Garden Grove, California · CITY OF GARDEN GROVE, CALIFORN A Development Sorvlr.CJs Department : 113 P.O. X 307 I GARDEN Suite: •reel No: 21506302 Type: 833 Date : 04/23/92 Insp

------------,--.----------·--------------T--- .

--'--~------~------··-----

. INSPECTION RECCI<D

Plan Check BOnd··-···

Routing: #I Bldg. :r:speetor

l he~~='• <'ld:nowledge that J "live r~ad this opplic!l•>: .. • t~.: :;~ate that -:-a ~b&YIS i:1 correct e~.:i "gre3 to comply with e :..•::: •t•ees and s-~-~ lows regufeting bu: f!•~g construction. ! P.erll--::-, certify thot I em FCperly registered with aH;/:•· 1-::Jtnl<ed a~ reqc··~.d by the City of Ga•di!n Grove and/or Sta~e -:..~ =.~F:mie, or +h~~ ·'"" the legc:~l owner ::.: the obove described P"-:..:>'.o""• ~~-t I cerfif,, ·~~r in the ,performar.ca of the work for whkh ~.:, :.e.:-::t is inu~ : tl'le~ll n ~mploy a~ .. - per$on in violation of ~~~ "":.•"t:'!':~'s cc.m~~,;.,. •l·::ln ".!Yof tho:t Sio . .:,; Ca~fo,rnia.

Spig~ .. ~;;; . ' . ·".:· f.~,;J.,_t;:..-<!.,·· Date / - ·; -~ ..... ~ errn - ....... -· -~ -- ~ . ,.. .. Uc..~

Addr- )7{? ,G:;~~tfatf it:.:~·-'.__

PLO"l' PLAN Deportment of Building Bernard C. Adams D:re :'c:"

1

Electric PermiT No.

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. lnsp&;for

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Service ~"=• Amp. ConcMt

Ptrmit No.

CITY OF GARDEN GROVE, CALIFORN A Development Sorvlr.CJs Department

113 P.O. X 307 GARDEN

: I Suite: •reel No: 21506302 Type: 833 Date : 04/23/92 Insp Dis

--·--------------- -----------------------1-------------------------- ---------NGUYEN. HIEN DINH (UM) I Applicant: PERFECT CONSTRUCTION

I Address : 10512 BOLSA AVE,*105 I WESTMINSTER CA 92683

Phone: I Phone: 714-564-4696 ·------·------------·------------------------1---------------------------------------

l Engineer: I Address I

--- EXP: PH: I LIC: EXP: PH:

COMPENSATION REQUIREMENTS

DATE

roposed Work: REROOF. T 0 OLD ROCK, EW COMP HINGLES 0 VER 2 LAYERS OF 15 8 FEL

~-------------------------- ----·+---------1700 1300

ssuance RE INSPECTION

1 1 1 1

39.70 10.00 15.00

ENL PLAN/CULT ART 5.50

B F'ER 39.70 INSF'CT 15.00

MISC. 5.50 ISS lO.OO

Qij7337f' ' ~92

3200 226 BLDG PERM & . 617 ISSUANCE FEE

20.60 39.70 10.00

TOTAL FEES

1-53a2 If work i~ not ctarted within ottn•r•llnform•tlon 188 de.ys from date of issue or

-6317 if abandoned for more than 181 days, th1s permit will be null •nd void. A FE~ MAV BE CHARGED fOR RE­INSPEr.riON DUE TO NEGLIGENCE, lNCO~PLET~ WOR~. ~~ ~AlLURE TO MAKE CO~RECTIONS.

