HomeMy WebLinkAbout1511, 15, 21, 25, 31, 41, 45, 51, 55 Bruinbark Ln - Permits found in onbaseI
COUNT' OF ORANGE ,
CERTIFICATE OF USE AND OCCUPANCY I-[[ r COpY
ADDRESSI 511 1 r CL r
Bldg. Permit No, Group Lot Block Tract '
Use: Condo Ill th
i
_ r
ISSUED TO ON
OWNER:
TttyPgfr%rA }:seal F kt-411-0 Seril4cac
i1
The building described herein has been inspected and found to comply with the provisions of all County of Orange
Ordinances applicable thereto.
t
THIS IS A LEGAL DOCUMENT AND MUST BE GIVEN TO THE LEGAL OWNER OR PURCHASER. 3
Mail To:
F.G. Mc LELLAN, JR. j
r Manager
Investors Real Estate gervfce.3
t; Environmental Management Agency ;
2790 ciarbor Blvd. i,�210 P.O. Box 4048
(%OSto Mesa, California 92626 400 Civic Center Drive West
SANTA ANA, CALIFORNIA 42702 I
F 0250.138.1 —�
i
APPLICATION FOR A BUILDING PERMIT AND A CERTIFICATE OF USE & OCCUPANi,Y
CQUNTY OF
ORANGE
ENVIRONMENTAL MANAGEMENT
AGENCY
REGULATION
P.O. BOX 4048, SANTA ANA, CA 9270?_
REGIONAL OFFICE , ��"�1� CENTRAL OFFICE
26052 GETTY DRIVE 400 CIVIC CENTER DRIVE WEST
LAGUNA NIGUEL, CA. 92677
SANTA ANA, CA.
714.831-2610/;6// 151je /521 %452
714-834.2626
,r
.ADDRESSEW
JIN
DESCRIPTION OF WORK
ADO ❑ ALTER E) REPAIR ❑ DEMOLISHAREA
2E p J. `' •' ` T! . O>�- NO. OF
FAMILIES
SQ. Fr.-!�
OWNER /1C y !/ 1��' Cl
i)n -S (= ot�ORIES /Y
y� PHONE
PROPOSED USEOF-
STRUCTURE i2" N
STRUCTURE
.+1vsY
ADDRESS �c.� yAL� A A � !/-•-} �J/�/ %
CITY , /1dz-1ZIP 92-62LifGs
_
ARCHITECT Ot- l PHONE ]
ENGINEER-- / • _ '�_ __ �/ / n. ry
CONSTRUCTION _
LENDER NAME — , j�� ❑ UNKNOWN
��L,
ADDRESS �(� �, 1 ` *� � �, /{
BRANCH
PHONE��y((
CONTRACTOR 'j 7I
ADDRESS / J% A + SI!a?
- �� �� c,�_ -
t-
GRADING PRE. P.C.
' ^ �
ADDRESS �. 7 ( , _,. / --yyam-
• -� /�' -- (��.lCf�
..; - l
,i�.sY. tcL_ 4 FEES
VALUATIONS f B. PT C�-j
f
FEE "ram
�.,
CERTIFICATE FOR REGULATION PERMIT
s r---�74
/
Contractors
OCCUPANCY TYPE OF
�:7 /
GROUP CONSTRUCTION
certify that the following Contr. Lic. No. ___ _.- >� ____-- _ __ and
PL l HEG PERMIT I
Classification _________—__ _______ _______ is in full force and effect.
APPROV -
.Workman's Compensation Insurance Certlf on file v rifted by
7 -
Expiration date l -_---•
`'
RAD N PER Ep"U UGH G ADING O.'`�
____
YES NowOU GraQlil Approved
Other Applicants
.I hereby certify I am exempt from Sec. 7031.5 of the Business and Professional
APPROVALS DATE INSPECTOR'S SIG.
Code, Div. 3, Chap. 9, Contractor's License Law under the following section:
0 Owner (Sect 7044). Or
FOUNDATION: LOCATION
❑ i•�
11 Minor Work under $100 (sect 7048), Ot
REINFORCED A M ^K
0 Employee working for wages only (sect 7053, Or
SLAB: REINF. ❑
0 OTHER: ---- _.. --- -
MEMBRANE ❑ '
Certification of Exemption from Sect 38W of the California Labor Code, Article 3,
UNDERPINNING
Construction Permit:
MASONRY:
0 The permit is for One Hundred Dollars ($100) or less.
BOND BEAM ❑
0 I certify that in the performance of the work for which the permit is issued
FIREPLACE
shall not employ any person in any manner so as to become/
subject to
ns C,
the WorkmeomI :ens:ilion laws of Califorma
IE
ROOF" SIATING
d
,
If, after making su: tr cerNhaihon I. appllr nn} ,, t,,, , , � ,� ; ! , �.�„rif•
- _-- _---- ! '' I
subject b) th, �, ,,,.r t „•
1.: "
applicant S',d11 1, ;, ,. :. ;{ ._� t s"wt 01 this p rlmt
shag be deemed revoked.
