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HomeMy WebLinkAbout29610 HAGUE ST_ 1 0 CITY OF LAKE ELSINORE CONSTRUCTION PERMIT PrpieCtAddrf-ss_ L fv�----•- ��--------- -- ' -_ Applicant to-fill in all spices except those%within heawl border lines and sign all appropriate declarations �1 Aassssor'>Pot Cot No. - _ •------- -- --- 1 M- PERMIT NO. TRACT y0. 1 LOT N0. ; UN!' N0.Owner's Name �� ��'�iFr �hpnt_ -- 4.123 , 31 cr Eno _ tense rtc;. TYPE GFOXISTE I(Yi - ADD -` AITERIT10N REPAIR A.TcI:17S1 _..-- _ -- -- - tIrNYE3is�N OEYOIrc-''° OiF:ER _ - A_P. �_ --- ! A. _` :.• j' pESt�IPiy]!t fY isQRr-UiE S•Main Buildi Accessory C;ont,actor's Name- -Peon. _ _ de E. n9:. 1 y Bu:ldiP.g: Z A-t'i:eSS=•rtl•I,ryf -- _ --- _ TTPEOFPEriI' G°AGrilzr FGJ110ai10.1 StRUCTURAL T3 Fiont - iEka•ri EtiCT?:CAL fttttlto 11.ECNAAILAI ei -- N :,iy L.piss%•too. ----- -- - Rear L;CE:45EO CONTRACTOR DECI_-.RATION .',iir'R -- --------- --- ---- AI - I.'.e-eby af,.,rr,that 1 a,n licensed undcf orc,.smor•s c•Crsarter 9(cammenciny PP,01ECj i7s. ,.R'=i Ots $d F. __ OCca�laCy _-- K�. Right 1 r N yrrn sec son 7000) or D.vs,cn 3 of the Bes+tee and F1n_tr.;*oiis Cs.9e,and i �Sitrir t i Vie :x! _ Acres 5 G n,i+,veal!is m fuii foreeand etlf !. - J7 _ License roil ----_----- . --L.ce-se No. -- aI1 S�C�-'� _PCE - - ------- _ - Ping. Ref._ ^Harkin Req./Provided E Date _� S.9natur• - Rrrturics Planning Notes 0 WORKERS'COMPENSATION DECLARATION — ---- _ - - _ _ .-_- - M I hereby affirm 1n}.t I nave a certificate of consent to seilinsure or a certificate of Worl•e:s' Compensation :asurance, o, i-aFr;_tre_A copy thereof (Sectior, 3900. i.aD. C.1 - tA.':V Nri. Company-=- -- ---- -- -- _ - Certrt.ed rnpy is hereby furnished. - _ - Certit,ea copy is filed wish the city Auitelm's 13,,os,on. _ Date nophcant - - EXLMPTiciN FROM WORKERS-COMPFpISrTION DECLARATION ^.rl,s sect,un.,re^not be comCle,ea if t^e pf,•'s-t'rs!or One hur•dred(SILO;or •-'• - --- - ---__ 1S! Cet:.fy :hat ,n Snt oeflurrr.an Ce O•!rf At.,- •a'Tr,.ch this cerr7•t,s,stuej.: tr t'. n.,: cmp!• , ariv perst,n it- any mar:-gr s.as to beromt s:io,ec! .G Ule PLUMBING FEES - ELECTP.ICAL FEES MECHANICAL FEES i4-••ors• ::tmDentat,p•. Laws 6t Ca,,ro,ri,a. - - CO - , AIX: a CIA31MGFEES r),•e -S,gnaru,e ..__-._ -_ _.-__.._ Alter,Repair , Generator C 5KW_i 5-15KW Bailer _ KOT,CE ir•a•:e, making !h.S deCfatat,.rn_yc s-o.ra become subme: to the Auto Wash on r r —j Cai -- cu talus .ro•.cxs' L..�ropenufion prov.srnns of :n+ t arson Csae, you onus! lorthw.tn Cons1�c.ion Pale Sub. [- Under Ground -- - Fir, yards u.'..^is w•:,• such provis,o,•s ustr.t oe•n�t snag: be deemed revni,ea. f)ack.IIOW Preventel i CppkinSnit_ DUCi-$trU['afa: ______Cu CQNCTRUCTION LENDING AGENCY i BackfhW Irri tiara Pole LightLLi ht TEvaooravve an •Vrrri'ati� s3663310 ?:,,r.Check fee$ _ .. t•o'eL, a'•,+m:hat thtte,s a const,tic t,,,n ten Gi•Sg agency lot:he oet fnrmince �_.-.- � -,----_�-- ' 6• ^e .W•k for w'n,cf, this pr-rrrut .s -ssuca (Section 3097 C,v. f_.) ; Ctarifitrrs _ Dryers El Gas .