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~~~or~~:: -·p L.A~I
APPROVAL Foti'r.a;tic)f1 and locdion
J'<eir.•forcir_l_g
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• ..~rmit Authodzed By
Pouting: :#r I Bldg.
.A ..... Pl_a_n _Ck. _<5~~-
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Usc o( Building Ar(!;I!J of
~uilC.:ing
Validat'ion li.rd1.··;,. ~rrgr:.A:f.
PRE~~Nl ULDC:;. ,'.DDRtiSS MC>VING
Er~erO&ehmont Permit
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' certify th8 informtttion hereon i~ colnplnh! end correct, 1
Routing: .~I Building lntpettor ·"~~ Qffic~ Fll• #3 Owner I
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If Ht•t l.i~f~o Ai>ovo, See Code
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r li'e'r•bv -.ci'nowild • tft.f Aobov• It c.)trect .n': ·~,.•• ~l~tk.q •Jte:trful wlrlnq. I her~b·,• cfirtffy lh•t I •Ill od bv !~• Cltv ol G~rcion loyal O\Vh"' Qf lhe' •bovil fotnHtnt::t} of the w<.;r• fat person ltl ''io14tlon ol tho (Plnl~.
' SlgnoiUtfl of p.,mlttee
One Slgn-1 ir•n•for"'"' A~dltloMI Sign, s.,,.,, ;,~lt4ti.:ln
Additlor•~l Trarllf •. r.r fl•sh1m, Tim•
lamr' Holding D~~icu, hi 2n l"mp Holdiug De~ica1, Nut. 100
Sign •nd I Tranlft~tm~r. Mand Altetlno or Ch11n9ing l.1•1terlno
For 1::or~neetln; ~Hoo~-~pJ ,, - ............. =-"-~"·-·----·-·--" .......... ..,.:..... ... _ .. _.
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PUiliC WOitKS
.kord of Surver -+ -J-: ·:W:~=Jds=Dedi==IQ=oti=iol=n ==--=_ -~f=t ___ -~-:r=~1=~·::-=~·~=·-=-._--~:~~!~!~~~·-rz=-..::..~~l.~f/..~A:=:r1.:;.=:0:;-~-•,:y4c.s ...,.....
--~;----·-"!-lLr&JJ.L.~112.c:...&:! A~l«o .. N J &..i; ;~ s:tb~ OWNER-BUILDER PERMIT RE!>Titli..:';ONs, An -..-l:.ul~ ..,.... ...... 'IIIPIIhln
{~~~;;;~~~~~~~~~~~;;;~~~~ · th<t building for which this permit Is i-.d, 1-v bulldinga ,_,...,, Sold building moy net contain mote that! 3 dweiiiiiQ ~nita. Otherw:S., Ifill permit con be laued on!; •n a controctor llce!llld In the State of Callfom'" and a businaa llcenM mull be procul'ftl from the City of Gon:':en Grow •
. WORI:MEN'S COMPENSI,Tir"lN INSUlANCE .. ltEGIUIItfMENTS• A ~ 1!!!!'!!!..'!~~!!!...-----~.!'.:-.-:-f..----·--1---J!!'-"'-"'""""'rA--···-·--1 or duplkate thereof of work.,•n'a COIIIplniCitlon INUronCII mutt be 011 file wtth the Clfy of Garden G~"CV~t ! ,. t ~r to the 1Muoi1CI of thla permit unlelt, I. n. -+-----····-~--··----·-·--·-·! permit is for lfll than $101 valuation or, 2. The QPII)Ilcont quallflee 01 OR O'Nner-builcler and signs the statt1nent below •
I certify that In the p.ltformonce of th. work for whkh this plflllit II lllul4, I shall not empJov any person In any r.'IOftnet' 10 as lo become aubjlcl 10 tt.
·---·------I wor~men's::;;;; of L ~ SIGNATUR~V7 - w.- ·----
(or) CERTIFICATE ON FII.E--·----·--·---~-------··---
APPLICANT'S CERTIFICATION• I haw carefully read and tllo~IMtd the oiMMt Of'lplk.otlon ond fl"d t ... son•• to IX' true and correct. All provitlonl of the laW\ and ordinance~ of th. City of Goo-den GIOYI and Stat. of Collforftlll will be complltd with wtltther lf*illld hlrtll1 or not.
~~~~;;~~;~~~~~g~~~~;;;;~;;~ ONM•f-bl,l!t!oiP -.t ,.W. ...ahl,~ th" building for which thl!. permit Is imled, (a«ellOry building~ exctp'-<1). Said l,uilding may net confoln more th<ln 3 dwelling ~nita. Otherwise, this permit con be issued on!, '1' a controc:tor licenMd in the State of Calllcwnt" and a business lice~ musl ! Jt> procured from th. City of Garden Grow. ·FOI.Widotion
aodUxcmon ----~---- WORKMEN'S COMP~NSJ,TfnN INSURANCE REQUIREMENTS, A cert;flcote -----+----·"'·---=--·~-~-- ---------------1 or dupli<ote thereo1 of work< '.m•s compensation Insurance mu11 be on file wllh
the City of Garden Grov~ ! ' 'Jf to the luua~ of this permit unle», 1. Thla • ""-'"'-'::C~"'0:.'~~------1----------+---·----------------·--i permit i!. for less than $1()( voluollon or, :2, The applicant qualiflfl 01 on C!'Nner-builder and signs the state1nent below • Roof Shtg.
Rough Frome I certify that in the pccformance of th.i work for which this permit Is lllued, I shall not employ any person In any 1':101\ner so os to become subiec:t to the woro:men's comrensation lows of ~alifornlo.
StGNATUR~,_,.~~=2~~~~~
APPliCANT'S CERTI ~ ICATIQN, I haY~~ carefully read and exn..,lned the obowl Clflpliwtlon rmd lind tho l<lllla to bt tr·u& !lnd corred. All provlslons of til. law~ and ordlnancos ol the City of lio•dtn Gro~t~t and Stnte of California will be <Oinplitd with v.hethar spetlfled herein or not.
PLOT PLAN
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C I T Y 0 F G .\ ll. D I N G a 0 V 1, C A L I F 0 a N I A
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ADDI.!S:i OF COKf'LAINT: __________________ _
. ..._ __________________ .. _____ ,,\._......._~ ---·---·----1--------1-..~------·'" ..... __,_ __ ~...--~.--~
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---~-: -~~----_j-~ _________ .......... ____ _
BUILDING PERMIT I Pc;rrnit No. I
Twdf\Jo.
Remcrrk, I certify 1h;:t~ I hove rcod l'hi~ r.rpplic(lflon ond ~.tot~~ 1hot 1ht: ohcw+! infor-INSPECTIOt'--1 RECORD mation is corrc•cl, I ogrc•r; io <:on•r.ly to <:II Ciil' Ordinuncc•; ond $,,,,,, ''""'; -------·----- rclotina fo buildi~g con!'.:ructlr;.n, I Cl~rtif~r lhut iu lha pcrformunc•.• cf th.:~ ------~-'-'~~_;:_g:..;'/.:..J.:.:'l:._ ___ + _ __;D:::A:::.T.:.:E=-· --!----~IN.:::S~P.;E:.::C:..:T.::O~R,_________ abcva work I r.hall nor "'"plot wry pcrr.nn in vi:>lorron of 1hc L.1bor ((ldc F0:Jn(kJ;·ion I o'7 Ccdifornin rcloti:1g lo Workn1on's Cc1npcnsotio11 Jn•;urc1!1Ce. I fur-th•H CJf'\d LocC1tion O[f(l~0 to hold tlv.:! Citv or G(ud•!n Grove frt:rJ nnd h·:Hmit:s~ frum rmv ~i(:~ ·--"- --·- __ .------------~---··-- -~----~.1 ----··--·----------- ·--- bilitr· orlsino out of infury or bndily <.k11nogc r•:J:J\. 1 :tir~!J frDrn work' p<'f·
-~~~~f:-~~;.g ------ --1------- ----- __ : ________________ :o:::~i:yr::,:~oln~:: ~:,;,:~~~~~::;~,::.~;:~ a~:~~,:~[~~:·;i<~noc is;, lui!'"'''' ond cff0ct. Rough fror~-~------------~- ---------- --~--------·----·------·----E.ederal Sign & .SignGt_ln,-.~---- _____________ . _
1
- -- . -- ·--- --~ ·--·· ·-- --·--- - ··---- - Contrr;c;tor AllfiJl)'l.~ ,] "''i'-'rl L\ I!~ lath or Drywall ·, _____ ,______ C'WNtl~-l3UILDtl~ SIGN flU OW Pla.s. Br·tyNn Ct. ---------------·- I .:::edify th< t I \till ~~Y.r·mpt ft(tfll 1;w ptOVl•tiOI~I;, 1_,( Lh 9, Di\' 3, 8 ... wd ~_, --~ --- -· ---- --- Cc'rl~· ((<llllrur:1or'' liC"n~~~ idl.'v') lwt uu•;r,.~ (ch~·..:k l'!~t· t
Other
Finr.1l
U:i!iry .J
[l I om the owner ol :h~~ olJ0VC' pr0pt!fiy und W1ll f.H~r~lonoll~ ~H'II··q,n :h•l obovc. work.
