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HomeMy WebLinkAbout2352 MARCA PL; ; 82-361; Permit"' z 0 ~ a: C ... (J w 0 a: I[ 0 (J a: Ill 0 ... 5 I Ill z ~ z 0 ;:: ~ z w IL 2 0 (J "' ic w :,.: a: 0 3 i[ D I her•~. •ffirm that t am llcensed under provisions of Chapter 9 (commencing with Section 7000) of DMslon 3 of the Business and Professions Code, and my llcense Is In full force and effect. Loe No ______ Class _____ _ I hereby affirm that I am exempt lrom the COntrac· tllf's Utense Law lllf the fOllowlng reason (Soc. 7031.5 Business and ProfessiOns Code: Any city Of county which re-quires a permit to construct, atter, improve, demolish, or repair any struc1ure, prior to Its issuance: also requires the ap--lliicant for such permit 1o file a signed statemen1 that he is licensed pursuan1 to the provisions of the COntractllf's Uconse Law (Chaple< 9 commencing with Socti<>'I 7000 Of Division 3 ol 1he Business and Professions Code) or that Is a · e<npt therefrom and the basis for the alleged exemption. Any v!otatiOn of Section 7031.5 by an applicant fo, a permit sub- jects the applicant to a civn penal1y of nof more than live hun- dred dollars ($500). D I, as owner of the property, or my e<nployees with wages as their sole compensation, will do the -k, and the struc· ture is not intended or ottered lllf sale {Sec, RM4. Business and Professions Code: The COntractor' s Ucense Law does not apply to an owner of property Who builds °' Improves thereon and who does such -k himself or thl1l<lgh his own e<nployees, provided that such improvements are not intend· ed or otte<ed lllf sale. ti, howeYOf, the building or imprvve-menl Is sold within one year of completion, the owner-buikler will have the burden ol proving that he did not build or Im-prove tor the purpose of sale). D I, as owner Of the property, am exclusively contracting with licensed contractors to construct the project (Soc. 7044, Business and Professions COde: The Contractor's License Law does not apply to an owne< of property who builds °' im-proves thereon. and who contracts fllf each projects With a contractor(s) license pursuant to the COntraclllf's License Law). D As a -ner I am improving my home, and the IOllow-ing condiUons exist: t l~on:iv'!.tbe/:;o:rt= r:rr!.°:months 3. r~ 'i:"'~ol t 1 ~~ :pti<>'I during the last thre,e years. D I am exe<npt under Sec. ------• 8 & P.C. for this reason ____________ _ □ I hereby affirm that I have a certifiCilte ot consent to self-tns.ure. or a cert1hcate of Wor'kers· Compensation Insurance. or a cert1hed copy thereof (Sec 3800. Labo< Code). POLICY NO _______ _ __ COMPANY □ Copy IS hied with the city 0 Cert1hed copy ,s hereby fum,shed CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 11 the perm11 1s IOf one hundred dollars ($100) or less) D I certify that in me performance ol lhe wo,1( tor whicn this permit 15 issued. I