST i NOTE: If ?Iter makmg such certifiCate, the applicant for the permit should become TO BE DONE

    ~,.:;cr. -- subjec.t to the Worker's Compensation provisions of this code. he shall forthwith DRAIN ASSMT FEE IDIST ) comply with the proo11sions nf Section 3700 or his permit shall be deemed revoked 0 I certify that I h;:we read 1'

  • oocu-IWICY

    UI!E DE

    ST. BONO

    'MlERBOND

    'MlER A.'SSMT FEE (ACRG)

    1'1\lER ASSMT. FEE (FT.)

    PARKVII'Y TREE FEE

    PARK & REC. FEE IOIST

    DRAIN ASSMT. FEE (OIST.

    PLAN RETENTION FEE

    PGUl CHEC!(

    BLDG PERMIT FEE

    ISSUANCE

    VALUATION

    s 4, 0Dt1 AUlHOftiU:D IY

    /~ / .

    1. I i,;.3PECTO k

    .- TOTAL FEES ...;;~ ~- f"! I -~~-~ \.I~

    O.l-!

    4-11-.%-

    INSPECTION RECORD

    ~ INSPECTOR

    State Compensation 7 g6 RR R Insurance Policy No.209 - Expiration Date OJ -OJ -9 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 sc as to become subject to the Vlorker's Compensation laws of California.

    NOTE: If. after makmg such certificate, the applicant for the permit should become subject to the V/orker's CompensatiOn provisiOns of thi3 code, he shall forth-mth comply w1th the prov1sions of Section 3700 or his permit shall be deemed revoked.

    0 I certify that I have read this applicat1on 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 ho:d the C1ty of Garden Grove free and harmless from any liabil;ty arising out of injury or bodily damJge resulting from work per~d r~evantto tl)is perm·

    !MIIINTl CO!tll'l'IACTO,.

    1 l"l~A11 ~~X CUUIFICATE NO £ltP'IfiATI'lS':'f D-..rt'

    I certify that I arr. exempt from Section 703 1.5 ol the Business and Profess:onal Code. Division 3. Chapter 9, Contractors' License Law, under the following Section· Owner. Section 1044 XI Minor 'NDfk under $200: Section 7048 0 Em-ployee working for wages only: Section 7053 0 Other: J. C HOTT.ANn

    I"'INT) P .. Oftlllfl1' OWMffl

    DESCRIBE WORK TOBE DONE

    BUILD PARTITION WALL A1ID TWO R()(MS IB WAREHOUSE.

    If work is :-oot started with1n 180 days from date of issue or ·! ~t3'1d

  • ~---- ·---------------

    I \

    SHOW NORTH ARROW, I'ROI'ERTY LINES AND ADJACENT STREETS,

    I (

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    It u l- - - - - - - ~ - --

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

    *1 Building ln1P.I*2 AIIIIIOr/•3 PermlttH/lM File I ~ertifV thft Information hereon 11 complete 1nd correct.

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  • APPROVAL INSPeCTOR

    ST. EIOND

    MTEREIOND FINAL r-------------------1------4------+---~

    WUER ASSMT. FEE (ACRG.)

    WI.TER ASSMT FEE (FT I

    -WO.Y TREE FEE

    PARK & REC FEE (DIST

    ORA.N ASSMT. FEE (DIST

    f'lAN RETENTION FEE

    PLAN CHECK

    BlD

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  • SHOW NORTH Al'tl'i

  • ST. BONO

    """TEA BONO

    """TEA ASSMT. FEE (ACRG I

    WI\TER ASSMT FEE 1FT I

    PARKWI\Y TREE FEE

    PARK & REC FEE IDIST

    DRAIN ASSMT FEE I DIST

    PLAN RETSNTIOI; FEE

    BlDG PLAN CHECI':

    BLDG. PER'AIT FE F.

    ISSUANCE

    VALUATION

    t!>

    TOTAL FEES

    OAT£

    INSPEC110N RECORD

    DATE

    lnrpe.._ 11t111•rlll u.e771 -~--· ------.......