[J I '"" '"'-' OWil<)r of ''"' (11_>(1\'(' rrop<':rf)' '"'d I will :,l''''"'d ,,, I""'' l'l;l of tht' nbuvc \Vl'tk rn~rlt'rlllt.'rl bv lkt~,,~·cod nmtr.~cL""-~L !J I urt1 1~,,~ \.W~o'llLtt· 1 1i ' 1
'1' 'lllljV(! Pll'P•-•rt•r· lit HI \VII: r,•n'!::•~···~· lh:1 ~,-.. ~~- !· ,l· lur\11 tf1~_.· ~,_d,ov~~ Vl'i..Hl 1.' ·.h \\'~JI)L'', ... 1':, lhl·ir [•Lll,,, •. ~'n'j>'!l ,, -~- .. ' '· l ,. 11 in·;tHUI\u.• ·fur IHV t'~r; 1 ·k~~·t.:':~; u: H:q~·!tt.'d by lhL· l.,·l·,lr l ,_, .. _.!,• 1:,f 1 •••. 1 .:._ trti,~.
O\\'tl ·'~• Slq!l 11l·,~l' l\v,\,.1:1~·:·1!, .. 1 ·. l ,. 1 ''l,,· .• lr wnrk is 11ctl :;lrtrl~>~ \'.':lhin (,() (~ttV'J fld;l~ ·.l\!:1.' 1.1f :::~, ·' ,_., ·~ u:, ...... _i.,, \, rur UIOI'"t! lhllll 1 ~0 ti. .. J·r·!i, lith p-!1"11\il will lH~ Ill. It tl1hl \1):d. ·- ------------"---~·--"-·--·-- ----~· ·nr:Lc~~i\ri6P~--- --- -- -· ---·----
I'R~:ilNT' tlt.IJG, 1\IJIJilt~S
I Dntn .. ·- . MoVINt• ·· ~ ,, j 4 ., ) :) .. t..,·t->N,_l~;;,ll;;;(,;,t.,o-.11 ____ .. ___ ~-·.;,:.\1.~111 ~-~
-----·------- --
EtECTRICAt PERMIT DEPARTMENT OF DEVELOPMENT SERVICES
GAHDFN GROVE, C:ALIFORri/IA PHONE: '537-4200
_$.:!l2.P.~9~.d~}-: __ 400.=-3=-24-=-----------Lor NO.
Fixeurcs 1st 20
F ixturcs Over 20 ------------------------~-----4-----+------~~ Fixtures, High Voltage Type
Rcdiont Heat
ISSUANCE Of PERMIT 2 00
TOT._L FEE
lt~STRUC:TIONI 'JSE TVPEWRI~FR em flALL. f>OII'IT r•Ftl, t- ._ .... FIRMLY, BE ~UPC /\L.L CC'Pir :, Af"~f u:f.ilf!LF, f',/f) ~·ruv:,t.;rH, l·'!·llMt'r TL:J A DOUBLE ree WILL UE CHARGED IF 1-<llRK IS STARTED BEFOm: PERMI"f IS I~SUED.
.J()fl ADDRFSS I CLI:PRt.c Hr>t" r, "o ----
9001 Garden Grove 1 ------------·----------------~-.-------------------O'i/Ni::R PHOIIf:
-~
l H A V t C A R F 1' U L L y R E ,6, C THE A 8 0 V E ,•, P P L I l: /, i ! 0 N AN !:• t: f'.l ~)W THE SAME TO 8E TRUE AND CORRECT. ~LL PROV!.SION:·~ OF STATE AND LGCAL LAWSCOVERIIJG THIS TYPE OF I';ONSTRUC'.ION WILL SF COMPLIED Wl'iH WHEThCR SPt:.C!FICD Hf:I:;!EfN OR ~iOT NO PERSON SHALe Bt EMPLO'I'E i IN VlOLATION OF THf:' L/l.!~OR CODE OF THE STATE= OF CALIPOR.~IA. SIG."JA.TURE OF PF.J:i•.~I'!'Tf"E DATE
X
~a Nl1l r: fJ H ;\~.a: !:iLHVIt.. ~ .... S I~~ l~
!'IMP~-,.. Wlql . - ---·-·------ -
THHL'L PHASt-: 1j 1:~ H Vt c l ~il t!~ l~ tl J Wl1~l- lJ 4 I'>H I
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INSTRUCTION! 'JSE TY,.EWAITF.A OR IALL "OINT ,.I!N, P.~
EI.ECTRICAL PERMIT FIRMLY, I!IF ~UPr A~L C('lf'lf •; ARI LFGI~L.f', Nf) PAA~U:: f'~RMITTE::J A OOUBL! "EI! WILL BE CHARGED IF \WORK II STARTED BEFORE PERMIT IS ISSUED.
DEPARTMENT OF DEVELOPMENT SERVICES JI)B ADDRESS rL"P~I C 'ERt-41 T,. N(j
GARDE:f\1 GROVE, ,-;ALIFORNIA PHONE: 537-4200 9001 Garden Grove Shqp,,..Q~.d~.~- .10Q3 24
I ~;~~:4411 O'.VNER LOT NO. TRACT NO.
Atlantic MRichiield. -..JL.~~-'-~\~_E_E!. __ fl.'.:_~~\I;~~EO_I': C ()()_E _ NUMSEII EACH ~EE
~-·· . --=F OWNER 5 ~[)DRESS - CIT ( Residential (I & H) sg. It. .01 Gara~e, Res•d. (J) sq. ft. .005 ~45 S1 Marioosa. - Los Ap.geles _ _
NEW BUILDING OR EXISTING BUILDING .1 O~CUP.NC'' ! u"E or tHotLDING ANn Serv1ce, Single Phose $1.00 AOOITIOH - A"£1. REMOD,\L AREA GROUP ll~ "UMBE~ Or U!ll;s ·--I--- SQ.FT. ~~.rT. , Service, Three Phose 1.00
ELECTRICAL CONTRACTOR ~----Meters, Single Phase 1.00 Meters, Three Phose 1.00 Federal Sign and Signal Corf?-! 1 221-6141 Pole, Power, Light, etc. 2.00 ADDRE 55
St. - _Lo~ ~:e~Ji~ ;~~~5
~~~ Sub-Panels 1 <P 1.00 1100 No. Main . VALIDATION Sub-Panels 3~ 1.00 '1 1:": 12-70 11 107 f.i<k:::l·n'•·A),QC
Outlets 1st 20 .20 Outi.:ots Over 20 ' = .10 I HAVO: CA11fFULLY REAC THE A eov E A PPLI ( f, TION .NCi 1:N?W Fixtures 1st 21) .20
THE SAME TO BE TRUE AND CORRECT. ALL PROVISIOW, OF STATE AND L.G:AL. LAWSCOVERII>G THIS TYPE OF CONSTRUC"ION
Fixtures Over 20 .10 WILL 8 ~' COM PLIED WITH WHETHF..R SPeCIFIED HE'lEIN OR NOT NO PERSON SHALf.. BIO EMPLOYE·~· IN VIOLATION OF THE LA \~OR
Fixtures, High Voltage Type 1.00 CODE OF THE STATE OF CALIFOR ;lA. SIGNATURE OF PERMI'rT~E nATE
Ra<liant Heat 1.00 X Washer 1.00 - . =-Dryer 1.00
BRANCH CIRCUIT PANEL: CIRCUITRY CIA. ~RKR. WIRE NOMENCL.ATURI:: NO.or WATTS wA rrs WATT
Hot Water Heaters 1.00 NO. SIZE SIZE OUTLET Ll ~2 L' --Dishwasher ].(l" 1 I -·- --Domestic: Range or Ov.,n 1.00 2 Mot.:>rs Not Over 1 HP 1.00 3
Motors Over 1 Not Over 3 HP 1.50 4 ·-5 -6 --f---
INSPECTION RECORD ---· -- .. '---~---APPROVAL. o" rE: INSPt C TOR ---- - .... --··--·~-=~==· --· .. ~
Underground
Conduit --· -~-~----~--
·I---Wiring ~----~-··
-~--... -~-
---.-.,_.......,,__. ~ ....... ~-~ .·· Ceiling Heat Cable --- Fi;·,~-;;;~ ~- ·------~-- --- -~-- -·~~---~~ -~--·-~=-----· -..--- ""' ··~~~ ..................... ...__ ~ --~- ----~-
Time Clock ---~· ~= ........ k· --!-------~----~- ~----~· ___ ...._ ____ _____.......
