HomeMy WebLinkAbout1816 PENINSULA PL - Building Permits'
APPLICANT: DO NOT FILL IN SHADED AREAS:
CITY OF COSTA /MESA CONSTRUCTION
Project Add" 4216 �iV Tel ii`i Unlc
PERMIT NO.
UNIT
MODEL
A.P. M -
- Zone
hjD
E
Main Building Accessory Building
Z
PURPOSE: ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR
❑ CONVERSION ❑ DEMOLITION ❑ OTHER �s-�F IJGOC M/iA�>L
/ /
DESCRIPTION OF WORKIUSE OF BLDG. « //.zL oval
P�T/P-J.t!//tlG �ffGL
t
N
Garter's Nm}e: AG '/ f
Address / -- / �r OO
A
L8„ /
C
Right
N
G
AmbJEegl! nr. g G/ flag. Na: /7-593
Addna: .nP Unit: /e G
F V SL Zoe
K
S
Rear O
R
Ping. Ref. N Parking Req./Provided
E
Permittee ST arra As< ceci��
Planning Notes: �5 L/
D
M
ii4�i E A-S �WNf�
TYPE OF PERMIT: ❑ GRADING ❑ FIRE ❑ STRUCTURAL ❑ SIGN
❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ REINSPECTION
JOB DESCRIPTION: ElSO. FT. OCCUPANCY GROUP
g0
CONSTRUCTION TYPE VALUATION $ �n� GRADING CU. YOS. _
CATEGORY: ❑ MINOR CONSTRUCTION ❑ MAJOR CONSTRUCTION (Under 200,000 sq.N.)
❑ MAIOR/HIGH RISE (Over 2110,000 sq. ft.)
Remark: SS
Address:
60 07 Qm
T
S
UCENSEDCONTRACIDRDECLARATION: Ihereby affirm that l am licensed under provisions of Chapter 9(Commencinp
with Section 7000) of Divis�ionn 33 of the Business antl Professions Code, and my license is in full force and effect.
CITY UC.:Q//C.8i7 STATE LIC.: 33447^.`) yClAS3: .i-
Date: 2-Z8—QD Signature: �T • ��..L-+
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a Certificate of consent to self-insure
or a certificate of Workers Compensation Insurance, at a certified copy thereof (Section 3800, Lab. C).
LICY No.: WGDo/G03L77T7T7g EXP. DATE: 3-% �O
i 11�
PUNY. ��'y%�2iRil� lel?
'e �:Certified copy is hereby furnished. �_Qrified Copy b filed with the City Building Division.
Date: z-Z'8-90 Applicant:cIP14ir „/ /J
a
(This sermon need not hi completed if the permit
h FROM WORKERS' COMPENSATION that
is for onein th perfoTION:rmance
e for one hundred (t1o0) or less). I certiTy that in the pertormance of the work for which this permit s issued,
I Chad not employ any person in any maturity so az to became subject to eN Workars'Compemaaon taws of California.
Dale: Signature:
NOTICE: If, after making INS acclimate, you shads became subject to the Workers' Compensation provF
sons d the LzbeT Coda you must townsmen conMy with such pmvkinm or ft permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the pertor-
mance of the work for which this permit is issued (Section 3097. Civ. C).
LENDER:
ADDRESS: ��M� RS ' ��ti�- ?
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License taw
for the following reason (Section 70315 Business and Professional Code: Any city of county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the appli-
cant for such permit to file a signed statement that he/she is licensedpursuant to the provisions of the Contrac-
tors' State License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions
Code) or that hershe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 70315
by any applicant for a permit subjects the applicant to a civil penalty of net more than five hundred dollars (5500).
❑ I, az owner of the property or my employees with wages as their sale compensation, will do tee work, and
the swdura is not intended o offered for sale (Section of a p Business and Professional Code: The Con-
tractors' State License Law does not appy to an saner of a property who builds or Improves thereon, and
m her own employees, e pmdtle0 that such improvements
who does such work offered
Merse.l m however the
are not intended or offered far sale. IL however Ire budding or improvement is sold within one year of Com
pence, the owner will have the burden of proving oefshe did not build or improve for the purpose of sale).