INsuLAT:oN ) "'
/r.rJ
hereby acknowledge and state that the information I have provided is correct
1SOUND UNF RGY)
both on the permit and this certificate and agree to comply with all County
LATH
rd• n sand ate laws regu.iat igg building cons cti
EXTERIOR
y .
LATH ❑ DRYWALL
(A II ants S nature)
INTERIOR J j �• f
^�
V ZONING REGULATIONS `
PLASTER
BROWN COAT
LEGAL T� C BLOCK LOT �
DEtXRIFrnON b
FINAL B
BUILDING f
(PLEASE ATTACH METES AND BOUNDS)
FINAL ZONING r :l•7r
f� p/� f
ZONE affx/[ �T / 1^fiw VARIANCE NO.(jP Ae 3-45-
REMARKS
/ /
e
BUILDING SETBACK C/L ST. PROPERTY UNE 4Ae
/ N
SIDE
YARD. RIGHT EAVE PROJECTION
�y `� ,
`rO
SIDE YARD. LEFT �1 EAVE PROJECTION
REAR YARD (TO P/L) .2.5/ STRE WIDTH _-fe
PARKING SPACE REQUIRED/ O YIDEO
orlo%f
MISC.Tr / �i�.JC�10r yA/1
c��c..IcR.
'lc
A�
a. 9P,00.v�I)J�
A.P- 1/47 - .i Z2 V -/ -e /,o DIST. NO. ter„
.4
ZONING APPROVED
17
VALIDATION
1 )AN 19'79 84 799 820.00 +
1 531.05 + 119 351.05
CASHIER DATE PERMIT NO. PERMIT FEE
CODE PLAN CHECK TOTAL
INSTRUCTIONS TO APPLICANT: Use Indelible pencil or ball point pen and PRINT
F0250-28.2 (R 2/78)
Otherwise, fill out form with typewriter.
.;� Ji,: ,.,
,; �, T:FaJJr ;rl.u,
forlr.fr.tratton co.!i• YES
1. Projc; is cr.: f fnr;.s to 1'$F:$f.!ilF'iR'r S]'/1!;ll:lfiDti �
J �1th S�rc1.,J F..
�gvlrc-c•t.l;
t LI
p. Yl +ui s
T:. r., c't't!•itlnn In:niTstfon
capaclt
,[': t APJ'I:nVj:L, for elec ter.i---%c --� __►III
llnit:� kl�t nl:�nce
-
5' r.t•`e Cycle CocL Analynfs AI'Ffipi'FD for
6. Yrojc•rt At'F'ft�it•!U f •. '--: -; •. ---.-____-------•--_-...
of A/C ` Q
REGIONAL- OFFICE APPLICATION FOR PLUMBING PERMIT CENTRAL OFFICE
P.O. BOX 4048
26052 GETTY DROVE COUNTY OF ORANGE 400 CIVIC CENTER DRIVE We§T
LAGUNA N:GUEL. CA 92677 ANTA ANA A 92701
to 7ta-sat-26< GULATION
7ta-1334 2s2s
BUILDING
ADDRESS _ - -�1= --=--- -- -- ---- --
`G'' y LOT NO. '
TRACT-- f _ --= JV --------
---
TOWN
OR AREA j!'�'-f_� —G�1_' '�- -----------
/
CONTRACTOR �'[ C=� `1�=�►'f G ` pi l,�
_-�
NEAREST
ADDRESSl��gg ``,,
CROSS STREET --------------------------- -- ---
-
OWNER •�' f -" 1 �J `- U ��_
- --1' - _ --. - --
TEL. r�
CITv .?-yJ� NO. �� 1
FOR REGULATION PERtdiT
PROPOSED PRESENTCERTtF!CATION
Contract �
Oassi5caWn
USE USA--___--_-_—
-- �-
I cerbty tha the folto,%ing Contr. lic No. _ � and
'
PERhf#T FEES_
-
--sin full force and effect. Ylorkmen's ens n tare
Certil care on fife venf,ed by --- Expir e: s
NO,
TYPE OF FIXTURE OR ITFM
FEE
`
Other App'cants
t hereby certify I am exempt from Sec 7031 Sot the Business and Professional Code.