1.00 Sign, Tran. or 1 Ballast -,-· L..
·--~- -~~ --·~-----_:.~ ................... _____ ... ____
1 2.00 ·,;;;:_ F.aeh Addition(ll Tron. or Ballast ( 1.00 I
!-· ·----~~----~~ ~· -~· ---~!-------~-~-----~-It'_,,.., s.~rvl ee
---------~-- .. ------·~~~---!------·-··-~ -~~-· . ----- ~-·--- .. .,._ ___ -----~ Sign Ho'>kup 1.00 J::!~.AL . / i!. - ~ '.:' ·-?.._ .... ~. 14 '- ;f :::_,_ -~- ---~·~- ~...._.~ .. ,.._
Utility N(ltlfied -- ----------~-------- ... L.....-..__~-~---~··---- ------~-----------
$1N(.ll E I'HAUE BLHVIC l'. SIZ!:
ISSUANCE OF PERMIT 2 00 AMPS. WtRt..' ~til UlNt:llltT -~~.::-·.=::~..::=.,_ __ .;__ __ :_ ___ .:..___:_:.:::._::::_~'-.~...__~ .... --~ -~~-
_____ __:_ ____ ~-----~-THI't!:t: I'HASE StHVICL Sill': tl ~ WI At lJ 4 Wll1!'
.J'OTAL FEE /") ~; ,1'\) liM,.~. WII1E RIO. CONDUIT
I ,.I'.RMIT~~f!O IV
':__...:;";...;;'.:_.:...._.._,~.'~~:..;!::t....__~. .:;t;;:;.:=::..;~L---·-::::_~;:-_'.,' ~ -.:..::__._;-:=..."'::'!-.~-~--"'-·--
' INSPECTOR l DA Tl! IUILtiiNQ ,.~T NO. SIGN .. HI'!MI't ~~tilT. MUf, Alii COlli.
~-'>i•/7..-- ).::J "II ? , . I l'tlllolltt .... .
: 1 :::-. -::;.•m!LII
.... ----
INSTituCTIONI I)JE TY,.EW"ITE" 0" I ALL ,.OINT I'I!H, -~ El.ECTRICAL PERMIT IO'I"MLY, liE ~U~E ALL CO,.I~:l A"l· LFGII!Lf:, NO EltA~U Pf.RMtT H.~ A OO~!BR~~T "!! WILL B! CHARGfD I,. WO.I( II STARTED B!FORE P IS ISSUED. DEPARTMENT OF DEVELOPMENT SERVICES Jr)El ADDRI:'SS rL1pi'1,C f'E ..... If; H<j·
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G~;~ • C4~QJR24A PHONE! 537-4200 9001 Garden Grove LOT NO. TRACT NO.
OWNER I_ PHONE
Jll' NO'f L15.TED B •.• OW ''EE CODE NUM8E~ uc~_ PEE Atlantic -Richfield. 629-4411 OWNER'S ADDRESS Cl Y
Residential (I & HJ sq. It .01 . Goraile, Resid. (J) SQ It .005
- - 61i5 s. Marioosa - Los .Anlleles Service, Single Phase $1,00 =~~~~~':;~D~NZ"-~! EXISfiNG &UI-LOINij I oc-~~ 6~~c' ~~E .e~:~~ Lg~ N.:'.:r"•o ltEMOOt~L AREA Service. Three Phase 1.00 SQ.FT. ~c .rr. Meters Single Phase _!.00 ELECTRICAL CON rRACTOF\ ! P>t.lNf Meiers Three Phose 1.00 Federal Si•n and !Uonal Corp.~6141 Pole Power Light. etc 2.00 l";~~E~o. Main St. - _Los ~~e 2; 7~ ~~~~:~ Sub-Panels 1 cP 1.00
Sub-Panels 3 <j> 1.o_O_,j VALIDA ION ';lltJ2·70 11 107 M*~l't:'.-:.:~ Outlets 1st 20 .20 Outi<'ts Over 20 '1_() I HAVIO CAr<F.FULLY FIEAC THE ABOVE APPLIC~TION AND t;NOW Fixtures 1st 20 .20 THE SAME TO BE TRUE AND CORREC.T. ALL PROVISIONo\ 01' STATE AND LC:AL LAWSCOVERit!G THIS TYPE OF CONSTRUC'~ION fixtures Over 20 .10
WILL BE' COMPLIED WITH WHEThO.R SPECIFIED HEREIN OR NOT NO PERSON SHALL Be EMPLOYE:) IN ViOLATION OF THE LA"O" -Fixtures High -V-ol,;;-ge -Type 1.00 CODE OF THE STATE 01' CALIFOR:;IA. SIGNATURE OF PEFIMITTE"E DATE Ra'.liant Heat 1.00
Washer 1.00 BRANCH CIRCUIT PANEL: CIRCUITRY
Dryer 1.00 Hot Water Heaters CIR. nRKR. WIRE NOMENCLATURE lo~~i.~'r WATt'S I w~~·s lw.gTs 1.00 NO. SIZE SIZE L I Dishwasher 1 ,(l_D 1 I Camestic Range or Ov"'n 1.00 2 Mot.:>rs Not Over 1 H P 1.00 3 Motors Over 1 Not Over 3 HP 1.50 4
5 6
INSPECTION RE 1 :ORO APPROVAL DA rF.; .. INS_P_EC_TOR
Underground Conduit
W irin;
C ,; 1~2!'1~ He~~~..«:~.!~~. _ 1----Fix turu Time Clock 1.00 Sign l Tran. or 1 Ballast ' 2.00 ~. l·...:.' F.och Additional Tran Ba lla;t ( 1.00 I lrJ\"! 5-~rvi ce
-" Sign Ha..,kup 1.00 FINAL ./ {!.- 1 7...:.·' t 11_ 0:...:_#-:;;:::.. - U_!~!..Y._t:lotlile~ niNOl.b PHAS!; S!!HVI(I'. SIZ_, ISSUANCE OF PERMIT 2 00 AMPS. - ·--·~ ~.~"''----"---"--'- ."_10 ttlN~uiT 'I'H"IOIO I'HASF: SI::I!VIt_, Sl~l!' tJ ~ WIIH: U. 'I< IRE _TOTAL 1111! /""\ § b_'\)l _ ... ~ .. ~- WIIU' ~10 C:OitOIIt!j : p INSPECTOR I "rru.uT~yro IV I ~~tltNa "''EJIT No liON ,.IIIMI't N.o.
.. !!I::' : ::: ::. . ~:'"t .. ~ ¥:!:l ~~- ''!' ~~ . ; ~tin, IIUt, Alii~ • '-liMit ••
BUILDING PERMIT PLOT PLAN .,., ...... of ...... , ~C:I'IY OF .ARDEN GROYI
NAME C?F ·:ONSTRUCTION LENOER 1o I!IRA,Nc'H'"'
•
BUILDING PERMIT Df,.t.RTMENT ot IUILDING & SAP!TY, OA~OIN o•OVI ,H 1374~ ===:rc _____ ·_ ... ,;cc::'-0~;~;""'·' ;:.:;,.·.:· -·,;•;··:"·:,;c·";c
fiR! • O(:CU· ZONE • PANCY TYPE __ ·-·-····-- .. ----·'""~~=:....-·-·-···----"fl: ~~=~-~s--jf;)~·=l~~i-/)Jr;~~---
use c· ? ZONE - <;._.
Plas. Brown Ct.
Other
Final
OWNER-BUilDER SIGN tmOW I certify that I om cHcmpt frotn the provisions of Ch. 9, Oiv. 3, B ond P. Code (Contractor's license low) bccau~o (chock one): 0 I arn the owner of the abova propertv and will peraonolly f"'rform ,,,. above work. Jli( I am lh!l owner of the obovt! properly ot1tl I will contr<>d to hovo "" of tho obove work performed by licensed contractors, O I om tho owner of the obuvo property and will c111ploy p~rson~ to ,,., •. form tho above work with wc:ge& 01 thc 1r sole cnn1pon•otion. I w•il furni>h ----·-------'------ ----'-----:---------·---f insuro.nce for my employees a. oequlrod ),Y ;he~~ of C:"lifornio. ~~::::.::..:~'!'.:~~~~~::....!.:±:::=.:==:====l __ i?u:'f:/t ~:l-1_ . . .ayl.//:._& ___ ~-~--- __ .R.~o Own~>l'& SlgMiute 1-\othorizod Ago111 fl-' DO•o =------------...;....;..,~:-:-,,-------------1 If work Ia not started within 60 days fron1 dut~ of iuuc <> if ob""J""ed Check~----------{-~~~::---f;;;J;:~~~----~!_::~~----~r_o_r_m_o_r_e_t_hu_,_,_1_2o __ d_o_v_•·-'~h~l•ipet¥trm~it;~Ar~ll~bqe~n~u-ll~a._n_d~v_o_id_. ________ __ Bond b=::..--:o·;.-.=-~--~~~~~~~---·-·---..
