0307-196 (COM+CFO) LICENSED CONTRACTOR DECLARATION BUILDING PERMIT PERMITp
I hereby affirm under penalty of perjury that I am licensed under provisions of LA3'!7- ! �
F- Chapter 9 (commencing with Section 7000)of.Division 3 of the Business and DATE VALUATION a , LOT n TRACT
N Lu Professionals Code,and my License is in full force and effect. c' t. >
O ch License# Lict Class Exp.Date
JOB SITE
6 a -s t �"3 C:• : I ,. ?'32/11: ADDRESS ]°fl` s b. '7t` j$�.`�4't�IR��:F'i3G..t�, APN
Z -`Date + ' -t Signature of Contractor -'""'^' •"`'` OWNER CONTRACTOR/DESIGNER/EN (NEER
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F- OWNER-BUILDER DECLARATION 1. f ,,11 ll r7x7 5 ry 1�-t��ow—CiOT(Z'�y�r U(71-7C?Y,�4�r��9/.�,A%TC�•,,
J V .!V �ILZ�I t n.L Jl �.i d:''+...�Sr..L '7 4�"40 a is`'J`L.Y'.?".+.d Y 14.5 �A"a ll.[dY ..i�.Cf�f.923-53
H Wd I hereby affirm under penalty of perjury that I am exempt from the Contractor's >wirZ�.k77Jl LS CA. 91203 WV-1: �0C) CA 91211.,1;
INSPECTION RECORD
OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
Set Backs Underground Ducts
Forms&Footings z—3- Ducts
Slab Grade Return Air
Steel Combustion Air
Roof Deck —/ —< Exhaust Fans %
O.K to Wrap —3V_ Y F.A.U.
Framing —io - Compressor
Insulation 2 O Vents
Fireplace P.L. Grills
Fireplace T.O. Fans&Controls
Party Wall Insulation Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall-Int.Lath
Final — 3
Final /— POOLS - SPAS
BLOCKWALL APPROVALS steel
Set Backs Electric Bond
Footings Main Drain
Bond Beam Approval to Cover
Equipment Location
Underground Electric
Underground Plbg.Test
Final I Gas Piping
PLUMBING APPROVALS Gas Test
Electric Final
Waste Lines —4 Heater Final
Water Piping Plumbing Final
Plumbing Top Out Equipment Enclosure
Shower Pans O.K.for Finish Plaster
Sewer Lateral Pool Cover
Sewer Connection — Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
J1 LAyNL 7)W 9 4
Final
Utility Notice(Gas) —
ELECTRICAL APPROVALS
Temp.Power Pole
Underground Conduit
Rough Wiring �— —
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp.Use of Power
Final
Utility Notice(Perm)
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IIIIIIIIVIIIIII 71
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Certificate of OdcupanCY
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Icoroanho
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of9 Building . & Safety Department
This Certificate is issued pursuant to the requirements of Section 109.of the California Building
Code, certifying that, at , the time of issuance, this structure was in compliance with . the
4 provisions of the Building Code. and the various ordinances of the City regulating building
'construction and/or use.
BUILDING ADDRESS: 78-875 Ave 47TH , BLDG ,
Use classification: . A3/R3/ Building Permit No.: 0307-196
Occupancy Group: 'R-3 Type of Construction: V-N Land Use Zone: R-M
Owner of Building: SCPH Address:- 516 BURCHETT STREET
City; ST, ZIP: GLENDALE CA 91203
By: G'SHOWALTER
Date: 01/28'/05
Building Officipf
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