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1136-99 - 2300 IMPERIAL HWY E R-1 (3)r APPLICANT # A'%& MLt Wt 1f') Ir'� per) .sSaSCI�N C(DO�w�o ADD5112 ill. IW $a ' p "U tIptlE i1uw11$ t ,44 Z4 (L45 4A5 -247. OERl NAM Q 1AI IRE&L CO -- t4419%R7 ADDRESS /. Y W 4ebu PHONE(118)(dfl.(%3O W� �Qp 1 CITY (j 41 f,.n STATE21�P-r r , 7YflVW Y NAME ADDRESS PHONE CITY STATE/ZIP ENGINEER � PHONEh ADDRESSDD 1�id Burled h14)145101L fntilMOP tEACii STATE21P CA t1 t.4 PP 1100'"'1 Y Wed`' `'���I L. CONTRACTOR NAME MAIUNG ADDRESS CITY TELEPHONE STATE ZIP CITY LIC NO I hereby affirm under penally of perjuryt a rem licensed under prow- beans of Chapter B (commencing with Seaton 7000) of Division 3 of the Business and Professions Code end my license is M full fan and effect License Clan Lie No Data Cony Signature WORKERS' COMPENSATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penally or perjury one of the following declaration =1 have and wit maintain a csrmkW of consent to sel+mure for workers compensation, as provided for by Section 3700 of the Labor Code for the perormacee of the work for which this perms is Issue I have and will masdam workers' mltpensabon insurance as required by Sateen 3700 of Me Labor Code for Use performance of the work for which this permit is issued My workers oomp.rtaaban insurance earner and policy number are F Lamer Policy Number (This section need not be completed it the permit is for one hundred dollars (S100) or leas _I certify that in the performance of the work for whi h this permit is issued I shell not empty any person in any manner so as a become subject to me workers compensation California Laws of and agree met if I Should become subject to the workers compensation provisions of Section 3700 of the Labor Cab I shall forewent comply with those Provisions - Signature WARNING Feature to secure workers compensation coverage is unlawful and shall subject an employer to criminal penalties end cell fines up to one hundred thousand dollars ($100 000) in addition to the coat of compensation damages es provided for I Section 3706 of the Labor Code merest and attorneys lees " I hereby affirm under penalty of penury that I am exempt Iron the Contractors License Law for me rollaway reason (Sec 7031 5 Business and Profession Code) Any oat or county wham requsn a permit to construct War improve demolish or repair any structure prior to its issuance, also requires me applicant for such permit to tie a signed statement that he or she a licensed pursuant tome provisions of the Contractors License Law (Chap S (commndng the Section 7000) of Division 3 of the Business and Professions Code) or mat he or she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031 5 by arty applicant for a permit subteen the applicant to a ovil penaay of not more than fete hundred cotters ($5W)) ) I, () as owner *Me properly Or my employees with wages as urea me compensation will do the the r S W 3 C work and structure is not intended or offered for sale (Sec 7044 Business and Professions Code) The Contractors License Law does not may to en owner of a property -who builds or improves thereon such work and who does suworkhimselfor through his or her own employees provided that such improvements We not in or offered for sale If However the budding or improvement is sold within one year of completion the owner balder will have Me burden of proving mat he or she did nor build or improve for the Purpose of sale) w ( ) I as owner of the property am exclusively contacting with licensed contractors to construct me promo (Secbn 7044 Business end Professions Code The Contractors License Law does not apply to an owner of property who builds or improves thereon ono who conbects for such projects with a contactors) license pursuant to the Contractors License Law) O I am exempt under Sec_ 8 a PC for this reason Date Owner W - Ca J CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there a a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Cm C) Lenders Name I - Lenders Address - - cce/q BUILDING PERMIT City of El Segundo DEPARTMENT OF BUILDING SAFETY PLAN CHECK NO — - BUILDING ADDRESS /' goorir(,R rtid ' DRAWING NO - -- — TRACT BLOCICIPAGE LOT/PARCEL L..