- 700 LAIRPORT ST S9C0000151
APPLICANT tow s „704,9aeZ
�J�a�. a ADDRESS/
(, ezcftwootfiv y�EN LO0/ 083
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/�S.L./[.1975
CITY JW 4'S,`,6te iiip �t PHONE-
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ADDRESS PHONE
CITY STATE/ZIP
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NAME
ADDRESS PHONE
CITY STATE/ZIP
ENGINEER
NAME
ADDRESS PHONE
CITY STATEIZIP
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Ly
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NAME (A%/LS,✓D� let ,p
MAILING ADDRESS 5 ,r c /i'4y s' ri ovE
ry `TTELEEPPHHONE
CITY
•
STATE ZIP
CITY LIC NO r) 1 I ` 1/
)W /
I hereby
licensed under provisions or Chapter 9
3 of the Business end Professions Code and
No q 96
affirm wider penalty of perjury but tam
(cammenatp with Section 7000) of Division
my license is in lull force and sheer
Gass Cl" tic c
_I�CMse
`If\D
tiro Z.Conti
Signs e
WORKERS' COMPENSATIONI
WORT ER'S COMPENSATION
I hereby affirm under penalty of perjury one of
I have and we maintain a ceituicate of consent
compensation as provided for by Seaton 3700
of the work for which this permit is issued
I have and will malntan workers compensation
700 of the Labor Code for the performance
My workers eohncarriercarrier
D A TION
the Meowing declarations
to sett insure for workers
of the Labor Code for the perform
insurance es required by Section
of the work tor which this permit is issued
numb/LatePolicy Number 709?t ZS
is for one hundred dollars (S100) or less
for which this permit is Issued I shall not
subject to the workers compensation
subject to the workers compensation
I shell forthwith comply with those
(This section need not be completed if the permit
I certify trial in the performance of the work
employ any person in any manner so as a become
Laws of California. and agree that d I should become
prayi:ons of Section 3700 of the Labor Code
Provrslone
Date /Fa ZO/a0 Signaturesubje
a Wto securean m gremarkers . hulowfdl shall
subject
c an wnemployee to criminal penalties and card I uDTTT hundred thousand
dollars (3100,000). m addition to the cost of compensation damages as provided for in
Section 3706 of be Labor Code interest end attorney s fees
LENDER OWNER/BUILDER
I hereby Shunt under penalty of penury that I
for the following reason (Sec 7031 5 Business
which requires a permit to construct attar improve
to its Issuance also requires the applicant for
am exempt from the Contractors License Law
and Professions Code) My cry or county
demolish or repair any structure pri•
such permit to file a signed statement
the Contractors License Law (C -
of the Business and Proless:. - Code) or
for the alleged exit . .on Any violation
subjects the ap• ht to a curl penalty of
with . ,es as their sole compensation will
or . :red for sale (Sec 7044 Business and
w does not apply to an owner of a property
such work himself or through his or her own
are not intended or offered for sale It
maim one year of completion the owner
or she did not build or improve Mr the
contracting with licensed contr moos to
Professions Code The rector
who builds or r es thereon and
license ant to the Contractors
re
or she is licensed pursuant to the provisions or
icomrnencvig the Section 7000) of Division 3
that he or she is exempt therefrom and the basis
of Section 7031 5 by any applicant ton is permit
not more then five hundred dollars ($500)) )
( ) I as owner of the properly or my employees
do the
work and the smrcrura a not intones('
Professions Code) The Contractors Licens.
who builds or improves thereon and w. does
employees provided that such icy - emana
howevei the budding or impro l is sold
builder will have be our . , . proving that he
purpose of sale)
( ) I as owner of property am exclusively
construct the pr• (Seaton 7044 Business and
License La ... not imply to an owner of property
who •• . as for such projects with a contiector(s)
Licen Law)
( am exempt under Sec_ B a PC for this
Date nee
CONST TION LENDING AGENCY
I hereby affirm under pre of perjury that there is a construction lending agency for
me performance of work for which this permit is issued (Sec 3097 Cry C)
Lenders N
Lenders Address
ELECTRICAL PERMIT
City of El Segundo
a. BUILDING SAFETY DEPARTMENT
Atlmg 700 U4l4poRr4VE - BuliErrlgriceS 9
Tract - Blocky Page Lot I Parcel
`e
.9
C.
I certify that I have read this application and state that the above information Is correct
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representauyes of this city to enter upon the above
mentioned property for inspection purposes
essesa
/ 41/416
Dale
rg•tat of r
P C No -
No of Plans �• Reed
Ni, Date
" `-' Canon / _ Indus
SERVICE
/
NUMBER
EACH
FEES
Service Sae
Service over 600 volts
60 00
Additional Meters
5.00
Panel Board
10 00
/ SWITCHBOARDS (other than service
sections)
First Section
-
35.00
Additional Sections
3010�
60.00
Over 600 Von Sections
Additional Sections
55 00
OUTLETS
Switch, Light, Receptacle
50
Lip>ht Fixtures
50
aa1 fiance (Domestic)
4 00
Appliance (Commercial)
8 00
POWER EQUIPMENT HP
OR KVA
UP TO SHP
6 50
50 1-100
HP
33 00
5 1 to 20HP
10 00
Over looHP
50 00
20 1 to 50HP
15 00
Temporary Power '::
20 00
Permanent - • :r Pole -
20 00
Fire Wami Communlcat . - . Emergency, Control Systems, Smoke
Detectors 8 Si q . •: em - - -
QUANTITY
Control Equipment for above systems
ll
1 Z
ic7�
.. • t
.,/
dl,l A
QUANTITY
-
Investigation Fee
100 00
PERMIT FEE (Sub Total) I a VC)
REMARKS Plan Check Fee
Plan Rat Fee
Issuance Fee $15 0,0�1fm'
Issue Date
I Ifit%� ! TOTAL FEE 31 !W
The work
and regulations
Segundo, and
all amendments
This permit
hundred eighty
any time during
in violation of
READ CONDITIONS BELOW
authonzed by issuance of this permit is subject to all the rules
set forth in the ordinances and amendments of the City of El
the taws of the State al Callfomia in regard to such work and
thereto
becomes null and void if work Is not commenced within one
(180) days from date of issuance, or if work is suspended at
construction for the same period of time, or if any work Is done
the City Ordinance or State laws governing same
VALIDATION
t
Dstnbution GREEN a BLUE (Dept) YELLOW (Applicant) dos FOAM E 103 Rev t195
INSPECTION RECORD
APPROVALS
DATE
INSPECTOR'S SIGNATURE
TEMP POWER POLE
UNDERGROUND
ROUGH
WALLS
CEILING
SERVICE
UTILITY NOTIFIED
FINAL
NOTES
EMARKS
CITY OF EL SEGUNDO —/ CD
t(.%'- T ' EPARTIVIENT OF PLANNING AND BUILDING SAFETY
': AN' MO BUILDING SAFETY DIVISION
SPECIAL INSPECTOR REPORT
Each inspector must complete this report and mail it to the Office of the Building Safety
Division.
Daily ❑ Final l8'
Building Permit Na 9135 - ?? /1/-c,-??
Job Address iehelier /i eo,cr a. %4 5'-V Mr hirvrigcncio C4. Vas
General Constraaor Poyni A Jane go •
Type of Work: Reinforced Concrete 0 Masonry 0 Hi -Tensile Bolting 0
Prestressed Concrete 0 Grading/Fill 0 Spray -Applied
OGypsuther Specifym Concrete ❑ / - Welding ❑/MiS Fireproofing 0
17' e
Description of Work Inspected: 94x,' /i izIez novas C/isOAI rnsaroo . • AT"
/07LT-op Sup/o%g AS troeious
1Pfieemenr Ott i0 fics , gine %tie,o AS Wei ''f e'Sren/gtocnor Q0/in 5
11-6"4 "s%y° lionn2nw2Eas- TfJ chi % p//asiers f'n crony. aids .vim E7/S7/n7 awn, s -
Location in Structure c Sod/me ,4 erlQN, /— 6
7yft or gal/ used: aus0 drA - Oct 7000 •
Remarks I// waive C'Ozniflefir inf ioraion .&rupee ,pqz oOqectif /DP -Ai
))eki fit/0/nc/S1 pin's clehils s/7/.
/�5
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Jai>"onip/'. ace- GV/ L i - e' - £o,o4//'P J.
All work on this job to date has been satisfactorily completed and conforms to the approved plans and
requirements of the Uniform B Code.
/2 -17- 9 9 C 'Mk ,P 2,aWSI Ssuw- N 9P-3567 r137.20
Date Special Inspector Certifmtico/Regstration Na