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FICHE - 219 WHITING ST219 WHITAG ST. B-1 c on,F llE LtL"1L— _noo.w CERTIFICATE OF EXEMPTION FflOM WORKERS' COMPENSATION INSURANCE x I �s.�O rMm v IV BUILDING FPae DEPARTMENT OP BUILOINO 21°f w_laalnu� T,P —Tivre ar mxs *. INS CO.ET. UBC ED. Et ET.HPPF E "A HE E[XC EST EACH CES PP011DED OFSCPiPTN)N OP REMAPKe: AOORgx ALTEPATON 1. Vrn N)AY1AC IDrrl[7E'A1rC ry r tl�.�.n� wn„ w�aLy Y 'son ahem bMUxaFS.�.P o.n FOR DEPT. USE ONLY APP c. ET t mss. 0 EPT- Pu c- UJ L W /709 x : 2GYa0 ^ D ENEFEff PUN CHECK s —NC ­N FEE s AIDING PERMiT FEE n s 6. d71 PERMIT ISSUE DATE — _ READ c"Imots w Imo n «v w m u w raw. ua rwanm. vsu�.a cu�ma«�w.b m.an ""°'�wNs _ eaoH.am ;maeea..aa.2.wwe�:minm�w.rm,am Cwr ora�a�K. Rama m...r n.m »a. naann p m"Wa. �014, BUILDING. ERMN DEI.—N, OF U.-IN. OPlY T. o PERMIT 'rMON LENDING AGaCl m: FOR DEPT USE 7-c I CEftTIFLWE QF nem"Til" F".M ...... IRI N CE comp.E.. 'N.. , PERMIT 'rMON LENDING AGaCl m: 'E n"r�i � 9 9 & crtY d- /0 WORXEPS' COMPENSATION DECLARATION varYm / .I n...d. aaX r. wa�o w .i ♦PPUC r ..T <..Q�. CERTIFU —E OF EXEMPTION FROM WORKERS' COMPENSATION INEUMNCE BUILDING PERMIT CNy of El Bepundo DEPARTMENT OF BUILDING SAFETY Holz ooRESSw rNG Eri.6T. ZONE FlSE 20xE REO'D YM09 USE011UEDING use ED. wumwplpEs 1.E No RECo cPiPnox on xEMenKS: Drtwx TExnno 5 t ., 2 nl r'•FS o6 11 •w�ar',e �v�...a...w.mm.,. ..�. u�nm.m. S y xS L saw.F d wdF.,I..wd FOR DEPT. USE ONLY .PPS PEC. —13 qT E.I R.iAE6F LED PUBLIC B f ENERGY PIAN CKECK f CH- FEE 0 iEE f MY PERMIT ISSUE DATE o coxoiTioxe oELOw uenanr a p uiw�n d n. Dmb r ngat m Fv vx Nn um npuau �M Oryd O6Fpada. W nx N.. bm4 mn rpua b u.nwak w9m.glaY I�MaM aura nwmpddl w�v xmqum+e F�• rid��.wdq Fmmunm ww pMZd mw,w HUry�w. NdanFbdaWkndamcp Odnuad slnFgremiry FUm. APPLICATION FOR ELECTRIC PERMIT City of El Sagundo, California DEPARTMENT OF BUILDING & SAFETY FOR APPLICANT TO FILL IN T HEREBY ACKNOWLEDGE THAT I HAVE RFAB THIS APPLICATION AND STATE THAT THE A.— IS CePAUCT AN' AGREE TB COMPLY WITH ALL CITY ORDINANCES Me STATE IAWS REGVIATIND ELECTRICAL WIRING. THE CITY Of El REG VAT N0 TALE OFRCIYiL FORN9q Ca TNpT IIRM THE .LEGAL OHNER.OF THE ABOYE DESCRIBED PRe TY. SIGNATAAE ���9Ea1GsGy OF PERMITT .�r�? V -B �L BF 100. 7`" /�lfL ?�•� OWNER�lG��ff �^ ADDRESS Cltt A � To. No. ELECTRICAL L^ — GOmRAEIeR ADDRESS CONTRACTOR'S/ // n PXON EACT�� p9U � Ll;�. LICENBE C rR CBNAmE No. CON ACTOR' N0. J // .PURPOSE NO. HeF 9T.1. OFBL00. !H EIGHT or F-11 'mo. AREA METERS / FAMILIES NEW BL00. M Om BIDO. IVEO Y I DATE eF APPL /y P MIT ,(''GATE 1r59VED lY IV U '� IBSY9VE0 INSPECTION kECORI _ APPROVALS DATE INSPECTORS SIGNATURE CONDUIT WIRING FIXTURES POWER UTILITY CO. NOTIFIED FINAL Plans End speeiflcetions and such other date e3 wlll eneble the department to ascertaln whether the proposed work will conform to the fequiremenis of the Staid Laws and CUV Ordlnances musf Be flled. At1DATION N1Y•15.