WATER CLOSET (TOILET)
G
__—__ __—__------------------
BATH TUB
-------
----
-- .-
D v 3, Chap. 9. Contracior is License Law and under the following sec Gore
1 OAner (Sect 7044). or
FAnof Yio<k under S100(S cl 7048). or
Empkryoe working for wages only (Sect 7053). or
O tr e r
--
j�
__-----------.__._-_---
SHOWERSTALL
---- - - - ---
LAVATORY (WASH BASIN)
--
CerNf,caf!en of Exempt.on from Sect 3800 of the Cakfomia Labor Code. Artcle 3,
— - - --- -- -- -
KITCHEN SIN`C DISPOSAL [71/
-- --
--
Ccnsrruction Perrrnl
it,e ceim t is for One ltundred Do+iars (S100) or less
,"ARBAGE
-
LAUNDRY TRAY�tUTO WASH. MACH f j]
— ----'!%
-
-----"--
- -
—
shallnot
Imp! y an m then ,r% any ncema n r s h is for become mess
emp'oy any person ,n any manner so as to became subjeCS to the Workmen's
Compensation Iahs of Ca1!forn a.
-
DISHWASHER
It. after making such cenificabon the applicant for this permit should become subiw to
the Workmen's Compensat on provlsbns of th-) Labor Code,the applicant shall forthwith
-
_
SERVICE SINK
comply v,!h the proVIvons of Sect 3700 or this permit shall be deemed revoked.
iherebyack.nowte6geand state that the!nformationlhaveprov+dediscorredbothonthe
FLOOR SINK
FLOOR DRAIN
permtandt'n;scertficateandagreetowmDlywithalt untyOrdrnancesandStatelaws
reg r.ng b&id:n< onstr n
Date:
URINAL
nature) Permit No.
_ f�A nts Signature )
INSPEC ION RECORD
DRINKING FOUNTAIN
SAND TRAP (_] INTERCEPTOR f-1
SWIMMING POOL FILTER
WATER HEATER —
APPROVALS
DATE
Inspector's Signature
WATER SOFTENER
GROUND WORK -SOIL ONLY
-IL
, RES COti1M ---
LAWN SPRINKt LR 71
----
-- -
GROUND WORK WITH
INATERPIPE " ' GASPIPE
TRAILER li00K•UP
ROUGH PLUMBING
AS SYSTEM LPG r1
GAS PIPING
NO. OF OUTLETS NAT. r
_
- 0
ALITO. FIRE SPR. SYSTEM
WATER HEATER
/
SEPTIC TANK
L
94SEWER
SEEPAGE PIT
HOUS SEWER (VALUATION)
SEPTIC TANK
GAS TEST
<� • f�
SEEPAGE PIT(S)
SPRINKLER SYSTEM
fi
LEACHING FIELD
FINAL
*
'f
PERMIT ISSUANCE
3
.00
UTILITY CO NOTIFIED
BUILrUNG PF�$j l;I NUU t BE
jj GG��
TOTAL FEE
(1 ?,
((✓
REC'D BY PLANS
CHECKED BY:
VERIFIED BY:
VALIDATION
PERMIT ISSUANCE APPROVED.
4 ; E 6 - 348t 6Z3 243.21 + 3 - �c►�.ci
CODE
PLAN CHECK
TOTAL
r
AI!PLICATION FOR %ri`c_CHANICAL Pr-Rr%IIT
REGIONAL Of FICE (COUNT Y OF ORANGE
?E4)52 GETTY 0MVE. ENVIRONMENTAr MANAGEMENT AGENCY
I-AGU14A NIGUEL, CA 926t, REGULATION
714-831.2610
CENTRAL OFFICE Q
P.O. BOX 4043
400 CIVIC CENTER DRIVE WEST
SANTA ANA, CA. 92702
7t4-834-2626
ADDRESS
- SS -ii Bruinbaxk_ Lane — Bldg 6 Unit -- -1030_ —_ ,_--- NO,
COUNTY (], DEAREST COf1TRACTOR y� �+
AREA
ROSS -- - - - -- — -VIlla Htg LAG AA; -
OWNER
ADDRESS
PROPOS
USE 0
r�
vectors Real tate Service
EO PRESEN
csidencial--
TYPE OF ,XTURE OR ITE11 PER UNIT FEE
EACH CENTRAL FURNACE iNCL. DUCTS & VENTS:
_Day__-& Ili_ght - ��, 000 - 10.00
l.1FGR. TYPE BTU
LIP TO AND INCLUDING 100.000 BTUj.