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PlOT PlAN

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CITY OF GARDEN GROVE Public Works & Development BUILDING PERMIT ,

lnspection Requests 638-G771

General lr.formation 638-6661

p c :#: • ,.- INSPECTION RECORD For A~plt~ar.t to Fill in occu , OCC. FIRE 1 ' - I - ADDott:Ss f:u \ 1 PANCY_l_~~ V1~ LOAD ______ SPRINK. ~ APPROVAl ! DATE INSPECTOR -~

1 us F. , i FRONT 1 LEFT 1 RIGHT 1 REAR ,· : -- f-:-x-. sao_ BLossoM ZONE · i ' . ! FOUNDATION & LOCATION l ILuT NO. III>..K NO. TIOAe~....-o-; II'K'oiiVlTIIV;

~ R 1 "avP'Ol ' l L.- r··· I 3 0 7 -K'I ,;.b k·.l, SEE:PLOT PLAN I; ;CONCRETEFLOOR 1 fiO .. 2146 h · ... ·. "-'.K'-_.J._ ' e, ac s ' I l REINFORCING I o..-Ne:" ! 'rEL. No.

II :'c~~~NG qn _ B-507 l RooF SHTG , I rnv t!F !,ARDEN GROVE . .£38:-6851 __ _ ' .'\ i>(!A"f::, , NAIL!N<> AODRESS CITY Zlr

I 'IL}' OAT" 'ROUGH FRAME

~LANous::: ,, ·· ;' 1-t....t-JqjiNSuLATioN.ENERGv 1 11"<1)1 nrllr:TA P!CJV .G....G APPRQ•,JED 3Y .-/ ,. -"- ~ / _

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S~~OKE S.~TECTOR TEL:- NO. STATE UC. NO. & TYPE ---·· --- ----------~--~------

0 "1R!(ING

G.G. SAN"'. D<S.i ·O.C.SAdT.DIS.; CUE I ONOTO~ LAN~5C~Ptr-G . I 3-...... ,., ... ,.iON --. . ---

FEEREQ'= FEERE~'O. : I •••·o fov>D£0 . :PARCEL ~ .. ~AP

R.w DE::- c-~;;C'N LAND usE FINAL i I I FEES AND BONDS ="'lNAL 12 -II- ea l :5ct:f. .. co..,TUCTOR

p=v_:_~OOE_i_ __ _AMOUNT UTlLITYRELEASE l I M£JiJiX .. ~fJ"J'!isFQRCES-- CITY ZIP ---=~------z,p--1

IDENTIFICATION CODE

_I - - -· •. --- ---- I TEL.. NO_------------ l"Si'ATE uc. NO.

57 6C''· .. ::

I WATE'~ S·::-1:\iD

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'wVAT1=~ ~SSMI ~EE I~"T I

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F ~ R K .•• , :... " T R E:: E ::: E E

PqESENT BLDG. U:5E SFD DESCRIBE WORK

PROPOSED i BL!:lG. USE SFD I

,ro aE coNe. Demo{see plot plan), two pati PAfH( o. ..,Ec FEE ;o,sT ': [covers~ bedroom~ return 9<""':".ge to orig.

- - -·-------7· ---- Lstat.e rer ·r. · _ OPAl~~ A.S.S~.•T. ~EE iO!ST. ______ _:!---- NEW~ '>\DO~ ALTER.:fJ REP.<>dR ~ DEMOLISH 'X-'

~PL·~._ RE.,-~~T'C~-F-~;-- ~- : ::~:. A4os ~~P'~~~~ES~J~;~~~.:W~~-LIN~ --------·~ ----.---1. ·-- ' !f work is not ,. .... , .. in 120 days. from date of issue or if i '3LDG. PLA~ C!-iECK I ; abandoned for rno:-:e !han 120 days, this permit wi~i be null and ----- --- . _ _ 2 BUSINESS TAX CERTIFICATE INFORMA"fl void. :BLDG PE"'MlT "EE --- ---------- I c:.rtify~ .. tf!"afollowif>9Con~~or•s LicanMNo. A FEE MAY BE CHARGED FOR RE·INSPECTION DUE :o

and Cl-lfoQitiO •• on full force and erfe<:"t. ~EGLIGENCE, INCOMPLETE WORK. GA FAILURE TO MAKE -.---------------- , CORRECTIONS. ; !SSL!l.'... ..... (:~ , (11'11tiNT) CONTJfi:,.:C:TO" (SIGIW.TUII'!Cl c;ON""'-"CTCII ~--:... ---------- : o .. AUTMCitiZO:D ......... T RELOCATION '!ALVAT!ON

s

•uSINIESS TAX CEIItTl~ICA""r£ NO. t;'U'''•ATJOtl CATE ~---------------------1

35fl£Lnli.. ;A'>T;;,]'~7<~;;;J~­

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I T,?~TE~l PTY PROJECTi ___ _tiO . CHARGE

