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HomeMy WebLinkAbout2528 BACK BAY LOOP - Building Permits N CITY OF COSTA MESA 4 ►� BUILDING DIVISION }:`'a..4i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER �•1� is . PERMIT '` � - P06-00653 (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.csUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 • Job Address: 2528 SACK BAY LOOP 1'L/�('� Status: ISSUED Suite No 'y-v 2\ Applied: 08/102006 .(`��/A Issued: 08/11/2006 Vicinity: Y O Parcel Nunmber: 93765072 CyS \• ' Applicant: PAULEY, SHANNON 04 ISSUED BY: lip Address: 17390 MT CLIFFWOOD ------___ //„ Phone.''714=241=1414,_ FOUNTIAN VALLEjr" ( A%�-; (-Zip::•-92708 r -;`�,`\= / 1 Owner: MCLAUGHL-IN, DIANE i I, _I L . L I A, . 7/ �CS �� Address 21(1 528.B(ACK•BAY LOOP#42 'N" 00 < \\ Phone=949650-2323 z �\J NNNCOSTA MEES A Off`' Zip; 92627-5418` A\ Contractor: COAST PLUMBING HTG AND AC \\ • nvAddress: 17390,MT-CLIFFWOOD ` VA l' C/ Phone: 714-241-1414 � � C Q y� \i FOUNTAIN VALLEY Zi 92708 . _ _.___� \ (�� \\� \ / Y� \/O� •^(.License " 529127 \` •;� r, ,r� \��� �1-.,, • I,; ` / o7/ - l( / (r.---t--1---JHA(/ SCOPE"OF PERMIT-- L.--„..-\\'-----..:, /2V V ','' A v ', '1I /I ,WATER HEATER CHANGE OUT,NO CHANGE IN LOCATION. ---- / / �.. v 'vA nu' v \- • I rr i< �� FEE SUMMARY �+ H;; �' I AMT QTY - - -AMT- _ , H' AMT '.gia 'I(' T r'r-- r r r • R 6 ' � ISSUE FEE � , - $23.50 7 �°Jj Laundry Tub'/}Wartier,�l77 $0 00 •D lSump Pump �i , --$0.00 10, I Backflow irrigation 1 $0.00 0 \S.Ic If Landscape Irrigation �!/!IL$0 00.. 'TC) j/ h-1' . Swimming Pool 2 $0.00 'N) �I Backflow Preventer ; t I $0.00 0- . -=P-Trap - _ -- $0.00 -0 - - • Trap Primer f \ $0.00 !110, Bathtub--- U $0.00 0 Pressure Regulator $0.00 `�0° Urinal r/ I $0.00 . 0 Clarifier System ` (j',N;, $0.00 0 ' Process Piping(per 10 ft), $0.00 jai Vacuum Brkr Bkflow(1-4) ' $0.00 -')0 Connect(Ice,Soda etc) : $0.00 0 tLNVRecceptors -„"-s -x$0.00/ 02,--,..L„ -.:, - VacuumBrkrBkflow(5+) . '$0.00:,\ 0 Denial Units '‘,A. D shwasher-^ \\,,J° " $0.00 0 Sewter Capfor Demo 3-- $0.00 .0' _'I Wash Basin Set/ / if $0.00'` 0 brain;�Floor _-' \ \[\ $0.00 0 I Sewer Connect $0.00, 0 I Waste and VentSystem ;$0.00' /0 Drain,Rainwater \ , $0.00 o) Sewer Private Line I$0.00 0 '-.Water Closet(Toilet) / $0.00 / 0 Drain;Roof .� $0.00 0 Shower _.,,,$0.00%}0 Water Heater/vent fZ-\$12.30/ 1 Drinking,Fountain,\\ \$0.00 0 Sink,bar $0.00 0 Water Piping'(Inst or,Rep.) , $0.00; 0 Expaneioq Tank j \$0.00 0 Sink,commercial;ti4 $0.00 0 Water Re-pipe" < $0.00 0 Gas Earthquake.Valve $0.00 0, Sink,Floo7;f '" i' "_ $0.00 0 Water Service ' / ,$0.00 0 Gas(1:4 outlets) $0.00. 0 Sink kitchen, `$0.00 •• 0 WaterSoftener $0.00 0 Gas(Over 4 outlets)c s $0.od' 0 Smk°service/mop :.r, 0" $0.00'4:':9. , .. OTHER �-/, , :$0.00 Gas Repipe v' $0.00\0 J, - ef'spa(pnvate)'� 0 -'C-\ - $0.00 '"0� '. ' VIOLATION 4- I/ $0.00 Gas Service\\\ $0.00\0 - Spa(public),2,,0 0 O ' $0.00 0 ,..i-FLAN CHECK i $0.00 Interceptors(Grease,Oit)\$0.00N0k\ - ' 2 . ,61/' - _c :'REINSPECTION , %/ $0.00 0 Interceptors(Sand-Auto) C$0.00< �0 V�� o 0- - ` 01:,-----2" // -7 �� <_/"/"<�: <�� ' c_ r...5,":,'"--""--TOTAL CALCULATED S: $35.80 v "Nsi V \\OM MENTSTSPECIACCONDITIONSi l -/ //\ � �rM; i l.-1 :1'''-?...):'--19--)-"X& %mo\c_�i, NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. • INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5828 2416-48(600) • DECLARATIONS �� l • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. WI have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this penult Issued. �-My workers' �°�nsa n Insur carder and policy number are: /� 7 -7 •Cartier? f'C+- !