shall no! employ any person in any manner so as to become sub1ect to the Workers· Compensation Laws of Ca1tlorn1a NOTICE TO APPLICANT If. after makin, this Cen1 t,cate ot Exemption, you should beeome subJect t".l the WMers· Compensahon prov1s1ons ot lhe Labor Code. you must forthwith comply with such provIsIons or this permit shaill be oeemed re'loke<J D I hereby affirm that there Is a consuuchon IeooIng agency fOf the perfOfmance of the wM tor wn1ch 1n,s perm,t Is issued {5ec 3097, C1v1I Code) Lender's Name ___________ _ Lender's Address __________ _ USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. w CARLSBAD • ~LDING DEPARTMENT ., ' f 1200 Elm, Carlsbad, vdllfornla 92008-1989 (714) 438-5525 AF, j CATION & PERMIT . J~~ ""L-"-'1 ~?~--=-p, ·':.:.T·i;oM7i~ BUSINESS LICENSE# , 1ov;T'f _,__ PERMIT NUMB'. 1':i-£:\u. ~.1 &.-L-b,-i.--u;,, n;:t~ ' 7 ~--· =• i,/~ . :;:/·s (~G :;::ro r::::;.. 'o\J I=-~ ~'JI /.-;,,-~ CONTRACTOR'S AOORESS LICENSE NO. PLAN 1.0. # BLDG USE CODE 'tft I BLOCK 1-,,,,r ,~~~~L-~--z-.; ... o2. DESIGNER LICENSE. STANDARD PLAN# BUILDINGSO.FOO)tGE D~S'CRIPTION Of WORi( --, , ~l)..l/., X /""\ DESIGNER'S AOOR ESS DESIGNER'S PHONE • ) I / I.IC f !:: -.,. , ~ _ \ .. --rJ """' _ ~ : \ _ ooc I i 31 t ., , ., ... , c:: 1 1 • , _ -~ \'t.~ ---~ ~~ --~~--:~ NO FLR= ~ r-~ E; CENSUS TRACT I GP LAND USE I PA,K~NG SPACE I RES rNITS I GRADING f'.ERMIT ISSUED I :~~~VELOPMENT I ~:t."..-J occ uf'AD FIRE SPR lo 7 i./' y D N D v□ Noc I v·N v□ NO Not V1fid Unm Machine ~rtified QTY. PLUMBING PERMIT· ISSUE 7 ff!-QTY. MECHANICAL PERMIT· ISSUE =3 ,!;:'-SUMMARY/ACCOUNT NUMBER ./-~ }C{ EACH FIXTURE TRAP Uf-., ~ 1', { INSTALL FURN. DUCTS iJP TD 100.000 BTU ll-. -BUILDING PERMIT 01-00-00·8220 ..._I l,,f Ch ~ c,.; ' EACH BUILDING SEWER 'f-.. ~ OVER 100,000 BTU SIGN PERMIT 01·00-00-8221 I _ j .EACH WATER HEATER AND/OR VENT -. 7 BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-Q()-00-8800 ~ ~ '3 1 ~,- / EACH GAS SYSTEM I TO 4 OUTLETS -,___, ,-BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-00-00-8222 --'I J ~,A!'~ EACH GAS SYSTEM 5 0 R MORE METAL FIREPLACE •• ELECTRICAL 01·00·00-8223 -:;; ¼ . 1~1" ,___,___ EACH INSTA~ .. ALTER, REPAIR WATER PIPE 7.-VENT FAN SINGLE DUCT l/-. _ MECHANICAL 01·00-00-8224 -, , - ~~ACH VACUUM BREAKER ~ ( -MECH EXHAUST -HOOOIOUCTS MOBILEHOME 01--00-00-8225 WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) _, c-n1 AA n1.----/ TOTJ;L MECHANICAL STRONG MOTION 80-92-33·0519 / J ,~ TOTAL PLUMBING I 7 / .J/ II . /' FIRE SPRINKLERS 01-00-00-8227 , QTY. ELECTRICAL PERMIT -ISSUE "-~ QTY. SOLAR. ISSUE PUBLIC FACILITIES FEE 32·00-00-8923 -~ BRIDGE FEE NEW CONST EA AMP/SWT /BKR L ~ f) ~-,, ...f i COLLECTORS , SCHOOL FEE· DISTRICT 1 PH 3 PH -/ STORAGE TANKS 11 // Carlsbad < -• \. 80-92·21-0519 EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE // K 11 Encinitas P -. ._ 80-92·22-0519 _ • , c 1 PH 3 PH PUMP (/ / ·y -San Oieauitl ,-;, / .