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Zip No.
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OWNf:R--RUILDft: SJ(~N imOW
' r:-:::rti+r 1hor rom e .. <:t'!mp' from rht· provisions c)f Ch. ?, Div. 3. U onrl r. .::::..r; (Con•\"cH:to,.·!. tit.".:"~SIC" low) bc,ou:se (chl"-.::k on"-.'):
li!'~ <.1'":1 the own{"r 0~ the obovon p~opedy und will pc>r:Jonully pcrio ·rn lh-r~ r.:bove work . I :;'Jn1 111~ o·t.f'!e:r of f~H' Clbov~· prc.wrtv ar1d I •til! con!rac1 1o ht1..-~·· '!;.t!!
c.·i ~he ub:~•.-c wor!<.. performed by lit.C'I,SCd c.:ontroctort..
'~-: ~F'"' the 0\Vr.N cf th•• ClhOVC propcrf\' t'H"'d Wq! empiOif pc-ro;;('IP'I 1f.l r~~r. f:,lr:·~ th~ ... :tsbov'.:' work wdl, WU9('>r, ..:1!1. n~(·lf :'i•J\(• C.\~l':\p(•ns::tll(o/1 I w.il ~.ITtl··-~· i,..5'.'ro~-::~ for rrv '!mpioveo! 0::1~ r~quirtod bv •he- Lnhot c~. ' ... ,f Col,fom:tL
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· I certify th~) in!orme>'ion hereon i\ ce>hple+e f.nd c:orrec~. ltMin9: ~.I Building lns~e+or "1 d>Hoc:t~ File til Owner'
~·· .. ··- .. "' .
Permit Number
' b 2.-¥/ '?'?..P Blk.
'•·,
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=",'""-'~E:' ~Eqv1l
J-MPS: ·~~·;'. :".:_';:;"::..·~·
.)A\"!:, s"J.:;..~ VI
' ;,<,4t>·,, " Wlflt: Rill :U>i['\JIT
v-· ~:;~;:.~, ,.--;~·:rl.~ ~~ _;~;~;j(('""~;; ' ')i ,, ; r ;~£.-,~;-~;~":~;"· ~ ~i-~o .. :-,·· ···-":-<-·· _, ..... : L ~-;-~--~'--~-~ .. -1i~L.. .
------------------------~~~----
•, • £L£CTIICAL PERMit. ·.;.
DEPARTMENT OF BUILDING AND SAFETY 5.!7-4200'
i H.I.Vf.' C.A.~~F:...·.i..- ... ':1 M!-_A[) Tt-1£ "f'OV!; i!:.PPLlCATION A""ID KNOW cHE SAME 1"0 BE 'fR'-JF ANO CORRFC"f ALL F'ROVIS!C.NS OF 43:TATE A~O LOC.A.:.... t.AW$C6.'!!F=.:F(lN\O. T!-iiS TYPE OF CONSTRUCTJON WiLL Bf; C:>!o!OUEv •t~-;t< WHI'l"Ti<ER SP~ClFIED HEREIN OR NO'L NO PERSON. SH:A..L.L 'BE EMPLOYED H~ \iaOLATION OF THE LASO'A'. CO:::E OF !"M!E ST,qE Of" CALirOIINI.
... DA-TE
-~ ... , ~.,__ ... -------
WATTS WA TT:S W,. TTj l' LZ L.3 '
-------------------t--------
f- 51 Z F_
wt P.f: Rid- CONDUIT
p~-.o~:.:..1:- •,f P·,•r "'-)'/!: '·: .'1 WIG'F
A.MP'1 ~lti. (,)NDUIT " -·· . -·--·. '' .. ~--·- --· :.~ .. - ... ~:--.. "'*' -· .•.. !!!.! •• ~=-~:...- ·-· ---·-·-·----~---------,:)r: :;,..._.,-y "it) 1'~1::-,N P.F,'AMIT "J('I I' 'IE: ... T 1-!(A':", AIR CONti,
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---·------·--···--·--_;_L_ _______ , ____ , ,----,..-L ________ _
CITY OF GARDEN GROVE . Public Woc:ks & Oevelopmen• BUILDING PERMIT
INSPECTION RECORD
APPROVAL DATE INSPECTOR
Inspection Rtqu .. ts 638-6771
General lnformatiQn 638-6661
l .~
·" rvr,lt. ~-... . ~· ·--···~ I ttU05:!. a.o.sANT.01s.l lo.c.sANT.ols.l 1 DAn 1 '""'•L LANoscAPING v .... ,,A,.ooN --·~=~..SO.Ge_ER.' .... ~-~··---11.~50 ..