- ce V TYPE OF CONST GROUP USE ZONE REO'D YARDS NO STORIES SIZE OF CONST USE OF BUILDING AEe.. f_....SPRINKLEREDC/' ES NO- - WET STANDPIPES YES NO DESCRIPTION OR REMARKS NEW ADDITION ALTERATION SefiuMIQH 0 tfhtau(tg, sumps cot Usi Ewf4 1144Uffok tufu tOAKAVZ i DPI 'D — Ul Billet eouwfatou5. a I y that I have reed me s pecat n red state that Ow above information at ormation canon I - certif- ee to comply with ail (Ay and county ordinances and stab laws relsMlg to Melding bunion. and hereby augmnze represerhbeves of ma city to enter upon Ow above ter inspection purposes Signature of plant or Agent Date APPL REC BY (s Gin CG O BLDGSAF FOR DEPT. USE ONLY FIRE DEPT PLANNING PUBLIC WORKS USE CMP USE CMP USE • PARKS/REC BLDG AREA BLDG AREA BLDG AREA VAL W hTION OF JOB -Y... SMI FEE CAT %S ENERGY PLAN CHECK $ PLAN CHECK FEE BUILDING PERMIT FEE PLAN RETENTION FEE TOTAL PERMIT ISSUE DATE READ CONDITIONS BELOW - The work authorized by issuance of this permit is subject to all the rues and regulations sat form in me Ordinance and amendments of the City of El Segundo end the laws of me State of Caldonaa in regard to such work and all emendinents teem The permit becomes null and void tt work is not commended within one hundred eighty (10)) days from data of issuance or it work is suspended at any time during construction for me same period of time or If any work Is done In vlolatin of the City Ordnance or Stem laws governing same ALIDATION Diarmuaon WHITE (Derr) YELLOW (Appilcanil dos FORM B 102 Rev 195 INSPECTION RECORD • Plan Check No. APPROVALS DATE INSPECTOR APPROVALS DATE INSPECTOR EXCAVATION DRYWALL FLOOR JOISTS STEEL FRAMING - WALL ROOF BOND BEAM PANELS INSULATION RETAINING WALL LATH, EXTERIOR LATH, INTERIOR MASONRY ACOUSTICAL FENCE FINAL ENERGY REMARKS APPLICANT ,. CPCik 4 eivOl tie/ ID b c tf) ADDRESS I ,yy 5'112 taf4 -Qu6 Su• LOD w N N P,ecH ZIP PHONE (114)4A5 -.612. IARCNRECTI OWNER �IAiA�ak4tbE/1N slcia45 Co. i L S, .5wiy� PHONE( I4(41-n3QQ ADDRESS lam �K/ 1 �l " ! CITY / 1 V pi STATEJZIPC* NAME ADDRESS PHONE CITY STATE/ZIP ENGINEER NAMOrseE-A,, 9 '°U, ADDRESS PHONE 'Mils(' ibinp VEALAI STATE/ZIPa /1q7� Y "L.,rrTl WORKERS' COMPENSATION I CONTRACTOR NAME MAILING ADDRESS CITY TELEPHONE STATE ZIP CITY UC NO I hereby Warm war penalty of popsy that I (commencing wtet Section 7000) of Dlvison my license Is in full lore end effect lane Class Lie am licensed under provisions of Chapter g 3 of the Business and Professions Code, and No Date Cons Signature WORKER'S COMPENSATION I hereby affirm under penally of perjury one of I have and will maintain a certificate of consent compensation, as provided for by Section 3700 of the work for which thb permit Le issued have and will mamas, wwheta' comppaabon 3700 of tie Labor Code, for the performance My workers' compensation Insurance loner Caner Policy DECLARATION the following decimations to selfiroun tor workers of the Labor Code for the performance msurary as required by Swoon of the work for which this permit is Issued end policy number we Number (This section need not be completed d the permit is for one hundred dollars ($100) or less I cents that in Ina 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 workers compensation Laws of California end agree that d I should become subject to the workers compensation or Section 3700 of the Labor Code I shall forthwith comply with nose Provisions Signature WARNING Failure to secure workers compensation subject an employer to criminal penalties and dollars (3100 000) in addition to me cost at compensation Section 3706 of the Labor Code interest and coverage is unlawful and shall civil lines up to one hundred thousand damages as provided for in attorney s fees W( Q said Swho %. w Z 3 0 I hereby edam under penalty of perjury that I for me following reason (Sec 7031 5 Business ant exempt from me Contractors License Law and Prolesadns Codef Any city or county demolish or repair any structure, prior such permit to file a signed statement that he me Contractors License Law (Chap 9 which requires a permit to construct, alter improve to Ila issuance, also requires the applicant ter or she is licensed pursuant to be provisions of (commenting the Section 7000) of Division 3 Mat he or she is exempt