12 HERITAGE DR - BUILDING INSPECTION (5) ---
PUBLIC PROPERTY
I DEPARTMENT
AIURIERLEY DRISCOLL
MAYOR 1?0 WASHINGCON STREET•S ALI:A(,M.��sncxl;sEl-rs 01970
14t 978-745-9595 0 FA3t978-740-9846
APPLICATION FOR THE REPAIR, RENOVATION CONSTRUCTION
DEMOLITION OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: �r „��� A {�r� e s Building: �qr�
Property Address: ( cL V^r,
J 0. �QYVT l �A I -1 -7 G)
Property is located in a; Conservation Area Y/N_) Historic District Y/N N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name: �Y n C i1 l L C_
Address: 1 Z
S�
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN Fxic'ribLG BUILDINGS ONLY
Addition lj Existing /"
Renovation Number of Stories Renovated /\J//l
Change in Use New
Demolition {q Existing tj I�
Approximate year of N Area per floor (sf) Renovated I�
construction or renovation
of existing building New n1
Erief Description of Proposed Work: II ,
E� Z� k cQ A—
r�,+ mortis a�_ c9
Mail Permit to: -- — ---
What is the current use of the Building?
Material of Building? hJ If dwelling. how many units?
_Will the Building Conform to Law? �� Asbestos?
Architect's Name
Address and Phone k j
Mechanic's Name 1
Address and Phone J
Construction Supervisors Licens # HIC Registration#
Estimated Cost of Project$ Permit Fee Calculation
Permit Fee $ — Estimated Cost X$7/$1000 Residential
Estimated Cost X$111$1000 Commercial
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above
4 stated
specifications. Signed under penalty of perjury
Date :
0
N -
O
w
� 9
Q� a v
` aq
o e o
.3V q � L 6Vi
C6
w - E_
1
�i
=0212V03
or
tSPdJEP BY
Academy Tent & Canvas ;j
x r t No. 5035 Gntord Ave. j
Los Angeles,CA 90059
F 419.0 i
(323) 277-13368
This is to certify that the materials described below hereof have be6n figMe retardant
treated(or are inherently nornflammable). ADDRESS eat ARLI•++Wsv
FOR TAYLORREYTAS---= STATE
CITY DA
Certltication is hereby leads that_(Check"a"or"b")
(a) The arUclos described below this conifleato have been treated With 8-ftama•retardaM chemical
approved and registered by the State Fire W(8mhal and that thQ!8PPl1cdti0n of said chemical
was done in confonnanoa with the laws of the State of Californla and the Rules and Ragula"
lions of the State Fire Marshal. Chem.Rag.No. ......................
Name of chemical used..................................................._........
Method of aPPfloation.........................................................................,_.............
El(b) The articles described below hereof are made from a flame-resistant thbric or material regis-
tered and approved by the State Fire Marshal for such use; Fabric has been tasted and passes
NFPA701.96.
Trade name of flame"resistant fabric or material used nm)•-.r�••V "•... Reg. NE-4L QI..'
The Flame Retardant process Used ..w..lN...... Remfsved by Washing
David Bradley By Tom Shapiro President
T
ntandent tla
Nomo of ApprMatm or Produttien$UPe'n
TWS FABRIC WAS USED IN THE MANUFACTURING OF THE FOLILOWING
LEA=x2o U/W PARTY TENT
IZA 22yOOpXXy33y0 U/W PARTY TENT
�
CONTROL NO.O U/W COMPLETE FESTIVAL CANOPIES
2EA 30X45 V/W 1PC S1000 TENT TOP ONLY
CUSTOMER ORDER NO, 30X60UlWIkC510dOTENrTOPONLY 9�
ILA 7aDIX40 U1W 1JFC QHCrOP9 ONLY
CUSTOMER INVOICE NO. —1gA2Wo U/W 5PC RIdP�yd�A.�C$MENT QW1K TO
2RA 20X30 Y/W P,4RTY t�"v
YARDS OR QUANTITY 1OX10 U/W MARREL MARQUEE
3EA 1OX15 U/W RIM A4�ZMENT TOP
COLOR 2EA 2fIX20(tW1K1r41DDIySS
STYLE
DATE PROCESSED
ALL MATERIALS ARE CERTEMD BY THE CALIFORNIA Sf*: E B H+a
MARSHAIL AND MEET THEE REQUIREmxrM OF THE NFPA 701'AND UL214***