    For Appicant to Fll in

    State C-ompensation --:_, , 1 ;_,_ a 0 /- $ Insurance Policy No. i>Jt.-"-'10 ;;. ~ Expiration Date- 0 PRESENT I PROPOSED l ' 0 I certify that in the performance of the wo;k lor which this permit is issued. I BLDG. USE BLDG use t.,) .p shall '•OI employ any person in any manner so as to become subJect to the I Worker's Compenoation laws of California. DESCRIBE WORY

    NOTE; If, after making such certif1cale, the apr '•cant for the permit should become TO ee DONE subject to the Worker's Compensation provts10ns of this code, he shall forthwith comply with the provisions of Section 3700 or his permit shall be deemed 1 Co'"' CJ'

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  • ST. BONO

    Yli'TER BONO

    Yli'TER ASSMT. FEE (ACAG.)

    WO.TER ASSMT. FEE I FT l

    PARKWO.Y TREE FEE

    PARi< & REC FEE !DIST

    CIRAIN ASSMT. FEE \DIST

    PLAN RETENTION FEE

    IAI'.i.UATIQN

    fA

    TOTAL FEES

    B-F'!...f:Ji 2E'. 32 E!-?£~. 43G t! C

    !SS .:[i._ ~G ::.U2646M1-28~87 nr::;:f:

    Co I.J r/2 ~ C.IOI"i .f G LA /h1..mA /J~-JM-Iet/'1"7 5JJ/~

    970-F3 7L/ state Compensat1on --;.;-, 1·0-1~1 n.: .3-1 at"J Insurance Polic; No. Wt..N :2!-0 Expiration Date -oo PRE~ENT 0 I certify that in the performance of 'he work for which this permit is issued. I BLDG USE _

    shal: not employ any person in any manner so as to become subject to tha • 'Norker's Comp.>nsat~n laws of Cahlornia. DESCRIBE WORK

    NOTE: If, after making such cerHicate, the app'ermit shall be deemed

    0 ~:i~\hat I have rtlad this applicatio~ and slate that the aoove inforw.ation is I c otvC!i!.. t=r G correct. I agree to ·comply with all City ordinances and State laws relating to pending construct1on. I further agree to held the City of Garden Grove !ree and harmh?s rn an iabilit ar i!l9 out of mjury or bodily damage resulting from

    Tl L./- i..l ;O

    ?2.? 4/CiO

    &0]

    work or d I 0 . rmit. "71"1 9"11"c" ...... ~~~-.~ ~c·~ .. ~ ""'"'- __ ., ____ ... _ I --=---~M~!"i:':;~~--l.L.:':;:;;:;:::: .... ==--//-C-J-' -- / . L . I . - ' . - -· ........ -

    O.IT!E

    EXi"I"ATJOH O&l'E

    I certify that I am exempt frvm Section 7031 5 of the Business and Professional Code, Division 3. Chapter 9, Contractors' License Law. under the following Section: Owner: Section 7044 0 Minor work under $200. SectiC'n 7048 0 Em-plope working for wagEs only: Section 7053 0

    Other

    (HUNT) PIIIN11Jn'Y owNER ! SIGN.lTUtitl I fl'ftOPE !tTY OWNIUI 0111 AUTKOftll£0 AGENT

    DATE

    tf wcrk is not started within 180 da·1s from elate u! ~~~ue or 1f ab3ndoned for more than 180 days. this perm1t w•!l be null and vc•d.

    A FEE MAY BE CHARGED FOR RE·INSPECTION DUE TO NEGLIGENCE, INCOMPLETE WORK. OR ~A!LURE TO 'J.AKE

    CORRECTIONS

    PRESENT 13LDG ADDRESS

    MOVING CONTRACTOR

    ADDRESS

    DSJOCP'·•C'

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  • 1900·11 Warner Avenue Santa Aha, California 92705

    i 14·250·9282

    April 1, 1988 ~~~·L

    Mr. Stewart Miller Zoning Administrator City of Garden Grove 11391 Acacia Parkway Garden Grove, California 92640

    Subject: Parcel Map 87-313 11521. 11531 and 11541 Salinaz AVQRYi OUr Job #86540

    Dear Mr. Miller:

    The construction of the building finish floors for the subject project have been completed in accordance with the requirements of Chapter 7, Section 9700.4(c) of the Garden Grove Municipal Code.