therefrom and the basis of Section 7031 5 by any applicant for a permit not more than live hundred dollars (S5W)) I f I, as owner of me property or my employees do the work, and M aeuctun is not intended Professions Code) The Contractors License builds or improves thereon and who does employees provided that such improvements however the building or improvement is sold builder will have Ibe burden of proving that he purpose of sale) () I es owner of the property am exclusively consvuci ma prompt (Sedan 7044 Business License Law does not apply a an owner of property who contracts for such protects with a contrarian') License Law) ( ) I am exempt under Sec_ B A PC for this of me Business and Professions Code) or Ice me slieged exemption Any violation sublecrs me applicant o a am penalty of with wages as their sole compensation will or offered for ale (Sec 7044 Coyness and Law does not apply to an owner of a properly such work himsef or through his or her own are not intended or offered for sale if within one year of completion the owner or she did not build or improve ler inc contracting with licensed contractors to and Professions Code The Contractors who builds of improves thereon and license pursuant to the Contractors reason Dale Owner WI 0 xwl CONSTRUCTION LENDING hereby affirm under penalty of perprry that ben the performance of the work for which this permit Lenders Name AGENCY is a construction lending agency for is issued (Sec 3097 Civ C) Lenders Address BUILDING PER IT City of El Segundo DEPARTMENT OF BUILDING SAFETY PLAN CHECK NO BUILDING ADDR TRACT DRAWING NO 3(a- 9, loco rV WINSIku - k% i (I ) BLOCK/PAGE LOT/PARCEL TYPE OF CONST GROUP USE ZONE REO'D YARDS NO STORIES SIZE OF CONST USE OF BUILDING elf SPRINKLERED NO WET STANDPIPES YES NO DESCRIPTION OR REMARKS NEW ADDITION ALTERATION ,1/ytf��puMvy tto` �(�1�Gfrpy(�1(��tp ��sunors roc,{ US}eldb, twrkk �t aktv.r u(1ucouNfaiou6• for 1 certify that I have read alai end an pert the above INTabm is coned agree to comply with ell ally end co ordinances and stele laws relating SO building Vucson and hereby aahaise repraaentab vex of Mrs bay to enter upon die above property inspection purposes Signature of or Agent Date FOR DEPT. USE ONLY APPL REC BY C, swi CC C BLDG FIRE DEPT MN? PLANNING PARKS/REC PUBLIC WORKS V Z C N CMP USE CMP USE BLDG AREA BLDG AREA CMP USE s BLDG AREA VALUATION OF JOB yc'`' SMI FEE CATS �l jt Zesis /be5f $ CO ENERGY PLAN CHECK PLAN CHECK FEE BUILDING PERMIT FEE PLAN RETENTION FEE TOTAL s ! . 'PA 50 t ala ill `AVE 4 PERMIT ISSUE DATE READ CONDITIONS BELOW The work authorized by issuance of the permit is subject to all the rules and regulations set forth in Me ordinance and amendments of the City of El Segundo and the Imes of the Sate of California in regard to suCh work and all amendments me-eo This permit becomes null and void d work is not commenced within one hundred eighty (100) days Iran date of issuance or if work is suspended at any erne drimng construction for the sane period of time or d any work is done in viofeedn of the City Ordinance or Sob laws governing *erne ALIDATION Distribution WHITE (Dept) YELLOW (Applicant) doe FORM B 102 Rev 1195 APPLICANT Cit. l, a ylI 41 (OONm flA tErs) ADDRESS I 4112e bop PA • Si. ►co ITV ZIP 1410411101100 t(oaii GI2( (list) QM -lily ARCHITECT OWNER NAMEQjWjM s(s�is Co lI ADDRESSfSf1Lgas L h 4 Jgab PHONEI leek3m CITY 0, 4/,s tu4 ,pj STATE/ZI`Pet PM' NAME ADDRESS PHONE CITY STATE/ZIP ENGINEER NAM fin. ..'• ADDRSIPHONEhWIQS-y1L ginNi•s*vkI"ic ylyeie^ STATE/ZIP cA 6 `+�g4Q WORKERS' COMPENSATION CONTRACTOR NAME MAILING ADDRESS CITY TELEPHONE STATE ZIP CITY LIC NO I hereby affirm under penalty of perjury that I (commencing wet Section 7000) at Division my lianas e in hA force end effect License Class Lie am licensed under provisions of Chapter 9 3 of me BUWese end Proleesions Code and No Date Conti Signature WORKER'S COMPENSATION I hereby DECLARATION the following declarations to set insure for workers affirm under penalty ot perjury one of I have and will maintain a cerefl ate of consent campensatlbo, as provided for by Section 3700 of the wont far wheal me panne is issued I have and will maintain worker. compensation 3700 of the Labor Code