% 46791 C— d 2.90 ELECTR BUILDING � ` �-__- 2- ����� Z19 WHITING ST. M-1 SpAlni: "TWb PAGAAL93 '41N 22&q NAME tilt STATEmP NAME t5 STATETP ­M­ VAL H-w—va"'Effi— ONE --ZEE= Adaum WORKER'S COMPENSATION DECLAIARO" Prr,N St AI cPmwe CERTIFICATE OF EXEMPTION FROM WORKERS' Dm . —WE SAN, 11. bme _E LENDING AGENCY =MUCRON YMMe uprlMeMw M. PERMIT P—RFOE REMARKS P.-- luwncefd 51500 r— OTAL s'911 VAUDARDN'll­ lil (:'i ALL APPLICATIONS MUST, BE FILLED OUT BY APPLICANT APPLICATION FOR PLUMBING PERMIT GAS PIPING. City of El Segundo, California BUILDING DEPARTMENT TO THE PLUMBING INSPECTOR OF THE CITY OF EL SEGUNDO:. Application is- Herebyy mode for a permit t construct and install the w k hereinafter set forth Ties application is made blect to the foltossing dit which re hereby agreed to by the undersigned applicant out which shall be deemed wnditiom entering into. the a rase o[ the permit, FIRST: That tim permit. 4)os not grant any right or privilege to canstrars or fmtall the work herein described or any portion thereof upon any street, ally or other public place or portion thereof, SECOND: That the permit does not grant any right or privilege to use °q of the:wark themin described or any portion thereof for any purposes that is or may be hereafter- pmhfbited by Ordulenca of the City of El. Segundo, or by SmmLnws. (U E INK OR INDELIBLE PENCIL) / l Street _....A" at _ Plumbers N __......_...11L��.2�G /GG /.f _ .C/��d. , - -_ Plumber Address�..d� 1 t/rC�L[ Stole Urinates No _ No Ph _ .......�_ - Owner's Name_...:..._. r ..... ..... .. ...m ._:. _. _.___.._............_ Owner's Address_ �/ 4 f G __ .. . FIXTURES )T6tal .............. .........j Bath tub .:......._.:.__._.......... Wish trays. ........... ............. .Furnaces- ._ ........... ..... Floor dr in.._...:...r.;.,__..:- Showee_ ..... Water d. sets..._ „...__....�...... Dish Winhe . ...... m. urinal ........._.;..__..... Ievnt6ry _._.._ — Water Refrigerate ........ Drink fotmmfm._.._..._..___ Kitchen_..... ........ .:.... Gos. Sypems.._ .................. Water softener_...._._....,........ Daniel Lav, ......... .„.._„::_._. SINES Flow.-___­­­ S. : _ Septic ads fount. ...._.__ ..._. ...- Cea p 1 . Miscellanea .. _ ._. ...... Additioal informedon..._...._._.........__._....._.: ____ .......... ..__ ......i .. ....._....__.._._......_..,._..._.......