    The project is located in FIRM zone A-7 as shown in Flood Insur-ance Rate Map 060220-1013, dated September 30, 1982. The mapp-ing shows a flooding elevation of approximately 88.0 feet for this project.

    Our survey of the structures made on March 29, 1988, recorded the following finish floor elevation for the construction:

    11521 Salinaz 11531 Salinaz 11541 Salinaz

    Very t r ,uf1 y ,40 u r s , I . I /

    ,r-----.. ' / .·> ./ / 1/ /' " ~. I ,· F 1· /\ ..... I ,I ·-.... ~~-~- :~.-:." '·.-::-,· h / /

    ... }~ v '- ' .· /j /'_/ ·.. . ~e-, 1' ~ ~~ r .• · .

    ! '

    / Jo~·n r.:. Goetten ; RC...£ 12188 Exp. 03/31/89

    .,..__ .

  • II S"~l , . II ~~I

    GARDEM GROVE UNIFIED SCHOOL DISTRIC1'

    CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY _FEES

    Developer/Applicant t11/11tJ 377

  • TRACT NO. LOT NO. N*EX. OR JOB NO. EXCAV. PERMIT NO. -----

    OWNER _Bz~eL- C.o,.Js~o).J PHONE t:t1 f 1 cat:tc..ooREss _l..B.~~JbL ,.., auJ__s.L___ .. OR.At.J&e '.C,A '11J..00S"

    COHTRJCrOP._pRJm/3 Cor-trR./JGrQf:..S PHONE coo B'?>14-ADDRess .ffo 1 s l~ P~t.mtl ~ 1.tJtJ STATE LM:ENSE NO.-----------....

    PLAN CHECK NH:XA1lON S.S. USE FEE IN6PECTION REMIURSE1.ENT LEASE AGREEMENT lNC ST. BRO . .§IUAL. C.S.D.#~ SEWER CAP

    ASSESS. DIST. TOrAL

    PIPE

    FOOTAGE

    CLAY CLAY C.l. Pl.ASTC

    DEPTH AT HIGH END----- DEPTH AT l.DN END-----

    TYPE OF JOINTS: WEDGELOCK ---- BAND SEAL----

    TYPE OF BLDG. TYPE OF CONNeC110N

    SINGLE EXIST. LATERAL i,t'

    MULTIPLE UNIT EXIST. WYE

    ~ SEWER CAP

    -'-· SADDLE MANHOLE

    OTHER OTHER DIST. FROM M.H. BORE (CASING}---- il=================f

    REMARK~t:r-c~ cJ ;6-~ eta-~~

    DATE APPAOYED APPFIOYED

    I hereby acknowledge that I have read this application including th~ Standard Sewer Notes on the reverse side and state that the aboYe is correct and agree to oomply with all city and county ordinances and laws regulating plumbing. 1 certify that I possess the above valid State License, or I am the legal owner of the property described above.

  • gza uu. (#. _: a: ash£& a tzzc ZL. AA .: ana 1 t aut !Qi44i u .. SJ£ a.au.swuatt tst a s Li s a 4 r _ .~~G:~~C:~ ELECTRICAL PE.IT tn~~7~~.,.... GMt~~':,~~~~ , INSPECTION RECORD FEES For Appfic11nt to Fifl in

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

    SINGLE PHASES[ riVICE SIZE L. UG LJ OH IF NOT LISTED BELOW NO. EA. FEE ADORE'S AMPS VOLTS RIG. CONDUIT SE£ CODE /.' ~

    7HAEEPHASEsri~vtl'E SIZE U ;;w .. e-U4 wore [JuG UoH Residential {Jill.#:(

    Pole, Power, Light, etc. OWNER'S ADDRESS CITY CondUit Sub-Panels 1 4>

    W,r,ng _ Rough 1~. -,-, t"':('f !AJ Sub-Panels 3 ~ / S l.s'n NIIEW •utLDtN'i OR lr.xtsTIN'i MUJLO•nG. occ;u,,.N.cv l"K 0# ~,.,. l:J" &J t.., ~ ~ !{J'f' Outlets j !2,_. {a ~,.0 ADotTII)N- AH~A Ra:Mool£&.. AJIU!A ..;.-.ou~ Oft~ c. UJ~~t'r 5 ._____ Fixtures /erformy \. relevant to th ler.rni' _ J ,1 ..:-

