- 800 DOUGLAS ST Nf
OWNS -BUILDER DECLARATION
ore9y aging urger penaly Di grgun vet r am exempt IN r• rift Contractors IKano
l .w la the loge.rig mason ,Sec 7931 t Rucaneaa a Pra'eaaons Code Any ay or
w„ry wh.ch require, a permit to 0M:t-oct altos, arnieCive. demdnh, or repair anY
:grain.:, once to rb iassarrce, atao r that the applicant for such peftail to fees ,Sind
'.ta:eevgt that M of she t llCensed o Wart la the Poasons of a., ContrccIc, Lames()
Law (Crape 9 (com m.:nenp worn Sac 7000) of Do 3 of the eulmess and Professans
Coen; ter Ir I hero• sti „ exempt therefrom and the Wes fa the aft id er,mmd+0n My
sxdayo•.,n S„_ /031 : by any a000canl to, a gertnd vwlei the appl.ex.tto a ow
perfat, of not more tag, for, hurwiwd deters ($000) )
p.1 Inc nos:.• •y. or my ^mrvpyees with wv»an tho., OMw
c eemben we en this Nash r.1 tM arnoctro if. net intended ur oNmul for soh
7.Elefeness anti !toteseons Codes rTn COM:achxy I,rtcnse Lew does Mt aptly wt.
an csenre of
propene wino builds or improves ,harmer and was aN. J does such work mIa
',hough his w her nen a m:.yeea Povwtw trial sue• rmpTh oremonrs are ai
'tnder o altered to sale It Igwm Or CC LA.efuw or rm; rnmwain is sad O•
yea' Ur romr,I ce the vmer. W uder oat Mine ire Swoon of praying rat ho or t e dig
TI.31to.14 of rnP•evu for n., purgoa r o1 Sate 1
'e- novenaaogl , m teclio e contractung wen I. eruct w+hxten to
xest:uct Ile pm.•n.: :044, bustons and Prcessons Code The Gone actors
1 [ t npM. is aavn•r of owho burrm'. Thereon. and
Me co. •'act,! - not n pen, n, a Yo•
a..CI P'tp•Ciswraa come, toes enW pu-u.mt he the,nrntraelen
aw,
.a rSBPei rerun
Oa- 7 a. 1.. .. '..,•n,.m ran
LICENSED CONNRACTORS DECLRATION
. _ u::y o:pa 43, Mal am ;tensed Vneryorrsn to•Chaplet S
ray n )OLD' •O vision act Ire R✓grog end Prole ssvvy,.nee
,
and r, .r era, ,rr lea
n... t Curt attar
WORKERS* C MPE VSATION DECLARATION
a , ..th,g.. n r :,aaallr r; a,:,t.. � ,,,.a a :•... nPw rid cal_: ,lost
.e m., a . raann.ate:r inn. lie
rod aora la veggie@
' tp. .ra:0, or penvitlu: IV le Siam, nheD a' •he Labor Code, for the performance
nt Ire . nY fa unit+` Ni% porno l.a
D.erg an cthg ..r Boen arlpenmaon.. d bon y Socha 3100 of
ap, Ire the cagol rttM w..rr, lc r.-Ir ThrWfenen-ere tosser. My
sae >r0enaatro.o runner Camrrorv: putty ether are
Carrier
Policy Nrmbe-r
+..ra ae «minded n.-.e prim n.>r rive run .0 rla,me. ald010.lose)
m... waww lr�,,, tlw,. ere tsar or rug .man.•m..3.3
d 'e... r u+.w''. Ala
.eaea 4......+.a ti..�. .�s.e %,te at.. Mtn, C'de t
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O"MA T 14 LrZL. Sgnaturc r:l AFPI�
WARNING: FAILURE TO SECURE ORKERS ,eOMI'ENSATION
COVERAGE IS UNLAWFUL AND SHALL S'IPJECI AN CMPf. OYER TO
CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS ($100r000). IN ADDITION TO THE COST OF
COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 370E OF
THE LABOR CODE. INTEREST. AND ATTORNEYS FEES.
