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Home My WebLink About2407 La Macarena Ave; MULTI-PERMIT FILE; CBR2018-0431; Permit(city of Carlsbad Residential Permit Print Date: 04/03/2018 Permit No: CBR2018-0431 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: 2407 La Macarena Ave BLDG-Residential 2550704700 $0.00 Work Class: Lot#: Reference #: Construction Type: Bathrooms: Orig. Plan Check#: P/M/E Status: Applied: Issued: Permit Finaled: Inspector: Closed -Flnaled 02/21/2018 02/21/2018 MColl Plan Check#: Final Inspection: 4/3/2018 2'3L07PM Project Title: Description: EDUSEI: REPLACE 50 GAL WATER HEATER Owner: Contractor: KAFUI EDUSEI 2407 La Macarena Ave Carlsbad, CA 92009-9124 601-842-7393 AFFORDABLE WATER HEATERS AND PLUMBING INC WATER HEATER -PLUMBING, ELECTRICAL, MECHANICAL Total Fees: $98.00 Total Payments To Date: $98.00 28358 Constellation Rd, 698 Valencia, CA 91355-5044 661-259-7131 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactlon." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030, Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. $0.00 1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov $98.00 THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: CJ PLANNING 0 ENGINEERING □BUILDING l-:J FIRE □HEALTH □ HAZMAT/APCD ('city of Carlsbad Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Ck. Deposit ~----~-----~ Date SWPPP JOB ADDRESS SUITE#/SPACE#/UNIT# APN hw=,-,,-~#J;;;,,""c h?~,,,_=t_,_ __ L~:'-',B"~] ~oC ~1~ I'°~~ T~'- DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) # BATHROOM] TENANT aus•_•_,._•_•_A_M_• _________ LI c_o_"_•_"_·_TY_,_'~l _o_c,_._G_Ro_u_,--1 EXISTING USE PROPOSED USE Co fY/ ADDRESS ------~----· ---- lcm STATE 5() / n I I on GARAGE (SF) ZIP ,f'on, e.. I o c a -t--1 o rz PATIOS (SF) DECKS (SF) AIR CONDITIONING YES0No □ FIRE SPRINKLERS v,s□NoO --. CONTR .. •.CTOR BUS. NAME--.4. ·r ,,_,f ·ov,r.~e ADDRESS vVa t e _c _ _}_ftfl±. ftw er~ ~"J 3SK C.a y1s--J-e I I at1c, r, /2.. oL CITY STATE ZIP 1 / '.-1 IP ,,,,, .r 1 . c~ c~ A--____ ~ __ 7_ I ,j 5 __ c; __ _ !c:-: 0 -.~-:----------~-'AX __ -·-------·---···········-~~}~ ;~; 0 S 7. D;~ 1) /2 S 2 -~1 5 ~ --1 STATE LIC. # -----1-srA'fE"LIC.-f-c.L.en_i___±J__ ____ @_ ·ciis uJ h -'~,fau~. uc.f~5? _Cb_ \.(> 2731.., S' C3 LP I 2 7 2 (Sec. 7031.5 Business and Professlons Code: Any City or County which requires a permit to_construct. alter, improve, demolisti or repair any structure, prior to its issuance, also requires the applicant for such permit to f!le a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law fChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or {hat he 1s exemP.t therefrom, and the basis for the alleged exemption. Any violatron of Section 1031.5 by any applicant for a permit subjects the applicant to a civll penalty of not more than five hundred dollars {$5001). I WORKERS' COMPENSATION 1 -I Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I p/ve and will maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. GJ"i' have and will maintain workers' compensation,. as required by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy numberare:lnsuranceCo./a,s:,,r<rZOCe Co I o-f-tiJf tYe1r t: PolicyNo. 