The URL can be used to link to this page

1238-01 - 2250 IMPERIAL HWY E (3)r VERSION 12 2000 I License My repair to file Cprmactprs Business for to LJ pensabon 7044 apply Wok prwements prevenient burden tractors lAntraclas proves pursue OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractors Law tot me rosom q reason I sec NMI Y Business and recession Lode city or county which requires a permit to construct alter , .. derwfisl or any structure prior to its issuance also requires the • • "cant to such Deana a sgiei statement that he or she Is licensed pu.. to the pro-swis of the license Lem (Chapter 9 (commencing Sec. 7000) of Div 3 of the and Professions Lodel Of that he or • - is exempt therefrom and me bass the alleged exemption My violation of - 70315 by any applicant for a panel eGa the applicant to a awl penalty • '• mom than Ina hundred dollars (SSW) ) I as owner of the property IX • employees with wages as they sole coin we do the warp and .. . ure is not intended or offered for sale (Sec Business and Proles . ..e The Contractors license Law does not to en owner of prapert • builds or Improves thereon and who does such himself a horsed or .. , In or her own employees provided Mat such are not •-. or offered for sale If however, the buMing or Cm is sold wit one year o completion the owner -budder will have me of prow* • he or she did not burro or improve tor me Purpose o sate I Q I as . of me properly any exclusively contracting with Scented con to .. ,. . the pro1ec (Sec 7044 Business and Professions Code The ••• • Law does not awry to an owner o Property who Coals or Im- th • =• and who contracts for such projects with a contractor(s) license • the Contractors License Law 1 an exempt under Section 8 &P C for iris reason Date Signature of Owner I Chanter Prole LICENSED CONTRACTORS DECLARATION hereby affirm under penally of penury that I am licensed under provisions of 9 (commencing with Section 7000) of Division 3 of the Business end inn Loge and my license is In lull torce and anent L 1/ /c A 7 / 5-6 1-30-02 License Class raise Number ate Y-Z6-S. ate - Signature of tracts I Q compensation formance 1--1 Sec. is Issued - WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of penury one of the lodrnung declare s I have and we maintain a certificate of intent to sell -insure 1 as provided for by Section 3700 of the Labor Cade for of the wow for which this permit is Issued I have and we maintain woken compensation insurance by j rW a me Labor lode to the performance a me EWxk la AT Derma My waters compensate Insurance carnet and policy number are Gamer Orr, Policy No LS ,4 /3L//C:3--rodLlwbssl I theseosi need Ms. mNbbd I Pe purr slot ate I certify that in the performance of the wodc for which dxs permit is issued not employ any person m any manner so as 10 become subject to the Workers lion laws of California and agree that ill should become suluec to the compensationprow Sec 31e Labor 1 shalt forthwith W of me vim Mesaprow -oz ate Blunatu of p"cant WARNING FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL LL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,000) PV ADOMON TO ME COST OF FOR COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 370eOF ME LABOR CODE, INTEREST, AND ATTORNEYS FEES I hereby for the Lender's Lender's CONSTRUCTION LENDING AGENCY affirm alder penally of pejuury mat there is a construction Tendon agency performance of the work for which this oerma is issued (Sec 3097 Cry C I Name Address I certify coral ama to enter that I have read this application and state Mal the above mfDonation is I agree to comply with all city and county ordinances and state laws m- to a gamso construction and nerebv authonZe representatives