    -+----l------1----1 'f._ -. J,- A. / J ;:::u ~ ~ 4' 0 E.RMIT A .. ~LI~"NT Sl RE: OAT£

    Servoce f. . 7 f BUSINESS TAX CERTIFICATE INFORMATION , 1 Jl certify that the following Cont~~at tor's License No.--·-------lu . I _jf//) 1, and Classification /) is f'!l! fo!.",.!J,!'~~-t.i / _yp/

    FINAL ! . r 7 7 - -'%!? I '(I ( J... - .MJ. .r.?f~ a ,L-t.- .., " - ~- . !-- 1 • V ' ii V i ITEM Tf CODE FEES (•RONT} CONTRACT~ (so,..ATUREI co~TRAc.'(oR DATE I·= Utoloty Nof•foed ! ~- /./-> /CV ! n I Plan Retention Fee ! . . _,)~:2.:;::-,~=b=-~=-=~ 7,.,./.~'ff~===Oc-cR::cA::-U-T_H_OitoZ£0 AGEN-T-=====-==--\' .1_ ~/ t' .// (j 0 ' (J/I"!Ji

    1 -~:_;-:-,~-- (/-;::-- BU$1NESS TAX C£RTIFJCA'1'£ NO. EXPIRATION DATE ! .t

    1 • Plan Check \ .a...· I !l9V 1 certify that I am exempt from Section 7031.5 of the Business and

    t

    IDENTIFICATION CODE V Permit I 1 "7 6 o-0 Professional Co~e, Division 3, Chapter 9, Contractors' License Law, ---- ----Lr . ----- -T - I [lssuanco I -~ 0 0\) ~~~~r~h;.~~:~onw;~~!er:Joon: Minor work under i200: Sec~ion 7048 0 _L__ 1

    ... Employee working for wages only: Section 7053 U

    ~-;;,~.-... -'"-"-~-.-M-,;·..,o~ !""" •·

  • ... . . . r-· ~~~~~-li-f Sod Ptotr~; L------

    I G.:Js Ptnmg

    .Gus \'Pnt

    -s

    Main Dra1n and Vacuum Lmf.:S

    Water Heater

    Backwash

    \'Vater lateral

    ~-------- Vl.t

  • I fOONo!CE VENTS

    GAS PIPING

    DUCTS

    SINGLE DUCT FAN VENT

    --hmr.HFU HOOD -

    MIHANOLING tNT

    EVAPOAATIVE COOLER

    DATE INSPECTOR

    ~!EATING CONTRACTOR

    BOILER OR I I I I I AOOf

  • NO. EA. ..EE

    AMPS

    APPROVAL INSPECTOR

    Ur>derground

    Cnndwt

    V\IHong - Rough

    LAND IJSE

    Fer AppficMJt to Fill in ADDRESS

    State CompenSIItion Insurance Policy No. Expiration Date _____ _ 0 I certify thl"t in tho performance of tho work fO

  • INSPECTION RECORD SINGLE f'HASE SERviCE SIZE

    AMPS

    THREE PHASE SERVICE SIZE

    AMP$ VOLTS

    APPROVAL DATE INSPECTOR

    Underground

    Condurt

    Wirmg - Rough

    Heater

    , Foxtures & Trim

    Ufer

    5efVIC€

    FINAL

    Utlllt',t

    f-- --

    LANO USE

    FEES

    NO. EA. F£E

    For Applicant to Fill in

    State Compen .. tion Insurance Policy No. E"piration D~t•------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 10 as to becom• subjltCt to the Worker's Compensation laws of California.