5 0?, 2 4 ✓ 7 OJ-__ ExpiralionDate /, /. / ~<--- This secUon need not be completed if the permit Is for one hundred dollars ($100) or less. D Certificate of Exemption: I certify that in the pelformance of the work for which this permit is issued, I shall not employ any person in any manner so as lo become subject to the Workers' Compensation laws of California. WARNING: Failure lo secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,0001, In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees. /,, JES CONTRACTOR SIGNATURE av 1 ~ENT I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ □ D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's license law does not apply lo an owner of property who builds or improves thereon. and who does such work himself or through his own employees, provided that such improvements are not intended or offe1ed for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). l, as owner of the property, am exciusively contracting wtth licensed contractors to construct the projeci (Sec. 7044, Business ancl Professions Cocfe: The Contractor's License law does not apply to an owner of property who builds or improves thereon. and contracts lor such projects with contractor(s) licensed pursuant to the Contractor's License Law). I am exempt under Section~------Business and Professions Code for this reason· 1. I personally plan to provide the major labor and materials for construction of lhe proposed property improvement. OYes ONo 2. I (have I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (Include name I address/ phone/ con!ractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (in dude name I address/ phone/ type of work) J!S PROPERTY OWNER SIGNATURE ~T DATE -----------------------~~ y Is Ille applicant or future building occupant required IO submit a business plan, acutely hazardous materials registration rorm or risk management and prevenllon program under SecliOns 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D Yes O No IS the applicant or future building occupanl required to obtain a permU from the air pollution control disirict or air quality management district? O Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the applic8tlon and state that the above lnfonnation Is correct and that the infonnatlon on the plans Is acx;urate. I agree to comply \\1th all City o«lnances and State laws relating to IN.lildlng construction. I hereby authorize reprasentabveof the City of Carisbad to enter ul)Jll lhe above mentbned property for OspeclKln purp::ises. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD l AG'\INST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permtt IS required br excavations over 5'0 deep and demolioon or construction of structures over 3 stones In height EXPIRATION EvefY penrnt ISSued by the Bu1k11ng Official under Ille provisons of ttus Cooe shall expire by limItati0n and become nun and void 1f the buIklIng or v.ork aulhonzed by such ~rrrnt Is not rommerced wittun 180days from the dailofsuch perrrnt or if lhebu1klmg or'MJl'k authorized by such permit Is suspended or abaldoned at any ttme anerthe V,Otk IS commenoo:I for a perkld of 180 days (SecllOll 106 4 4 Uniform Bu1kling Oxle) ,.