N this coy upon me above -mentioned properly for inspection purposes • Sim! re of cant or Agent BUILDING PERMIT BUILDING SAFETY DIVISION COMMUNITY ECONOMIC & DEVELOPMENT SERVICES DEPARTMENT 350 Main Street El Segundo, CA 90245 I Rennet 1 inn. t31f1 FJLD1Te SITE ADDRESS !MPegfrit-l+r1 2250 E. SUITE / IDENNFYINNGG NUMBEBEERR��2 P /' ASSESSOR PARCEL NUMBER Nor( PAGE PARCEL APPLICANT / CONTACT PERSON r..I JI�mw� DATE WO I DRESS a f t 6i,-ct- PH «l1�✓��((((�� fro CITY (/�� y/•SrVp��J}-STATE E��/�2ZZI{IPP/j(Q� c Ij� DJ PROPEIL�OWNER PHONENO edge' N "AD,41-�0Y12 SS —Ma t lA/Y ZIP 121213b Er. WO CITY STATE V IINf/ 11VNTTz '(�y3i p2 ADDRESS rut{► c t ZIP (��J� LOVt PHONE NO r /S•- CITY /5� /� �,.�8/tAYT�Ey /2 /vf&3 �:�7301 Err77GIGIINEEERRj� l rSS Rl CITY _ _ - - STATE ZIP CONTRACTORS NAME �C zti eoNsr CITYLIC NO I77y_7 iZEN5 `Z• ys76, A WO/ C. !3, 3 (VP C/IT�Y F. �J'Q - STATER ZIP -fy 07 PLAN CHECK/PERMIT NUMBER / Z3 8 _a / I CMP USE BLDG AREA -NEW - -RESIDENTIAL LMP USE LUG AREA ADM ION I,UMMr LMP USE rIr. D ALTERAX..... BESCRIP och p v TANrNA1 r 4 t M vane-n45 4144,/02 AP AM') gPEA 4ti,y • REF U OCC Gg0UPIS) TYPEISOF CONSTRUCTO' SQUARE FOOTAGE s. o NO OF II STORIES — FIRE SPRINKLERS ES NO STATISTICAL SSIE Of T �7 UNIT(S) IN EFFECT 1/�5 'S A. °V a PLAN CHECK FEE S S /y� V o8 AilOOF ENERGY PLAN CHECK S RECELP MBER� INRVLS IDA7Le 471_ / S LAN CRECK FEE S REVISED VALUATION - ENERGY PLAN CHECK S RECEIPT NUMBER I INITIALS I DATE ,snL - PERMIT FEE T $ `s- `. �/J�,, 00 .,.L RETENTION FEE S 5t) SNIP FEE S V ACCELERATED FEE S / Ll TOTAL BUILDING PERMIT FEE $58 'Y _ SCHOOL FEES PAID _ HEALTH DEPT APPROVAL - (I SANITATION DIST PAID f1 FIRE DEPT APPROVAL ri PUBLIC WORKS FEES PD r1 SCAQMD APPROVAL r1 OSHA PERMIT OBTAINED I— I, INDUSTRIAL WASTE APPROVAL RE U ER UDR D 10 IN S DA - (i D2- F lai'I✓vv�V/V?\ (/.n='' A_---) D �V NO INSPECTION DATE INSPECTOR REQUIRED BUILDING INSPECTIONS AND APPROVALS 81 Location and setbacks B2 Soils Engineer's Approval B3 Foundation/Trench lamas 84 Structural concrete slab on grade 135 Raised floor teaming 86 Under floor Insulation B2 Fast level floor sheathing BB Second level Flom sheathing B9 Thud level floor sheathing 810 Roof sheatng 811 Concrete block 1st Grout HI and Grout MI 3rd Grout kit 4th Grout MI B12 Steel training B13 Fire Dept frame n /s al B c L/�'/�'��J f■KA V_ 4 BIa Building Dept frame inspection h mo 2O '`' _ 4 a .7Y • VE/ • 015 Ere spnkler hangers B16 Insulation/weather shlppng B17 Intend, lath and/or *ran 5 .2..L i1 M ''K BIB Eamnor lam Big Rated floor/Ceding assemblies B20 Rated wall assembles 821 Rated opening protection 822 Rated shaft construction B23 T bar ceilings B24 Lot drainage_ B25 Planning Dept Approval 826 Fro Dept Approval BP Public Works Dept Approval B2B Fnal Budding inspection approval DESCRIBE COMPLETELY THE INTENDED USE OF ALL SPACE APPLICABLE TO THIS BUILDING PERMIT The following statement must be signed by the Building owner (When approved by the Building Official, the owners agent may sign for permits other than the Initial or shell building permit W el me applicant or future budding occupant handle a hazardous material or nature containing a hazardous material equal to or greater than the amount specked on me hazardous materials information guide? Yes or No land If the answer to the question was yes will the proposed budding or modified Malty be within 1000 feel of the outer boundary of a school', Yes or No loan I have read the hazardous material informal/On guide and me SCAOMD perm6ting checklist I understand my requirement under the Slate of Gastonia Health and Safely Code Section 25505 25533 and 25634 concerning hazardous materials report ng Yes or No N+al NAME SIGNATURE INSPECTION NOTES• a. ream