UP TO AND INCLUDING 500,000 BTU 7.50
UP TO AND INCLUDING 1.000,000 BTU 10.00
UP TO AND INCLUDING 2.000,000 BTU I 15.00
OVER 2,000.000 BTU Ijl 25.00
EACH BOILER OR ABSORPTION UNIT INCL. VENT:
SA N,E
AS
-- ABOVE
r.I FGR.----- TYPE BTU
----------- ---------- ---- ------
EACH REFRIGEPATION SYSTErt:
- -
1,AFGR. T"{PE BTU
UP TO AND INCLUDING 5 H.P. 5.00
UP TO AND INCLUDING 15 H.P. 7.50
UP TO AND INCLUDING 30 H.P. 10.00
JP TO AND INCLUDING 50 H.P. 15.00
OVER 50 H.P. 25.00
SUSPENDED_____
—FLOOR FURNACE _----- HEATER
WALL HEAl£R ___ UNIT HEATER
DECORATIVE APPLIANCE (INCL. VENT) 5.00
'.1FGR. TYPE BTU
EACH ALTERATION REPAIR OR ADDITION TNCL. 00 -
CONTROLS, DUCTS, REGISTERS, ETC. 5.
wACH COMBAN USTION
PRODU_PERMCT T VENT NOT INC LVUED -- 2.00 -- ----
EACH AIR HANDLING UNIT ONCL. DUCTS) —
UP TO AND INCLUDING 2,000 CFM 2.00
UP TO AND INCLUDING 10,000 CFM 5.00
OVER 10.000 CFM 10:00
EACH EVAPORATIVE COOLER (COMAIF.RCIAL) 3.00
-- —- .. --- _ - - ---
EACH VENTI—LATION -i-AN_ C-ON-NE- C T E D TO A •l,00J\f1
SINGLE OUTLET OR INLET (COMMERCIAL) L
EACH VENTILATION FAN CONNECTED TO MORE 4 AO
THAN ONE OUTLET OR INLET (COMMERCIAL) VV
CHANI
( NCL NFAN EACH HOOD g E C OMMERCIALETYPE)CAL EXHAUST .00
EACH INCINERATOR (DOMESTIC TYPE) 5.00
EACH INCINERATOR (COML. OR INDUS. TYPE) 20.00
INCIDENTAL GAS PIPING 1.75
CNY
AN U NO PEC_EIF. ILIQUP.SREDU(LrIS TDBELOw IS 4•00PYF - --
- o _it /. ,L-A
BUILDING PERMIT NOt?ZJPLAN
Permit Issu ince
3 TOTAL PERMIT FBBY RIFTED CHECKAfF
Miralom_ a- Ave.—
CrrY TEL.
Aanhiem . Calif. NO 528-8
L.ERTIFICATE FOR REGULATION PERMIT
1
Contractors �p�Qf�
I certify that the following Contr. tic. No. — 289588 _ and
Classification ________...�__.is in full force and effect.
s _p Lion Insurance Certificate on hle ve8,Zlb�
--_ Expiration date: O _
Other Applicants
I heraby certify I am exempt from Sec. 7031.5 Of the Business and Professional
Code, Div. 3. Chap 9, Contractor's License Law under the following section:
❑ Owner (Sect 7044), or
Minor Work under $100 (sect 7048). or
Employee working for wages only (sect 7053, or
13 OTHER _.-----__--_-- _
Certification of Exemption from Sect 38i7) of the California Labor Code,
Article 3, Construction Permit',
The permit is for One Hundred Dollars ($100) or less.
I certify that in the performance of the work for which the permit is issued
I all not employ any person in any manner so as to become subject to
the Workmen's Compensation laws of California.
11, after making such certification the applicant for this permit should become
subject to the Workmen's Compensation provisions of the Labor Code. the appli-
cant shalt forthwith comply with the provisions of Sect 3700 or this permit shall be
deemed revoked
I hereby acknowledge and state that the Information I have provided is correct
both on the permit and this certificate and agree to comply with all County
Ordi noes Slate I regulating 0ding construction.