/IL///) ('Pdlry Number..U/J'1�/�L�D /O j7hfs section no no be completed H the permit Is valued at one hundred dollars(S100)or less.) ❑ I certify that in the performance of the work for which this pe issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Calif o , d agree that if I shout subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with.thesetprovisions. -ApollcaniSignature:J -zee" i Date:_ g • /1 v 0 'WARNING:FAILURE TO SE RS'OOMPENSATION RAGE IS U L AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF CCMPENSATI GES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,(MEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licen�s�edd unnnd,��cDcfrDsulsco,0,s f Chapter 9(co mencing with Section 7000)of Division-3'of the Business anyJ)of io4 Code,and my license is in full Cr storend Sig atrer .. LClassa - Coo to restore Signat`re;� w Q Date:--�g - / - !7 C CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Landers Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builderwlll have the burden of proving that he or she did not build or Improve for purpose of sale.). • ❑ I.as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Om 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ applicant or present o future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or volume of 55 gallon, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 if an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aka—mi.-for such on or constructimodification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (11 yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution-control district or agency is required for the work which Ls the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No e (If'yes',attach certificate of compliance from the appropriate air pollution control officer). ----CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above Is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:1 certify under penally of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner( [\ to V t .ice (J1�7 i Or Authorized •...INant L_Date gooFJ, INSPECTION TYPE PAIL MKS POOP! IMSPECT106 TYPE PAM MAL$ 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root _ 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Flre Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy - \ _ - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • - __ . - 0565 L/09/85 - -8.00 TL CIT - Y OF COSTA MESA C�ONST,RIJpTIO PERMIT PERMIT NO:��� TRACT NO. LOT NO. UNI_�NO_ ? ,/ - _ ._ Project Address ] I r ' Applicant's Mailing Address. l '.30. e Gl-C T � TYPE OF CONSTRUCTION NEW LiADD U ALTERATION U REPAIR " M,, p ❑ CONVERSION ❑ DEMOLISH '❑ OTHER, A P•# _ Zone Owner's Name .-7 a lltol-�A (flip-o-,ti._ PhoneA'Sz��1` DESCRIPTION OF WORK/USE OF BLDG, ' • Address ! "/�--Z r, -to 2 ' F t2 • S Main Building: Accessory Building: • Z • Arch/Eng. License No. TYPE OF PERMIT U GRADING. ❑ FOUNDATION ❑ STRUCTURAL E Front • 0 Address • ❑ TENANT .0 ELECTRICAL i0 PLUMBING Mg-MECHANICAL B Rear - _ - N Contractor's Name •Phones 3 `` ❑ 'OTHER • f h- 5 S . .. 1 PROJECT DESCRIPTION SQ- FT. •• J OCCUPANCY C Right N Address(mailing) -I 1 5 0 r - P a��• K G O�YI qa . • CON ST RUCTION TYPE VALUATION$ S Left • City License No. J ZONE - GRADING CU.YDS. ACRES- R- LICENSED CONTRACTOR DECLARATION • - Ping. •R¢f.