L] I, az owner of the property, am exclusively contactingg with licensed Comractms to construct the project
(Section 7044, Business and Professions Code: The Contactors State License Law does nm apply to an
owner at propeproperty who builds at Improves thereon and who contracts for such projects with a contractor(s)
license pursuant to the Contractors State License Law). 1 am aware that proof of their Worker's Compensa-
don insurance should be provided to me.
❑ I am exempt under Section: E 8 P. C.
for this reason:
. ELECTRICAL FEES
Automatic Washer Motor L1 41 HP El 1.10 HP
Christmas Tree Lot ❑ 7450 HP 11 54100 HP
Construction Pole ❑ over 100
Sub Pole Outlet
Cooking Unit Pole Light
Dishwasher Sign Outlet
p p
Dryer ❑Gas ❑Electric Square Footage Fee
PLUMBING FEES
F.A.U. Standing Section
9
Backflow Prevention Repine
Fireworks Stand Sub Panel -
Baekilow Irrigation Roof Drain
Fixture Swimming PooVSpa
Bar Sink Service Sink
Garbage Disposal Switch
Bathtub Sewer Cap
Generator: Size Temporary Work With'„'
Clarifier Sewer Connection
-
Meter ❑ up to 200 amps Transformer
Meter ❑ over 200 amps Size
Dishwasher Shower
prinking. Fountain Solar Collector
Microwave Trash Compactor
Floor Drain Solar Piping
Floor Sink Solar Tank
Retrospection Fee
S30 Issue Fee $15
Gas Service Swimming Pool w/Spa
Gas System Outlet Toilet
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning
g Approved By Date
Building Approved B
9 PP Y Dele
J
Application Issued By �� Date 2 ` O
Interceptor Urinal
Kitchen Sink Wash Basin
Laundry Tray Washing Machine
P Trap Water Heater
Water Service
SUMMARY OF FEES
BUILDING PERMIT $ � MECHANICAL $
PLAN CHECK $ 24-4, PIAN CHECK 25%'$,
$ SMIP $
PLAN CHECK 25% $ GRADING $
ELECTRICAL $
PLAN CHECK 50% $ TOTAL FEE $
v
Reinspection Fee
P
$30 Issue Fee $ 3
MECHANICAL - FEES
Date: owner:
1 do hereby cef ify that I am aware of and understand the requirements of California Health and Safety Cade Sec
tions 25505, 25533, and 25534 and that I or any future building occupant willaulLoot (circle one) need to comply
with said state codes and the requirements far a permit for construction or modificatlen from the Air Quality Manage-
ment DISVICI. Residential construction applications are exempt from these provisions.
Date: Applicant:
I hereby CattilyCattilythat I here read applicationon arta state that the above information d perfect. I agree to Comply
Cattily
with all city and County ordinanceses and state laws relating to building construction ad hereby authors apaun
Waives of this city to enter upon the above-mentioned property for
rIInspection purposes..
Date ��ZB-9D Signature: �.✓h�T /"/• �y/f—
Driver's License on Social Sernmr, M:
Boiler
Heating System•8 Ducting
❑ 41oo,000 BTU + ❑ 10o,0oo BTU +
Duct-Underground
Duct-StructuralPLUMBING
Hood or Type 1 ❑
Canopy Type 11 ❑
Duct-Ventilating
Exhaust System ❑ Multiple ❑
Refrigeration System
El 4100,000 BTU + ❑ 100000 BTU +
Fan
Fire Damper
System Repair/Alteration
Fireplace/Fact. Bit. IC80 p
'DUPLICATE RECEIPT*
-01 00055057-00055069 T ICE T
DATE • 02/28/90 TIME: 11.52
17.94
aReln.n Fee
s3o
Issue Fee $15
0865-48 re, 10188 White - Building; Green - Code Enforcement; Canary, - Applicant; Pink - Revenue: Goldenrod
- Assessor
V" �114 . "KI
CONSTRUCTION AND PLANNING
APPROVALS Permit#
Date
Inspector
PC & SPA
APPROVALS P6rm it #
Date
Inspector
1. Tem'pd rarj Electrical Service or Pole
52. Pool & Equipment Location
2; Spil Pipq-Undrgrn'cl.
53. Steel Reinforcement
1Ejdctr-lc6I Condu,i? Utility `rJn'd'rgrncI
54. Forms
4: Et4cirlic!iI Con'd6it-Undrgrnd.