@S'_ •• ~,~~•T'SSIGNATUR'_ .Gd--t.J DATE ,z Lq £r__%~~--- ' . * i ' ' ' ' , PERMIT INSPECTION HISTORY REPOR'((<::BR2018·0431) Permit Type: BLDG-Residential Application Date: 02/21/2018 Owner: Work Class: Status: Scheduled Date 03106/2018 03/21/2018 04/03/2018 April 03, 2018 P/M/E Issue Date: 02/21/2018 Subdivision: Closed -Finaled Expiration Date: 08/20/2018 Address: Actual Start Date 03/06/2018 03/21/2018 04103/2018 IVR Number: 9668 Inspection Type Inspection No. BLDG-25 Water 060665-2018 HeaterNents Checklist Item BLDG-Building Deficiency BLDG-Final 060666-2018 Inspection Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final BLDG-25 Water 052297-2018 HeaterNents Checklist Item BLDG-Building Deficiency BLDG-Final 052298-2018 Inspection Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final BLDG-Building Deficiency BLDG-Final 053826-2018 Inspection Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final BLDG-Building Deficiency Inspection Status Primary Inspector Failed Chris Renfro COMMENTS Failed Chris Renfro COMMENTS Temp/Pressure relief valve needs to drain to an approved location or exterior location Failed Michael Collins COMMENTS No access, left card Failed Michael Collins COMMENTS No access, left card Temp/Pressure relief valve needs to drain to an approved location or exterior location Passed Michael Collins COMMENTS No access, left card Temp/Pressure relief valve needs to drain to an approved location or exterior location KAFUI EDUSEI CARLSBAD TCT#73-18 UNIT#01 2407 La Macarena Ave Carlsbad, CA 92009-9124 Reinspection Reinspection Passed No Reinspection Passed No No No No No Reinspection Passed No Reinspection Passed No No No No No No Passed No Yes No No No No No Complete Complete Complete Complete Complete Complete Page 1 of 1 B U I L D I N G 10/27/97 17:08 Paqe 1 of 1 Job Address: 2407 LA MACERENA AV Permit Type: PLUMBING Parcel No: 255-070-47-00 Valuation: O P E R M I T Suite: Lot#: Permit No: CB973225 Project No: A~704147 Development No: Occupancy Group: Reference#: Con307 uction Type: NEW 75 1012etea ~: oir s fd~D Applt; FRHT 10/27/2~?00 Apr/Issue: 10/27/17 Entered By: JM 633-4848 Description: WATER HEATER REPLACEMENT Appl/Ownr : MCGREGOR TERESA 2407 LA MACERANA AVENUE CARLSBAD, CA 92009 *** Fees Required *** Fees: Adjustments: Total Fees: 760 F e-s..... Collected & Credi ts .00 .00 27.00 *** Fee description Ext fee Data Enter "Y" for Plumi;;1nq-J;:"$-sl,.le Fee Each Water Heater and/o V.ent * PLUMBING TOTAL 20.00 Y 7.00 27.00 ·-·- ""'} or ·-----.,lb_ -~ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 ~FROM : AJFOSTER INC FAX 461 5443 Pl-ONE NO. Oct . 27 1997 03:54PM P4 ~ FOR OFFICE USE ONLY PLAN CHECK NO. ?]'3L2£; PERMIT APPUCATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 EST. VAL. _________ _ Plan Ck. Deposit _________ _ (619) 438-,161 Validated By __ ..._ ______ _ Date ______________ _ ll~IP.ROJE~Rla>IIM4~Mlil&M'Cm 24Q7 La Ma@rena Ave. Addrtu llt1~ludt Bldo/Sul\e II "-· llutlt,eu Ntm, Cat thl• add11u► Lo91I OucrlpllOf'I Lo\ No. SubdMtlon Namt/Numllet SFR . ou c,11111.,,. of Work SO. FT, lof St0tltt c;-.11,,. ... Wll.TF.R .HFATfJt &~~~--~-~ ... , i -.om AtTil'l:I\SORlft: d_llQ.l;J~!'P.P.-liinll lNalir. . • Mc;GrecJor, Teresa 2407.La Macarena Ye . Nun, Addrtst Cit'( -~~~,).\JcAH:r,'!iafJO'.!;:~~-~~IA\'WOOonfluiiiB.G~m~.! eWfil.IX lCd:iNSON/KBISTY FOSTER 13706-B HWY 8 BUS. N,m, Addltn City Unit No. l'huo No. PropoHd Vu I ol Bedrooms Gwtt/llp · T o\al , of unll• I of Bathlooms ~!;~.8-~Wlm9,WH~~-jf;'ftMnrfll11Jffl'lfSffl!fflll -=- N Me€FO'!JOI", T-E!r@liil 2407 La Ma,carena Ave. CARLSBAD ~. ~ffl'~~48 omo Acklre11 Clly State/lip T1l1phont , 15&3l'CDN.TRA~ll!l;.eo~e • -• -PZU'cW \~~w· IS,c. 703,. 