& ., -" 80-92-23·0519 • · REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE /.,/ ...,. • ·• 1)"' /I San Marcos" • 80-92-24-0519 • TEMP POLE 200 AMPS 1 /"" 11 ll.V / _ I ,.12. /1 , ' OVER 200 AMPS , JI I 'J r, I'll" /6 ~ l /40 -I\ -~ <,,, .,-/ 71..q L -' TEMP OCCUPANCY (30 DAYS) -----r-·-----tt--/ / .I \:t ""--~· ~ ., u. • TOTAL ELECTRICAL I ~q So •· TOTAL SOLAR TOTAL FEES PAYABLE I 7 1 J . ln l a. I HAVE CAAEFULL Y EXAMIHEO THE COMPLETEO.:'.APPLICATION AND 1 PERMIT'' AND DO HEl;IEBY ~-Ew,y perm,t muedt,vllleBulldlngOfftcial-lfle. provi~softhf■ * AN Cl8Ht\ PlllllttJl-~_R C11111 , CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Cod9 8'11111 nplnt t,v limltalion 111d ~ "'!'f -vOid tt Ille building or WOflt -s•r DEEP~-........... -~ -· ~ -. DECLARATM)HS ARE TRUE AND CORR£CT ANDfRJRTHER CERTIFY ANO-AGREE IF A PERMIT IS ~ \7 =" =.::a ,sornot..=n:-~-: =:=~.~; snum,aowe,C . • ~· . . ·. •' _. ~ ISSUED: TO COMPLY WITH ALL CITY, 00UNTY MO STATE LAWS GOVERNING BUILDING CON-......_. 81 -tinw after !fie W11 ii -ad lor a --.o ol 180 ...,__ . . · · · · • '- STRUCTION, WHETHER SPEQFIED HERE111J OR. NOT, I ALSO AGREE TO SAVE INDEMNIFY AND APPUCANT'S SIGNATURE .If, 0 0 AP :ROVED BY ~ ~ '-, r;_:~ KEEP HAAIIIUISS THE CITY eF CAALSBAD A6AMT ALL LIABILITIES, JUDGMENTS, CQSTS ANO x· ;:: . • (!#HER CONTRACTOR \ · ' / V ~ . EXPENSES WHICH MAY IN ANY WAY ACCAUE ~ SAID CITY IN CONSEQUENCE OF THE . . BY~ □' I , ••• , GRANTING OF TH1s PERMrr. ~ ... ... .. i • • r ...... -;:;, l . ~ ~ ~ . _.>·., " ' -----... . . . T ~ ;)..-3/..r:; I . INSPECTION TYPE DATE INSPECTOR BUILDING • FIELD INSPECTION RECORD ......... FOUNDATION . REINFORCED STEEL ' Pl. 'J-{ilZ,. l'T (A') REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES I/ INSPECTION REO. IF INSPECTOR'S DATE MASONRY CHECKED APPROVAL -V .,_/,. ~,,-, .. ' GUNITE OR GROUT SOILS COMPLIANCE ..... ~ -,/A.J .~-d~L".rT#/lf """~~ FLOOR & CEILING SUB FRAME PRIOR TO ~r -.f, FOUNDATION INSP ' --• --... --~ ~~., -o,t::· -~ #1« ¥"# e,fV SHEATHING . STRUCTURAL CONCRETE FRAME ? • .4-f'3 ,f OVER 2000 PSI ... ..._ ~ ...... O'J . EXTERIOR LATH INS"' AT,~•· .. _,;,,.'n_,f I /l PAESTRESSED CONCRETE i8') f'\,,,-r /,)O(U(_ ,. 1$/)' ..-,n ,_ p,-~ ""'IJ€ &JAJ sv,,1.v INTERIOR LATH & DRYWALL ~_-,.,_;,,. 11-' POST TENSIONED ,eu1L CONCRETE PLUMBING I FIELD WELDING SEWER AND BL/CO HIGH STRENGTH PLUMBING UNDERGROUND BOLTS PLUMBING TOP OUT 7-14-f;'t. 1' SPECIAL MASONRY TUB AND $HOWER PAN GAS TEST ?-/4-'n 11' PILES CAISSONS ' ELECTRICAL " . TEMPORARY POWER , ---:.5';j :rt' ELECTRIC UNDERGROUND I/ ' ROUGH ELECTRIC z.-f/1.