55. Electrical Bonding
5r•'SteeCRejrtforcement
56. Rough Plumbing & Pressure Test
6. Efeitric'al LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7_, Fo
,lc--
oOl
-58. Electrical Conduit-Undrgrnd,
8.,Fo,Aatio6F
59. Gas Pipe, 0 Undrgrnd., Test
9:;Water Pipe-Undrj?nd.
60. Backwash Lines, P -Trap, 0 Undrgrnd.
10.* StrO.ctural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & H6 6se Conn,ection
162. Backwash & Ieceptor-Final
12. Sewer Ca p
7
63. Heater & Vent -Final
13. Roof Draiers
64. Plumbing System - Final
14. Rough Plu , mbing
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18: -Rough Electrical -T Bar Ceiling
tjl
69. POO L/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit
20. RFactory:
,�ugh Fireplace
21. Ducts, in Strutture
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping El Gas 0 Oil
23. Gas Pipe -Rough & Test
t.
72. Underground Flush
24. Roof Franiing, 1
73. Undergrnd. Storage Tank E]Gas 00il
25. Roof Sheathing
74. Overhead Hydro
26. T-Bar;Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Framg'and Flashing
76. Dry Standpipe
28. Lathijjg &'Siding
77. FIXED SYSTEM FINAL
29. Insulation-.,
78. FIRE PREV. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster, Br6wn Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating & Air Conditioning
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.. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
IWA IWEERS
17390 Brookhurst Street, Suite 100
Fountain Volley, California 92708
(714) 968-1221 • FAX (714) 968-9286
March 21, 1990
City of Costa Mesa
Building Department
77 Fair Drive
Costa Mesa, Ca. 92628
Attn: Mr. Victor Clift
Subject: Fine Grade Certification
M
J.N. 207-03
I hereby certify that the fine grading for lots
2,4 6,7,8,9,10,50,51,52,53,54,55,56,57 and 58 of Tract 13224
were graded as shown on the approved precise grading plans for -
said project.
Llewellyn D. Incledon
R.C.E. 17593 Exp. 6-30-93
Low 5 IIP6-
1
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA-CnONSTRUCTION PERMIT TRA T No LOT o
Project Address I kI/o YE/�11N�'t.)L�i 'Pr%ia>f -
Applicant' smailing Address 180 N RTVERVT D DR
Owner's Name KAIIEMAN AND BROAD Phone
Address SAME AS ABOVE
Arch/Eng. MIKE. WOODT.EY License No. 015730
Address SAME AS ABOVE
Contractor's Name 'E''• �A�"�E Phone
Address (mailing)
City License No. 46894
LICENSED CONTRACTOR DECLARATION
I he•eby affirm that I am licensed under provisions of Charter 9 (commencing
action 7000) of Division 3 of the Business and Professions Code, and
is in fullfogiandeffect. 334495
1 ss Lc se
S'9 t �sez/J
-?S' COMPENSATION DEC RATION
ifi firm that I have a certificate of consent to self -Insure or a certificate
nrs' Compensation Insurance, or a certified copy thereof (Section
- No. C•) - 4189-1090trans.trans. ins.
Ified Copy is hereby furnish
ertified py i til d with the ci Build g Divi
Date Applicant
EXEMPTI N F OM WORKERS' COMP SATION DECLARATION
(This section need not be completed if the permit i5 for one hundred ($100) or
less).
1 certify that in the performance n the work for which this permit is t to t t
snarl not employ any person in any manner so as to become subject to the
Workers' Compensation Laws a California.
Dale Signature
NOTICE: C after making this ions roti the you Should become subject to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
comply with such provisions or this permit shall be tleem<tl revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there i5 a construction lending agency for the performance
of the work for which this permit i5 issued (Section 3097 Civ. C.)
Lender's Name -^R8
Lender's Address
OWNER BUILDER RATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business and Professional Cotle: 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/she is licensed pursuant to the provisions of
Contractor's License law (Chapter 9 (commencing with Section 7000) of
Yion 3 of the Business and Professions Code) or that he/she is exempt
efrom and the basis for the alleged exemption. Any violation of Section
. -31.5 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 (Section 7044, Business and Professional Code: The Contractor's
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
employees, provided that Such improvements are not intended or offered for
Sale. If, however, the building or improvement is sold within one year of com-
pletion, the owner will'have the burden of proving he/She did not build or im-
prove for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed con.