Dl CJ~I,-.1·' 3, '3!:1
Sqte CompenNtlon
~nee Polley 'No. · Expiration Date
t--.,-------------l---/-~--l-----r----1 certify thlt in the performance of the work for which this permit II ued, I lhell not employ any person in any m ... ner so e1 to become
subject to the Worktr'l CompeJ'Iatlan IIWI of C.lifornle. NOTE: If, after m1king such cenifitltl, the eppllcant for the permit
ahouid becoml subject to the Worker's ComPehntlon provisions of this code, he shall forthwith comply with the provision~ of Section
· 3700 .. or h:l permit ihilfbit dHmed reveikld. 1 I ,gt I certify that I heve rMd thia application and nate that tha above In·
t-~-----------1-11----- -+------+.---1 v-t'ormatlon Is conect. I agrn to comply with all Cltv ordinanc• and State IIIWI rllltl~lng conatructlon. 1. furttl• aarM to hold
JtilffJfove frH and hlfr.'ll- from '""-··m.l ... -..- resulting from
'· 00 ,., .• ,_.,21. l)fl
··~
IJI=-
NO. OF DWELLING
~-TORIES_ J~_!S---:---·::-:c:--lf work it not stlrt•d within 120 days from date of inua or 1f abandoned for more than 120 days, this pormit will IJe null ancJ void.
RELOCATION
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TEL:· i·~a:·-
~U'I\IR [] l'EMOLI5H 0
'l~Y 1 0·65
swim pool
OWNER-8UILDE~ PERMIT <ESIRICTIONS· 1\n ownor-builder must r•slde wit~in the budding for wh•c•1 lh:-. pNnHI ~~ JS.$Lit•d, jncces.sory build1ngs CMt.epted). 'Soid building mov n;·t r~·nt(lin more tho" 3 dwelling u"tlts Oth!!rwise, thts pe-;~if con be i~!>t~ed 0nl-.. fo .1 contrm:lt."'r fittJf"-Y!d in the~ Stt:lte of California and a bu!iine!.S fio:ense mu'if be prm,ured from the City nf Garden Grove.
WORi<MfN'S cr~MPF~ISJ·' ICN I~ISURANrt REQUIREMENTS, A c<rtificot" or duplir.ote lhe.·r(:'of of w:_ • i. ·n~ln'!i. cornplf'r'lmtior, 1n!iurance rnu~t btl on file with the City of Gwder, Gro"''' cr\c1r to th~! ,gu\:'lC.H of this permit ur.les.s; 1. This permir ;_~ +·or IN-!. tho""~ :Et 00 vc.du•.llh::-11 01 2 The oppl•cont qualifies o:s an awr:er·builder ond ~'9"·"> 1h•· stof(!f1W11f b~low
~ cerflfy thot lr'1 :he re·in: "lU:lCO o! 1ht1 ~\")fk !or which 1hi!> permit is i~ued. ~ sf all not employ ·Jn·t pe• ','Ht tn ur y mnnn".'1t ~.o o~. to bcron1e subject to the wcrkmen's co~np~tlS{'It•O"' i.;wo;. of Corlforn1t-:
SIGNA TURf
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Electric: Permir No.
.A.N'i'HONY .. J?OOLS 5ti71 J.i'IH.i:.:>TuNE BLVU.
lkcnm No.
· 1 0~• S.ign-"1 Transformer '
1 Addil'co.naf Sign, Sar:!e. l()ca.ti.t~fl .
Ad_difoMI Transf. odlashe_rs, __ Tim~ Clock
.L<tmp Holdhg De•ic~s. ls!,20_
Ln'!'f.: 'lolding Dn~l~i:s~ Na•t.IOO
Si.?J:1.~nd I !r_onsfo~!:':'c:, t-1owJ<j
I z.oo I .. ' 1.00
1.00 '
.05
Alhuing or. Chan_9ing Lell~rln9 . I I 1
~or Cann<>ding ( H k ) ! I
Permit F'!_D ____
0
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ln>pector
Wire Conduit
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16401 Pa1rway Ln. City Lie. No.
~3 Owner lldg. Permit #.·-···----·--
....
I (t!rtif-,· thnt I have ri!!od thi!:. opplicalion and state thctt th~ obove mtor-INSPECTION RECORD mt1tion il c<>rrect. I agree to comply to oil City Ordinonc<'s ond Stole lows
------=:==~--:.._.;;..;...::..::.:.:-==-...:.:.::..::..::.:.:.=---::---=-:===--r--1, reJoting: to building construct.or I certify thot in rhe pHrform,,nr-!'" of 1he APPIIOVAl DATE 1~"-SJI>ECTOR L_ l\obove WC"rl.: I !.hall not employ any pt'rson in vmlution of the Lnbor Code
Fc7r~d:::nTO;:;--- /{"- . , £ (r•·""'· ll'of Cultfor,,o r~lc1ting to Wor~mon·s Cornpensation ln•umnc~. I fur1hcr and lc·cat 1on ~,... 5 / ? Lf C) , ·~ D\l''"" to t>c1d the City of Gord·'~ Grove free and hnrml"" from ony lia· -·---· __ . _ .. ·-------,--. -~-r'--,_.(.--"!2--:..C/t..tt..:;...c;...«-.v.c;<: _______ bility oris.•:-tg out of injury or bodily damage re$uhlng trom work per-
Reinforcing : formed ~levant to 1his permi,.