�� —ry(�
Date: __ 5
(ApplicantsSignature)Permit No. ///
Application � f�
Approved By(;�
ISK3NATUREI (DATE)
INSPECTION
APPROVALS 14TE
Underground
ugh-_ tt
Ut' ty Notified
71T,VT 1 r1r.J
INSP. SIGNATURE
�
CASHrER 14 14t�� PERMIT N ,� PERMIT FEE
�` CODE �/99•08
DATE PLAN0 Hf
I� TOTAL _
REGIONAL OFFICE APPLICATION FOR PLUMBING PERMIT
2605e GETTY DRIVE COUNTY OF ORANGE
LAG'Y-4A NIGLIFt. CA 92a77 714-831-2610 EMA — R GULATION
CENTRAL OFFICE 4f
P.O. COX 4019 l 1,
400 CIVIC CENTER DRIVE WEST
SANTA ANA CA 92701
714-:334.2626
BUILDING
ADDRESS G-� l `'�'f 1----- —
LOT NO.
TRACT S 0�------
TOWN
OR AREA <�=; _c_ _r� . �1 �,
,
CONTRALTO �(;.6z_
NEAREST
CROSS STREET ��
ADDRESS
-�x
OWNER_ „� _ _ I _ �F r,I . _
``'
CITY C C:�-• /' ! NO. r% Y ,�v
— "� '�
PROPOSED — USE
USE G-y� �� E
C RTIFICATIOF! FOR REGULATION PERMIT
Contracio
I certify that the fo"owng Conir. Lic No�1--,L_L1C and Classification
PERMIT FEES
—
__— is in full force and effect.:? n's ens 71 yw'�T1,iy
Certificale on f,le verified by —_-date:�G
—
NO.
TYPE OF FIXTURE OR ITEM
FEE
--—___----
Other Applicants
I hereby certify I am exempt from Sec 7031,501 the Business and Professional Code.
WATER CLOSET (TOILET)
— --
--
-- —
Div 3, Chap 9, Contractor's License Law and under the following section:
1 Owner (Sect 7044). or
liAnor Work under S100 (Sect 704-8). or
IEmployee working for wages only (Sect 7053). of
_
BATH TUB
.-_--..—
_
SHOWERSTALL
!Other.
LAVATORY (WASH BASIN)
- -
--
--
Certi!tcAl n of Exempt,on from Sect 3800 of the California Labor Code, Article 3.
Construction Permit
i the perrNI is for One Hundred Dollars 1S100) or !ess.
KITCHEN SINK [] GARBAGE DISPOSAL (.)
-
---
f ce!my that in the performance of the work for which the perm tis issued I shall not
employ any person m any manner so as to become s�bjeci to the Workmen's
Compensation laws of Cat,fo;roa
LAUNDRY TRAY [? AUTO WASH. MACH. ! ]
-
------ --
DISHWASHER
If, after makmg such cedificaton the applicant for this permit should become subject to
the Workmen's Compensation pfov,sions of the Labor Code. the appFcant shall forthwith
--
—
SERVICE SINK
comply with the provisions of Sect 3700 of this permit shall be deemed revoked.
Iherebyacknowledge and state tha! tileinfor atonIhaveprovidediscorrectbothonthe
Pei andth.sceR,Gcate Com with all County Ordinances and State laws
R ' t dg bud �ng con n _-- C
_ Da:a: 9- IL 7 2
Signature) Permit No,
FLOOR SINK
-` --
-
FLOOR DRAIN -
URINAL/(Applick1s,
DRINKING FOUNTAIN
INSPPECTIYN RECORD
SAND TRAP (] INTERCEPTOR []
SWIMMING POOL FILTER
^
WATER HEATER
APPROVALS
ATE
Inspector's Signature
WATER SOFTENER
GROUND WOHK-SOIL ON
-
LAWN SPRINKLERS RES. "' COMM
C� C_J
GROUND WORK WITH
WATERPIPE ,! GASPIPE ;
TRAILER HOOK-UP
ROUGH PLUMBING
GAS SYSTEM LPG • ;
NO. OF OUTLETS NAT. [ '
GAS PIPING TO
AUTO. FIRE SPR. SYSTEM
WATER HEATER
MAIN DRAIN
SEPTIC TANK
SEEPAGE PIT
HOUSE SEWER (VALUATION)
G
-'
SEWER
SEPTIC TANK
GAS TEST
SEEPAGE PIT(S)
SPRINKLER SYSTEM
LEACHING FIELD
FINAL
`?