-rt ',fl . ELECTRIC SERVICE I -. ·-· BONDING . G. F, I. -SMOKE DETECTOR . MECHANICAL . DUCT & PLEM., REF. PIPING ~ ::>-11· S,3 l'T ' HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WH.EN ALL APPROPRIATE ITEMS ABOVE HA VE BEEN APPROVED. • ·---· JOB SITE FINAL j;'_/ PLUMBING , • ELECTRICAL '·/,I,' -;' - MECHANICAL ,,.,J"" .. :,,, J GAS ., '/ .A -···--BUILDING r-.: :;;. ,1 " . SPECIAL CONDITIONS ·-• CERT OF oc~· 1PANCY ISSUED ~ N 82-3~( ][_ ESGIL CORPORATION D:l20 C'IIB ~APJ<~AKI•~ nn .. St TITF: 12:.? ~A N DIBGO, CA 9212:l (714) uH0·1•tHH ~\.Q. ~<'-u_,.'.1-> ~w.{LVf-G...J,ir.__) l .n,·,.u z QJ. '-~\. -u_~ c~ f ~ C.,_f "'Jr;::;,._, trt !~~t~ J~IIISDICTION1 ________ DATr.1f~2 :-~?JtcT Aoo11css, c-:::i3~2 (lJ812 , ,..; /7L . TO: fo,127!/ &e=. _________ _ PLAN CORRECTION SHEET ' "'' r•l•n• r~cca•,cd by jurhdictlon ____ -4--_ ·•n• r•lana received by plan checkar_--r--,...,,_ ~•t~ 1n1t1el plan check c0111pleted /l --+-,t:::,,......., ~ ,., ~'> t,-L;:::-++~:::....:~.....;;;.;_tt..1..---,~;.!.;;.~~~;;;;.:;~=---~ [nll[;~/'11101 PLEAst IIP:AO ');)v ''('\ L\ ·\I,'\\ rlao check ta la~atad to technical r ire \nta c,nta1ned in th• Unafor~ eualdanq Codo, nat'o'f•' Plu11!>1n9 Coda, Unafor~ H~chanical Code, National tlectracal Code and 1t1te laws regulating energy conservation, no11e attenuation a nd access for :~e h~~dacapped, The plan check 11 based on requlat1on1 enforced by the Ouildang lnspectio :~partment. You may have other correct ions bAsed on laws and ordinances enforced by the ?lannanq Department, £ng1nccr1ng D~partment or ot~er departments, ~ -'-'--_;;S kf'. _c, _,_c-: ··1 :w , I Pt: J-Jrrlc- Pie••• uke all corncUon1 on the or inal_,,..+---+--.;;.;;..:1,;,,._...,_~ __ .;...;;;....;;;.._~..;:..~_,; ..... ~a..---4 tracing• and 1ubfflit two new 1et1 of pra tli, anJ any original plan aot1 that may have bt:en returned to you~~ the jurisdiction, ~) 1' tc.: /3Lf&-U J4,,,7 , ~ ~ To fac1l1tate recheck1n9, please 1dent1f ~ ne•: to each circled atem, the sheet of the plans upon whach each correction on this sheet h11 been made and return th11 c~eck sheet wath the rev11ed plans. S-5 -;p s ;/, f-r-: J//(},I .se cj, "'4 I Cl e I I > !cf:' 71/ l j r ~ r J, ., C '] r ► • . ~ ,,. I J l'L/\N ntu·K NO. -------- OWN!-;U ------------01\TE REC:'l> DATE CIIECKEO CHECKED BY .---+--------------------------...--------------- PLAN CORRECTION SHEET Pl an C'h,.cll No.---'8'""--/_-_5£---'~--~-------- , "'' r•hn1 r.,cc1•1cd by ,urhdiction _____ t;:,___ D APPLICANT COPY < b CITY COPX ;;? D PLAN CHECKER COPY ''"• r•lan1 rec11vcd by plan ch1cll1r I f/I,~ :>aN anaual plln check c0111pleted /~/"/ by'......l,'wt _.,._.=-..,~.;;,...-,.r#--...;..."---'--"-'-~~--'"----"---;;.._~--=----4 [''l'l[.