-!•lectric xhaust S.;_teru Multiple 3300.3312 Permit fee I - - _--_ Le nt,•% Name - _ Dishxuher_ Fan Cooler TOW fees S OWNER BUILDER DECLARATION ( Fixture. Trp;s eaF.A_U � eating Syttom$Ducting1-ercby a1•vm ",it : am evemf.l tram ;1-c CC-riaC:ne'i L�Cense Law lot •re or,,,a rcaton 1r Cl.on 7ni(.5 e6s,ress a•.d N-fess-nai Code: Any C.1, ti. FI00f Dfaint f'ixlUreS 0-100.'60 BTU fr 100 000 BTUC.,.n:y v.h,',; reu,wes a permit tl,rcins:ruc: deer,improve•aen,oiisr or repair Floor Saks "' 's 3..10.33I2 Summary of Permit Feessire:tint, pile• r„ ,Is.,suanc,•,also reat,••es Ire applicant for SuC1,permit Outlets ood or C - oy t� f.•e a s•st.s^ at.:C'nerr. r.,at he!sne is hce,setl p:t•suant to ine provisions of --_-- --�— - - n I'll Cn.+tractor's ucosse (pro(Chapter 9;co^=:--.:i,:-with Section 7000)or Gas Service DUlle(S Switches lype 1 -woe II 110dm1 S r 04,Is':n 3 of the Bu,inest and Profess.ot.s Code) of inat ne,sne :s exempt �Interceptors Meter D ur,!p 100 amps Refrigeration System r — iricreno^+ an a ine bat,t r„t [no anegea ereno:tin. Any v,o,aann or S�cuon - _ g 7031.5 by ar.y appt,cant for a permit slaves trip aoolicant to a uvu P•Trap Meter C1ower 100amps "0.100.000 BTU C100,000 BTU i a�nalty,7-net more'."a -five nuraled anlla•s(S500). - -- - -Root Drams (iecrrca) 3 - • +s %;wiser of the properly or my c•r.p Lj ecs w.tn v,a9cs as tnei, sole _ -�— Sub panel Fite l/l/Faet.Bit.Ir,BO iCompentati„c, rip 7n ine w,,,k,and the s:•..Cl.rre s not intended nr Mf[•rc0 Trailer$ewer / E - V.eChanKal S „_ fy sate (section 7oau ©ustness and p,t•essal ai Cody: The Contractors .I_ ._. -- - 15 50KW _ System Repair.I�IteraUpn r L-C�••c L..w a„cs,.,,t ao Diy ih in iwnt, o'a r,,aperry vrri„hm;.11,or tmper.ves SeV_r Ca Transformer Othef = M t %Leer, ana will. does tucr w:•r. h"m;a -r•se• r.. :hfnu„n h,s of tic, r,v n -.-- - D - -- f}--_ - - 5O*_KW FirR Dampers C r♦r•p'nfecs,arnr.a,•,t„at suet. ,moroven'ena ere not ,nttn,ted nr uIrered f.,• SevRr Connection• Bidq`T 1 Motors r�0•i HP 1f/7-$ T Registers 110-231 SNIP s -. • J� w lair. Is.nvr,evc,,the n,ptnin,l of.mprr,,p•-�c .:n 5';ta _tnin one yea-rat Cori. -- ,^ ( --�_---- -- -^ D tt.on,!cc � rn,r• vnq rave :tin burden of D ',r:nq ne!snA aid riot Dn,iy of,rn• S31ar Collectors I tic. Solar G6.15 HP 016.15+, Incinerator erova for+tic pu•pnte.,,calms- as owner rf tr.e p,npe,-y.an,exc,siv r ++•Orrin •v,rn i,censeti v,n. Srilar wiping Sing/Fam.Res. Mise. O (:YCgf`n 70- c5s i a ess,nns Coda: -- S017,f Tank -"---f--'-- 3360.3370 Somm of PlanChecli Fees t• o 1.,�n:u.,,t lcc fc cct ,.Hi.s,n r Pro% _ _ MUlti•Fam. Res. t',e Ccntraclor% I,Cenw Law does nrat apA r (,an „wne, or p,nit.ty wnn I b.,..ds „- ,,.,p,nrr•. :r,erenn,ana wno c-ini.arts 1nr sucn prr,iecis with a con• �Sw,mmin Po,il/ a swimmingPool/Spa a — r Ira•:lor(sl l,cente L..irsuant try In. C9nt•c:a^ c •e.d ewr ,�am aware Ina: -1- 9--� D --- -� 8t k:nz $ _ �•��� / the„ yy, -er•s Cnmporsat,on mars,, s olwided to mo. Water Heater ' Issue — -u t S PlumDrnt S - -- I am t.cmp undm ctrn L .f',i� tr.. •s.a;un ' -- _- �Piatrr Services______—_ Italo FobEkcinai S // ��?, UwnCt y G!O11C System LaTo 'f��-Y.k? 1 nereb cell fy that I nano sea - •cat.on and i:,ito that trio stxive t MsfG. _ - _ I � ' Other $ -•n 9 formatr.n ,s t w.