•ua PEIMIT PLOT PLAN ~ II,& I& ••• ef ..... , .~~;;m 011 .AlDIN .. OYI
at
f
' CIMIENSIOI\l PL.OT PL.AN COM"L.IET~L.Y aHOWING A i ru~GS ON, THE I..OT AND THEIR USE!,
;; 11 . A-
LOCK
":. ,B-81ltll8 Public Wexks & Development - Garden Grove, Ca.
Inspection 638·6711
PLAS .. BROWN CT.
IIIEC'08V:
-.u-lrH4rJ•IZ£0 8\'
I. 1NWICTOR
lnform:~tion 638-6661
I certifjl tho1 I hove read th:s application or.d state that )ne abov .. inlormotian is correct. I ogre., to comply to all City Ordinoncn and State lov.s reloto"9 to buikling construction. I certify that in the performance of the above work 1 shall not e:npi!:'y ony person in violation of the labor Code of Cr::I;fornia relating to Yt'orkman·s Compe-nso!ion t:1suronce. f further ogr"e to ho:d the City of Garde" Grov" free and harmless from any lia. biit~y at,sing out o' irtj:.:ry or bodily damage resulting from work per~ formed relevant to this~er=it.
CONTRACTORS SIGN BELOW
OWN~R-BUILOO::JI SIGN BElOW I certif0· that I am exempt from the provisions of Ch. 9, Oiv. 3, B and P. Code (Corttractor's liccn'" !ow) because (c .... ck one): lJ I om lhe owner of the cbove proper1y and .... m penanally p~rform ,...,
eb;:)'V~ work,
0 l om the owner c f the obo,·e c>roperty and I w;lt contract to hove all of the above work penorm"d by licensed contractors.
lJ I om !he owner of the above properllf and will. employ penon1 to ?<'•· farm tl,e above work woth wages ns their sole camp~nsntion. I w1ll ''""''h insurance for my employees as r~ ;uired by the lubor ('ode of California.
- ---1 - .. By-·--·-.. ------=--Own~,·, s~gn"1h.l't' Au1~orwtt.l A41Pnt Date If wo1 ·.< i• not started within 120 do~·s from dot~ "' iuvo: or if <>h-.,•d>•'·.·d lot r ,,,~ thtm 120 days, thos p~rmit woll be nul.l and ·o10id.
; 00 FEE MAY SE CHo\RGEO FOR FIE·INSPECT:::~tO"N''""'"o~ .. ~U,-::F.',.-::T~O~ ;,'1FNCE, iNCOMr \..E:TI: \,.,~RK, 01~ fAIL.URE TO MAKE -r--------":::-"-t-··-if·-=·=B.i'.~.t!.Q..~--. - ----· ~..--:..~~-··-----------1
·-·------·· ··--·--~~-.;.;..;~~~----·-·---.. ;:;:7-·;---~~V\ll!i~~~~"Not
AOOIUSI
Public W'lrks & Development - Garden Grove. Ca. Inspection 638·6771
LATH OR DRYWALL
PLAS. BROWN CT.
SOUND INSULATION
OAT£
I. I,.~SI'EC'TO~
lnform:~tion 638·66G 1
t ISSLIAN
TOTAL
I certif:< tha1 I have r~ad !h.s applico1ion or.d state that >he abo"" informcfion is correct. J agre-e to comp!l fO ail City Ordinances and State loYwS reloting ';Q bui1ding construction. r cerrif·{ 1hot· in the performance of the obove wor'ic t shall net emp;~-,· .::'II"'Y person in violation of the lobor Code of Cr~:fornia relating 10 \.•.crkmon's Comper.sa~ion l:1suronce. I fur1ilcr ogr-~e to h':l:d -:he City ~f Gorder, (-..rev!' free ond harmii!SS from on;• ltabii,,y wising O\,;t o' in~( .. .:r..- or bodily damoge res.uhjng from wo1k perfcrmed r~levont to thislJerT~i'
CONTRACTORS SIGN BElOW
QV;NER·BUil0":11 SIGN BElOW I cerr>f-,· that I om exempt from 1he pravitions of Ch. 9, Oiv, 3. & ond P. Code (Cou:rc("tor·s- ticcn~~ l.ow) becous~ (check on~): 1:"j ' om ~he owner of ~he cbove p,..openy and wilt personollt pt.:'rform the
"b:>Ve WO!k,
::J l om the owner < f th<> above property and I waJ contract to hove oil of the above work p!'rf armed b., licensed contro(tors.
Q I em the owner of th~ above propertr and .,..;Jt employ pN$0"' t., PN· form tJ..e cbov~ work wtrh wages n!- th~;r sole c:omJ:c-nsntion. ' w,a h . .-rt\l~h in,urance for my employees as. r~ ;vi red by 'he hJbor (ode of CofHornio~
R ~\OORfSS
7/25/80 LETTER OF EXPIRATION
<,
...... , .
CtTV OP GARDIN GROVE Puilltc Watkt • Development
~-........ .. ELECTRICAL PERMIT
.-.INSPECTION R£CC!-qo FEES
l
lnt9fCUon .......,.. ~~~-1771
a...t•••• .•.• .... , For Applicant to Fill in
F~ .L t ,.~J\·a. sf ii\/li;·f-T>t?t ·"!'1 i~ii{"T";"(ifT---·--·---- -jj;'""N'rni$Tromow+;;O, £A. FILE Ji\DDRIEIS Sll:IE COOl
,,,.,111 ~·HN:;~:~';iv~<:t ,;l;>t~'~ ~~~.;;~; TT4 w .. :,'Ti ~J1
:t·Ffc',:1 fi;;jd;;l.,_l}f.l:;-rA-3)·;. ft~---~:~~~ .. ---- ·---··------ ---- L.OT ~f-~~ ~f-:~~~rNor_!~~.f~~(-" ..
r.
'- AP't"Ft~~:~~~-T---·. ";~L;~'-~----, ;~~;~-;;~:~~~- --------- l___ - -'-~ .• , Untwr~r=~~.:· .I I_ ----- Aco -~HON~
r OWNIER'I ADDRIESS CITY -Conrh.Ht
---1-·------+---:~~.;.~~~·:~E~ff ~~~~~~~~~~~~~ .. :IH·· .. :~ r~~':U;:'.:'::'"' :=~~~~
-·----+---- SQ, 1".:1 . "Q· P'~ fi (~ ... ---~-- -- --~--· VALIDATION --.ll~~~~;.~~-· ------ LJIC'
WtTiflq Rmnltl
~.,._:ltet
~--.-----------'
----+-----· , ...
FL~tures ~ Trmt ------1------J---.......... ~- ~ss.~;.if.::-: J.(t. ·JU Woshcr __ (:HE · , .f:~ ,. : _ • (!(i
Moton ·--~--------·---------!---
ITATIE LIC. NO. • TVf11f Dryer += · .J ELECTRICAL CONTRAC1"0R hot Water Heaters •
- Dishwasher ' -- 7'-ok/t- r_ ;A? c1-S 4l".. I~ :z ?..r7..:l .. c /t!J Domutic Range or Oven I ADDRESS CITY PHONE
t------ -- ---+ ~~osal I ___ ~/j/? f. /~ ~~# ,d:/~r4-'Y' ~.Jt1 -4~6.3 I + -+ Powar Apparatus--H.P., K.W. or -- --------- ---------- -- K.V.A. Motors. Tt'ansformers, etc. WORKER'SCOMPENS,,TION REQUIREMENTS
t--· -··--·---
f--
~-----~-----
I-=..".::._1L~Iot Over 10 each
-.q~--o [Not Over1 oec-h f{,; J/ _/? 3 ---+------
_____ ------ --+- -------- ------~~~~-~;~:~\:Over 30 oach ~-~--~-~-~ [C c)
-·---- --!----.---.. ·--·-·--
!'o:n"::'"-~~-- ..... . ... ---y=1=-:__r-- ~---r·--1 i~~oku~-- ----- ~-·~--~--:--·-t=J~--~~-~----r==
State Compenution ~ 1.3: 7" / _7 ,.g_ -/¥-? .J lnsuranog Polley o\Jo.':Z.::i :J Expirati.Jn De . 0 I cermy that in th• P•rformance of the work for which this perm" Ia
i11u•d. I shl.lll not t~mpl?y any penon in eny l,;aniHII' .a as to b«ome 1ubjeet tO tho Worker's Compenwtlon laws of ::"allfornilll.
NOTE: i I, attar mak inij such certlflcatfl, tht applicant for ttle !)tim it should b~~eoma subject to the Workor's Comp•nutlon provJ.io,. ol this code, he shall forthwith comply with the provisions of Se<:uon 3700 or his permlt shill! b• dettmltd rtt~okerl.
:J I cl!rtify that I haW. n>od thl1 appl!cetion end sute that the eb011e •11-formatlon Is correct. l agree to comply with ell City ordinance~ en•,; Stat• laws relating to pending conatructlon. I further agree to he;.;<J the City of Ger<Jen Grove frH •••d harm I ... from eny liability «it· ing out of injury or bodify rlamaiJtl resulting from work parforrned
• '
~
;,
!JfM relevant to this permit. ;,. o • f. '. ·~~12.77-- · //-o ... • -- - ·- _____., _____ :_: ___ +--:_ ___
~_!tHi:t;t;:;IJLICANT SIGNA'tUfl. IJ.,.--t=='"' +::----:- =~-r ~ A .u ...... TAX CER····c··· ··oo·M~~
-;;;NAt 1 ... - _ __,. • ~) ____ ~= -~;~~~~,F~;"~f~~~:;!. ... ~---~---------~-'1 ~----'?j~~~- ___ I_TEM ~---.~-- ___ coo~...... FEEC '"'""T) cotnowcTo~ I•~':."~J¥~~~~~:i~ UTa f'lan Astention Feo lut,;,,, Not•'•~d l
!DE;NTfFICA"TION CODE Permit ---------- - r -----1 ----·~T - ~~------ ~;;:;;~~;--------- ---·~~-----t-r"-1--r-= l I ----- ----~ -~---- ___ J
f.i"•.J1UJHI0 ii.- nnuf *~f_;,-[,ir~rf PI-R61!1f~,.r,,:~~-J-:_.,V~Hr ,~F.JiT:_:_Ai;""'~-_ C{;oN(J. "'-"MIT riC.. ~------- ---A:-:-:UT:::H~O::::~::'I:':z:'! .. ":a~U~Y::-'_...J. __ .:;....J,....J __ ~
--LAND-u;~--~-UILOI,.,.a~ oo\'tc.
if work i• nfJ!-;;;;;,.;,:;-;:~hin 120 d;;; ftotn da~• uf iuue 0' li-. ~ _, , (~ __ ;.~:'111n..J. lor =~r• tl!sn 120 d8YI, thll p.,mlt will be ~~i~-"nd , ·~ j// -~ -lb(.
LJ: :loi .:•c' L _,,
f-.--
.USINCSI· TAX C5:"TII"ICA'T~ HO. .JilPIRATION DATt
I certify that I am exempt from Sec:tion 7031.$ of the 8u11n- •rid Profea•lonel Code, Division 3, Chapter 9, Contra<:ton' Llcenw 1.-. ur1der the following Section: Own~r: Section 7044 C Minor work ut>det 1.100: Stctlon 7041 L1 Ernp:oyH working for w11ges only: Section 70153 0 Oth""--------------------------
1,.,.,,.,., ,. .. o ... at.-T~OWNW" fii•~=;,~::Jo-:.,r::"",.:.~'"•" •• ,..
~E~CFaE~~~. ~~=-c-;g:;;::-_;-,-#;;-L;;~::::~..,~~o:-w.,~,-;o:::-,,..A~K-, ~r::,~t..,~t:~:N~'~~"';.t:~~,'-~cu:.t ,_'1':1611:'1:. N~TO·.,.o:::out-n~,....tO_.. r~ CQBRECTIQN$. -·-· ~·
·ELECTRICAL PERMIT DliVELOPMENT SERVICES DEPARTMENT
===G=A=R,,_D.,~" GROVE, CALIF. 638·6771
2.00
2.00
I .20
I I .20
1.00 I I
I 2.00 I 2.00
l 2.00
I 2.00 I 2.00 I
2.00 I I !
11.50 I
INSTRUCTION! USE TVPE\iiii'ITEA 01~ I!IIALL I"OINT I'EN, PIIIII:U FIRMLY, Ill! 51HH: ALL COI"IFS ARE Lt:GIBLE, NO ERAIUA£1 PE~IMITTEo. A OOU8LE FEE WILL IE CHARGED IF WORK IS 51'.4RTED BEFORE PERMIT IS ISSUED. !PLEASE PRINT!
ELECTRIC Pf.RMIT NO.
I !
2 I --------------4----·4-----~---+-----1
CITY OF GARDEN GROVE
Bu11d1ng-Zon1ng Division SIGN FIELD CHECK
ADDRESS: ~_A~ ~· CONTRACTOR;== 2?1u.<:1 · (Jk. ~f::'JI. OWNER:_~~
PERf.1IT NO. 0 'lf) Jl) Y: ,tji.,
DATE: 3-Z.-77
PHONE: 'f1f-t t, z,(
RECEIVED BY: ~r.f&IQ-f"f----
{BUILDING) OR (LOT) FRONTAGE: ------- ZONE: ------
Z.A. APPROVAL REQUIRED:------ALLOWABLE SIGN AREA:------
EXISTING SIGNS:
TYPE
1-~-2. ______ _
3. _____ _
4.
5.
6.------TOTAL
COMBINED TOTAL:
AREA
PROPOSED SIGNS:
TYPE ~ ~~ AREA
7. ~~~l&'dt£) 8.-----9.-----
10.
11.-----
12.------
TOTAL
AMOUNT OVER OR UNDER: --------- ----------COI<ttENTS: Signs Nl ) , ( ), ( ) erected prior to issua~ of permit.
( ) Property owner's approval required for pole sign.
( ) Spaeing between pole signs N( ) and I( l inadequate.
{ .. ) MttJ;£rials of signs f( ) 1 ( ); ( ) do not meet code.
(APPROVED) (DENIED) BY: ---·---------... -----
BZ-000.1-Rev 9/75
P.C. ;f/ OCCUPANCY
US£ ZONE
Ctt'Y OF GARDEN GROVE Public Works & Development
.. BUILDING PERMIT
INSPECTION RECORD
APPROVAL
I FIRE ;eavProj.l b i l I . 'I I r ••• T ~ I zoNE t ~--~--~- -- .,a,·::::JoooF ::o.J AD< CONCRETE FLOO_R u ~--= r_:__
PLANNING ACTICJN
ST. RC~:O
·WATE"' 'SOND
lntpeetion R~ ilS-6771
a..-.. • ,. • ...,.., 638-fte1
For Applicant to Fill in
; ~-,ATE-~ ~-Ss!\n FEE \ACRG.! ·T__ 7 I WOR~ER'S COMPENS~TION REQUIRE~ENTS 1 6"""2~- -, ""' 6' .::S I Sit dbv _ ~ - ' St- Compensatoon :WATER .._SSMT. FEE fFT.)
·PARK\\_,Y TREE FEE ....___ PA?<:!; REC. FEE fOIST.
~ranee Policy No. Expiration Date certify that in the performance of the work for which this permit is
IS$Ued, I shall not employ any person In any manner so as to become subject to the Worker's Compensation la;n of California •
~lOTE: If, aher ma~ing such certlfioate, the applicant for the permit should become subject to tht Worker's Compensation provisions of this code, he shall forthwith comply with the provisions of Section
)( :noo or h:s permit •hall be deemed revoked. I certify that I h.ve reed this application and state that t:,e 8bove ;n. c-----------------+1--·--..----------1 formation is correct. I agr" to comply with all Ci'!V ordinanca an..1
C.~ A~!'• ASS~'T. FEE fO!ST.
~ Pl.A" ";ETENT!O!'.. FEE
~ 8LGS ?!..AN CH~CK
BL:J:;. ;;l£q~ ... ~C7 Ft.:.E
rss:...~-:.\.CE
!~ ' "
State 1-. relating to pending construction. I further AGfH to hold the CitY of Garden Grove frN •nd harm I- from any ; lability ariting O'!J of injury or bodily ~amage •nulting from work performed r~l~tAJ this
CPtUN'fJ ""O..,.IITV awN•" I•••!!!T!f'.!'~-"-'!!!!" ..... "-Y-c.?,~Nitt
STORIES-
NO. Of" OWELUNG
UNITS
If work is nl)t ''arted witrtin 120 days f•om date of i-.oe or •! _ abandonee! for more <han 120 dav•. th11 r>erm•t will be null Mid -void.
A FEE MAYSE NEGLIGENC:<i,INCOMPlETE WORK. OR i'AtLU CO RR ECT!ONS.
RELOCATION
CITY OF GARDEN GROVE Public Works & Development
· INSPECTION RECORD
ELECTRICAL PERMIT FEES
rst!\;(il:; PHAS: SER\l!CE S~Z'E
f _.:..·~;rs \/Q!.... TS
! TH1=1EE ?HAS= SE:lVtCESIZE = 3Wwe
] OH 1 IF NOT LISTED BELOW I NO. I EA. I FEE I SEE COOE
RIG. CONDUIT -~.:.:'4\'Ne Uuo~R-3lsq.ft. I -r I Garage, Resid. (M} SQ. ft.
,_jUG
Inspection Requests 638·6771
General lnfornwtion 638-6661
For Applicant to Fill '" ADDRESS
:?Ao/ ~~~ .~/2(.1//~ RIG. CONDUIT -·JOL IS
L.OT NO. BLK NO. TRACT N0.
