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PERMIT
<br /> CITY OF LWI - _._-__
<br /> C(>wlp�tlTY DEYELQPNENT DEPAR�1Vr, BUILDING JNSF'ECTT04 G1V1t:TGN, ?!I W
<br /> N� a_Mo!.s
<br /> 1912i Application Oats: 6/81/9Y _ Permit Oahe: 6/vt/68 _ ________�'�'�ic No 3'ti4�
<br /> AWrM: 2449 W KETTLE1W LN Assasw Parcal .: 2) rkG-t+0�4 Subdiwisirn:N;�;r: _ tot A,.: _
<br /> hVW1V 01 M I 4NWAS, A A 0 ETAI 2. FNKMra A,i l:t�•i,L,j1,
<br /> Rd11 g Anktnelse: : 801 E'NMY 12 Ottr/State: L(X11• CA lip C(X#o: 95"»1)-OV14
<br /> I"t C ADD ALTER RFMODE -
<br /> L le�a+tt Types: _.__._......____.w._.........._._._-
<br /> t�r' 6rour,: 1.1Efi: rvp=:
<br /> J nMW Owtripthe: REMOVE 3 UNDERGROUND FUEL TANKS
<br /> FMW *mw; MARTIN MPE Subs (Y/N1: Pirr.re N4.: iia ;c
<br /> C(latrrector: JIM THORPE OIL INC I.l;eli5d N+l.: 4S�G9! P1*x.� ru.•: :uv i1,: ntl�
<br /> : PO BOX 357 CitYr'St: 1+;q;+F !A )it): N5'G1 io it,
<br /> l rAr MINr;" Addr>Yss:
<br /> CM>li1tS Mo. Dasa tion ANY 4tr/val+1� 8VD�vi�VBi�i ifuniks t81•�g -.--y�t��__��i_..._....___.
<br /> 649 F DEMOLITION, FUEL TANK RFMOVAI
<br /> Z0011!2: Total otyllAllft. w Totalyaluuti+al: ? ;
<br /> FEE OAW
<br /> Building Permit Fee 50.00 6/01/88 Aaiitiorlal t.114C Net,
<br /> Pian Review F66 4+746ni+t"!rt ive F-•-c
<br /> Additional Plan Review Fee ypv<:ir,i ing +:ti;n
<br /> Mechanical Equipment Fees
<br /> Electrical Equipment Fees 1 ifi-ty Man Ruvit;w
<br /> Plueibinq Equipnlel►t Fees
<br /> S.M,I,P Faest C=*rcial Waytew;�t .r 1:dpa;i ty {,-a
<br /> 6.14.I.P Fees: Residential u�«�, �,-rvi;;: • r,.:,;,;: a
<br /> 1'01At. FEES:
<br /> M>RI(Elt'3 DOPHN3ATIOM � CffrTIfICArE GF E1r✓FMV'1"I�tN Ff�•41a6rF'EfrS C+�fPEr�4ATi•:t: it�S1!ta>:F "
<br /> I hereby affirm that I have a certifficate of consent to 1 car'Zity i:ha,t it, the itt!i fri rlr,rr:.r ;7 t•Y w', ' t',>r Wil.:r, V.,fO
<br /> self-Insure, or k"certlflots of Workers Cowensatial per-wit is issued. I shall rat almo)oy arty nrrson in anv +t•.;nnsr
<br /> insurance, or Nl certified copy thereof (Sec 3600, Labor t'c,cJe) bo ns to 4,e!:)nw SU!-ai,.:1. 1,; �.�,- 4+.rF;r. ,'n,;<.n::,:i•J, t.e;; «,
<br /> Galirtxnia. •
<br /> Policy No, 1098135-95 •
<br /> Caetpany : STATE FUND Date Al;p 1 i,;ant
<br /> NUrICE TOr�Ef,1Nl`TEE: If, atter ,n.;king t{',ii Certificate of
<br /> Certified *y is htrebY furnished Eger ,t.icm. YoU $N:,04 1:•;,i8r? gUDi�rt (.• t;t!; w ;i'$ .. t;; ,a+ri.•
<br /> o !' FT4Yi;;ii.(1g of 1a W, L.y+i(.rI,ir'�C, yr,1 p•,i;l 1'. t:%+w1+:•+ .�!'v . .i r., ?�.
<br /> CertifW,ccpy filed with Building Inspection Divisiom provisions or i"his poonit bh.el) 6�t dc:a+red" ravot,,,,tirl.
<br /> I Certify that: I hii4 read this Pert and state that tlla abova infure►stial is +;orrect. I a'aree to Imply with ail r:ity Ordir,hnr..�s
<br /> "and Stats Laws relating to Building Const uct ion. and hereby BUth(4-i L6 l i l)r«!4r,ti�l.l Yt S of t 11� +.l t,y of (,xi tr, :-AIV 90",r1 rr�� 4d:;•.:'
<br /> mentioned prwperty for in4Wt s,
<br /> Contractor~ , __ _ _ _. -- — ..._._._..__v.._.._.____ '`n'' !� ✓.1-__ ... .... ._._...
<br /> fwrarSitlnbt of Cc�1tr��ctar, former r"•r Agent
<br /> Agent for .(ontl'actor, Owner +�;+��,+ ,•�;
<br /> 00 NOT COIN .pRQONER ANY cow TRUCi7(ly
<br /> ADORES OF IN' IfY STATE ZIP Tfl EN+iNL
<br /> NOTICE tG A XS �E(pkf
<br /> M vtt MW Sii l,lilQT '"04 IF MURK IS MOT STAORD IN too DAYS CtR IF W'PE T14AN 160 t`Ari
<br /> +. 0p MOT Co".OR CXk MY CONSTRUCTION UNTIL THE "X Ji INy r + ,
<br /> PE..1 F0 A 1l ]. kkrt:>ti`E! !h� 1'rIF IN >Cr '.�
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