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20520 . APPl,lCAIVT TO FILL 0N INFORMATION WITHIN RED LINES— USE BALL ROINT PEN OWLY 6vildio Pmectldenfilim[bn - � PFRhLLTNO. Bvilding Addres: ._ ('o�('0 /�.62�t F�L.:ToN w�/�y,Ctr,Pk�. 77rJt����45011� G � � A �: o� St.e'Dl�RsS'�"�'4'� c��P��irA�^ �S' CiTYOFNPERTII�70-BUI[,DINGDIVISION P t Z_, IR � � Contrackor'sNUms: Lk.No: � q APPLICATION/PERMIT �pF �'1 �V BVILDING-Ei.�'IRICALPLUMBMGMF�t:HAMCAL CA7EGOftY CAMRIX./�' �/' '. AmhileR/Englneer. Ltc.Na: [?W . t'� � q� � a C". -_ - .k Addresa: - PERM14TI�fJANCE • d..� � � 1" 11=i LICHN56D CON9RACTOR'S D6CWRAT[ON ry, Ifiere6yatlllmtLetIamllcenevdunderp�avietoneefChaphr9(camme� J �'�C���MU+L 1 4� J08D@SCRII'170N Ingwith5ecfion70W)of d.vlelon3o(MeBusinessandPmfessionaCode,end m �y�� �.�..��1 nrenceulnfuilforaanddkd. �- 1'�.5 ��� S�p.��+V�^' � (✓�Tt�� LlceneeClam LIeA Date ConhaRar AHCHI'LECT9UCCLARA710N 201-1WU �QZ . Iundentardmyplareshallbeuxdaspubllcrecordx OVBR1000AA4m.a SQ.Ff.FLOORAREA 9/^.{2.Ff. ��� L���o���o�� ���E� �D�, t? r6� 't�+���. owivccn�erncaen oec�annx�� � .� '{, ����� ° IM1ere6yaf(Irtntlu�tlIemexemptfrmnlAeCeara�4oleLi�vneaLew(m�fie ��'�C �.2� ��, u� �? ppp (olbwingremon.(.Se�tlov7P3I5,BuelnracendPmk�lp aCbda:MYtlryar q.ma.ME1.6R0 p7�f.f p ��^ � ��� muntywAkhrem�'veaapeimitmm�ukuctalter,Wpmve, evwLL+h.orreP+�� 1'��'�1 f � � �(�� � . enyslvcwxapriwbifefewance,aleomrylmiheappAweefocmchpermittu �3WeRD � � V file a ai�N ehatement tM1at he ie Acensed punuant ta the provbfom af the � {� Con1mdor8LlceasaLaw(Chaptar9(commendngwlthSeeWn700%ofDivi- sWA,�N� ,�' . P'O:F emn2oftheBuslneasundPCa(eas�omCod�JartM1athauercmpttheehoman 7ALUAIION' ��� Uieba'sisfartl�eallegede�emylmn.MyWWatianof5xtion9�1.5lryany 'J ' l"� .�� 4 r---�� o� eppllcazrtfwape�mieub�actnNeappllcant�oatlWlpanoltyNnatmorethaa • L� ; frvgyundredddWa($50�. _SQ,{.7�, S'NRffS 2ri'BCON5IRUCTION � � �n DQl.aeawneroftMproP°rty�ocmyempioyeeswkhwageaasifielrsnte ' clm�en¢aHOn,wllldofhework�andthesku�turebmtirtmdedmoffe dfor ^'f ��o sale(Sec.901y9ueitreeea�dPm(e�iamCode:TMCoNranatsLlcereeiaw a—M �y doesnotepplytoanawrxro(pmpenywAobuildaor�mpmveatAereoryand � ��^ whodansvchwodchlniee7EmMrougAhisownemplayeae,provldedthatsuch OCGGROW RFS.i1NI79 Improvemenhare'roFiniendedmofkretlforsele.i(,hmvever,thebWldingor ' qpyp{,; ^'.� , Mpro.rementusddwitLlnoneyeazafmmpltlSOqN�eowner-bullderuHllXave . � .' ' _ ti, � t1�e�urdeaofpmWngthathedidnetbWldwimpmvefotpuryaeeoiseleJ. � "y'�'- . . ... ..�+� " � '' � � g�,ppDZONE APN L,J I,ae ovmer o(the p�ope�ty,am excluslveiy mnfracting wlth licenced � ����Q "' mntracmis tomwtm¢the pm�ed(Su.7M4�Busine�e�ProfenfomCade: �� � TAe CaMmctor§Lfeeme Lew doea nIX appTy io en wma M property who e� . hullda ac Improves iAaeon,and who cenMam fa eueh PNleua wltM1 a J ALTER'DRAAf&VFNT-WA7IIi(RN p'� . cS� y �}actac(s7�cenaedpunwMtafFeCOnhacFOr'aLlro�eLaw. h . t},3§�,*TMk t"�- � ��F3'�`an�x"t{v`. . �,J7 am ezempt mWer See B 4 P C for tXle remon BA«�W PROSECT.OL+V[C8 Owner N.w. . '1� Dat 9'3 OA DRAIIJ&YLOORROOP,eIRRI�,C�N➢. SAMTARY Y N � SA'f3ONDECLAd IO�T� R&:E4�fY ❑[hereW efnv��a5at