    NOTE: If. after making such certificate, the applicant for the permit should become subject to the Worker's Compensation provisions of t.his code, he shall forthwith comply with th• provisions of Section 3700 or his permit shall be d ... med revoked. I cenify that I have rvad thi> application and st&te that the abOY4 in· formatio11 is correct. I agrH to comply wi!h all Ci IY ordinances and

    • laws relating to pending construction. I further agrH to hold City of Gard9fl Grove fr• and harmless from any liability aris-out of injur'ti/or bodily dam- resultina.from work i>erlorm

  • f APPROVAtC 1------------,-+-~·--, I ~ ~ So1l P1;Jo:--.i- - --.. ·~

    Ground Plun)tJHHj

    'Ro:Jglt P~t;mbinq

    ~.:~ Ptping

    1 G.J5 Vent

    s~wec

    rv1aw Ora!!'! and V.3cuum L:ne~

    ~'Vater Ht:a~E-'

    Backwash

    \.'Vater Latera~

    ~ ... ~.:...L

    ~~~L'"'~. ,;Qj __ -~,;~~:;;-,- ;nJ--~-!'/t -r.;~,c""·"~:· _ -----~_ - I d--( ! M'T NO. -----; - ' . i~ .. -..or:..:. :s nt:"";' ~!art&(J •:Ji~h~.-.. 180 r._:~p·~. hc,n dote nf •ssue or ,t 2t'ar .. _~o:>neG fer r-:or(; th;JI1 180 d·1Vs., ~his perrn!t will he '1t.:ll an'i •101:::. ------------- --------1. INSPECTOR

    FQf' Appeieant to fill Ht

    State Compensatio~ " E>cpiration Da~/--L 0 !.certify that in the performance of tha work for vmich this ~mit. issued, I shall not employ any penon in any man net' so .. -to~ subject t:o the Worker's Compentation laws of C•fiforf'lia. NOTE: If, after making such certificate, the applicant for the per-mn: should become subjecf to the \'Vo;ker-·s Ccmpensahon r;rovisiof'IS of this code, he shall fortf"lwith co;'Tlpl•t ... ·.-ith the prevision:; of Se-ctiorl 3700 _or his permit shal: be deemed r-evo""£d. 0 I curtity that I have reod This application anc1 state ~hat th£. above 1n formation is correct. I agree to comply with all City ordinances anu StdtO laws_relating to pending COf\strvction. I further agree to hole! the City of Garden Grove free and harmless frcr.: any ;jabili'ty aris-ing out of injury or bodily damage resulting from V'iMk P.erform..-:1

    lt~th~erm

    (PRt .... "t") C~~~

    ---------,-,-----,.--,-OUSINESS TAX CEHTIT· fCATt: NO. E.XPIJ:IJI.""HON DATL I certify that I llm exempt from St.ct ;:;r. 70J1 .5 of the Business ~n::! Professional Code. Division 3, Cha~ter 9~ Contractors· L~cense Lan, under the following Section: Owner: section 7044 0 Mt~O" :.~·K :.;naer ~00 Scct.D·1 704,... _j Employee working for vVagesonly: Se:." C!~ 7053 ,_ Other:

    (PRH'>iT) PROPF-P.TV OWN!:R (S~;;-U-;F:J -;;-o;.:;;;:;:~.::;l'.f~ OR A,u-:--t-

  • APPROVALS

    FURNACE

    FURNACE VENTS

    GAS PIPING

    DUCTS

    Kli.CHEN HOOD

    AIRHANDUNG UNIT

    EVAPORATIVE COOLER

    BOILER OR COMPRESSOR

    DECORATIVE APPLIANCE

    UTILii'i CO NOTtF;::D

    INSPECTION RECORD

    DATE

    !f ·!t-Jri-: is r.o! st(·. t.;:;cu vnlh!n 1~ ~:,rs ~rem d~.~:,j cf •:=:.ti'7 -:-.~~~·;war.d:·1~1 ;[Jr rr·,·. r·_· ~~·Jn 180 do:/s. th :, ~c~~t ~~~::!.::' n~J:i ;Jnti /'.._;

    . r\~ SPEc.; i u,-:

    NO. SFEE

    L:.'\iJ USE

    A~".£9 ,,~,,

    LOT NO fJLK Nrj_ 1 r~A.c-t r,;o

    ~u5. PM!<

    II! A-t A! 7 T. txao:;.-r;•.,c eUILOit¥; P.EMO~F.L- AREA

    SQ.FT

    ~.~:--:::_ "" "'{.'0 .-_!_;

    State Compensation "! ( 0 7 ( ~ _ Df- 0' 6 !C,Surance Pohcy No. ' · / Exp~ration Date __ I_\)_~_