•wept, wee t r y ,pn au city and county oranlanCeI, _ - ana hate tcwt root:mq It !at q a sit ,n,ants nerOhy authorize rerra- —lAWowd k Dale - _ senta:,res •.+ tr•s my t to i aaayo•mpnrlonoa pr/iporfy ref 'T �addia - 33603315 PganlhR S -- 'espe't,in purge r r t- pQ Signal:for% 1-%� ,- _ (rat, _ _ '0_GV luue WcaliM[nod By - _ -Date ?� D,..or%'I.kentc r,r ci e► _.._� _ -- Tsui I'm On S J •�� -- i!7nitceufurnT tiro'T.rtmpol7ry fife Sopy.Gnary Asstssot P,nk Appluni,Gnldenrod•Accounimli jo I I I 1 d _-_ CL e j w L -' f Y Y Yu V� Z h• I i I I I 1 f��i Wp I ! - 1 I Y p `✓i JI ¢ �" .9 w' Q' w W+ .�' I�3 ,o% c.1 t } -! r y: .F-r ZI _¢ ' ' 1 r t I p C i H JI �' as >1 _ c• UI of �! ci i a. 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WI Lit, - p i �' _ V! •rl f I ` � � Ei_ Q i I , oa �S p i I Z �, m ! i I 1 °Ot t «� I ea 1 p y V ; f l + �� c r I Ui i ( Si ( I I m` c{ UI I I c,I ct ; I ci O: I r c. up F` r f I :3 t of + I ' f T I °d 0 Z _ c' rl �' U' I c: ._: ti Q! 11 I �, i I vY r r Y f 4 '�f t yt - I cr ,� i I �: p ' I ' " - , W i c f t j r ai c; h N w >' ct " I c Ui t cf u? �' °3t c, £' a+ i N� Q' a+l ' �; r 51 d{ o(f of J' 7 Q! of u• u r O Q >f j� , i U. °I I Of J �t = -I j =°' p -. ov e. a ,o a� �� v1i e`, �S) ~ 4' o� iLl -;a ' U. aei m1 QI ~� 2j1 t L I Z �I LL I �� a' _ , ` -� t��, u� u1 _ C- Q LL r `° ay ,-C„r i [ dl. �� i � � I �' CI � •$I 4 N � 7 _Ot _•p 41 �t CY Ir •.�+ L N + JI G � O• C I Li M, �t h (' { L7 d d I H Ci iL SS1 I i1J i Lil: =1 -.� C d I d 9" I v' d 1 ¢ U N ¢ EL a ¢ „I e i t Q -� p t 7 e, s w e at3 �' v io ,� S)' E 3 ? ${ 1 u o a+ ( I ZO ` +. E� _ �' _ I g, _I =i r =i t� �' N� n' �. Lit trfi� U "' Q� = hf " o� ' f { co, m ru, Z a tom; a rn -!I a _ _ u c OI _N u o u o o ° r = a of o - f v Os °) �I 7, O (( O 7 3i s 3r 7 to ,n) �I I tp Iw 'S q 2 V f c� Q ►- rpi a� w in t�� LL Fn 31 r7� 1 0} o of a� o c ,o �� �; °i m A 3 ZI m �I o! �I r,f `Jj Q� 11 Y Q zI OC,i p a xl ¢� rX. rL Il� OC, 0� C�� a� C I Cc F� Li `� c ,- 0 u e e e pi ei ,�' q e � o c m{ Z — o O� w u 11. L%I xi Li; 31 t7 ug CO, m� -j v�i CITY OF LAKE ELSINORE BUILDING DIVISION O W N E R - B U I L D E R V E R I F I C A T I O N A city or county, which is required to give notice pursuant t%) Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of an owner-builder verification. Attention Property Owner: An "owner-builder" building permit has been applied for in your name and bearing your signature. JLo building permit w 11` e issued Until this verification iss received. 1. I personally plan to provide the major labor and materials orsconstruction of the proposed property improvement. Yes No �r 2. I (have/have not) E signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the posed Name 111 t� Address Phone ( ) Contractors Lie. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work:Name (1 4 z ! 1 Address Phone (714) _ Contractor's Lie. x 5. I will provide some of the work but 1 have contracted (hired) the following persons to provide the work indicated: Name Address Phone TyRe of Work (If additional space is required attach subcontractors list.) I hereby affirm. that I have received a copy of the information set forth in Section 19830 of t tate of California Health and Safety Code and have complete b ve information to the best of my personal knowledge, in compli `thi State Law. � r o Signed: Date: — Name: (Printed or Typed) , _V..10 till �_ r3--(P-1 Z3 - - ms ilia fr.SI UT.MPAR 1 ALL V&WM IMSTSX LAAPVP OVED ' ;Y a 1 i .j .. 1 G t'p..... _._._ t f fuming ------------ - i fit ?w�unq Ubotat dit Of--Soudetn 3310 Airport rfay 1514 p Nor1h 7ESnNG �9 BOW CA 90806 Suzan Sraat L%d:P.O.Box 47.9M,31 Sant Ana.CA 92703 (213)4264M (714)354.2W ' (714)8284432 FAX(213)42C-6424 FAX(714)554.49W compression Test on Gunite CUSTOMER: Gannaway, Willard EXAM NO: 8 9-1-.6 C 7073 : DATE: 08 'Ct ga JOB NO: 90E142Q1 PERMIT NO: :YOB VARIOUS p;;GJEC-S (Gannaltiay) See "Sampled From„" for job OSH PD: ADDRESS: Name & Address OSA AP #: FILE t: PAGE ARCHITECT: CONTRACTOR: ENGINEER: Bayless B.C . SUBCONTRACTOR: ---------- __ D.J. Gunite SAMPLE FROM: - F?oo,----------------------------------------------------- 29610 Hague, Lake c=s;r.oe ------ MIX: 1-4 SPEC. ST1t. p ----------- ( SI) : 2000 ------------- _ CAST: 07/19f89 ------------ SLUMP: -- DATE TESTED 07 : SPECIMEN NO - AGE (DAYS) 12 TOTAL LOAD (LBS) 62000 LBS PER SQ IN 35u0 SPECIMEN' SHAPE: Cly:.:rider SIZE: 4 .750 X --- -. 0 COMPLIANCE: ----------- A REA/SQ IN: 17.72 Cylinders 2 and 3 held in field SPECIMENS BY- Charlie e DELIVERED BY: WG RECEIVED DISTRI$U'"IONS -------------------- ---- E VED ON: 07/21/69 Lake Elsinore Dept. of Bldg. & Safety, 1 Gi=inawuy, Willard, 3 er, CE ALl RE►OItTS ARE fWMRTEO AS TN[ CONFIDENTIAL Branch Manage-,* M 11EOMORIG THEM IS RESERVED"";MG OUR Wn'"EN APPROVAL AS A Al11TUAL PROTECTION TO CLIENT;,TNc NDLIC AND OURSELVES, O►ERTV OF CLIENTS, AUTNOR12AT10N FOR ►U/L1CF f10N OF Out REPORTS,CONCLuS+Ogg 011 EXTRACTS FapA1 0r1 r CITY OF LAKE ELSINORE CONSTRUCTION PERMIT ' Proioc I Address Applicant to fill in all spaces except those within: teavy border lint and sign all apprap�te•detlarati0ns Assessor's Parcel No. Ovliner's Name ELill ft /�- rPPh//o��ne�_ PE I � i TRACT N0. LOT N0. UNIT N0.' Address �/ _�S�lt c' _ Arch Eng-_ ' PEE „ ,Licence No. 7 1 T1PEOf"ONSfRUCflt)B PIEW ADD 17 ALTERATIONRfpltlR COARERSION kt+]USH THER r A.P. # .. ;i Znne Address OESCRIPl")N OF WORVUSE OF♦3LDG —Lj� C� _ - _ 191Z-�S� E Main Building: Acse;soly.Building_ 7-�EFOZ v^,pnsracwr's Na Phone _ _ _Address t II, i _ _� TTPEOFPERMR GRAB FOt NDaT10E1 %"'$TRII�TURAL T Front - License Nn, _ _ TENATeT �3'1"ll_CtR1CAl PLUMBING MECHANICAL Rear t N L lt3f'C'3;•ST ECIARATION - OTHER 046� _ _• r' _C _ - )I 1 hereby affirm that ) at+t,censeo under previsions of Charter 9(Comrien U.tq PROJECT DESCRIPTi(NI 4q;FT - occupancy _ �' Right With section 7000) Of Q.v•s.on 3 •Jf the uS.nCSS a d Professioris Coca,ano Construction type — ale Act S �--�- _ S Left G my hcersc is in tun ro ce and cffa �� d�11QQ�� Lcense Class- _ - ' z valuation f-1Z - 1 —Pea � •li��( R _ Pf� . Ref.