# Parking Req./Provided E' I hereby'affirm that-I am:licensed under provisions of Charter 9(commencing Remarks: - Planning Notes: N1 with section 7000) of Division 3 of the Business and Professions Code,and _ - T my license-is in J forte and effedt. . . , • License lass�—� 34Si?6e .c>r.au •' _ S Date W^714-acr Signature .f •' Of.a - I I ' PLUMBING FEES I _H . WORKERS'COMPENSATION DECLARATION Bar Sink Showers hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL ' FEES Sf Workers' CompenAtion Instance, or a certified copy thereof (Section Backflow Preventer -- Service Sink - _ "- - - - " - - 3800, Lab. C.) ' J / '- - - t4.7 - i Automatic Washer Transformer❑ 15.50 KW , Policy No. •� l L Company Backflow Irrigation Sewer Cap - Construction Pole Sub. ' • 0 50+KW ! Certified copy ii hereby furnished. - ertifled coat),is ile with the city Buil n i o ///1 • Bathtubs Sewer Connection . Cooking Unit Meter ❑up to 100 amps Date •-4 -L '�- Applicant t ) -D Qr EXEMPTIONIFROM WORKERS'COMPENSATION DECLARATION , Clarifiers Solar Collectors ' Dishwasher - _ _ _ Meter _❑over 100 amps _ ___ ' _ (This section need not-be completed if the permit is for one hundred ($100) or - ' less). Dishwasher Solar Piping' ; Dryers ❑Gas ❑Electric Sub Panel ' I certify that in the performance of the work for which this permit is Issued I ' shall;not employ any person in any manner so as to become subject to the Drinking Fountains Solar TankFan •Motors❑01 HP ❑1X-8 I ' Workers' Compensation.Laws of California. 1 . Date Signature • Floor Drains Swimming Pool w/Spa ', ' • F.A.U. . Inc.Solar ❑9-15 HP 016-15+ ' NOTICE:If,after making this declaration, you should become subiect to the . ' Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks -- . Urinal ' - I - - -- -- - comply lwith• such provisions or this permit shall be deemed revoked. • Fixtures , Microwave' • CONSTRUCTION LENDING AGENCY ' Gas Service ; Outlets' Water Closet Device Boxest • I hereby affirm that there is a construction lending agency for the performance Pole Light of the .work for. which this permit is Issued (Section 3097 Civ. C.)_ - 1 a Interceptors Water Heater Outlets Range Lender's, Name. - - - - -. -. - 9 Lender's Address - ' ' " Kitchen Sink' - •• - Water Service • Switches Sign OWNER BUILDER DECLARATION ' " • ' I hereby affirm that I am exempt from the Contractor's.License Law for the ' ' Lavatories _ • - , following reason (Section;7031.5 Business and Professional Code: Any city or - Auto-Wash Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P--Trap i Laundry Trays ' , ' ' Generator ❑0-5 KW❑5.15 KW Trash Com actor ' .any structure, prior to Its issuance, also requires the applicant for such permit P to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ' the Contractor's License Law(Chapter 9(commencing with Section 7000) of. • . . , Division-3 of the Business and Professions Code) or that he/she is exempt ' - - 1 `herefrom and the basis for the alleged exemption. Any violation of Section ' 1 0315 by any' applicant for a permit subjects the applicant to a civil . `' • ' ' _ , enalty of not more than five hundred dollars($500). - ' ' as owner of the property'or.my employees with wages as their sole -Reinspection:Fee' ;$15 Issue Fee . $ 3 ' .compensation, will do the work,and the.structure is not intended or offered - - for sale (Section 7044, Business and Professional Code: The Contractor's ' MECHANICAL FEES Reinspection Fee $15 Issue Fee $ 3, License Law does not apply to an owner of a property who,builds or improves thereon, and'who'does such work himself/herself or through his or her Own SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered.for ' Boiler Hood or' Type I 0 sale. If, however, the building or improvement is sold within one year of com- -- - - Canopy Type II 0 Zoning