    ..)\ f certify_ t~at in tha performance of the work for which this perrni! :s ~""''' l shaH net employ any person in any rn~nner so as to becOf'I'ie sut~ect :r.: !!'"~.: ~'klrker's Compensation laws of California. ·

    NOTE: II, altsr making such ceriilic8te, the applicant fo1 the permrt sr,cuio D€o

  • .. Dlfelop!MM S..ices o.p.rtment . INSPECTION RECORD

    AMf••,

    APP~OVAL

    Underground

    Conduot

    Ufer

    Seh•,ce

    FINAL

    ur~·qy Nof,ft&:d

    ·r~--- -~.~-----~---·--··

    I I - - .___L ____ . l ____ L_ ___ _

    r.;-v;-.. o.~~ .. L"'MIT ,.,

  • For Applieant co Fill in

    .P.e, ---'l'lfA ;o.,.--,.0 . ! - - ---"" .WI'l''JI"O. - -

    .jS§ f I f'&h I , 3 I

    --~~--·-- ------L----------....-·

    PlurnhHHl .e-~~.u::-,;o"/'~ -~---+-A: "'"'7 /lf\.J.. If It IL. - rt ~muo"c u.,,_..uou• --+---1---i----t--hw'N .. u"'< anng··~~ -----------"-

    'lent

    -~ Sew~r

    ~~:-~ram and 1 Vo,-. 18 "avs. ' , . . VOid .

    . TINsPF'r.fo~

    State Compens~tioi"~ ..., '2_ '8 ~ lnsuranc~ Policy N~~ . .,.. "7 Expirnion Date/---/ ..,. b 0 I certify that in the performance of the work. for which this permit is

    issued, I shall not employ any parson in any mann..- so as to become subject to tht~ Worker's Compensation laws of California.

    NOTE: If, after making such certificate, the appli.:ant for the pef"rnit shoutd become subject to the V':orker's Compensation provisions of_ this cod2, he shalt forthwith ccmpJy with the provision~ o~ Sect!Qn 3700 or his pormit shall he de~med revoked.

    0 I certify that I have rend this application and >tate that th" above m formation i~ correct. I agrco to cornply wrth oil City ordirtance-s and State laws relating to pending construction. I furthor agree to ho;d the City of Garden Grove free and harmless from any liability .. us-ing out of injury or bodily damage resulting from work Performed rel91/ant to thlw:>ermit.

    I cettify that the 1ollowing Contractor's License No ________ _

    and Ciassifica"tionc ~fun;;;;:!:~~ .... --7. - ---- o•."rL (PRINT) t:ONTRACTOR

    --g-t)Si'N~~C"F:~£~ t:XPtfiATleN OA,..-£

    I certify that I am exempt from Sectil'Jr·. 7031.5 of tho Buswess dnd Professiona~ Code, Division 3. Chapter 9_. Contractors' l1conse La-.r.·. unrler ~he following Section:

    o ... ·Jnf!r: $CC\i01i :04d 0 ~'liner -~~vor,-.. r.ric $.,;?00 Sec-'!.n.)n 704-8 = Employm~ .... ~ .. ork;ng for wdges on!v. Se:::: .. ·V""l 7053 ..

    0 ther: -·-- ·--------

    {Pill~~"() PRGP!:TITV OWNt:R (SlGN;:;;:~~-; P,._·;-;.·~~""";:;-.;~1'.-:-_:-;;-0~ ;Ad>HC.Rl71 G ,:.~-~~

  • ~ ~-- ,.,

    APPROVALS

    FURNACE

    FURNACE VEN"f')

    GASPIP!NG

    DUCTS

    EVAPORATIVE. COOLER

    BOILER OR ADCF>Ess , 1 COMPRESSOR I Absorption Systecn to & ;ncL SOOM BTU. _ '(230

    DECOR.'\TIVE Boiler or Compressor to a. inc. 30 H!i. /'r IY APPLIANCE

    FIN.i\L

    U:IUTY CO. NOTIFIED

    If work is not started vnthin 138 ddyS ~rom date of ISsue vr if aban-doned for more than 180 days, this permit will bt> null and votd

    ,PEt:l OR

    State Cori1pe'!sation 7 ( 0 7. ( 3 . cr ~ ~

    ranee PoliCy Nv. ExpiniiiOr. Dale • . I Ceflify that in the performar.::e of the work ·.;>r whtch IIlia perrrif i:o ...,.., I BOller or Compressor over 50 l-Ip. ! I I I ·I· 1 sh~H not employ ~ per~on in any ~Jer oo as to ~ ~ ID ._ · · · WorKet!s Compensation laws of Cabfonw;,

    LAND USE

    NOTE: If, after making such Cllrtif~eate. the a;J!Jik:ant for lhe per".rt should becorlle subject to the \Ak>rker's Compensation~ of this code. he.,., forholllft comply with the provisions of ~.ect;c;, 3700 CY his pe

  • RECEIPT

    -------·--

    ~ . :__· --------·-----··----·

    . '--

    . ; ~..,z tJ 20695

    ClcY OF GARDEN GROVE, CALIF.

    --.,.:-/'-···/ -------·-·· /

  • .{

    CERTIFICATE of OCCUPANCY CITY OF GARDEN GROVE -PUBLIC WORKS 6 DEVELOPMENT

    TNIS C:I"TII'IC:ATIE ISSUEO PU"SUANT TO TN! "IQUI"EMENTS 01' SIC:TION SOl OI'TNE UNII'OIIM IUILOING C:OOE C:EIITII'YIIIG TNAT, AT T>41 TIM I OF ISSUANCE, THIS ST"UCTUitf WAS IN COMP'LIANCI WITH THE VA"IOUS OltDINANCIS 01' TNI CITY IIIGULATIN G COMSTitUCTION Olt USI FOit Tit£ FOLLOWING:

    JOB ADDRESS __ 1_15_2_1_S_f_l_H_;P_Z __ (;__~_l_f_~_. _1_) ______ PERMIT N9 _1_15_4_

  • f ,. c;;ueqaw a:q

    CERTIFICATE of OCCUPANCY CITY OF GARDEN GROVE -PUBLIC WORKS 6 DEVELOPMENT

    THIS C[IITI,ICo\TE ISSUED PURSUANT TO THE REOUIREME'ITS OF SECTION 306 OF THE UNIFORM IUILDING CODE CERTIFYING THAT, AT THE TIME OF ISSUANCE, THIS STRUCTURE WAS IN COMP'LIANCE WITH THE VARIOUS ORDINANCES OF THE CITY REGULATING CONSTRUCTION 011 USE FOR THE FOLLOWING:

    J OS ADDRESS ___ ].L].L.5.~..:.1JL.J].___$1.Ll;..~,l...t.I_."Is:..f~7-----'(~""-'1-'i...a.G:...-...l3"f)------ PERM IT N'l --tl-e5~444~Q;

  • CERTIFICATE of OCCUPANCY CfTY OF GARDEN GROVE -PUBLIC WORKS 8 DEVELOPMENT

    THIS Cf:ltTIFICATE ISSUED PURSUANT.TO THE ltEQUIREMENTS 0~ SECTI~N 3Dfi OF THE UNIFORM BUILDING CODE CERTIFYING THAT, AT THE TIME OF ISSUANCE, THIS ST!IUCTURE WAS IN COIIIPLIANCE "IT11 THE VARIOUS ORDINANCES OF THE CITY REGULATING CONSTitUCTION Olt USE FOR THE FOLLOWIItG:

    JOB ADDRESS _ __,_1_,_1.::.~.:::3..;..l_S:::..f:..::.l:=.I::.:r.....:·r:-:!=--__,('-=r:..:L::.;:;:~~-=•:-:2'"'") _______ PERMIT N9 __ 1_5_4_4_R_l_fl __ _ USE OF BLDG. ___ P_:_C!;_'~_T_f'_J_,~_l _________ _ "., v•,, GROUP_. ------ TYPE------BLDG. APPROVED BY __ T_f_!:_n_C'_~_!_~~-~-~-~~----· DATE 4-2,-!J8 "1 USE ZONE ____ _

    ~P-124-q] ZONING REMARKS ____________________________________ _

    , 094 ~ "~T~ ST r.~ .. ~~rr .. , Cl. 9?6 ADDRESS . ' . . ''

    BLDG. OFFICIAL