PERMIT ISSUANCE
3
.00
UTILITY CO NOTIFIED `
B IL
NG P T NUMBER
TOTAL FEE
/?
11
REC'D BY PLANS
�l
CHECKED BY:
VERIFIED BY:
VALIDATION
d A U 8 1 5 1970
PERMIT ISSUANCE APPROVED:
1
CASHIER
4AR 19' 79
DATE
350, 680
PERMIT NO.
13.00 + 3
FEE
CODE
r
PLAN CHECK
13.00 *
TOTAL
r
1 ilk
r ;f
W; f A N,il ""A S /\NITArty (:IS r r .iCT
1r. o [,,OX 1200
COST A MESA, C:ALII-01MIA 9262G
APPLICAI10,`,' FOR SEWERAGE FACILI] IL:; USE AND CONNECI )()N PEftMIT
Oidinartee No. 6 E?f8,Ctive 9 29 J
PERMIT VALIDATION �fL—
PEIIN11T rJo.
Date
—.,._--.�..-+.--�_..-«�.---..._._..---.-ram .-��-._ - - _.....�._ .••:3:_ra7+�7^' �.c..�taSt.-.T�::6L=tA_1:2'S'1LX'rlCZi41CAt��' ��: c•JT.:/1 :4�tdC
CONNLECI ION CHAfiGf_S Applictini to fill in this aroa only _
- --- --I F Building Address
NtjMUL R F I X I UrIE FEE/FIX FEE
Bstltwb S 15.00
— — - —_ -- — Tract No. Lot No. _.
Laundry I ub or Washer 15.00
Shower 15.00 OWfler �`�L � 1, _lL� ALL ! - ��/i:✓ '�
nk, bar 1.50
Sink, Kitchen 15.00
-- - Wash Basin -- - 7.511 — % Address( _LIAA
Wash Basin (Sat) 15,00 e- 7i+.
Water Closet (Toifel) - 45.00 Telephone Number .��`� /p
Bidet 16.00
Dental Units 7.50 nNOCiSSLo By
Drinking Fountains 7.50 ,
Floor Drains 15.00 INDUSTRIAL_ USE CHARGES
Intercootois loi Grease, Oil, solids. Esc- 22.50
-- - — -- — --- Cu. Ft. per month per acre in excess of 15,000.
Interceptors for Sand, Auto Wash, Etc. 45.00 Rate Is $0.50 per 1,000 cu. ft. per month per acre or any
3_a�indry Tub or Washer (Self Service) 22.60 fraction thereof.
Receptors 22.50 (non ad valorem us3r -- double above) $
,�. Shower, Gang - Par Road 7.50
}� ;,ins.s, llnr-Ccinr•,oreial ! 15.u0 SPECIAL CONOiTIO(:C
Sinks, Coinmerciel or Industrial 22.50 r ��� �J-
Sinks, Floor _�_.-.- ---- 7.50 -- - --
Sinks, =lushinq Rim
Sinks, Service---------------f 22.50 �----- ""
Swimrrd:,g Pool
Urinals, Pedostal 45.00
Urinals, Stall 15.00
Urinals, Wall 15.00
Urinals, Well Trough 22.50
Connection Charge $
NOTEi A sewer permit I equlred at the Limo of , r�
/i Sotilor Rook -up. lJ/�
CMF 0706-60 Rev. 7-78
TOTAL CHARGES
Connection Charge $Zj
n U C>�rge 1 c�
Penialties _
Total Due
Penalties: Charges are double if connection is made prior to
obtaining permit, plus $5.00 a clay. ($25.00 a day for a
public corporation).
APPLICATION FOR ELECTRICAL PERMIT
(,(, N, 4 HAIL ( , it ; K-0-
COUNTY Or ORANGE
C141i It-, C-FIN I (A I tj I OVE li','F'�T
OF f 1( ENVIRONWNTAL MANAGEMENT AGENCY
(i TT I I IV i
SA? CA ,2
i f REGULATION 7W
0 ',1
huI L.DINX
-4-4,1
AM)RE 1'e5 -i41
'W T
EAf 1
0
CONI 11ACI(.'R
.,NFif A
7 0 s
PROPOSE1) PIRLS[ N1
USE
TEIL
CIT`11'ze�j 0
PER UNIT
I I i
single or Multl.l Dowlq r in
6
1 X It
(Neo' or Wlocatel) OF 1
Ccaitfa--turs
3
1
Gard �fl
5?