5 Bu1lnH1 and "'•'••Iona Cocl1t MY City or Co11n1y which reqw• • P.,mlt to COl\l\rll01, 11\er, lrno,ov•, tlemodlh or 1t11alr any •trucu ... , prior 1o 1,, luv,nc,, ,1,, r•quires th• ,ripke,n for ■uoh p11mlt to IA, • &Jo,111cl ■tattm"n \hat M la Rctn1tcl purau.nt to th• provlaioM of tht Contrector'• Uc,nu law ICh1p1tr 9, commer>dlng wllh s,~lon 7000 of OM1lon 3 of th1 Buslnen 1nd l'rofHII-Codel Of that he le e11tmpt thtrtftom, tnd tti. b11l1 for the alleged •~tmPUon. Any vlol■llon of S1ctlon 70a1 .ti by any applc.,,t lor I Ptfmlt aub)IIC\t Iha apptlcti,t to• Cll'tl ,-lty of nol mor• than lbt~~•d do~!_llfa't-? " & J FOSr~ ;p:i;.room.r; J 3706 B HWY 8 BUS. · BL CAJON CA· ~ Ham, • • Addtt11 City Sta11/Zlp 1211~~ I S111tUc11nul 630J2Q Uc1ntt~l1n C-36 ,CltyllUtlntHLk;-11 ______ _ buigner Nam, Clly Stele/Zip Telephone &1111 Ucom, I NIP. _ j Sii:W.oJUC.Wi!iCOMi>ENt'4.'tl6~~ Workerl' Coffll)tn.a\lon Dld■r■tlon: t htr•by affirm under ,,..,.t1Y of petfuly ene of flt lollowlnt,ole~er1tlon1: O I hevt ■nd wlll meln\aln • cenlllct\l al c",..."' 10 1tlf-ln,ur• for wort.,■' eoin-tlon II prevldad by 8■clh1n 3700 of th• Labor Code. fen \h■ perfon111nc, of th• work lor which 1h11 p..-mlt Is luuod. O J_h1v1 and wtll m11n1,1n wOfktrt' com1>■n .. llon. • 1a11ulrtd by S.clkm 3.700 of \he Labat CA>de, fo, \ht parfo1mence of l"-~orlt 10, which Ulla pe,,..,, la Inv«): My worl:.tr'■ eomptn11tlon lnn,ranc• c■,,l., •nd polley lllimbe,. ~•: CONTINUOUS ll\luranc• Com111ny FARMER INSIJBANCE Poley Ho, N2007-56-51 Expiration 011, _____ _ ITHIS UCTION Nllb "OT SI: C:~Ml'UTID IF 'THI l'f.l\MIT II FOIi ONI HUNDRED DOLL.ARI lt1001 OR LEHI Q CllnlFICIITI OF IXEMPTlO": I cerilfy lhtt In the periormtnCt of UIII wolli 101 which this Ptllnll 11 ltauwd, I ahtU hot ..,,ploy 1ny Ptlaon In 1r,y mannt110 es· to btcom, tub)tcl to the WOfb,.' Co,npenaallon l1w1 vf C1Rfornl1. WAIIN1NOt F,1111,1 to HC\lf••wMII.,,' cempentlllon ene,19■ 11 Uftllwful, and 111111 ■ubjtot .. IIWlplly11 ,o crlnllnll penaltl .. ..,.. dvll fl'"'I Up to on■ liundrad tho<nand dvll.,, If 100,0001, In addition lo the 0011 of cem,,.r1,a\lon, cltn1•11t1•" a,ro-Ad■cl lot In Section 370t of 1111 labcf' ~. lr1t■r"t Ind 1ttot1,.y·1 , .... :SIGNATURE _______________________ _,_______ DATE _________ _ 7, 1·"'-oWNEfl•aUtLDE.R Ot~TJON$i'i,tf,~ln-~~--~~~ i!l~'f.'~l:t''' I hereby offlr," that I ,m ••'""Pt !tom the COn\l■c\or'1 llclnH l1w IOf \ht folowl09 rtHon: 0 I. u ownor ol the propt!W or my tffll)loyn5 wUh w■gaa H thol, ■ole oon,perw1tlon, wll do tM work and tl\9 1t1~t111w I■ not intended or offa11d lor 111, (Ste. 7044, Bu•lnns ,nd 1'1ofu,lon1 Cod.: Th■ c .... u•ctor•• u.,.,... LIW doll not apply to "" owner ot P1'111M'IV Who llulldt or lmp,ovH ther•on, •nd who does sv,:h wo,k hlm,etl or 1hr0119h hi■ own ...,ploveH. PfOvlded thal tuch lmprovtMtnU u•""' lnttndtd Of oflu■cl lot ■al■• If, however, 11\e bvlldlnf 01 lmprovem,nt It ,old within on, yo1t of campCllkffl, \ht own■r--bulld■r w1II heYt lht bwden el PfeWlf Ullt ht did Mt IMld or lmfl'Oft for \h. -poH of t1lel. O I, u owner ol tlw 111ooerty. am t1<c!U91vely eor,lrac\lflO with lk:■Ntd oontr,c:to,1 to con■trucn/,e proJtelt 1s,c, '7044, llualnen end f'rof,nlon, Code: Th, C0'1111ctor't UctnH law ~ not l1IWf ,o an OWntf of IHOPtlt'( who ~ o, lmJlfO'tH \MftMI, 11111 conttKU for wch PIDJtc\l with OOl1tm:torCtl lc1naed Pll'flltnt \a th■ Comract01'• Uc1nH Lewi, · □ I Im el<lfflPI llndtr G■ctlon -----ButlntH Ind ProlHliorlt Cod• ,,,, thl, rtnlll'I: 1. I Dt•ton,nv pie/\ \0 provide th• r,uJo< labor •nd m,,.,,.,. fo, con•~tlon of \ht propo1ed pro,«ty lmPfOVtmttll. 