HomeMy WebLinkAbout15282 Relay - CofOr
14 70.
-PERMIT. .
BUILE NG::
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Ap�llcdiii to %ill r» arc�`tvr`tlfiif"Leavy lines di`ly, � t �i"�rtr tip. . ;.
c ' : NbDEVECOOkimo SE,t3VtrESl Wre,SS P.Q,`Bt�X t�ihlCA 3GIFO'5F#NtA 92648 ,k
t"oio. 1 rar,~t No. Eiior>. girt. i3fs+tciing Acid+e; � xt
Pion Cr)eck. No.
CiiNr)a► %�" AI�X/e,,
(,.c»i):+ncy t Typc+ of iStitt n c.c. LOW)
Arfdress. � e!, Not I -- Use on tote_ P irking Spa�.ns Required
pity �ta.q Zip) Pianrt+ng Action Zone
Yes
..
�Cndsi3l Prf'T.,it Z�
ton~ Tel, t�'rt:�uY �,�e
..
Atdr.st s S4r,te LiC, Perinit
No, r thoti-e .� 7 to 'L 32+[L r Plan thp,k
C ty j•�j uttY Lic. NO. mix issue
-'COnservaticin�ti _ -i-- ---- !
rO i#eict'o( En fi r TO. No,
"empt No. rr'f / jr%'" G/ 1`C}'TI G
r
hdi3rQf; � Lic. No. Comrntrnity Lr'rf .t) �-r, _� __ ,.
rs.
r _ i_it3r TFer .1 f t - Fin 5S
x3p_,._- - - - — -
Sq Ft. Living NLt, of No of Chack'Oite /� {
T Si3kttlS FAmilies
r.
5ct. �f: Ctlrago Dr34ciipticsn ` ._. _.. _... #VC:W
of Work
AM)
At C3
lr §pectio t Rkord
!! f %if �irW""J U %% + Approval t Data i specter --
Use tSl: inij r 1 Foundation _ Y
I and Location
V .tuatipn RELOCATE !�.
t#rtchzdfnb Labor &`h4at.} l t Floor Slats
read Ihit application and agree to comply vfith at' locat and : Sheatisrng� -
t�,t_ #avis.Opl#cabte to buitdipq ccnStmOlon.
'f i arr:yaiidlti registereC"and licensed as required by thx+ CiiY of
Hu'Mlrtgton.t3each,and We State of California, or i ram rxg
Ci' 2, t "aln the legal owner of. the aC,ove riestr3heU Property.
r hava`tlted:With:,ttte City of {rttintington i3eacn, Lath or i
i A certfif(cate'of`consent to self -insure issued by the Director Df vval!
r 6f lndd�#rtal Rein#ions, or
A G4t'tl, fcate t f tvorktrs' COMP26S3ition insurance issued by i(
an adrttltte¢ iits=area. or €_tro.;n Cuaz (#
) 3 �AO'exact copy or'duplicate tilkreof.certified by Me Director
or the ini'txrer; or
LI {..i et~rti y.that n tite pettormance of ti5e Work for_vrhicn trnls Perking
pefn)it is:tss+ued, t shall not employ any person in any manner
'SO asAd becor a SuojeCt to the tvOfker% CCintipenSattOA layrS Of
the.Sfate'bt Cditforn a,:, ,!�', Landscaping ..
i ceitfy.'(or declare) der pertaity of perjury that t f `t"'og IS
trtye' dtOrrea t; and i?5.d��executbcl 0 t _ _day Land Use � p
of " i9 _at Calif' t;ohs COr�rl� permtttee 1 F;r»l
tf `Ork iS 'ffot commenced "1$0 days. ircm date of issue of this
p+:,rti[iitr;dr.ii'�Jbrk It abbrtdone'd for morn_ than = $O days, il)i5 permit l?ti)ity
Strait be il-t it and void. Release (' i
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