BUILDING PERMIT
BUILDING SAFETY DIVISION
COMMUNITY ECONOMIC DEVEELOPME,T
SERVICES DEPAR1MENT
350 Main Street
Else'gundo, CA 90245
24 HR Inspt:GA:on Reguee,: Line: (3' $) 524 - 2379
SITE ADDRESS:
800 N DOUGLAS ST
SriTE I IDENTIFYING NUMBER:
ASSESSOR PARCEL NUMBER
Book. Page: Parcel:
APPLICANT / CONTACT PERSON:
JIMMY PAOLA
ADDRESS:
2310 E IMPERIAL HWY
EL SEGt INDO CA 90245
PROPERTY OWNER:
NORTHROP
ADDRESS:
80U N DOUGLAS ST
EL SEGUNDO CA 90245
TEL: (310)535-3660
TEL:
PLAN CHECK/PERMIT #:
DATE: 7/21/2004
NEW
ADDITION
ALTERATION
RESIDENT IA
Cry MERCIA
CMP USE:
CMP USE.
CMP USE.
BLD 3 AREA'
BL 7 3 AREA.
DESCRIPTION OF WORK
TEMPORARY CANOPY 60 X 40' Out c I Scope Te its
SEr t
SQUARE FOOTAGE
0
STAT CLASS
0/S Tent
50.00
VALUATION
OCC GROUP(S)
UNITS)
I V PE(S) OF Ct.'.51
FINE SPI WNKLbRS
YES NC)
CODE .A EFFt Cr
CSC. 0'
PLAN CHECK FEE S 000
STORMWF TER S 000
ENERGY PI AN CH .K $ 0.00
4F.-EIPT NUMBER
CLERK
TC
• DATE
$000 PLAN CHECK FEE S 0.00
ARCHITECT:
ADDRESS:
TEL:
REVISED VALUATION
ENERGY PLAN CHECK $
CONSTRUCTION LENDING AGENCY
beret y atom under penally of perjury Viol tere n a construction WMut) agony (or the
pettomuncr of the wag for time. the^ pnmm n nsuM (.Set 3007, Cry C I
Lenders Name
Lenders Address
I urtrfy that I have reae fanu.N state irut lho at
agree to comae with all only and county ordatanr.cs spew ates
COnstrKYon. an, Nosy au hw.e represenu47ea 0I this b
mentor A pigpen), for Inspection purposes
nt
natcy� 47 L. _Signature of Applicant w Agent yji r�
ENGINEER:
ADDRESS:
TEL.:
RECEIPT NUMBER I CLERK TATL
TO i
0 00
PERMIT FEE S 00G
RETENTION FEE $ 2.00
SMIP FEE S 000
ACPH $ 0.00 ACCELERATED FEE $ 0.00
TOTAL FEES COLLECTED S 62.00
'Ion *Caged. I
erg to bold ig
fond the above -
CON TRACTOR:
OWNER BUILDER
ADDP..ESS:
CITY BUSINESS LICENSE:
CITY COPY
TEL:
_ SCHOOL FEES PAD
SANITATION DIST. PAID
- 7.7 PUBLIC WORKS FEES PD.
[IL' OSHA PERMIT OBTAINED
ISSUED BY
TC
HEALTH DEP--, APPROV
FIRE DEPT. A'PROVAL
$i :AOMD APF ROVAL
INDUSTRIAL IVASTE APP
DATE
7/26/20C4
UATC°
NORTHROP GRUMMAN
Integrated Systems
and Aerostructures Sector
Nonon.p Grumman Co,u.'411 OP
„,e Homo V:M
El S'undo, CA 90245-280.1
To El Segundo Fire Department,
John Scott from Regal Rents has been hired by Northrop Grumman Corp.
_o install a tent on the 27th of July for an event on the 26th.
wil). be removing the tent at approximately 3:00pm on the 26th.
Thank you for
l7si4/
your cooperation,
raasi