1115-97 - 231 ARENA STOWNER/BUILDER
te
APPI cm
EL SEGUNDO PLATING
ADDRESS
231,233.229 ARENA STREET
CITY ZIP PHONE
as
4
I
BUILDING PERMIT
City of El Segundo
DEPARTMENT OF BUILDING SAFETY
EL SIASUNDO CA 90245 322-15$5 PLAN CHECK NO DRAWING NO.
gj
ADDRESS 4304 THE STRANMONE 5455?o01101 G ADDRE / r
CITYMANHATTAF BEACH STATE/ZIP-CA 9U26(, TRA
BLOCK/PAGE
NAME
TYPE OF CONST GROUP
NAME STUART SACHET
ADDRESS PHONE
CITY STATE/ZIP
NAME Thomas N, Cover _
ADDRESS 231 ARENA SvTREBTONE 322-1585 0
CITY EL SEGUNDO STATE/ZIP CA 9022-45_
NAME
SWUNG ADDS
2
CITY I TELEPHONE
STATE ZIP CITY LIC. NO.
I hereby affirm under penny of pokey Mt 1 am Lronsed mew Median of Chaplet 9 /"e"- .
(t nvMndnp wan Swann 70001d DiScn 3 M Me Business and fidessioro Cods. and
my kern* is In I W Wm and idea
licenseClass tic. NO.
Dale Conti. Sira de
• WORKER'S COMPENSATION DECLARATION
I teuSis aibm order penalty a perjury one of Me Iaowitg deauston,:
�I have and we miter a earlcote of consent o sea -Nave la waters'
compeno aon.as Marled Vol by Section 37000AOhe Lana Code, lo, the pad&mance
CI M ee work la *Mi t Inds permit is loosed
I have and we ma/ M weans' Oornpenyaal rnsvande. as reryn'td by Seam
4 3700 of Me taboo rpda,yor the p4*rmance of the wad la wt� tls peend m Issued
{ My waters' ccrpwvydnnimance censer aMP015' number we:
W Canner.
X (Tis seam need Ad be Compiled d a permit a lao a hundred dorm (S100) a)ns
O ._I wily that n Ma performance of the work to vmlcn Ws derma Is Issued.I shun not
�' angst any moon n any moaner so as U become subject b me wmker>' faapen>aMA
y laws of CekomOa, and agree tatd t sound become sub) Kr to Me wo*ns'mManaale
W Moriins a Section 3700d the tabor Code.' shall yoMwilh comply wlth Vs
>,g Provisions.
ODate ___ Shgnape
3 WARNING: Uwe o sews. workers compensation mange Is Imixnip, and snail
aubleci an employ., N &bind 'manias micro/ Imes up b one hun&od pd0sNd
dollars (i1OO.OMI. m addein loth, costal cnmpens.On. damages as ps0 ided Ica in
SMmn 3706 a the Labor Code. nlere31 and attorney's Ito.
I hereby affirm alder pena:M N pnM1ry that I am exempt from the Connectors Leanse Law
la the IoOuweq:eaten (Sec. 7031.5 Business end Prolnsiv Cade). My ay or wry
which lequees a pe(nie b construct eker. improve, demosas Cr ever. any sbuclu:e, pot
to Ns issuance. also tittles' the *flaunt ler oath perms to Me a sgned Statement that N
M she Is Icntea pendant loom MovM),v al ate Contractors license law (Chpa
to nnmeM+n/ye Section 7003) of Dimon 3 el to Buseess an, Plolesicns Code) or
Mat be a she a exempt Ihererrom and the basso la to edopedsaempuon. My vwlaboon
a S7akm 7031.5 by wry ppMydla a perm. opens Me Npplmvs to a curd penalty of
MI mote (tan toe hundred dollars (SS00p.)
WI, as owner ate pperty a my empbyps wdh wagss as Men solo ampensuaon wA
Me work, and Ma sanctum is not intended or Mered la .Is (Sec 70n Busses, and
Professions Cede). The CMVNlo,i License Law does not apply to M owner a a properly
who bolds et anproses thereon, end wN does suds sort hinst) or though Ns or her own
employs., purged Mel autA knMmement are not Intended a offered lot sale. II,
Roam. IN butting or nnMovnnnl is sold yA1ms Me yen al compses&n eta berm.
bother all cove the burden ol Hemp Mal he no she del not Gad a improve la the
purpose of sate)
() I. es owner of ere Mepepy. am evausivey centiaq)with licensed connelors In
contemn the piped (Section 7044 Busahera and Peolessbns Code: the Canunlas
License Law Nos not apply to W owlet 01 property who braids or sisplorss Person, and
whoccabaR lot such Molten wen a emnbanks(s) lions. pisuenI to Ow
License tan)
O I em earned Morn Sec_ Ba PC for ads Nilson
Dais.• �a
DAp _
LOT/PARCEL
USE ZONE
HEO'D YARDS
NO STORIES SIZE OF CONST.
USE GE BUILDING /J _ _ _ ".�a
SPRINKLERED ��/f ] YES
NO
WET STANDPIPES YES
NO
D RI ION 0171EMAcKS: NEW ADDITION ALTERATION
CA4 Plot /zg SFr O c e
I teddy Mal I have lead the epptcabon yyals. aasere Wlo armen la Canal
agree so comply ails a5 ayu5kapdb ordinances end Ian relaying to 01io1
ansuuckon, foe home yluTiatie >prneuOsadi 0..p $ to Metupon Ole abase
... Ilmeneonednrcaelvfnfn.�i.......,...G . .
C �l 1,t
Sparer. o! Appbcanl or Agwm
FOR DEPT. USE ONLY
Dle/73 t
APPL AEC
C3
CC
C
FLOG. SAFE
PLANNING
PL'BLP. WORKS
FIRE DEPT.
II PARKS/REC
CPR USE
C) CMP USE
t,
N CMP USE
BLDG. AREA
BLDG. AREA
BLDG. AREA
VALUATION OFJOa., $
SALL PEE CAT II e __ Ji'. rNERGYPLANCHECK
LAN CHECK FEE•��
BUILDING PERMIT FEE
PLAN RETENTION FEE
-1
TO l(gL IS
PERMIT ISSUE DATE (I
n
2 V e�jQ�
C' STRUCTION LENDING AGENCY
INWeby thxmu.• pa Iyol per Ham:.at a zontaucson Nn:ID.gemy log
OW prbemanc. Cl` .e - permit N Issued (Sec. 3007. Ca.C)
Lippert HaeN 1
Wien Address_
.' DVMWaan WARE eontl YELLOW (*scan).
READ CONDITIONS BELOW
The watt auth0naed by flounce 01 fur perms is sablea toes the Iola and IepY.ne eel loaf In
Ow menace and amindmnts of Ma Cmy 01 EI Segundo, and Me MOsome Step elcelo ,n
regard to seek •tens, end al amendment' Me:ep.
This permit Semmes mil and sold dooms Is not romneaced within one hundred ethty Mk, days
from dell ol Issuance a f work Is suspended at any time Outing eonesucbon I& Ile sale period01
erne cr N any work Is don. In eblebon ol d.a City (Manama or Epp Moe sown* setae.
date FORM 0-102 Poe. INS
VALIDATION