Approved By - Date pletion, the owner will have:the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date rove for the purpose of sale). /�,,I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By L A 4 Dat ' tractors to construct the project (Section 7044,Business and Professions Code: - -- - -- - (/ ' The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑o-i00,000 BTU 0100,000 BTU SUMMARY OF FEES ' • , builds or improves thereonand who contracts for such projects with a con- - • - - •- •' - . . - - - I • tractor(s) license pursuant to the Contractor's License Law). I am aware that BUILDING PERMIT $ SMIP ' $ I. of Exhaust System ❑ Multiple ❑• System Repair/Alteration proof their Worker's Compensation insurance should be provided to me. - ' I: ham exempt under Section - B.A P.C.for this reason Firepl/FPLAN CHECK $ PERMIT • act.Bit. ICBG# Fire Dampers PLUMBING $ 1 ISSUANCE $ - -- Date Owner HHeeating System& Ducting ' Registers PLAN CHECK 25% $ QENERGY P.C. ' $ I hereby certify that I have read this application and state that the above �¢100,000 BTU ❑100,0006 CO ELECTRICAL $ GRADING $ ' information is correct. I agree to comply with all city and county ordinances - e and state laws relating to building construction,'and hereby authorize repre- • - ll 11 � MICROFILM •$ sentatives of-this 'city-to enter u on the above-mentioned property for J I PLAN CHECK 50% $ inspection purpo .-y—aQ � `9y ,, p • ' - - MECHANICAL ,$ i-00 1 '0'•�C) Signature 4 N� Date 3•-'Z•�-7� , I 1 I TOTAL FEE $ Drivers' License or SS yr ' R• einspection Fee I $15 ' Issue Fee $ 3 PLAN CHECK 25% $ I •et • 1 ' CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor V` CONSTRUCTION AND PLANNING - POOH _SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole U• - 52.-Pool_& Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement c.3.'Electrical Conduit Utility:.Undrgrnd. ' _ . 54. Forms . 4..Electrical Conduit-Undrgrhd. `. 55. Electrical Bonding 5. Steel Reinforcement 4 ' , - 56. Rough Plumbing& Pressure Test 6:' Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE 7. Footings .. 58. Electrical Conduit-Undrgrnd. . 8y Foundation ) 0 59. Gas Pipe, ❑ Undrgrnd.,Test '9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10.•Structural Floor System °.•.)' 61. APPROVAL-TO DECK . 1.1. 'Property Sewer Line'& House Connection 62. Backwash & Receptor-Final • 12. Sewei'Cap • « • 63. Heater & Vent-Final 13. Roof Drains -? 4J f 64 . Plumbing System - Final 14. Rough Plumbing.. 65. Electrical-Final 15.- Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval - t' . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-f Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. LDucts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank OGas 0 Oil - 25. Roof Sheathing - 74. Overhead Hydro • 26. T-Bar Ceiling JStructurall & Monocoat 75. Dry Chemical 27. Frame and Flashing • 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall NailingHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED : - - 33. Final Electric Notes: 34. Final Heating & Air Conditioning Picibr CaV 35.-Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace - 38:-Final Plumbing . 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer. 43. Backflow Irrigation: , 44. .Landscape Irrigation System ' - - 45. Sound Attenuation • ' . , - 46. Handicap Regulations - . . •• . 47. FINAL STRUCTURE & BUILDING • . 48. Special Requirements Completed' p 49. Electric Release to Edison - - - - - 50. Gas Release to Southern California Gas Co • I ' ' 51. CERTIFICATE OF OCCUPANCY . ' ' _ . - _ Na. Date'