1
'ifrCTIIIC. I'«RMIT NO. •
Service Meter. Single Pha;e ! I . •
Service Meter, Three Phase j C:.WNER L_ J f ,.IJ 4tl ~ O:.M?S
r----- ~ -· OATr 1 1 APPROVAL INSPECTOR
Add'! Meter, Tl.ree Phase J TemporaryPowe•Po!e , I . j H/Z~C.. ~/.C.I'¥'//,..c;zz:}
r--·----1 U;-nj:~ .. :'!!''JU~~
I i I I CITY i Pole, Power, Ligh1, etc. l Ccc:O:J •
OWNER'S ADDRESS
ISut>-Panels 1 ¢ ·--------~-----r
: ;·; • :c:: R.-,.;.~ l Sub-Pa"lels:; ¢ j -t--,... l Outlets -j 1 1 ______ ;..._ __
-·~cw f.IUr!..OJNG OR ~l:.'ll~'l'!~C. l'o!..Jfl.Ot"v1:;. 1'-iC:.-.iP,I.•,~-; 1 -,..i~ -;;;F Hv-A;.--.. .. .-~..-:;; I AQOtTIQ!"o • /I.AE... A£-iCOC:i.. ·~£.A :-4uc;.w,.,. ; ::::rtf' l'ru~u£~":111' :..~1""!~
; ~-=-a~5:-
: ~<:(!:..;"es & ... -~
~ ~?~!C7'S
, \J'!'.:::r
Se,.--.. -
,-----·-----1 Fixtttre-s i i --+--1 F · .. ------..L -+--1 lxtures. M£:rc. Ouartz. etc. -- l ;--· ------
I ·.
SQ.,:~' :h!e~ 0 ~ .
VALIDATION ·---- ~& SQ. FT.
[i Heater--Not o-.er 1650 w ' I i . --r-----r--:, Was.,er J 1 I ;
---~ro-ryer , ~--+~-----r--· EL.ECT~It::AL. CONTRACTC•R ------. ~ I Hot Water Hea~ers __l__ j . j I I ~
Dishwast<er I + . STA"''E LIC. NO.6: TYPE
~cli:/&:tt.t~,~,~ : ;1/j'&/->:zfl·-o-/~7
T I
---
Over 1, Net Cver 10 each __L_ i I ! f'()' 10 No• Over 30 each ' I ~r,. \! ' -+------ 'lndv. CircuiT; --t-----:- ! d
__ _;i-neCl.xk --r- 1j ; ? ~ ----- 1 S•gn __ __ ___ ___ -t- J. i ~ -m
' f's;g~ Hookuo j / ;
I
+ I I I I
ADDRESS . _/_ . / C1~V JP'HONE
(/JUTf : .
&7s:&.l~ 5.1'- ~4- ·~:ft-.E~ I
WORKER'S COMPENSATION REQUIREMENTS State Compensatiol' ~r•nee Policy No. Expiration Oa·te ~ ~ c•rtify that in th• per'formanr.:e of th• wOf'k 11cr whith thil perrr.1t •s
iuued .. 1 shaft not "me loy anv person in IMV rna,..,., so .u, to become subject to the Work~r·~ Gompensa!lon JiiwS cf Calitorr~'•·
NOTE: If, aftor mat.;:rn; su~h (:~rtif:r:a"!'!, '!h~ ~Oift'3~1 for tl~e c~~t~ st:oulo becor't'le !Ub}ee:t to \he Wo~Jr.sr s CG.,:::ensation r.'"._:I'.ISrC!"'.S Of thiS COde, h~ Shall '!Orthli•Jith t::cmpll{ ;,.•.ri~"i t~t' PrOVI!liOflS G~ s~~J!Jl"' 3700 or his permit sh.;ll bo dnom~ rowe•. c-o
l'\1. t certifv that 1 have ruu this apph~•tion afl:d stato that th• a!J~v.o '~ J'f tormatton is corre<:! 1 •gr&• to con~OI\ wa~l"l all Cttv oralnanc.s Atl.:l St•t• ltws relating to pending constr~,.,c:tion. i futthtr agr•• t:o hold tn• CitY of Garden Grove~'" •no n .. :-nl- trcm any liebility ...... ing out of injury or boaily c!ame;e rHYi'ting from wor~ 1:>..-formad ••• t tu this Permit. • ,... ..J~:.I'1
. .J/ ..:i.-/7 -,&, -z~~~~.~~~~~M~I~T~At. •• ~L~I~C~A~h~~.~.,~~~T~u~R--R-------- OAT~
FINAl I 1-.,,.,=,.-""'---""'-...,-"'"'· ....... .,._ .......,.....,.....,.....,J,.~-=-4====b:=-l r..U.':£-;/ii'f!-~~- -..,6.,4-!:.ooj~~"""":M!:!~ ITeM "
l;:.':~.; :'">._- .. ! '?,:~ ---- -- ....... ~------~-~--au§ll'fE5S t'AX C~~Tl.-tCATI. r.o~ ~-XPt!lliA'\ION DATE
~--------;-:-::::::::-::-:::-:-.::-::-:--:~----------~~~~:_::~- I ctitify that I •m el<ampt from S-.;t;on 7031.5 of the Bu•inotU and IDENTIFICATION CODE jPerrnit Profnsional Code, D>v•sion 3, Chapter 9. Co.,tractort' l.icanH Law. -----.... , --·,----· --"-" ---r- under the followin(! Section: . • 1 : ! Issuance 01/'on..,.: Section 7044;:] Minor wo•~ under }!00: Sotction 7£'48 ~]
1 Emoloyre working for wa90 o!'ly: Section 7053 !...J
:..~--~--cc-~~~ .. ~- --' ------ -.--.~~· -- .............. , TOTAL FEES I J 21c:-;) 0 IJ:.J!l..-=-;"~,-:.... ·1:-~~p~-~~--;:-;;:~·~ 1 Vf:HT_ ~f"tr:•-.,;.-:_---.--;u~·--1 ! -.... J _-
1 , , j-C:O .. lO. P!:l!!!''ll}f!l' ~iO, --- ~ {- _,;,
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TYPE O'ea;r Ap;:J'::c: · · ·- / .· Date _______________ ·_=_ _ _:___c:. Before yo0 .. a::;:J',:. :~'")~>for <1 Busiov.-:.s Operatron Tax Certrfi.:;a~e c~n he processed, r: IS necessarf t'J ver~~y that your b'Js:ness win be cor.du~ed.
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APPROVAL DENIAL ,~-~
Ct'ler Plar'' -~ kl;ons ReqUired: - '\C YES
TYPE ---------Date------------
Bef:>r1: yc~c <i?p:.:a•,:-:n fcc a: Busi"'ess O;:Jeration- Tax C'el1iffcate can be processed. it is r;ecessary to verity that your business wl!l be conducted i:~e;~cocd:i':::r"· -r;.ti:r the pro-,i:;icns. c' th'. Gardsn Gro•;e Municipal Code. iN ORDER TO PROCESS your certificate, please answe• the que~~ior.s be:'ow a·,:! ·'":·:;rn m~ f:~:rr: al·::;~rJ 'fiith· 10~ a;J~Iication'. Thank you for your cooperation in this mattec. Ffe.'!'-><: P"'"'' ''"T~ij' . /?' Q· .,-,. _ /1 C/) Qz.t# B:;s:r.·s::.•, A:c·J:.-,·,c_ foo:l O',;;:<>N!p f.;;-.t2'l>'C' .. __ _l::;~,.,;L!_~ ___ _(.:::;!Jj?!}_E~_f,;;;.f?!i!'C'. ______ Unit/Su1te --~--------Cu::.;t:rr:.:-::'~ r~ra,: ..... ~:.r /:"lrt'r.e-,:--J. W~ a6r:.:r:;.::__ ··-·-----·------------------B~si~;<;~s r :a C" s- · f'IJ P £ C i r.tH.J _ ti!::._C:c:."'f:iBL __ c£. G/IR!J§LL_ GtSc."'C!Jic _____ -:--=-o.-mM·s H-,~:s- l'::J:!rr.,:c- ~ofc- PO: Bllx)' _ .. :J..f:Z3 ____ _&_y;&_0.J). __ j'!J.Jl!;.ff __ _£i,f-_(C-:A'.ft'LL C/) Cf2L~-i---------.C 4.3U.L4:3_ ____ _ S~ar& Cc.:t~ta:.t':I;1 .. S LJC:E::IS'<~· r-turnbet- -·----~· ~~-,·-~--,--------·---------·--- Class-R•nS'ic: r:·"·,-:~;•::· !:;'!\' c/1 :Jk--:-.'/S._tE/£ijr--- Total square footage of praoosed use ___ lj/r.J_~.::?._~~'C-.-,_...:54_£.C __
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CfTY OF GARDEN GROVE, CALIFORNIA ~ ...... ··~-
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Office Use Only Zone __ .;__;___:___:_' -----
_,;'\~APPROVAl- ; ~ DENIAL Re•. awed by .