I: sil It
I
(New or Rf-localed)
I (mr 1.1 j I h"il I hi".. foll. 'r, Cjklr Lic NoIn
addit;('r) t
fees shoran above!
d
III,? Lo%%(-finrj Inspection
Workman s cornpefisdtiori Lfisuraiice Cer?,ficate or, f lie VWrified Lv
LK,-111,11ion date. -2//
`7 :7-
Abo,v Fees Cover All Electrial Installations Witri;n NeW
or AcOoc,iled D,.%e�linqs E,,ccpT Radiant F'�Iatlriq Doors not
ircluklo sefv'(o
Otter Applicants
I her�'Iiy C0111-i I am e0�rIlt'JI horn 7031 ;i of theuusifiess andProfessional
Fl,i,,liani Cetl:nii IrJo ofHeal
S 112_�
Rooms I Per Room
I
coile- Div 3 l 9 conit.xiors License Law andc-i the following section
tsect io-1-1) of
F fixtures 1 20
25 ea
Add!l,oj!jl
%';,iur Work und.,r $100 fse(A 7018). or
❑ Employee working for viagi-s unly (sect 7053. or
1 20
2`. C-a
OLIVOS
Ado,lional
I
C1 OTHER
C(ttiticAjion of Exemption trorn Sect 3800 of the California Labor Code.
12 ea
Eleclfir,V Appliances or
I
FaCI0Fy-AJ(.'d SPII-COntalfli?d UflltS (No
2 00 ea
I
Arlicte 3 Constriction Permit
11 The P01"Ild is for One Hundred Dollars ($100) or less
T:fll.,, Clock (No 1
1 25 ea
❑ Icestify thal in W4, performance of the work for which the permil is issued
I shall not employ any person in any manner so as to become silbiect to
r Ictal Vapor Pole Mount
1 25 4tzi
I
INo I Arld I f4itfures
1
the Workmen's Compensation laws of California
If, after making such certification the applicant for this permit should become
25ea
S;,vciali �'Quqirnvnt HOUT
f, 00
I
mspv(.1;on lNo Hours)
subl-2t.1 it) III,,- W,:)i1kmeii s Cornpens.ilwri provisions of the Labor Code, the appli-
1200
I Ito if
cant shill fuylhwjlh comply w0i the provisions of Sect 3700or this permit shall be
deemed revoked
I hcr(Asy acknowledge and slat he Information I have provided is correct
! � and
0 an,
bolh (it) Incpermit 3nd this agree to comply with all County
at
Underground Raceway
200
I
Resirlentlal 5(qvlC(" I or 2 4 50-
3 00 ea��
-tl 47.—
Meter Underground (No 9�3 or rriorc� 4 50.
Oid!nanc , �a�jSmle laws latm building construe
_�'Cj. o n
Dal
P_'
5 00 ea
Cornweicial Sf,i�ic�- MvIvis
5 00 ea
Underground lNo
P
(Appircanis SicInalt v e) Permit No
Vwofli-\%,th Sendsce f1i"'Idcr4W
10 (8)
1500
comnwlcf.il
CussIfuction or F.If"'E'red VC)f'.
Y)
Permanent flolf,,
oW,"Lf(,,ATI0!4 APPROVED BY
Pedestal f" Ill'. .,I,, H i. 'r,
i�)iUNAIUMEj (DATEI
Older. List gencialofs. molois, transformers,
(See
I
flETERS
LIGHT
POWER
AC It RFG
VOLT
PHASE
etc ive rat.nq in HP. KW of KVA
schedule)
I
AND
SERVICES
INSPECTION RECgdD//-
APPROVALS
DATE
I?W.5iGNATURE
UNDERGROUND
E"
Lim
ROUGH WIRING
A If t.0
FlxfUFLLS
F A10
Building
Pirmil Insurance 300
3100
SERVICE
A-1
TOTAL PERIMT FL;_
? I
WORK -WITS( RELEASE
pernill
NoinberYg/-777
FINAL APPROVAL
n
I
00
LAN CHECK FEE
UTILITY NOTIFIED
L/
VALUATION
I E8 16'19 349,104 28821+
CA'j$0 R DAIL VEM111 PLAMil FEE CODE PLAN &q'b.C_ K TOTAL
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF ORANGE CENTRAL 400 REGIONAL OFFICE ENVIRONMENTAL MJ—NAGEMENT AGENCY PO BIOX 4048 VIC CENTER
DRIVE WEST26Ci5? GE71Y OR14E
LAGU:IA I`IGL.,Fi.. CA 926?7 REGULATIOL SANTA ANA. CA 92702
)IV 714-A3-25?§
714--B31.2010 W (10TSI��
AUILDING
DDRESS �� 1 ! '- ,S t` Ili_ �J�i� Wit TRACT I ► -LOT NO.