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I Ce<"tify that I am exempt from Se;tion 7001.5 of U16 Susin- and oPRESE:NT BLDG. Professional CodOJ, riivi ion 3, Chapter 9, Contracto~· Li<:ense Law, iADORESS e.e following . on: ·----------- ----·---

Section 7044 Minor work under ~00: Section 7043 0 !Mo·, :<';G M working for wa~ only: Section 7053 0 <CONTRACTOR

oth;;: i _________ _

( .... !NT) PIIO"":"TY OWNE" fs,..I!IAT'l"lt} P!tOPEOITY OWN!.. OATil: ~ADDRESS OW AUTHO,.rz&D •O&KT 1 J

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CITY_OF GARDEN GROVE . Public Works & Development

INSPECTIO~ RECORD

APPROVALS DATE I INS!'ECTOR

Sod PJp;ny

PLUMBING PERMIT FEES

I£ACH! • !

TYPE OF FIXTURE OR ITE!\' NO.

t \'later C~o~el \tc~:e~i

~ Sa:h Tub

S FEE

Inspection Rl!quests 638-6771

General lnfonnation 638·6661

For Applicant '(Q Fill in AOOIIt£'SS

8802 BLOSSOM LC'T' NO, BL-~-.-;;;:;:.,. ~~,-c ,----· PRNMif' NO. ----1

I ~. . , . ! .-flower i : 60 2146 · "'

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Rcu;co ;:>.c;..,..:J•n~ 1 , 1 G~'t:o;-e C>;;:-o-;.;• __ 1 [ 1 CliY_l!F G.!\.RDE.N GROVE p38- 5851 I Ga!, P,p,n·: j ' ! ~.:1·..:-::::::v "";'~be~ T·a.-~ J _ t 1 .:n.~:"i.E~ s io1.~CWESS i!IT\

___ -__ i _j__ ',·;-,:e: He·•~··· ___ .J_ 1 ~ 11391 ACACIA PKWY , ~:: ~.:·, ; ~;,;,;:~~~':':';; .. ·~m ~~~~~;~';,'~'; ,~;.:~~~::;c~ /::.;-;:::..,~';;'~~;;1;~

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;::;--~w3·-· ,.., __ n I AC:>NESS cnv 1 .,HONt

~ WaH!! La,'!•a· ; ---~~~-"': ~:-~:~.:!,~=~:~~~~: l I I ! Au:n•~3H Wash;,-:_: M:~:tw1e 1 WORKER'S COMPENSATION REQUIREMENTS I t f .,._., .. , ..... ),~ ... :-... St•n Corn~nMtion ' • ___ ~ l!.:-c•':.· .._-_-,!;:'·-- s ~•ncePcHcyNo. ;xpitation Date

o3 c-"-'..•_-:;s~ _ ir.~~ )t':l ~ cwt~t"- tha1.in ~ pPr1'()rmat\'C1t o!- tfte '""-ork for Which this. permit is tau.ci~ t s~~t not .m;')~C·V any pw;or:; in any rnann.,. JO as to become