— .:. . Estimate of Cost of Proposed Work. $ :................... ............................ I have read the boa applicatio a d know th t nts them F the same trod end con-t. I further state that I amt hor with the Iaws, Pit amendments thersto, goveraing plumbing and gas fitting within the City, of EI Segundo, and. State of Califam, oral the above work wdl be perforaiil in conformity therewith. SIGNED_ . ............................. _. ... ............ ... _......____._....._ Applicant. FOR DEPARTMENT USE ONLY PLUMBING PERMIT NG , . !;O ( iAPPLt TION .. ....... Checked APPLICATION for PLUMBING PERMIT STEEET /''A /F ��(� ABB- of OF LOB oC City of El Segundo, California DEPARTMENT OF BUILDING 8 SAFETY OWNER`/ -- FOR APPLICANT TO FILL IN ADDRESS w NO. PkPMIf FEES. FEE GAS BYTEM.OUTLETS FOR S D S PLUMBING PLUMBING PIPING CONTRACTOR WITHOUT FI%NRES GCN S SEWERQU @ $190 each $ ADDREESSSTGRS,q,./' SYSTTEMDIST. $ CONTNACTOR"d / IRIS `Llmi�s••EVNO['Srf�.•Y- �T/YTf y PNONE C/ NG ET RS ' $ CONTRACTOR'S EOV PIPI MFRREATING , , $ CI7Y LICENSE N0. NO. OF STORIES BAR SINK' " $ PURPOSE OF el't_ L IN HEIGHT SIZE BA1h7UB " ° $ OB oc. FLOOR AREA DENTAL UNITS " " $ / DISHWASHER " " $ METERS FAMILIES DRINK. FOUNTAINS " " $ NEW eUUG. E B DB.G. 1L_- FLOOR DRAINS " S RECEIVED BY GATE OF APPI. FLOOR. SINKS S 'V/ I .3 -�55% GARBAGE DISP. " " $. PERMIT N0: 10GATE ISSUED KITCHEN SINK „ - " „ $ kr7 a s ar uED'/%,/ IAUND. TRAYS " " $ INDUSTRIAL WASTE APPRDVAL _ LAVATORIES " $ SHOWER PANS " $ INSPECTION RECORD SLOP SINKS " $ URINALS „ ^ $ WASH. MACH: $ STANDPIPE WATER. CLOSETS " " $ PRIVATE SWIMMING $10.00 $ POOL U Go,o -B InlercelPtui anE'411 .AC. GRAB DR SLAG BACNFLOW PREY. ADS SEPTIC TANK 6 SEEPAGE PIT @ $2.00 $ MAINTENANCE PERMIT $20.00 $ MISC. 1 $ STATE TRAP THE ABOVE IS DOApgECTHAND AGREETTO GONeLyRWI 'I ALL CITY OROINANCES AND STATE LAWS REGULATING PLUMBING. 1 HEREBY CERTIFY THAT L AM PROPERLY LICENSED AS REQUIRED BY THE CITY OF EL SECUNDD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF TTHEEAABOVE DESCRIBED PROPERP SIGNATURE 1 / /may SIGNATURE ATUR TTE ///��� --- APPROVALS MAR-25-57 13 8 60 A- T. lt,pp APPLICATION for PLUMBING PERMIT STREET /'j City oF51 Segundo, California L. DEPARTMENT OF BUILDING 5AFETY 3 aWN FOR APPLICANT TO FILL IN qB ss civ -Vo J �_� . ZTEL. NO. PLUMBING HURDEV UNBIND &HEATING CONTRACTOR CONERACTOR'S.. INOLEWODD. CALIF. GlflEE! ADDRESS: PHONE UReI IR CONTRACTOR'S CITY R PHONE _ .. / I CONTRACTOR'S ......, U.S. I _ AD." METERS - FAMILIES NEW owe. ❑ BUG am.c RECEIVED BY. 1—DATE OF AP h IssuED .L� I ..VIAL WASTE APPP.OYAL INSPECTION REMARKS SEWER LOCATION LAWN SPRINKLER SYSTEM 0NCLVOIIGEBAICNEFLOV! 