COUNTY l NEAREST 7 l
AREA (I�SL �L� �• CROSS ST �.{� ;r ' e-., CONTRACTOR? /1.(
OWNER ADDRESS
E ��~�S?✓ P SEC �/mil/ CITY f NO
cfj� s
Residental 75; per S1000 PER UNIT FEE
of vatuaton or fraction thereof. I CERTIFICATE FOR REGULATION PERMIT
Relocatad Dwelling sq. tt t�:C sq ft. { Contract rs 7
Garage sq ft 14 sq ft I certify that the following Co Lic No Z'4� ` 24 ----and
Relocated Dwelling (fn 101tion to Class�hcalion ._______—___.t-"1- ------- is in full force and effect.
Pie -Lowering Inspection fees shown above) 10.00
Vloikman's Compensation insurance Certificate on file vended by
Above Fees Cover All Electrial Inslallations 15,ihin New ____..__._- _ _. Expiration data ------
or Relocated Dwellings Except Radiant Heating Does not —
include Service Meier Other Applicants
Radiant Ceiling (No of I hereby certify I am exempt born Sec. 7031 5 of the Business and Professional
Heat Rooms ! Per Room S 1.50
Code. Div 3, Chap 9. Contractor's license Law under the foilowing section,
1 -- 20 .40 ea 1 ❑ Owner (Sect 7044), or
Fixtures
Additional 25 ea 1 Q Elinor Work under $tn0 (sect )04B), or
1 — 20 40 ea 0 Emp!oyee working for wages only (sect 7053, or
Outlets Additional .25 ea 11 OTHER, ---
Electrical Appliances or 5.l)V ea I Certification of Exemption from Sect 3800 of the California Labor Code.
Factory -wirer) self-contained units INo ) I Article 3, Construction Permit
Time Clock (No. ) 2 00 ea 1 The permit is for One Hundred Dollars (5100) or less.
ID I certify that in the performance of the work for which the permit is issued
Metal Vapor Pole Mount 1.50 ea I t shall not employ any person in any manner so as to become subject to
Fixtures (No. ) Add i Fixtures .30 ea I the Workmen's Compensalion laws of California.
Special Equipment (ivt n $25) IF after making such cerhhcaCon the applicant for this permit should become
SpeSpe
(No. Hours) 1 Hour _ 15 DD subject tome Ylom rken's Compensation provisions of the Labor Code, the apph-
cial
cant shall fo,thwith compty w�lh ;he provisions of Sect 3700 or this permit shall be
1 deemed revoked.
I hereby acknowledge and state that the Information I have provided is correct
Residential Service I boll, or, the perm nd s cerhhcafe and agree to comply with all County
Meter — Underground (No ) 5.00 ea 1 r antes and S t lav r atatmg bu:ldmg consjllr coloon,
Commercial Service Meters
Underground (No ) 10.00 ea ` (Appl;cVJs Signature)
Work -with Service Resdential 15.00
Commercial 20.00 I
Construction or Metered pole 10.00
Permanent Pole. Add'I poles on APPLICATION APPROVED BY
Pedeslal or Piggy Back (No ) same service 5.00 ea (SIGNATURE) (DATE)
Other List generators. motors, transformers, (See I METERS LIGHT POWER AC 6 RFG VOLT PHASE
etc. & give rating in HP, KW or KVA schedule) 1 AND
' SERVICES
Motors up to & incl. 1 2.00
INSPECTION RECORD
1 to 10 5.00 i
10 to 50 10.00 APPROVALS DATE INSP. SIGNATURE _
50 to 100 15.00 I UNDERGROUND
Over 100 & not over 500 \ 25.00 I —
ROUGH WIRING
/O I FIXTURES
Building Permit Issuance 3.00 3100 SERVICE
Permit I WORK -WITH RELEASE
Number TOTAL PERMIT
r'? FINAL APPROVAL -A
Verified FEFf'j
By: UTILITY NOTIFIED l
4 Nov 261 ig 365,141
_. 3:00+ 2
3.OU
:M
CASHIER
DATE
PERMIT FEE
CODE
PLAN CHE,CxK
TOTAL