\.\a:-?:-t i.a;~~~: f subj.c.t to- the Worker~s COmP4'1"i'YtiDn Jaws of Califortti&. -~-....---------+~~----~--~~,~0:.:_::. .. -,-=~:.::.:·~·::.--.·~--,.-•. -.-o--~-. -~,~-<-·tt-- ; , NOTE: ~~~ af~tt': m.a~t:n~ such CE!:tjii~-a-..e, t.he apolicant ~or the p~~mat ..... .__ ... ~ -'' P.--: .. --~ '"- 0 ..... _ ... ~- , ~ ~ shouto b«om• sub;ect to t~• }•\Ork:~s Ccmper'lsatlon proviSIOns ~ ... 0 ~:-~ p ;:- ....... :; ~Ea •. ~~. D 1-t.H'. f ; ....... c1 thfs ~~e. he ~'1•H-fortt'lw.ith: ..:L";"'ttsl'!f '1.'\""it, thepro"\•ilionsot SK"t•on --:----~~~----j----------i-:::~_::_::_.::._:-:....:_::::_:_:::_:~ . i ~ .......,a100 or '"" ,.,,.,.,,~ shall bit d~«l rotvo~ed. :....~·~,.--. S:."'c ..,, -~~s , s ~ _!) r=:- ·~! ... ~ ~ t c•'!1fy fh3t 1-h.t\•e te.G this a;)O!I-cat;on .and st•t•·ttt~t the lbo"e in-

----------1,.._-~-<--~ ~ tormelicm •• rtw:t. 1 •il'" to <:O<TIIlly with all C1ty ordinar.ces and

·----- - ,-- \-- tha Ci of G •~ G.-e M at'OCI f1atml- from any liability aris---------· .,.. ______ ____.. ~::-..... ~~ ~:::·· ·-~-._. ·s .;:;!he"; i . -Stat• I '•. tirit.to QendFg con~tTUction. I further agree to hold

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mENT!FICATION CODE · """'-:

{o•w-IIT) C:~l'ot1"1fACt"04'1: (S~"':!;:~~,;~::t:~~ OAT£

-a4..~Sl"'ESS TAX C-IE ... .,-!FfC.AT£ .. 0. IU.•tRATlON DAT£

c~tif'V 'that ! am ex4MT!C-t from S«t;o~ 7031.5 of m. Business and Profes!ional Ce-d~. o;vfsion 3;- ~tw 9~ Contractors• License L•w. ~ ~ following Sf!$-!j1>n: , _j_ Own Sectior. 7~ k Minar we:' I< cmder Jt 00; Section 7048 0

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. li ;, .- - ; 0\feewo:rkH'!.~for \.-.. agesan)y;. S«:tJO-n 7053 w . )~.._;.~ ..... :··:.:0

~ -'C" :-c ·~~u-• ~•' HH~~<<:A' •c~"" ~<>- TOTAL FEES ITY PRo.JECT ! ! -~~~;;" l-;--="" .i:: -: - - .tl .;;,.~-;....,..._-tc.C-!!I:;U ..-:!,. "-.::- '\.rflnf\:~ ~~~NT[ ..-ROl>-EF."t'"l" ~-~!;lt l"~~N .... T"UIII!C.} ~-CPEIIITY-0-;;ttHE"IIt

.Oft -~~~J"%!:0 .-Qt!;M"T DAT.

r r '/'- ~-~n I I ._'JC'/ 7 it:_ '~ "";.'" '" ,-,;:_~ ~:--,_,r~eo:. wi:i'':-> ~20 c<ov• !r-em ·'iaa a: iss--'" cr ,, ~..,,.,,, "'"'- i )}:j'"'\(~"' I 0

.,..,., • A FEE ,,·c;··· B<.' 0:::'-'..:\R,:;Ec:: "c:CO:> P£.1NSI'l"CTION OuE 70 ~..,..~~~C~tt:: "b~ ~~TO 1h'J:-, ~~C d3VS. t~iS Detm2! '-":H bP. r.~~-; ,U!"'";j ~ /1~ f ? .. 1rd_ /1.7 NEGi_. tGENC'.: .. !~tr.._.o .. ~PLEfE W~"'IR:tor;. 0~ FAILUPE '!0 Ml\t<E '~. - . -- • J ~J l-7'\ I I. CORRECTI\..-"<fS. ~-·- I

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~ .. a. .................................................. ~~--------~7~ ........................ ~ CITY QF GARDEN GROVE Public Wnrks & Development ELECTRICAL PERMIT

IN3PErTICN RECORD fEES

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I IF NOT !..fST£D 6£LOW ! SE£ COO£ Rl G CC',i::OV 7 i---=:...:.-=.:::..= _______ , __ _

~;:~~G- -. c--.f~ Res;de-n:ia~ H~-1 & R-3~ ~- f":~

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L .:.,~-!PS ; THP£:E P~ .. \SE Sf:RV!CE :::,~z:::

NO.