Orher Plann,ng: Ac: ens Require-d: ~ ~;C YES
TYPE ... / . De~~ hr,:_::J::->!'' Date ---··-- .. ···---------~ ---~
Bernte yD:Y ~;j;:-;. ~. 7:~·::::", t;.:- a ELY,i:1 ;-:.:-.s OjJe:·ctrJ:---. Ta1 C&l'tit,.-;.::~e can he pmcessed. it !5 necessa:)' t') ver,fy that your bus1r.ess \',nil be conducted !:rll a!:tt:;;:,_-J',~!·i :-:. ii'r;; ;.:~:J :r::.! -,-~:-. n: n~ .. ;~ G:::·c:;r. Gro ~·t: ~-~-IJ.'l.!C:r~Ja! Coae: li~- OR~ER TO PROCESS yc~r cer1\ficate, p~ease ar.s·Ner the quest~ons
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CITY OF GARDEN GROVE, CALIFORNIA Office Use Only Zone ----~ __ ::_____ ____ _
APPROVAL _ DENIAL RevreY.ed by _____ .. O!her Pla~nt~~ .l.::t.ons Requrred:
- r-.o YES '·- .. ~~ .. "
TYPE Date-----------
Bef(;re yc~r a;;p:.=a~rc:n foe" Business Operation Tax Certificate can be processed. it is r;ecessary to verify that your business wrll be conducted r~r <'<U'ard'<'<r>~~- .~;i:iir the proc:i'sions c' th'. Ga1de~ Grove M~nicipa! Code. IN ORDER TO PROCESS your certificate, please answe' the que~ions !:Je:cr/l ar1~.! :e~..lrrr~ th:: fc~m aronq '/~ith. ':lJJU application~ Thank. you for your cooperation in this ma!!e~. Frea.,,: P~·~·· ·~c,b'.f. , , /? ·'J Cl} tlu:# 8!Js:~s·:s kJ'·Jv,-,s 9oo1 a~~'/JE.!LG.!l£J~'i';_{]_"-!/JJ. __ yll!20tj~~!l~--- Unit/Suite __ ..,,.,..- ------8tUS:~-:;~_,..-j. r/;t\':;.-;1 f:-Jdr.es:)· _ W.. uf:u:.s;.~ ~··----,·-·-·--------::-;-8!JSC:l'!'>S· rlac-nr; fill"£:. C ... _]t.<N~_t/f?. ____ t1:;__?{_'fEl__()__£_ G/l/2fJE}( &dQJ/.c _____ -,---=-o.·mer·~ H-.·c.e F.1dr8SS (:N;:; P.O Box) _ __ 2_ji( 3.-~.'i.J1Lt?U!. {?t flt,' E____fr,__<,_t.£.:_/2 If. N C!} q 2.(/~-~------Ow<Ter'<i· Dr· ie~·s Lr-;ensf: rl'r;m~e; _ .C __ 4_3_t;.C.L4!1_ __________ -----·---State Cc.'~~"a~rD(s L1C'e:1se r:~um!:)er- --------~- .. --------------- Cl~ss --------------·------R-;r;ai'e r; '"·~''' Gl\' £/? '2?~8-ik-tD.Ir--·- Total square footage of praoosed use _(}J,c.4~ :2. ~~_£c___
'!:ype ol t;-.:. "'''-',. ih'rs is a: O~ffu>~~· o·\~:y R·er.~;:- 11 ,..-;>:::·~
: .. New b. ;;iress. rn Garden Grove 9usiness name char;ge (p~evtous name)
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W::i: rr,:;r,;,· ~r! 2'1-)' pmce:~-. r1a~·:J::mg: .. m swmge invol\iin{Jl hazard'or.JS maferials. as 9tated ;,., Ga~~:r::·1"': C::r~:J·J~~· M~J,n:·r.:-~;J'a;. c·od1C!' ti.~"Z?'
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~- Wr:t• rrre.-u i:Je: HSB o: ';:o:a']:e 141 more tltratt~ S gar:·ons• of trammal:lle> !:quia' of any type?' (flash poin1 below 100°F) 5 ~ .. Jr:::' r~·:-~~re ~'Jr-1 U:1u.r~~:"1'g .. ~!h·api:i'g o~ ~;ra1 ::r[f:rfi:Jl o~ w~:rod w··~X~o·c;:ntl: prod'rutl:t.r..? 6 <~I W::'.i mNe tJe dr.~'r,rrg~ .. dan~ii!T-Q1 .. e~re;rairrme,;;tt or a-.'lsembl\:fge· or pem-on:;?
lb» V•i1.',! r;::t.:.Jpe::rr~. l'!r.~.:;-1 !te g:rre·arer: ffft'ra)rm 4~ perrs,::rm-51.' 7 w,:,, t''"'"'' ~.-, ,-_~;;;a·;w Qn ma:re,:i·a.f!;. exceea:r:rg fZ feet rn· heigh~ or tire sroragA· over 6' leer rn .. eig.~t?
':J(ii he·e b'! r:,;n,; of ~ei1Ti'cler;: b·e:yo,;;ot tire ~imple excM11ge· of parrs.? r~ Ha~; ell) ... !~;.,J.',:!' ''l:~~ f:\/f:~ b,r;·r:~'iTll u;;ed ~.$· ~ ga.:·o!mtr S·(fr"'iiJCe~ r;faftorr?' '} W,:J )i(J.'II C;c: r,.": .. rl'(J 8r c,~r~·tMI:~ m<!te-ri~!. (mC>\1:8S·- i:lo<.Jks:- ;,,deO)' depi-::trng cpecifrEld ana:om:r:a~ area,, o'
<:P.~j_,,; '''-~:"'!- (lg,,,.,, Gad<J,nl Grvve Mt!llqra:i c·ade 92'f6C.3> fo~ del::~irtos)' :1; W.::i ::1' it\';,"'' e,mp:·CJ'/Hf:S o~ ''o"';se:~ mod'e:i!ITgJ orc ,-n~erraining for· someone· (customers) nude or partially nude, e:thu; at
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Office Use Only Zone-~~_::_-~_'_;_-_____ _
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CITY OF GARDEN GROVE, CALIFORNIA 1 .~ Ff. f~
;~~: Re\ ewed by ___ _:___, _______ _ - - . ~'!J;.'J..- Other Pla~n!n~ Ac!·C!"lS Requi:-ed:
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a·e~ore ~"J'Y a.~;iJ. ~;-~··,' .. ··,fer a B;;cJi:-F:ss O;;erario:-1 Ta:.-: Ce~"tlfl.-:;;:re c::an he processed, it rs necessar;' r-:; ve~ffy that your bus1::ess will be conducted r:11 ar:~~}:J:-cfa"L:> ·.~ .. : ·:· m··: ;.:~~-~'~'1.~ :1T. o: q-.:: narae:r-j' Gro-~·e: r.1urw;opa: CodG. JN ORDER TO PROCESS ycur certJtcate, p:ease ar.s'/J€r the questions tra:'c'-~..: .:-:.rd ~~:;:...,.-r :l'i.:.- f:J.~,-r; ar-~nJ .,,.i:n· y;:;:~~ 8.pr .. :::8ti:J:'l. Thar.i-: yoJ- for yoJr cooperation in !h1s ma:ter. .·.~- / L
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County of Orange HEALTH CARE AGENCY
PUBLIC HEALTH SERVICES I:NVIflONMEN fAL Hi:)oL r.., (.)I'J,SII:JI•
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June 7, 1989
l•lr. C.T. Fuikerson ARGO Petro 1 eum Prodtlcts 17315 Studebaker Road Cer:itos. CA 90701
SANTA A~IA, CALIF'OPNIAo um.~; (714) 834•d,J~-€·
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Subject: Soil and Groundwater Contaminat~on Locate1 at ARGO Station, 9001 . .,Qarq~!!_ Grove Blvd., Garden Gr•ove. Ca1ifor•nia, O.C.H.C.A. Site I¥8'9UT97.
Dear Mr. Fulkerson:
Saseo on inspections and field tests condr,:cted on :·:"Jy 23, l9e9 it hils br.~cn determined that gasoline contaminated soii and grount;\ldter are pr·escnt at the subJect location.
This Agency is authorized to enforce the State Hazardous Waste and Under ground Storage Tank Laws and Regulations and, under contract with the St~b~
l~atet Resources Control Soard, is responsible for cversight of cleanup ot soii. and ';p·ound water co11tarnination 1'esul~in:; from unauthor'L!:ed r'.:lt:.l5e~;
fr'o:71 und~~·gr•ounrl stor.ase tanks. By this ·etter·, you ar•e 1irected tu cundtll,t an irwestigation to assess tne extent and signific:~:Jv; of contaminatlon ell.
the site specified in the subject above.