for the performance eareMy workers Compeaton insurance carnet Carnet2. Policy of the labor Code for the performance insurance as required by Section of the work for winch Was permit a issued and policy number aI Number (This section need not be completed if the permit I Certify that in the performance of the wont employ any person in any manner Mr as to become Laws of California and apse that a I should Section is for one hundred dollars ($100) or less for which this permit is Issued I shall not subject to the workers compensation become subject to the workers compensation I shall torawah tcomply with those ns of 3700 of the Labor Code Provisions Signature WARNING Failure to secure workers compensation subject an employer to Criminal penalties and dollars ($100 000) in addition to the cost of compensation Section 3708 ol the Labor Code interest and coverage is unlawful and shall civil fines up to one hundred thousand damages as provided for in attorney s tees CC W 0 i :T W x 3 I O I hereby earn under penally of penury that I for the following reason (Sec 7031 5 Business am exempt from the Contractors License Law and Professions Coder Any city or county demolish or repair any structure prior such permit to Me a signed segment oral he the Contractors License Law (Chap 9 which requires a permit to oonsbal alter improve to its man= WO requires the applicant tor or she is licensed entrant to the provisions of (C mmemmng me Section 7000) of Envision 3l Mal he or she is exempt therefrom end the basis of Section 7031 5 by any applicant for a permit not more men live hundred dollars ($500)) I () I es owner of the property or my employees do the the Business end Protessions Code) or for the alleged exemption Any violation subjects the applicant to a civil penalty of wall wages es their sole compensation will or offend for sag (Sec 7044 Business and Law does not apply to en owner of a propery such work himself or through his or her own are not intended or offered for sale II within one year of completion the owner or she did not build or improve for the work end the eaucture re not intended Professions Cods) The Contractors License who builds or improves thereon and who does employees provided that such improvements however the building or improvement is sold builder will have the burden l proving That he purpose of sale) ( ) I as owner of the property am exduswey construct the project (Section 7044 Business License Law does not apply to an owner of property who controls jar such projects with a contractor(s) License Law) (I I am exempt under Sec_ Ba PC forma Wntractng with licensed Contractors to and Professions Code The Contractors who builds or improves thereon and license pursuant to the Contractors mason Date Owner WI ea I WLanders .A I CONSTRUCTION LENDING I hereby amrm under penalty perjuryofperjurye ry that se the performance of Ole work for which this permit Name AGENCY is a construction ending agency for is issued (Sec 3097 Ca Cl Lenders Address 4 C(eft or BUILDING PERMIT City of El Segundo DEPARTMENT OF BUILDING SAFETY 9 I. PUN CHECK N%/ 3 - 9� DRAWING NO BUILDING ADDRESS Soto 9t4f'0q AL, 4/1 rp_11) TRACT BLOCI(IPAGE LOT/PARCEL TYPE OF CONST GROUP Gt, USE ZONE REDID YARDS NO STORIES USE OF BUILDING Of %c.c. SPRINKLERED WET STANDPIPES SIZE OF CONST umth NO YES NO DESCRIPTION OR REMARKS NEW ADDITION ALTERATION Al ft tiwokk, tuba ') &A'C04l st DM IPINL► U `6fik(EO 1f, t C?UNWIG%0. a I tartly that I have reed this n and state that the above Womedon b bored 1 spree to comply with all city and co y ordinance, end state laws relating to budding moon and hereby eumonse representatives of this City to enter upon pN above 1144 pr for inspection purposes Signature of ApplKam or Agent Date APPL REC BY / BLDGCFE FOR DEPT. USE ONLY FIRE DEPT PLANNING PARKS/REC PUBLIC WORKS 1 CMP USE CMP USE BLDG AREA FBLDG AREA CMP USE • BLDG AREA VALUATION OF JOB C SMI FEE CAT # Nay 1a it ENERGY PLAN CHECK PLAN CHECK FEE $ 1a' sI so BUILDING PERMIT FEE PLAN RETENTION FEE S TOTAL S PERMIT ISSUE DATE READ CONDITIONS BELOW The work authorized by issuance of this permit is subject o all the rules end regulations set loan In the ordinance and amendments of the City of El Segundo and the Laws of the State of Cantons in regard to such work and en amendments the-eto This permit becomes null and void it work is not commenced whin one hundred eighty (180) days from deb of issuance or it work is suspended at any time during construction for the sere period of time or it any work is done in violation of the CM Ordinance or State laws commune same ALIDATION Distribution WHITE (Dept I YELLOW IAppicant) des FORM B 102 Rev 1r95 .l . APPLICANT OPOI, < V411404E0 CAIVQ t0.