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
builds or improves thereon. and who contracts for such projects with a can -
tractors) license pursuant to the Contractor's License Law). I am aware that
proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section B. & P. C. for this reason
Date Owner _
1 hereby certify that I have read this
information i5 correct- I acres to tomo
antl state law
Sentdtive Lh15
Inspectio pose
Signature
Drivers' License r
0865-46, rev. 5/88
n and State that the above
city and county ordinances
and hereby authorize repre-
C UNIT NO.
ii>4 q 14
G - � / TZ
13224
BUILDING PERMIT
- _
A.P.# /f- Zone �-M
$
Main Building: Acc 55ory Building:
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION 1:1 DEMOLISH El OTHER
DESCRIPTION OF WORK/USE OF BLDG SED PLAN 3'$R
E
T
Front 1
I B
A
Rear
C
RightK
5
TYPE OF PERMIT Li GRADING IXI FOUNDATION STRUCTURAL
1-1TEN A�TX❑ ELECTRICALX❑ PLUM BING X❑ MECHANICAL
❑OTHERs\\i1T1—T_2371 GAR GR 463 DECK - 76
PROJECT DESC TION SO. FT. R .. Ate— OCCUPANCY R / M /
CON STRVCTIaN TYPE VN VALUATION § /bQ� N/7.
ZONE NA GRADINGCU.YDS.A_
$
Left
Ping. Ref. # -/1/(� Parking Req./Provided 5
Planning Notes:
Am. FOR SRUAt REQUMMENTS
ELECTRICAL
Remarks;
-- ELECTRICAL FEES
PC234-89-1
PLUMBING
FEES
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. El50+KW
-
Bar Sink Showers
MECHANICAL
Backflow Preventer - Service Sink
TOTAL FEE
Cooking Unit Meter ❑up to 100 amps
Backflow Irrigation Sewer Cap
25% $
Dishwasher " Meter El over 100 amps .
'Z Bathtubs Sewer Connection
• Dryers ❑Gas ❑Electric Sub Panel
Clarifiers Solar Collectors
Fan Motors 00-1 HP❑lh-8;
Dishwasher Solar Piping
F.A.U. Inc.Solar 09-15 HP,❑16.15+
Drinking Fountains 1 Solar Tank
Fixtures •� Microwave
Floor Drains Swimming Pool w/Spa
Device Boxes I Pole Light
Floor Sinks Urinal
Outlets Range
Gas Service Outlets Water Closet
Switches Sign
Interceptors J Water Heater
a 0
Garbage Disposal Standing Sections
I Kitchen Sink Water Service
Generator ❑05 KW 05-15 KW Trash Compactor
f Lavatories Auto -Wash
0
r 5 %
P -Trap Laundry Trays
S
Roof Drains
Reinspection Fee $15 Issue Fee $r9-
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date
Building Approved By Date %
Reinspection Fee
$15 Issue Fee
S 3
MECHANICAL
I FEES
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Bit. ICB0413567
Heatj System & Ducting
&D-100,000 BTU ❑ 100,000 ST
� r I Reinspection Fee I $15
White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
Hood or Type ❑
Canopy Type 11 ❑
lefrig ration System
WSd1F100,000BTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
I
N
G
R
E
Q
M
T
S.
DATE: ,,^r crs4 TIiiE: 1`
SUMMARY OF FEES
BUILDING PERMIT
$ ?9-4( .50
SMIP
���//
$ ��L_
PLAN CHECK
$ �FI37
PERMIT
PLUMBING
$ yq 00
ISSUANCE
$
PLAN CHECK
25°°,6$
ENEP.C.
$
ELECTRICAL
_
C�
GRADING
$
PLAN CHECK
50% $
MICROFILM
$
MECHANICAL
$ 5/b. SD
TOTAL FEE
$
PLAN CHECK
25% $
/OA>7.94
DATE: ,,^r crs4 TIiiE: 1`
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
PO' 4 SPA
APPROVALS Permit#
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
q.j(jg�/
(�
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. ElectricalUFER.Grnd.
57. APPROVAL TO COVER-GUNITE
'
7. Footings
58. Electrical Conduit-Undrgrnd,
8.' Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9 Water Pipe-Undrgrnd.