# Pafl;in Req./Provided I E oate_�j= Signature Remarks = Panning Notes - —�f3 WORKERS'COMPENS TION E LARATI N I M I Hereby affirm trial I have a c f ca)e of consent t�sclf•risure or a certN.cite �' - t ' or workers' Campemat.o,. t ranee, or a certified copy thereof (Section +-� -_ - _ S 3e00. Lin. C.) _ _ - _ _ _ z Pbl,cy No. -----.—. CompahY , - -� Certified cnpy is hereby furnished. / - � L� Certified copy is filed with the city Building Division. jh i -are.-- Applicant - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - - -- .� _ '" �• �i ITn,s sec.,nn nee:%not b,e cc-nPletact if the per nut,s fn,one ifunared(S100) - Icss) 1 Certify that in file Oer+•umyocc of We N.+rk for wA.Ch!hK t SSueC,t .- - - Shau not employ a:ly PcItOn ,n Joy r•an:+ r s.� ju c ine - FLUMPING FEES __ELECTRICAL FEES_ ' MECHA CAL FEES workers' o + L.+ws of Califp - — - ACGI N' GRADING FEES Oat! �Signa:arc _ _ /' _ __ Alter: °:pair ! Gener.tor L-'.0.5KW❑-5-15KW - Boiler i �` NOTICE:U.afte, maS-.ng tnis jeclara n,". ;ho a br_or.•�s-b rc: co If- Auto 4'a;h i Construction Pole Sub. duct-Under Ground Cut- _cu lards workers, Compensation brnvision,, of the t_abnr Crwe, you r. .St !rr:h lingo ----f— ----i Fill -- __.-cu.'FArds comply wren sic!: prnv.s.+-na of this permit Shall be deemed •evoked. , Baektlow Preventer !_ -, Cooler Unit Duct-Structural _ - CCNSTRUCTIOnI LENDING AGENCY 33601370 PlarlChecl.Fee$ I nc:.by afl.rm that inert�s a c.,n;;rue:i•in ceno.:n _ Baekflriw Irrigation— Poll;LI Light _ Fan •Ventilatin ,gcncv rt,r me aufc•man_e - --9-- 3300-33i2 Permd Fee, f of n e •;ra•k tar ,vh.cn this permit is •ssuea (Section 3,:37 C,:. C.) Clarifie- Driers❑Gas ❑Eleetrir Exhaust S stem - --- - Under% Name --•--_--.-------------. _.— _ Lender's Aad•css -__ __ -_ _ - .-____. __ __ _.__ __- -__. ___ Dis:•.washer i Fin r Evaaporative Cooler Total fees f OWNER BUIL LIEN DECLARATION ' Fixture Traps ea. j F:A.U. ! Heating System&Ducting _a I nereoy afl.fm :ha: I am exemp; rrem The CciltracU,r's License La. f,.i Me following reasnn (SccT.on 7031.r, Buimess ano Professional Code: sr-l� c-Ty a• Floor Dr3inS _Fixtures .� �i0.100,000 BTU 0100,000 BTU_i_ county wnlcn reau,res a permit to consl'ucl.alter,improve.demn;is^ ,1 •epa,r -`"Floor Sinks Outlets Hood or Carlo t 3300.3312 Summary of Permit Fees any structure,prior to ns Issuance,wan reau,res ine applicant Tor such permit _. 