~NI01 PltASt 111':AO rlaa check i• l1~1ted to technical requirefflente c,nta1ned tn the Uniforffl 8u1ldin9 Codo, Unifor• Plulllb1n9 Code, Unifor~ H~chanical Code, National tlectracal Code and atate laws re9ul1tin9 energy conserv•tton, noise attenuation and access for t~e h~~dicapped. The plan check i1 based on re9ulat1on1 enforced by the Duildin9 Inspection :~partment. You may have other corrections bAsed on laws end ordinances enforced by the ?l•nn1n9 Department, En9ineer1n9 O~partment or ott.cr departments, T~e items circled below need clarification, rodafacation or change. All circled items have tc be setiafied before the plan• viii be in confor•ance vith the cited code■ and re9ulation1. rer Sec. lOl Ccl, 1979 Un1tona Build1n9 Code, the approval of the plane do11 not perfflit the v1ol1t1on of any ■late, county or city lav, ~ Pie••• aake all correction, on the original trec1n91 and 1ubfflit two nev 1et1 of print,, anJ any ori91nal plan 1et1 that may have b1:en returned toy# the jurisdiction, tc. = /34;2;.. o~, To facalatate recheck1nq, please identify, next to each circled atem, the sheet of the plans upon whach each correction on this sheet has been made and return thas c~eck sheet wath the revised plans. I , ( , Ill,/ . ,1:lJ - . ~ (13) . . . 1'1./\N (')fl:CK Nll. owrn.:u DATE REC:'O DATE CIIECJ<ED CHECJ<ED BY ,1 -------- '-ff/iJ GJ..M' f -fJ114? -Jt1e Ceo/1-1 b v Sn VJ J q I le? -fn/k{ ,I --¥<, ~t<..U fl b t' ~:,o,,,,~ u. -• ~ r 1 ✓\l. <°"'H:'.(..~ ,::) , /!A ~ G /....,:;,>c't f h &1,-u A .,/,.L( .. <.J !J r?.eJa., n ,-f, ,ze_ r," fe J7 </Y? c~ct,~ /f?e,,f-" v n if /JJ Cf t:l?~ '-<1<2, lr-rTJ~ 1r-<;d1, t:~1 ~ UrJt,,YJ<.t:'Yl 'tucl.J/ ~OH u holtse c~e e-,,,f-/1 /lc:/ v t1 c(!,a,,J s 1cfJ E: <>-f.!. c; a'4_t"1 C,,&> / s- tJ ~ -h? lNAP dt)·I?, I kt?. /-kc,<_ .C..:'c-'f>..J> /JAJI? /../cJL/)? ce,/, n,!-'-<.ICIU/-,C? i/ /2.e t:i ,;1 I tu;? -yr7 ,'11 , / I 2 ,, ,~/ 'r..> L.:l!-' ·h -:> tY7 q 1/~___,{J -k, .-:::1. ~ 's. n--r .1vcrl-/'?1 o /2.P ":1c7'A;/ I r.::,,, f-J, C, I -~ 2.z l( .~> ,,,9-1;t7e, a ce<.,,:.,•,;.,, /n ,7a1"--C/P ~1evo~ ,_ J -• R..Q ,_,, 1? n1<?-t -t-:f-/J"Cl.. ~-R ~y-c:; ,, C.e-i,.e' .-G,,(,,u ,( .F-::> I ii V - - ·-· , .. I Dates~~\ Jurisdiction C~I\ 1.-s -e,,-D VALUATION AND PLAN CHECK FEE □ Bldg. Dept. ~(3'5G,.1L PLAN CHECK NO. ~ I -S-o C.0 BUILDING ADDRESS __ 2_z,_..,,_r _,;;2.,;;;.__tl"J_,1 __ A _____ Ra..,C_/ltir...;.__a..,,, 1.. .... 1:..__c_c_-_______ _ APPLICANT/CONTACT ________ PHONE NO. _______ _ BUILDING OCCUPANCY R<~ /,11 . 1 DESIGNER PHONE ------TYPE OF CONSTRUCTION V-..v ------CONTRACTOR PHONE ----- BUILDING PORTION BUILDING AREA VALUATION VALUE MULTIPLIER L •v• h -'=, rf-r "'1 -3 ,'-1"181(1' 4 2.. -I L/1.{1 BIG,, - '1~19AC, C!, ~7 2.. II. -7,,392.- ... 2.0 8 I.&,, 80 'I I "'• -eA I ( ~\; D~c i-:.. I E°J -r s-i.-, ..,....s I .j {,,. 8,2 /0]., - 'v &# ~"l_ I soe, ~. 1-.!-(,, 33&,-,- £11t1)ffl.tt'IS ('-1 ) Irv~ .... '1. ) Zo--vu '2 OoO. - Air Conditionin£ Commercial - Residential Fire Snrinklers Total Value J l,Z 1 0fc::,2.... - Building Permit Fee ___ .) __ °1_:...._Q __ •_S_C) ___ _ Plan Check Fee !) <o 3 ° 8 5'. COMMENTS, --------------------------- \ • ' INTERDEPARTMENIAL INFORMATION SHEET BUILDING DEPARTMENT BUILDING ADDPSSS: L-.~~"2-~ A;-(2.c._tt--- A. p. N: -VI 0 ~ 3 .s-"b----z-7 C. T: __ 7,_-i...