53.00 S FA.,. NON DEVICE} — VAC. BRRRS. Ofl .OVER 5 ($ EE.00 BACKRO EY. �.DB W PR FOR S J CESSPOOL x.$5.00 F _ - SepliGtank— Seepage Pit @ $IOAO E APPROVALS. MISC. § DATE INBPECTOR's SIGNATURE -CESSPOOL . _ ST PTIC TANK— SEEPAGE PIT _ SEWER �ERMIF $ 2 00 UNDER. FLOOR WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I NFREeY ACKNOWLEDCR' THAT I NAVE RTAB THIS APPLICATION AND GAS VERT STATE BY THE ABOVE 18 CORRECT. AND AGREE TU COMPLY WITH All HOT WATER NEATER CITY OBURN, CE3 AHD >,TATE lAYlS REGULATING PLUMBING. .PLUMBING FIXTURES 3— I HEREBY CEpT1FY THAT I AM PROPEgIY MCENSED AS REQUIRED BY y- UTTNNE CITY OF EL sEGUNDO AND STATE OF CALIfORNiA OR TNAT I AM THE GAS TEST .L OWNER OF THE ABOYE OExOflIBEO ppOPEgtt. UTILITY CO. NOTIFIED SIGNATURE ,.4.�2. -�T:�l FINAL r, y§ PEBMITTE VALIDATION 0- 16.0 z o 91 o o A 7 3.25 BATHTUB ®© DRINK. FOUNTAINS FLOOR SINKS GARRAG SHOWER PANS, SLOP SINKS� ®� 'NNP PE civ -Vo J �_� . ZTEL. NO. PLUMBING HURDEV UNBIND &HEATING CONTRACTOR CONERACTOR'S.. INOLEWODD. CALIF. GlflEE! ADDRESS: PHONE UReI IR CONTRACTOR'S CITY R PHONE _ .. / I CONTRACTOR'S ......, U.S. I _ AD." METERS - FAMILIES NEW owe. ❑ BUG am.c RECEIVED BY. 1—DATE OF AP h IssuED .L� I ..VIAL WASTE APPP.OYAL INSPECTION REMARKS SEWER LOCATION LAWN SPRINKLER SYSTEM 0NCLVOIIGEBAICNEFLOV! 53.00 S FA.,. NON DEVICE} — VAC. BRRRS. Ofl .OVER 5 ($ EE.00 BACKRO EY. �.DB W PR FOR S J CESSPOOL x.$5.00 F _ - SepliGtank— Seepage Pit @ $IOAO E APPROVALS. MISC. § DATE INBPECTOR's SIGNATURE -CESSPOOL . _ ST PTIC TANK— SEEPAGE PIT _ SEWER �ERMIF $ 2 00 UNDER. FLOOR WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I NFREeY ACKNOWLEDCR' THAT I NAVE RTAB THIS APPLICATION AND GAS VERT STATE BY THE ABOVE 18 CORRECT. AND AGREE TU COMPLY WITH All HOT WATER NEATER CITY OBURN, CE3 AHD >,TATE lAYlS REGULATING PLUMBING. .PLUMBING FIXTURES 3— I HEREBY CEpT1FY THAT I AM PROPEgIY MCENSED AS REQUIRED BY y- UTTNNE CITY OF EL sEGUNDO AND STATE OF CALIfORNiA OR TNAT I AM THE GAS TEST .L OWNER OF THE ABOYE OExOflIBEO ppOPEgtt. UTILITY CO. NOTIFIED SIGNATURE ,.4.�2. -�T:�l FINAL r, y§ PEBMITTE VALIDATION 0- 16.0 z o 91 o o A 7 3.25 PLUMBING City f El SG 5 9 0 BUILDING SAFETY I FEE dl l— °n' em..nenwabnq mmmwa.emw. an. ON x ME Si lF/LP plm LICENSE OOH PNOxE PN.. to D 1— 3 COMPENSATION DECLARATION t- C.). CERTIFICATE OF —MMON FROM MR—W WNIPENSARON IN NM D d.— 141111 AG�11Cl. -N=� .. Am PLUMBING City f El SG 5 9 0 BUILDING SAFETY I FEE dl l— °n' em..nenwabnq mmmwa.emw. an. glam PLUMBING City Of El SO BUILDING SAFETY I v P. PHONE WIN RIJ=ON LENDING AGENCY glam PLUMBING City Of El SO BUILDING SAFETY I v P.