-~~~L~ht;_··~---~---~--~§1~£-.:62- ££L~~~-----------~~-=:~~:= ~,~:'~!:~;;~·'om o lice~~~::~:.:~:: a5
~~~h:,E~-~icew '''"full force Ro1~gn frorne D' 2 .o I' ·;l lU ·
. -- _J_j_ D:.M'.:.._ ... j_"- - E(-Lot!-, or Dr-,.-wail ····-_·--/_f?j"i_d;J_~-~~: _ ---·- ----·----PIGS. 0'0•lm c~ -/P?.Ij .. t14-- -----·- -Orhe!' ~ ( ·~
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------------ _ Bv ··-,--,----------------cc-.~,rr,l-c-t~t Authorized ""~•·nt Dote
OWNtP B\.JI! DER SIGN BELOW I cr.r•if. the· I urn exemp1 f,,_,.,. !!u~ prc.vision'J. of (.h. 9. Dl\• 3 8 und P Cod'" C·-.,lr :dor's licunsc L~, ....... ~ be ... ous.c- (dwc!· on(").
)r:1 om !he owner of the oboYe property and w.JJ p-ersonal!-.,. 1-hH1'~vm thP. obnt,•t.• work.
[~/ I '.1!"1"' ~h(~ r wnP.-r of th~ nb.-,·.f" prop[•f'ty ond t will l.('nlrud ~~-~ l.,,_ivt' oil oi '*~e ot.,ove work perfor• .... f""d by iic(-n!l("'rl rontrorfors
:_·' f ,~,.,..,. thr o .. ·,nrq· of thr ob·.•··" r::oroperty und w.lJ c.11ploy t".,...,_.,,~ to p•.'r·
~nr·1' rht .. oboy<:. work v,q1h woq~·<; os th('lf sole cornp.-'r-&•l'•<1•, ! .-...:: ~t·rn•s.h insurance for n,y·M'T'Iploy~ o' ruquired by 1he 1.ob,1r C:..>d~· of Cul1fc,rr'lio.
' ,. -~.( ,_. /1 .... , (6: -L ,.£A-~~u .. :.-4.--.. ..).2L;.,!___ .. _ Bv __ .
fEES f"tt.Nnt'f' '!. .;, 1t,r:.'J1'vrt1 Au1h~'litcrt f1•wn• "P'"'I-------------_,.,...:..;;;:::;B::...,_,..l------------~ 1f '-\")f 1~. ,s, ntl1 siCJrted wilhir' bO dovt from dn~~ of ~~;tl(l vr ,f
(1~~:::k J 1:1 ~ p~;r~:;·";J _ -~-q_ ~--· 1or ,.,..,.~ th,·m 120 day<. oh;, p-.mif will b•' "'··" ~"" v•·•d
r, . ._, .. :l J; '~p·rotion RELOCATION
L'ole
'•::r
PRf5f.NT BlOC. ADD~ES.$
MtWIN(~
CONT~AC:lOR AOtJRfSS /t)~i~<-7 ~~--------------------------~-------------~-----------------------------
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I eertffy the infortMtion hereon is ,..,, ... ,.11•+• and correct. tt I ll'l•~dor f!ife #3 Owner
o;:' ,·:rwa·rt.·· i-::~ cnv· oft'
OAitO·N·· o'IOVE, l
-~--'--- ----~---------
PhoM Cl1y Uc.. No.
u...~ -~· G:4·ii~-:-_:A .. i:P. .. il .... -~~~=~-~:~~-~-~~~= ~-,v.,·:+,..-t---"-·--'--'7"-::-~-L<'--4L~_.II!::__-+----+--c'--t.::::c-; . New ~~c~v. ri:r.... Old Bid;. o
·~ .. - ~ ; 1.50 i
1.50 ; ....... ··•·· ·~ ,, .,. . . -. .. '
: W11ter l11teral 1.50 \ ·I ..... '
.2.00: -------;-- ....
! 8ackflov. Protecti -~ Devices -~-... '-•1
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~it _l.uthorlzed By~ UTILITY CO. NOTtftfD
R'OIJT:NC.: ;;1 P!~·:nbing "r15fleclor !:-'2 ~;wtatlc' 113 Owner !14 Offic~ Fil~·
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• ··, • ,.,.,. ~- ly1 . , Date ,. f ""i OTILIT'f' CO. NOTIPIIO
- ..... -.-..;.·-····--·~····· ........ ··"'~·.::.-· I.. • •• :. ~· I .~ .... '. • ,, •.•• 1... .. '" .
. · lNG: r1 Pl~~in; L~tptoctor ~~ t.r2 Statistics •3 Own•r 11.4 Offlc:e File I .)1
~. ,7-~·? ./ 7. 4-i:>
Bldg. Peormit h
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