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ARCIENG FIRM NAME
LICNC
ADDRESS
CITYICOM MUNITYISTATEIZIP
PLAN N
PLANS EXAMINER
APPROVE DATE
W." �a7f FOR CLEC TO DWLG
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FORM 284208)11.81) INSPECTOR
AJPUIfl /3f3!2i JPW 04l26"2
26950
t
,
J
REINSPFC;TION FEE
00
1
TOTAL
FEE
CA
C
NC
COUNTER 8.1 ,,/
COUNTER L.U.T.
,Qy
I- T 1 269501
TOTAL ' PERMIT. COST IS $15,00
NO.
OPERATION
DATE
IftMeroe
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs 8 Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
t
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L. E]
43
Final
IDA
Fireplace T. 0.
NO
_. _
ADDITIONAL O ATION
_ .. ... �_ � _ ... .. ..
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick „R„ •. .. .
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING AP RO ALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
PSL
r�
' P/
ELECTRICAL APPROVALS
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME
APPLICANT NAME (L, F, MI)
PETER MIROMOUSKI
ADDRESS
867 HAY ST
CITY/COMMUNITY/STATEIZI P
MONTEBELLO CA 906400000
JOB SITE ADDRESS/SPACE
77955 CALLS COLIMA
CITY/COMMUNITY/STATE/ZIP '
LA QUINTA CA 922530000
BOKPAG
"y74
135
PRC
001
C
4
TWN
RNG
000
SE
00
S
TRACT LOT
000000 0024
TOTAL .
FEE
MOD
ail
SB
CK
TRACT NAME
SCVLAQ 0?,7p�e
�240
,BLKSAVINGS
OWNER NAME (L F
C ONST I 'MUT I ON, SAV I NGS
PHONE #
CONTRACTOR -FIRM NAME
PETER MIROMOUSKI
LISC#'i/J
`7
ADDRESS
867 MAY ST
CITY/COM MUNITYISTATE/ZIP
MONTEBELLO CA 906400000
H�ONE # �y A r� p A
G:.1 -3-72 4-5248
P21-3-724-5248
BLDG. INSPECTOR
FINAL DATE
ARC/ENG FIRM NAME
LICNC #
ADDRESS
CITY/COMM UNITY/STATE/ZI P
PLAN #
PLANS EXAMINER
APPROVE DATE
USE OF PERMIT
REINSP FOR ELEC TO AWLG
BL ZONFSB
00 Rw1
SSB
000
SSB
aaa
RSB
aaa
.
OF
TNS?
ZONEORD#
LOT SZ
END
SIDE
0000
0P€i0173SU As 04/p -678P. 26,q48
TOTAL .
FEE
CA
CK
NC
COUNTER B.I.
COUNTER L.U.T.
APPLICATION FOR REINSPECTION
T H I S I S A N A P P L I C.A 'T I O N 0 N L Y
FORM 284.2011(11-8i) ' ! NSkCTOR ,
NO.
OPERATION
DATE
INSPECTOR
NO.
t OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33 Ventilation System
2
Figs 8 Firms
34 Plenums & Ducts
2A
Slab Grade
35 Furnace Comport.
3
Steel
36 Inlets 8 Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor
6
Roof Deck
39 Appl. Clearance
7
Framing
40 Fire Damper
8
Vents
41 Smoke Detection Device
9
Garage Fire Wall
42 Commercial Hood
10
Fireplace P. L. E]
43 Final
10A
Fireplace T.O.
P'
ADDITIONAL INFORMATION
y
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Loth
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
PSL
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P)
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME