- 700 LAIRPORT ST S9 (3) co 0 0 0 1 4ELECTRICAL PERMIT
APPLICAMCoats "TOR I/E` City of El Segundo
_ � ► BUILDING SAFETY DEPARTMENT
ADDRESS"'
5y V 7S C�fc1E 'NlUfJ�f� J'£N /-��/"'�j j 3 Aem� 7, 0 U4!f-' 9 r 4VE - ei `-Ig N0 .s
CITY SCAy�s,`,6� 14 9�2( PHONE- Trial - 810CIA IF D Lott Parcel
NAME `'/ !//', /G), i cenBy that I have read this application anti slate that fha Stages,Information le cortw
y G —_ agree to min j with ea city and munly ard{naneas and Stab lewd raWft to building
3 ADDRESS PHONE ` construction,and hereby auaanis,repmwnMt of inks city to fif upon the abovs,
O m
entub pmpe. y for tnapectkon purposes
CITY STATE/ZIP �O
NAME C /
Wpug- of=Wr abj f Dote
ADDRESS PHONE
R CITY STATEIZIP PC No - No of Plans Rea1d
w NAME INDate """ Com r Indus
W
2 ADDRESS PHONESERVICE N MBER EACH
v _
12.r CITY STATEIZIP Serniffee Size
NAME W115•,ev WP? CB 6yer e6d volt 8000
MAILING ADDRESS f7g -v ,A^�E Additional
/i`� A`UPanel Boer 1
G CITY TELEPHONE SWITCHBOARDS (other than seMcer seditOnS)
u
STATE ZIP CITY LIC NO
a
iI Ilalaby woe Idan penally.parlay MAI I am licensed under pmvisrons tiff Chapter 9 Additional Sections
V (ope manolp w Seeldn 7000)of D.C.3 0l Vro Bu.mi and Prof a her Coda andSections
My Iq«na Ia a wd f«rs and•as,« 6 Additional Sections 5 00
_I�CMa•Ga3a C1 UC NO q
`I�\Date Z Conti Signs, a OUTLETS
WORKER'S COMPENSATION D A TION Uhl Light, Receptacle 50
U ht Fixtures 50
1 ft."an.on ,peMlty of paTlry,one al Ns,Iolrowmg tlecl.algm
I Mve and we.0km a curb"W of consent m self Ina«a to worken \ Ranee Domestic 4 00
x comp.taamn .praised fa by section 3700.1 me Labor Cos• for the perff«m lance Commercial B 00
o w me work for which Inn pared Is Issued
1� I have end well maln0m w«Iwra companseiron maurartro ea regmnyd aY Section
y 700 of me Labor Code tar me panacea w uro work ter wmUt mid parlwt w Iawae POWER EQUIPMENT HP OR KVA
W My worka a bon��IrNa1vtSp Cancer end tioigy numb• • UP TO 5HP 6 50 50 1-100 HP 3300
a Carer (117Srtt 7!! Y/i Pally Number �O�fZ 5 1 to 20HP 10 00 Over t00HP 50 00(This section need not be completed it me permit n for ona hundred doll..S100)er Is,»
_I nary din m the performance of me Work for Which MIS Farm is Lmuad I shelf not 20 1 t0 50HP 115001
employ any dentin In arty mamwr von As femme interest As ear workan compansabon
y Lowe of Caw«nta,eon agree met it 1.Muld become subject to dre waken amlpenaeuon Temporary Power 2Q 00
t= «aytwona off Senbn 3700 of MA,Labor Code I eMd ffo Kh comply wish moss
Y Permanent r Pole - 20001
c Da1a 28 signa.ro Fire Wami Communicate , Emergency, Control Systems, Smoke
3 WARNING Felluramsecureworken mSp!.a m tie unjawtw asi shed Detectors 8 $1 Bm
subject an employer ro aimmal p.wbaa.m aid f up .nuMraa mou..nd QUANTITY
dollars(3100,000).In addition W ma coat 0 compensation damages as provebd for m
Section 3706 of the Lab«Coon Interest and adorn.,a lees Control Equipment for above systems
I n.aby an.rrtaer penally el penny ma I am exempt from the Contrac.a Lioen»Law QUANTITY -
ler me forowMg mss (See 7031 5 Business and Proressioln Code) My cry«rnmry Investigation Fee 100 DO
wbgn ra fuses a pecan ro conatrun enor improve oemolum or repair any Mrucure pn
to da Issuance also ffebulres me applicant for such permit 1.ffit.a signed.aMmam a
.,eon your Ilwruad purwanl Io ma Prowsgna of the CWrAcors License Lew(C
(commenrnq dw Sectl«t 7000)of D Ion 3 of me Busmen We Pmlesa Court or
mar M«non a sumps dwrolrom eon dro Omit ffor me alleged axe on Any,venison `1
of Sactron 7031 5 by only WPIlq l I«a Permit subjects the ep lino a ova penalty of 'V`gr{p•
not many man two hundred dollop(550oJ))
WI )I as owrwr of the parcramy or my empoyses wnn as as their sole compensation will
p do Vro worn,tine me strucwe o MI miamed or red tar sale ISec ]oak Buarnes era PERMIT FEE (Sub Total) r
r Pgiesslom Code) The Cannons Ucens w does not apply to an owner of a property
who builds or improves thereon end w does such work him Check
self or through his or her own REMARKS Plan Fea
employees provided Met. im amens,are not intended or offered for sale It
W howevit the balding or Impm tins sold within ona ye«of compiebtin Ion owner Plait Rai Fed
2 builder wit Mve did par SIMIep met he or she dro not aura or improve ffor me
3 purpose o1 awe)
I )I u owcer off Property am axtlmrvery contract no wish licensed contr son to tesueoaB Fee 18 DO
arrult t ma pr ($action 7a4a Business and Pmlessiom Code The rattan _ -711
LK8Me La hat apply M an awn.of property who builas or I es thereon and l5sus DataJug TOTAL FEE
won m for won Dmpns With o conueclogs)ticeme am ro ma Contractors
Lk. Lew) READ CONDITIONS BELOW -
( am exam0l under S.
B A PC b this ro The work authorized by taseanp of In1e 1»nnd 19 sub(eet to all the rules
and regulations Set forth In the ordinances and amendments of the City of El
wro nor Segundo,and the owe of the State of California in regard to Such work and
all amendment UW&to
CONST TION LENDING AGENCY This permit becomes null and vow B work la not commenced within one
WMroby edam undo Peat p.lury cow mare d a conshunron lending epenry for hundred eighty(180)days from date of Issuance,or it work le Suspended m
p the pertorm.to a i won which cola Permit Is raaued(Sec W97 C.C) any sae during conlrlxtlon for the same period of time,or If any work 18 done
2 m initiation of the City Ordlnance or State tease governing same
W Landes.N
—11VALIDATION
I.enden Addreaa
Distribution GREEN a BLUE (Dep1) YELLOW IApmgartq dos FORM E 103 Rev 1195
INSPECTION RECORD
APPROVALS DATE INSPECTOR'S SIGNATURE NOTES -
TEMP POWER POLE
UNDERGROUND
ROUGH
WALLS
CEILING
SERVICE
UTILITY NOTIFIED
FINAL
EMARKS
CITY OF EL SEGUNW --
' EPARTIVIENT OF PLANNING AND BUn DING SAFEW
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
Building Permit Na 9�3b' - 9 q /- D/- 9 9
Job Address �a6yes fr/ri'Rw &da-? �15'-p/74� 1�71�w-lwll �51 4�gcn�o C4 9"w5-
General Contractor LC 10- A .1,anB C:,o
Type of Work: Reinforced Concrete ❑ Masonry ❑ Hi-Tensile Bolting❑
Prestressed Concrete ❑ Grading;%M ❑ Spray-Applied
Gypsum Concrete ❑ / Welding❑ Fireproofing❑
Other Specify W '1�iP/LL64 Tn - lJncyoeS
Description of Work Inspected- P--"9r / dwxaws 6/isaRt 4012 er
CW 7/Lr-U,P So//4, g ,VS r-eC,(ew s
Q .,9 5s
75 6"X6"s%y"-�/o�/zonrnLm�n�ms- 771 c�ino- p./asks n �o�r Acme y DMA/.ems
Location in Structure C° 9•Q/al i/nB ,4 2;`tuN, /— l
T� of S)CVXr usCI: 61407 C'ra - 06L 7000
1,5
vuDeK i2 roiny/v�/CE cy/ 1, e- C4-
All work on this job to date has been satisfactorray completed and conforms to the approved plans and
requirements of the Uniform Bu2d4F Cods,
9 9 (/./RTP�Ds �o,Qas�i/o Ssu�-DT-� N 9P 3567 C'/3�.�p
Date Special Inspector CeetiSmtie T4&tration Na