0 Vl:8 ONO z. I lhev, / htv■ notl al9ned an eppllettlon for • bulldlnv permit 10: 1M P,Ol)o•ed work; 3. I htvt conlr1eted v,llh Ula foflov,'"9 puAOn (fin,,)\!' provide \hw PfOOOHd c:omtNCUon Clncludt name/ eddrtn / phon• number/ conlrktora llc9fllt numbtrl: •. 1 111,n 111 PfOYldt portion, of th• wo,k, but I hav• hlltd th■ foUowlno 111reon to coordfn■t•, a11pe,Y11t tnd provkt• th• mtjo, work Im elude ntm1 / eddru1 / phone """'b" I co,.tt1ctora ac,.,., numbt1I:. _________________________________________ _ 5. 1 wlN p,ovld■ ,om, of 11,, wort., bu\ I heve contrac1,d lhlr1d) th• fcrClowlng ptrtonl to p,ovld■ \he WOfk Indicated Unckldt name/ addnn I phon1 numbor / type of wo,k): __________________________________________________ _ PRO,EIITY OWN!R SIONAYVlll _____________ __,------....--- ~O~l1Cl'8!C1'.IOIU()ll.~K~JH~l~.iff.Q~·- ts tht tppllcont o, lu1ur1 bulldlnv ~ r■qut,■d to tubmh • bualnett plan. teuttly hlurdOUf mttttlat. ,egt1111tlon form 0t rl1k rnanac,,mtnt and p,evention proQI•"' Und1r Sec:\lOflt 2HOG. 261533 .,, Ull34 of,,,. Pltllwr•T-H,u...,_ lull~ Account Aot1 0 YES O NO 11 tht tppllc1nt Of flllllf■ buffdl,,11 _.,,, r..irad to obteln • pa,mlt frem tht ell pollution control dltuh;t vr air qualfty rn•n19tment d1&11lc17 0 YES O NO ,. \he facility to bt eondrllcltd v,,Jthln t ,000 , .. 1 of the --bounclttV of • ,ehool •lt•J O YES Q NO ,,. ,.,.., OF TH£ ANSW£R9 Allf. vu. A FINAL CERTIFICAff OF occu,ANCY MAY NOT II IHUED UNWS TH! AnUCANT HAS MET OR 15 MEETING THE IIEOUIREMENT$ OF 'tHE Of'l<ICE o, 11:MERGliNCY SEJIVlCU ANO TUE AIR POLLUTION CONTROL DIS-TIIICT. ,,:· ~•, CONS1'iluol'1oN LENDINIJiAGEN¢Y~•l&WlOr;,)mm.~... ~~j..'t,,,. ?· N(.,·: t 1,or•bY tfllr,., 1h■1 thert 11 t con,ttuclh,,, l""ding 19.ncy, lor \ha porlormtnc■ of 1h■ wo,lt fOf whleh thlt l)IHmlt I■ 1■1u1d 16ec. 9097(11 Clvll Cod1I. . . I certify lhtt I hi•• rHd tht 1P!Jlicatlon tnd 111\t \hit tht 11,ova lnform■tlon fa torrtct ... d that \he lnfom,allo" OIi \ht pl■nt Is aceutala. I 1g1H lo ,::omply wl1h oil OW oufinenen end State ,...,,, Jtlatlnji to blllldlnt eollttnlction. I hereby 1uth0fl&1 IIIPfNelllatlvH nl th• CI\V of Cttltbod te ■nler upor, · \he abo•• n>•ntlonad property for tnspec\lon IMPO"*· t ALSO AQIU!t TO SAVI:. INOlMNIFY AND KElP' .HAI\MUSS :,liE CITY DP CAlllSIIAt> AOI\INST A\.l LIAIIIUTIES, JUDGMlNTS, COSTS AND EXl'f.NSU WHICH MAY IN ANY WIIY ACCRUI: AGAINST IAIO CITY IN CONSEQUENCli Ofl ™I! Otv.tnlNG OF THts Pl:RMlT. OSHA: All OSHA "'""'l 1, twqulf■d '°' ,xeanllon■ IIVlf 11·0· daec, lhd chmolltlon or e-tructlon of tlrue\U<H OV■f 3 llcmH In height. U(l'IIIATIONt tverv p■rmlt IHIIM l,y \h■ Bulldlng Ollldtl und.r \it. proYltlonl of thl• Codt ,.,,. 1,cpl,• by limitation and become nun and void If Iha bulldin11 o• wOf\: tu\hoflnd by aucl\ pe,mlt It not cammenctd within 386 day■ from lh• d1\t of 1uch ptfflllt or II the b\llldl;,g or work 1utho1lud by such 1>~rmlt 11 suspended or ,b,,,doi,td" ,nv 11m, ,rtw u,. ork Is mm Id I I pttlod of 190 \Section 106.4.4 Unlto,m 8ul1ding Cod■I. I I /l APPI.ICAHT'S SIGNATUIIII! _.:::r.:t:ll.LJI-L,.£1::i~L-.-1~!..61.a:lt.J~:.L-'---------DATE IQ zq., _'::J1::: l WHITE! Fno YELLOW: Appllctnl PINK: Finance