-~· --------- . !~!i::::;~~;;;·::::r;;_:·=·::::::'······ ·UNITS REQ'D: __________ PROVIDED: _____ ~------ % COVERAGE ALLOWED: ________ . PROVIDED: ___ (\+-i,l~f------- PARKING SPACES REQ'D: PROVIDED: \) \ ---~~------ BU IL DING HEIGHT REQ'D: PROVIDED: --------- FRONT SETBACK SIDE SETBACK REAR SETBACK ALLOWED: ---+" +-f--- PROVIDED: E.\_ \=: INTRUSION_S_: ------1\)~"~--- ------ RE-DEVELOPMENT APPROVAL REQ' D: ___ =l\l~A~---- LANDSCAPE & IRRIGATION PLAN COi•iMENTS: I\ ~-------------- ADDITIONAL COMMENTS: ----------------------- OK TO ISSUE: ThS DATE: l'u l,31 -tcr OK TO FINAL: DATE: --------- ENGINEERING DEPARTMENT (t;=,IJ R. o. W: ______ IMPROVJt,,.i~N'M_: ________________ _ • PUBLIC FACILITIES FEE: SEWER CONNECTION: -------------- DRIVEWAY LOCATION(S) =-----------~ __ _ GRADING PERMIT: ________________________ _ EASEMENTS: _________ DRAINAGE: _____________ _ LEGAL DESCRIPTION: _______________________ _ ADDITIONAL COMMENTS: ______________________ _ * IF TIIIS ITEM rs NOT CIIECKED, BUILDING DEPARTMENT WILL MAKE FINAL INSPECTION. air flow company, inc. p. o. b OX 8 0 7 Att: Tim Building Department 1200 Elm Street Carlsbad, Ca. 92008 Dear Tim: a d d i s o n, i 11 i n o i s 6 0 1 0 1 phone: 1312) 628-1138 February 15, 1983 Re: 2352 Marca Place Lacosta, Ca. Confirming our telephone conversation of today regarding the above referenced residence, this is to advise you that the material we shipped to the above address was 26 gauge, bright spangle galvanized steel. If you have any further questions, please call me. JS/cs Respectfully, r-:5'~~ James Sproch --·-··· .... " ---•--·• lECEIVED FEB 18 1983 CITY OF CARLSBAD Bulldlng Department • < , '_i i \\ • . .. , .. -~ . -··;:-._, ___ .. ~ 11. j j );I( ,, " " " "' " " " "' "' ",1.v~.IJ1.1,-,\/i;.p1;JAA#,Ji..AJ;i..~,1!!.A.A,~JtJJIJJ/JJ.JAl), .. AU&~)( ~ E j QT r rt if it a 1 r n f ® r r 1t µ a tt r y E 4 CITY OF CARLSBAD ► 1 f 4 This Certificate issued pursuant to the requirements of Section 306 ,v ; ";;:: of the Uniform Building Code certifies that at the time of issuance ~ : this structure complies with applicable ordinances of the City ~ regulating building construction use. »-~ /4 U,eClassHkat;on SINGLE FAMILY RESIUENCE Bldg. Pe,m;tNa _ ___,8=2~-=3=6..,_l____ ► j Group_._R...c3<--. ___ Type Construction __ V.,_N,__ __ Fire Zone _____ Use Zone______ t 4 Occupant Load_____________________________ ► ~ Owne, of Bu;1d;n9<. RA! PH BIi Al O Md,ess 21 W 250 GROVE ST. ITASCCA, ILL. t j Bu;td;ng Add, .. ,'.'j, ;'-?~5-~:~~R_-~i. L .f _ LccalityCARLSBAD, CALIFORNIA · ~ ~ ~A:: _____ • _____ --__ By-~~-~~~r/4=-~=~~•~~•·=-L• .. _ ... ,_.,_"• __ ~::,; ~ _________________ Date __ l!IM,,.AY1.-<2:..;34,_._) :,.,98a.3'1-________ ~ NOTE: Alterotions, chang•s, odditions or chon·ges of occuponcy nullifies this certificate. (Post in conspicuous ploce) .ffo//W " " " ff)( ---•~----•---------------•-M------• --- ✓-