The Jbjective of this site investigation :s to pr0vide sulficient information to svalu,'lte 1) U:e sensitivity of tr1f2 sit\?. 2J th,; potJntia\ thr-eat of e~pos~re to humans. 3; remedial acticns and/or l"ternative mltigatio~ str~d~.'-;gi .;;;; .
At a mini::1um this inve5::;gation sl1ou1d 1n~'tJdc:
l. A :'ear· delinea~)~;n of th~ f\atur'f1 a~~:! extet:t :f st.i1 JtlG •3r'ounc •dt~r· G jt', tJiill t)(l t i I.) I\,
2. A r~:,rdr'O\lt!IJlooica·, ciiat'acttir'i::.aticn H:c1udin~ ~";;til to 'JI'~und .~a'::e. an.:1. if ground ·,·,at~r· is contamitiil~·2~. site 51Je~1fic: detcdninati '' ;.i grcJnd water graJient.
j, Th(, Pl'lHdndt•,t t·~ -~~115 Hid SW'I'Oun~:f·;] lan,c; ltS•.:s~ Jrld fuLh.: JSL' cf
thu site ~~~~lf .
..: ·tJ;,~ prJtential ir.~:JGt.;; ot ·~ontJI;Jin,l'::;.~~~ to put '- t1c1~tll Jrd t:1·:.: •.;t1,it"Of1int;nt, inc·:.I•J:ng th"" p:~tb.wt:,· tor• ~~ll1t:: .. :o'H'"t v.Jc .. ;r· mt'jr'C!ti·);~
J r1 ~: tliitTiiJtl \~1\fJiJS!.<,·\; by j lllioJ l c1 t: 1 otl,
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;.>:•eas~ nut~J Vllt :~lui.ttilfl~.;: •:t :;tt·..: ~r·ve:.;r. .• :;atl~Jn, :"'c~ry~·Juttjofi jr ·~nu.H" m1t·~
:Fstwn actHi td: .. by 1r1y ;l't!H~I' l'Jt~fll../ lj(if.!~ n•;t -;()nS! ~ . .Jtl~ <.!u .... sn·~\t te~m tnt: Orange ~~~)t1i1ty Ht!iJ I ttl c ,·,: At.;2f!t;/. Th·.~ r;~ i i fm''l l :lf.:! i ttl lrhl ~Htrt1 :.:HW, S~ction ,Z5;:::J8 ,t:)(4i f'f:JqUit'!.!!i that 1.1 Ll(!rr,un ';'lo!>Hl',l !ri OIHi'~f'')f':;ur:·~ :.t:.;J't>j~• tank: (1emon.str,:ac to the OrJrl'cJ!! C:0tmt; H(:l;; ., th ':are ,'\iJt"·,c;; that ':!\e:~'! ~ .~ ·:u ~:gnHicant so'l cont,1m111ation. SignH·i··~nt :.:~.mtamtl~at<un ::hiJti!!: fl:~ :.tl•• ~~:>:(.~:ss l-ifetime cancer risk du(> t.:.; inha;d.' .. t> ot· va~;:.:;:. ttr•n \lv· .H' o~: ,,.1rH.l!'i .. ir.ants, both insi'de and out!>ide r;ui'lding!i.. ri~j.: ,:;;;;;;c~::.I1Jcnt .;t H..:v'' t.!.>;p,;~,,u··· ~nus t be cornpl eted and approvM 0)' UH ~ :, ; ~~-l for ~: :. pr'j,J!H~ t:. 11n ~· ~ "HHJ a change in l~nd use.
Tne California Code of Regulations, litlo 23, Subch~~ter lG. Su~~!on 2b~.! require::; th-1 t the fo 11 o~oii n9 i nhrr.ta t·i on be rt~pr;rtud t:;, ~.he I o;;J1 ~~;~ncy l!\lt: ·y t~ree (3) months until cleanup is complete:
1. The results of all lnvest~gations completed a~ tnat ttme to determine t.h'! extent of soi ·1 or ground water f.Jt' surface ·..,ater cor~ta111 :~ati on Jw~ to the r"e1ea$e.
2. Method of cleanup irnp1erner.ted to ddte, pr"cpcsed ~ lean,m ,l,.:t~ ;:,ns. and approximate cost of actions taken to date.
3. Method and 'location of dhposal of the relea~d !1a::a;dm1s s:,J;;>$tance and any cont<uni na ted soi 1 s or ground Hater c,· ::,;wfa ct:! ~I.J t.;f· ,, i ndi Gil h• ~lhether a hazardous 11aste ::JanHest(si ;s uti< zc~ll.
Violation of these requirements ate subject to a c1~1. penalt~ ot ;p to f1ve T~ousand Dollars ($5.000.00} per day.
Guidelines fH"oviding further irtfJrmation .·eiH1ng L :,ite d~i'j;;,;~;:,··~·lt Jlld t~~ie s·:te investig.:~tion objective5 are ;wa.lJt:;l" u~·.r ··~c<Je!>t. ·'i't"hltll1h nnt re:jui,"ed, an initial ~IOr'kplan or study ctesi~:r1 may ~,'c :;<bmitt~!! h tllis 1\\jt'l1• y fer r'eviel'l and comment. Pleilse note tha~ for· Si~.:~ .ntll po·;~;1>;·"~ .~:· cc111 !l'llh:rJ J''oundwater contar~ino.tion; copie.i. of ·1; l ccr···(JS;JI_;r ~'-r~'..:. ~1ur% ,_'1J.r-s, ct11!1 !',.::,ml't.s ShJula be routinely cour·>:esj' copierj b the ~~·~·topr"idt';.; 'le,;·unill H •. 1lc1' c~oa1ity ConUci BoMd. tt you ~.-He J!lj QUfc:itb•r:i. v'::o~·~ cunt.•<t ":e Jt Ul·l) e::4~7920.
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CITY OF OAADI!N OAOVI!, CALI,OANIA D•v•loprnent l•rvlcu Oe~artm•nt
PUMIT NO. Type l t::
:U/0~/91.
21M2
In 6 p • c t u r il t' 11 a 1
Date lssu•d Tf.th :REPPLACe AASUL1Nl OlUPbNStHS De•c Location luit•
:9001 GAHllfiN ~lHOVIo l.li.VO
OWIHJt': Alf.I•NTIC fHCHFHLO CO (CR) Pared number Occupancy ~ppliOI.'IIlt :CHARLE~i f:, THOMI\fj COMPANY Pttonu Nurnhur
13701 ~. ALMA AVE GARDENA CA 9124!.1
I tartlty lhst I am exempt from Scollon 70: 1 5 'Jf the Business unrJ Pro· fosalonal Co<k!, OIV1slon J, Chuplor 9, Conlrnclo•s' li<.Uilse Low. und•Jt lha ''1fkJwll19 Saclk:m· Owno~: Section 1044 tl M1nar work U11dot $2()o· 3eotlon 7048 tJ Employoo worklny for wo~!JU only. Goollon 7_ 05:J 0 Otlltlr: . _ _ . . ._
!NSP~CllUN NECDRO APP~OVAL bAT~ INSP~CTOR
Underqr()Ut1d __ ~ -"~·~--
ondui t---·----~-~- ---·~-~ i r 1 n 1:1 ~ H o u o h----~~-~-----~~-·-·
H 1 ate t· "---"~~-~--~·~· ---~-~-~~~--~----= ........ . l'htut•ts & Tt-1111 ~~~-~~~-__ _
otor&o ----~-~~-~-~--~--f • r --~--~ ... ~~-·------·"·--~"'"-·~ ... -----~"--------"------· HV i C "---~--~~~---~~ .. ·-------~-·~---·~
·--~----·-· ~~--------···- . _______ , __ --·-'"' _._ -~----··-·"'
GASOLINE OISPPEN~tH~ J:ssu<~rwe
10 1 1 1
111 ••• 15.11
1.11 2.11
CIJLTUHAL All f'S GENEHAL PLAN
3200
': Pr:R i 110.00 MISC. I 2.00 MISC. 1.00
, rss 1 1:s.oo OUU!:I'rA.U .... f ~ 92 lASH 128.00
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~~~~ P~~MIT~/UlNE J 2 ~ 11 t' E ~ M :tl s I ;: u L l 3b11 ISBUANCk FEl
110.~~
0:1.610 J..U
:ltLU
tnapecllon Raquaata !41~5332
Ganaral lnform•llon 14:1.-b:SIP
TOTAL. FEES 121.11
It wot~ l$ not ~tart•d within 1a0 dfty9 trom d1t• of iaaue or lf ab~ndonad for mora then 111 de:ys, tftio parmit will be nwU and void. A FLL MAY H~ CHAkGED fOR RElNS~EtTION CUE tO NEQllGEMC!, lNCOMPL!l! WORK, OR f~!LUR! ro M~K! CORRECTIONS,