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FE£

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lnspe·~tion ri;;quests 638--6771

Gem•t"l lnform<!tion 638·6661

for Applic.lnt to Fill in

AOCRf:SS

8802 BLOSS01·1 i...OT NC. Bi...X N0.--0T'fv,<:;T-N~-" Ei...ECT"tiC ,;EJIMIT NO •

2146

CITY OF G~RDEN GROVE

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_j_~lL? IAI , PHONl;;

638-6851 CITY

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v~;,..,.tCA.'":10N

STAlE i...JC. NO. & TYPE

FORCES CITY ! PHONE

WORKEN'S COMPENSATION REQUIREMENTS Su'e Cc,.,,...,._t.on

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U;, •:v :\:c:·' .,-,: ~--=-·~-:-:-~-t-"'_-_·_"'_"_e ___ ~-------L.__ IDENTIFICATION CODE ;:,,....,: -·----

T!FICATE INFORMATION 1 c:e!"::~f;r tf:a! 'th• fOHOV!i!r:; Co~~rat:tor~s License l\ic., _______ _ a~ et .. ifi~tio ~~ tn tun fcrc::e and effecL

{•ll'tSiT} ee~'T~ACTO• {5~~·:~~~~~ii~~:~:;R DATE

!IU5!"'r.E5~ Ta,~ CEJ!i)T&--~CA.TE l!lfO. EXPIRATION DATE

-c~-::~~Y rt'\!Jt 1 c.tm ex~;rt from Section 7031.5 of the Busiftess and ~C!"l:~; Code~ c~v~$~On 3.., cr.ac'ff~ 9_.. Contractors· License Law. ~n" •o•<~wiC:! S~n;:

k~~T~:,,~~~;, .,., "" "" '""·"~ . ~S:~<!o::;:s o..--..-:~f_ Se-=· --~ ~o7V-:~ ·-..~~r.or ~..,o_rk. und_er i!_OO: Section 704.8 U -------------..-------.....,---f.....e~veeworKtngfw 1-~a~only: Sect•on 7053 U

TOTAL FEES fs1~"'--ATI,Jft«.} .-Jto•ERTY CWh~~

0~ AVTKCfUZ£.0 AG£"'fT : LJ. -~ l~ ·~i ; ' ------ ~:..~-=-M~Rr--:::e.t;! -av nv \..t~tnn.\;:i.. ! ----- "-'"" -~ ~----·----·--- ----- ~JI.!'Iitl u~---· 4! •...:_~:::IS~ ~ =:!A"t£

I -~f ~~~~ ~ ~! ~w;~.;,..:; n~i;fnn i2V t..:ay$ HO!":'\ ~ate- >0~ i~.H~ Of" t~ . A FEE r,~A.Y BE CHARGED FOR RE-JNSPf;:CTION DUE TO ~ ~~!"tdO!lW !;;1'- r.-zcr• !h-a, !20 ~a¥!-~ t~!.s n~m!~ ~.._m be ~ui! .and , NEGLIGENCE. INCO~.~PLETE \rVOP.t<. OR FAILURE TO MAKE

~vo~·c,_~--, ~ --~tl--~~~----------_i __________ ~).;C:O;;P.:·;R~E~C:T;;l•~P;.N:S~;:;:;:;:;:;:;:;;:;;::::::::::::;::::::::::::::~ DS .... , ...... ,..

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CITY OF GARDEN GROVE

ADDJIIItSS

!"LOT PL-.N AP'!'ROVO.:O BY

PLOT fiLAN

$3500.00

SHOW NORTH ARROW. PROPERTY LINr-5 AND A0.1ACENT STREETS.

4. Return garage to ol"ig. state 5. Reroof

¥fetsa':? ~lr::>e. '(b~~

~~~ ''fl>.i"ZD

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:1 Bailding !nsp.f •2 Asstssor/•3 Ptrmitteet=4 File ! certify the m formation horeon •s complete and correct.

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