I havo a certiflclM of conuat to aeiLineure,m a N��NfiES'PQi77LlI' f,�}' ��LTAX R��N,# . .. ceR1�raMOFWorksm'ComperoaHOnIwunncemacertlfkdmpythereof(Sec. � 38tl0.labC) � G � �� PARKF£6 Y N_ ��,q RHCffi']'� Cu�mp�vy C �' - a HUIG�ING�IVISIONPEES I ICeklpedcopybMRbyfuMehed, W LANCHECKFEE �Cetllttad mpylafll¢d wi�h Nw dtylroQeWoe divlalw. � CP1lYUlG]'EOFE%�dPf10NFAtOMWOR[CER9' �R�A9E •- PAjD a COhIP16N9ATSON INSURANCH SEwEtt-9nM.pn&YS'IO1iMEn ZWF3. Date Recei t# 7� (CNsseRionneednot6ecompietad6thepermkisforanehwdradtlollan _ p ptao)or�.n,.I - � war�ai-�naw/v�r/v.ecru ^ ENERGYFE& Y N - ImrtlfytNetNNepaAamunceo(tAeworkforwlUdilNspe�mitbbeued, 4 � ` — . Isballnotemployanypereaninanymanne�eouW6ecomewbjeRtotlre � WATIIt5Y5IFM/7RRARNG P�D Wakera'Com a6onLaweofCO.i oml Dere � r . ;.Zo ^veu�"e—.�� '�8' t�ewte�namm�t[�i.nas._sQ.ar. Date Recei t# �9 i(Ag .. nvnc&xo [ca �gwmcnmm�eorn.e.npnon,yo,� ahoutdbewrrcanbjRfFolhe Workem Compe�aHonpmWerousefMeLn6or T01'AL: : N Code,yoummt(oKfiwltl�amnplywlthwrLprovkMreorWepemJtsFSllhe e-n dea�rcd revoked. G `�� � p CANSiRVtT10NL6NOQJGAGINCY 5 5 IC E L IAe�ebya(HrmNatthereleaconewmon7e�Wmgage�u.yfortnepedorm EL&CTRICFEE � � � Z anaoftM1aworklorwNUthiapermltleWUed(Sec.3097,Civ.C.) �TAT" � � ) O Lendera Name �,n,y s� -.- �_; . � . 4 PLUMSIA7G FEE a � °h Iander'enddreee . � - :, .� . t .� r � �;�.�" MECHAMCALFEE U �certl(ytAet7luwreadNbeppOmHOna�dstatetkwttheaboveinPormaHOn ^'� �q '� � � W" bwrmd�.]agreero<amplywtthnllolyandmuntyartUnanmandRatelawe YHiMIT`Lu"VMICE� � {sW FE$SPf�ID: �' relazlqgtobultd(ngmnslructloo,aMherebyautFmizorepraentuttveaefthfa � y tlrymeMerupontAaebove-mennored pmpecryfarWpcafonpurpoeea. At.1FBORADDiOMECti. Z (We)agree m eave,iridemNfy an d keep fiecMeo the Clty of C4peill�o Date RecelptN � ' againatVabiLLHea,judgments�mmandexpeaxawMehmaylnanyweyacaue ����.7NGUMT(fO1P;IXJOCPM) SUBTOTAL• age4utsatdCiry m mnaryurnx of t4e gmnting eftAle permiC . ���,� � _ axtuomuNCnnnr(ovcxio,000cFnn CONSTRUC110NTAX o CONSTBUCTION TAX PAID: ' PP fant r Da ` F'�f-NC6THOOD(V+'/Di/Cp '',. NA� I15ATA70R(ALSD(SCL0.5URS ��. WNtheappHCaMmfulurebuildingoaupantsroreorAandlehazazdwa � �TiNGUMT(7ll100,000B1iJ) ��(($ Date R2C2i t$ �'' materialns detlned bytM Gl�peMnoMvNtlpalCode,Chepter9.t2.and Ne '�, x�Itha�dSateryCoa�e c1ion255szcn)x [-ma'rwcunnr(ov�eta0,000snp TOTAL: �'� ❑Y� �(f cro ' Wfllehezppll2nt rd fuMrebulidingoavpzntuaeequfprzKntortlw(cca �FNf[LA970NFAN(SINGLERCS7D) � TSSjJAj�]�D(�'j'E . ' whlch emit havaN.ous aG mntiminents u deflned bythe Hey Axea Alr '�. aiiry MenegemeetD&irittt �1LE&COMPqHPOR1U0.000B'N� ' .... Yes lvo lhavereadtheA�usm�tetlaisrequirertunwunderCiwpter6.95of �n���'NVFRIQO,a0�8TU) - . '. - � t�eGlUorniaHeaHhkS�(etyCodGSecHOre25505,]SSA3and25533.1 ��; � undvstarulNatlfthebuildingdoesnotcurrentlyAareatenanf,tfiatltlsmy ��'R�IDFNTTALMECEL SQ.FI. .� n ��^(}('� ' eaponsib111tytonotlty�heoca�pantohM1erequ4ementewAlchiwstbemet . !.7 4r �� 9;7td � ptlortvixue ceMaCertiflcateofOccupauy. ���. �.,�.���.✓1 � G'1�-zlqo �"�.�'�� ' Owtlfsar �- Da rer� 1SSUFABY: '��.�.. s" 7Y)7'AG . pa. .�. OFFICE COPY �k}{161i 8 �� '