($1Lt) ADDRESS 5112 41!£p M) J. bra pityZIP PHONE V.O -lilt 1 :11 LNu°'.6 AC •` u.41 (' IQ) ARCHITECT OWNER NAMEsII'lf t1E{,N iDi(c)t Co. ADDRESS l k F 4L ccl�Uli t) PHONE/-1�' J)01,cl / CITY/.r !t(" ,n �l STATE/ZIP - , NAME ADDRESS PHONE CITY STATE/ZIP st v I;AI NAM H n : oo ADDRESS 11r(? 4(1LSA :J IIq PHONE/ZZ1'44YJi S'7,lL CITYu ItAISttI Mom, ACM STATE/ZIP aI qz4,.4a L WORKERS' COMPENSATION I CONTRACTOR NAME MAIUNG ADDRESS CITY TELEPHONE STATE ZIP CITY UC NO I hereby affirm under penalty of perjury that I lcommendng with San 7000) of Dyalon 3 my In is m full force end effect Ucense Class Mc am licensed under eremitism of CaepM 9 of the Business end Professions Code and No Date Cony Signature WORKER'S COMPENSATION I hereby affirm under penalty m perjury one of I have end win maintain a ceMkate of consent compensation as provided for by Section 3700 of me work for which this permit is issued - I have and will memtam warkera compensation 3700 of the Labor Code, for the performance My workers' compensation Insurance carrier Cancer Policy DECLARATION the following dedaretlons to ssadnsure for workers of the Labor Cope for the performance insurance as required by Section of the work for which this permit is Issued and policy number are Number (This section need not be completed if the permit is for one hundred dollars (S100) or less I candy that in the performance of the work for which this perm) is issued I shhell not employ any person m any manner so as to become subject to the workers compensation Laws of California and agree that if I should become Subject to the workers compensation provisions of Section 3700 of the Labor Code I shall forthwith comply with those Provisions Date Signature WARNING failure to secure workers compensation subject an employer to criminal penalties end dollars (St00.000) In addition to the cast or compensation Section 3706 0l the Labor Code interest and coverage is unlawful and shall civil fines up to one hundred thousand damages as provided for in attorney a lees CC W ca W 3 O I hereby affirm under penalty of perjury that I ror ter following reason (Sec 70313 Business am exempt from the Contractors License Law and Professions Code) Any city or county demolish or repair any structure prior such permit to file a signed statement that he the Contractors License Lew (Chap 9 which requires a panne to corativa alter improve to its issuance, also requires the applicant for or she is licensed pursuant to the provisions of (commencing the Section 7000) of Dwain 3 of the Business and Proreseions Code) or for the alleged exemption Any violation Mat he or she is exempt therefrom and me basis of Section 7031 5 by any applicant fora permit not more than live hundred dollars (S500)) I () I as owner of the properly or my employees do the work end the structure is not mended Professions Cade) The Contractors License who builds or mproea thereonwho and does employees, presided d that such Improvements however the building Or improvement 0 sold builder will have the burden of proving (net he purpose of sage) ( ) I as owner of me property an, exclusively construct the project (Section 7094 Business License Law does not apply to an owner of property who contracts for such protects with a contractors) License Law) I ) I am exempt under Sec B 6 PC for this subjects the applicant to a evil penalty m with wages as their sole compensation will or offered for sale (Sec 70.4 Business and Law does not apply to an owner of a property such work himne or through his or her own are notintended or offered for sale If within one year of completion the owner or she did not build or improve for the contacting with liensed contractors fo and Professions Code The Contractors who builds or