L
60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural FIoor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor-Final
12. 'Sewer Cap
63. Heater & Vent-Final
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing
�./Q-9'p
oro
65. Electrical-Final
15. Rough Electrical-Conduit
66. Solar. System-Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
1.8. Rough Electrical-T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
I-10-,d
Lim
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
.20. Rough Factory Fireplace
-1044
L.&0
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping 0Gas OOil
23. Gas Pipe-Rough & Test
72: Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank 0 Gas 0 Oil ;
25. Roof Sheathing
74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREV. FINAL�aP)
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
9. FINAL INSPECTION
32. Electrical Power Meter-Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
ote-s: yd
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
of/gd
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
t%o%-90
"
48. Special Requirements Completed{l�
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
ft
IWA l..GINEERS
17390 Bruokhumt Sheet, Suite 100
Fountain Valley. California 92708
(714) 968-1221 - FAX (714) 968-9286
March 21, 1990 J.N. 207-03
City of Costa Mesa
Building Department
77 Fair Drive
Costa Mesa, Ca. 92628
Attn: Mr. Victor Clift
Subject.: Fine Grade Certification
I hereby certify that the fine grading for lots
2,4,5,6,7,8,9,10,50,51,52,53,54,/55 ' 56,57 and 58 of Tract 13224
were graded as shown on the approvd precise grading plans for -
said project.
Llewellyn D. Incledon
R.C.E. 17593 Exp. 6-30-93
LGT ✓ y / (/ Z /�rhrti-5 e, L
-
11
BN FORM 116 CALIFCRNIA SEA3REEZE ?1ASc 1
BIA FORM 1A86
INSULATION tERTIFICATION
This is to certify that, in conformance with the current energy regulations (California Adminis-
trative (ode, Title 25, State of (alifornia') and approved plans, insulation has been installed in
the building located at:
Costa Mesa
1816
Stu . Re. (If Aw].W.)
ROOFS
Peninsula Place
sb
Orange
C.01
5
Lal Mumbr
DESCRIPTION OF INSTALLATION
13224 .
T.0 I/..
Type of Material
Manufacturer
Thickness R Value**—
EXTERIOR WALLS
OWENS CORNING
Type of Material FIBERGLAS BATTS
Manufacturer
FIBERGLAS
Thickness 32fr R Value"
11
(or Tna. N.m.)
CEILINGS
OWENS CORNING
6141r
19
BATTS: FIBERGLAS BATTS
Type of Material____
Manufacturer
FIBERGLAS
9"1
Thickness__ It Value'
30
(ser Trv&
Sq. FL Covered
BLOWN:
Type of Matarial Manufacturer Thickne« No. Bags_
(far Td. N...)
WL/Bag_ Sq. FL Covered R Value"_
FLOORS
Type of Material Manufacturer Thicknes< R Value**—
(Of Tnd. N. 4
SLAP! ON GRADE
Type of Material Manufacturer Thickness_ R Value
(or Tn& N...)
Width of Insulation Inches
FOUNDATION WALLS (if required)
Type of Material Manufacturer_
(or TI.b N..I<)
REMARKS (if desired)
General Contractor filuilderl Kaufhlan & Broad
SuDContrxtor
(LW.tla. Yue,
Accent Insulati
(sur -SAME- a .... . as
License
Thickness It Value
License Humber 274283
March 2, 1990
('W:1..... J.d.:.i<lori.. C.d., Grit IwWeN« S2nMa., drtvu. Q�Ari M1r s . liV3 ✓ 1Y N Irf r•d s.r ly rr.A..1 M SI.N
'Cr✓iro. U.r cr✓N:.w ✓ M i..bll.li« ✓ :n..l.fir, . �a a (.I�Irw:..
erMilly N..I M ....4w^ 4. Y•.. i..wl4d Ie <rf.,w.x. r:lf M
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Form 115 —T) BUILDING NEWS. INC- 3055 Orezrkl Ave, lm ArgAes, Calif. 90034--(21M 870.;871
Forel+ 1486-a BUILDING INCUSTAT ASSOCUT!D!4 Of C/11ECANIA, INC, 157L B!YK!y Blvd, Lx Anpe!es, Calif. MS_1iln sz55171