1. Canopy to file a Signed statement that he�shc ,S hccnsrn pur.uant to the orcv.iir,ns ar _ ; Gas Service E)UTI('.IS I r$WItCI1CS Type 1 ❑ Type II ❑ the Contractor's L,censC L.fw(Chapt,)r 9(commencing with Section 70i 0)ni '�' _ —}— 6udamg f D,v s,on 3 of :hie Business and.P101CSSIOhs C-�ae) Or it at re;sr,.) is r.e-,ot Int�tt�ors — Meter u u to 200 am s Refrigeration System J r therefrom a•,- the basis for the alle,;td exempt,nn. Any v.nlat•• ^ s,ct..,,. - I Plumbing $ 1031.5 by any appucanl for a Mfnlrt subpx:a the ap011rant TO a '.vu P•Trap ,J Meter CJ over 200 amps 00.100 000 BTU 0100.000 BTU ti .�• eenalty of not more Irian five hunarea nofiars(scoot. -4-- - Erechlcal $ L- 1, as owner of-the property or ni; emplovices with .•.ages rs tnei, sold Roof Drains—__ Suh ap net Fire IJFeCt.Blt.(CEO # _ Curnpr•nsation, w.1• do file work,ana in! st,uclore ,s not interlard or nrtefed ' Trailer Sewer J-JT ❑ 15.50KW _System Repair/Alteration Mechanical f for safe (Section 7044, BusmesS and Prutessini:af r•.Ce: The Contractor; _�.—. - _ Transformer Other f License i-,tw loci nol apply to an owner of a OrGl:Crty who bu.lhs ar Irn0few)s Sewer Cap _ ❑ 50+KW _ -fire Dampers T _ -` thereon, and wh. C.p•,i SUCh work hrrlltC,l;ItCr SCI f fir ini—,gi 'fit o, •,a, awn -t--- -- — ,. employees,wnv.oc:T :r,al suu. .mnrovemena are nfrt .ntcndcC "r n+re,ea 'a, Sewer l snneciion•Bldg. Motors❑0.1 HP❑i%� Registers - I10?31 SMIP Res S - saic. It,however,The au 10rn1 or wp,ovon.&nt lsSold within ono year -,I rom• 1-- -- - T' 110232 SMIPCom f plet,on,the nwne, win nave the burden of proving t,C/She die nri:buila cr im• _ SfAar Collectors Inc. Solar 09-15 HP 016-15+1 Incinerator - FOve at Ilie ru,Dose of sale). Solar Piping Y Sing/Fam. Res. Misc. l- 1,as owner of Tf,c pfi,perty,am exrius,,,civ r-nntracting into I1:ansed con• --- 3360.3310 Summary of FUn Check Feet Iractors:o cm+struct the project (Sectior, 7044,Dullness anil Pin as$-ins CTcI: I Solar Tanis _ Multi•Fam. Res. The Conirartar'S -tense Law, doe% nut appl+ to an ownrr of p•ooerp,-who - - -'^ •�// bursas tit improves thereon,and who rwilracts for Such r•fril"ts vr'.h a can• Swimming Pool/Spa . •swimmingPool/Spa t Building f L30a I,aclo V license pu•tuant lr) if rootractor•s !Icanse Law). I ?Al 3d,are that '--'-- ""•--' - proof o/tne.r Work,ergs Cmm�unsatnn ,nswan:e should ao Crowded to n:o. L Water Heater z„5 ISSUE_ Plumbing f r✓ 1 an,exempt antler sectfo„ _ _ .__ 8,a,•r.C.Inr In.S reasot- Wa(er ry g ilISAIIP Ffia 4"sElectrical f Date owner}_ Lac steni . _ / Mechanical f -_ -- eti '-a- _- `� DEVELOPMENT SE I RE R ENTS / �-�- �N Othel f 1 herebY :amity a1 1 nave feao +nos apphc;,hen and star! trial ine above !Sidi.. /' ,-•-_.__,._, .n""Tai ran rs cn a I agree to rnmply wt+n all c-ty and crunty rted,nances E��a '-fie 336033J5 Q( and State to s r I fo U. on q cons-f..cl,nn,an7 necat,v authorize tapre- _ Planning j sentativet o ins o ant r ip p•Itie an_ovc•l owimtsd P Mart to WililinQAOprotfeflDT Dati -- nspect,on pt APQIIa1fOn(SspQ S Signal _ _ _ r Gate �- -- ____..Dab X 1nvatVLace r _ -.. _.. - Total Fees Dee S -ile Buibfr,Q. 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