improves thereon and license pursuant to the Contractors reason Date Owner W ca CONSTRUCTION LENDING I hereby affirm under penally of of perjury that therea the performance of the work for which this permit Lenders Name AGENCY a construction lending agency for is issued (Sec 3097 Civ CI Lenders Address ri 11' (.r1/ee�� BUILDING PERMIT g City of El Segundo DEPARTMENT OF BUILDING SAFETY PLAN CHECK NO 912 � BUILDING ADDRESS 1.060 DRAWING NO t'I�11 TRACT BLOCK/PAGE LOT/PARCEL f i TYPE OF CONST GROUP Y USE ZONE REO'D YARDS A NO STORIES SIZE OF CONST USE OF BUILDING off v,c.1111001 SPRINKLERED t`ai NO WET STANDPIPES YES NO DESCRIPTION OR REMARKS NEW ADDITION ALTERATION iu41tt\ Cf feitil((I,;r -apm(t F)tk ui!JA) 4'IEt:A F.W'L:NSry et siUlq'G)c t OM Thjs: _- to I frcedetboden L iM`.1 (Duo/IJ(tAO. IL I amity mat I have reed this appllecon and state that the above information Is correct I Leonia to complywith all oy minty ty oanelaws s end state relating to building Construction and hereby authorize representatives of this city to enter upon the above rryensone prr9perp for inspection purposes ` gag Signature of Applicant or Agent pate FOR DEPT. USE ONLY APPL REC BY,_ i 11 Q O BLDG'SAFETY "` FIRE DEPT fr i l PLANNING PARKS/REC PUBLIC WORKS CMP USE BLDG AREA CMP USE BLDG AREA CMP USE • BLDG AREA VALUATION OF JOB t» i SMI FEE CATN 4P%s MJ ENERGY PLAN CHECK a X'" PLAN CHECK FEE s till L ✓50 BUILDING PERMIT FEE PLAN RETENTION FEE TOTAL PERMIT ISSUE DATE READ CONDITIONS BELOW The work authonted by issuance of this permit is subject t0 all the rules and regulations set forth in the ordinance end amendments of the City of El Segundo end me laws of the State of California in regard to such work end all amendments the eta Tins pawl becomes null and void it work re not commenced within one hundred eighty pm days horn date of Issuance or a work is suspended at any time miring 000allucbml ha ere same period of time or deny work is done in violation of the City Ordinance or State laws governing same VALIDATION Distribu ion WHITE (Dept) YELLOW (Applcanp dbs FORM B 102 Rev 1/95 DUPLICATE RECEIPT DUPLICATE RECEIPT CITY OF EL SEGUNDO 350 MAIN STEED CITY HAIL -FINANCE DEPARIMENi HEADER MESSAGE LINE 1-10 ,r REG-RECEIPT 01-0023400 C Nov 3i ;9% CASHIER ID B 3 57 phi A Nov )2 1939 5504 PLNG-PLAN CHECK FEE 'L571 5= PEN CK 113E-99 TG'i.'_ DUE RECEIVED FROM P2S ENGINEERINC-Lki0'd4 CHECK 5371 5: TOTAL I Nl;FED C'UANCE DUE :371 0 0: HAVE i NICE L'• DUPLICATE RECEIPT u' PLILAIL RLL; r T ell oi el Segundo DEPARTMENT OF PLANNING AND BUILDING SAFETY 350 Main Street El Segundo, CA 90245 (310) 322-4670 APPLICATION FOR ACCELERATED PLAN REVIEW I hereby acknowledge and request an accelerated plan review for the following drawings: Plan Check No. / /3 to - I understand I will be charged $ 75.00 per hour, payable at the time the plans are issued, in addition to the plan check fee paid at submittal. Signature Date mote__ Requested By: ID thC.A1LE Address:GM- tVu4A NJE c 103 City: thikIfIlltifON 45EACI * Cit. 6(2649 MISCELLANEOUS RECEIPT Accelerated Plan Review - $ 75.00 per hour x....e, $ 4 fa Plan Check No. Project Address: Issued By: Date: JOB ADDRESS. Way ci eV Yratdo DEPARTMENT OF COMMUNITY, ECONOMIC, AND DEVELOPMENT SERVICES 350 Main Street El Segundo, CA 90245 Phone: (310) 322-4670 Fax: (310) 322-4167 Date: C.P - S - 0-D Dear Client: Please be advised that our permit files indicate that your Plan Check No. will expire on the date indicated below per Chapter 16 04, 16 08, 16.12, and 16.16 of the EL SEGUNDO MUNICIPAL CODE. The following information was used to calculate the expiration date 02S-00 , w/ PLAN CHECK NO . i(3 (P -9 PERMIT EXPIRATION DATE: OWNER: 24y Ph c-i,vt Should you find the above information incorrect please contact our office at your earliest convenience Unless you take action to extend the time limitation per Section 107 4, your permit will be cancelled and your plans returned at your request or destroyed. 7-r� - v7 Thank you for your cooperation in this matter If you have any questions or need additional information you may contact our office at (310) 322-4670 extension 411 or 395 Sincerely, Hansen, Director unity, Economic, and Development Services Department Wry e dAC 2• FB .