02020104 CITY m ESONO
BUILDING IN CONTRACTOR INFORMATION:
PERMIT _
1 BUILDING ADDRESS. PERMIT NO
22680 ALCALDE RD 02020104 _
WNER'S NAME APPLICATION SUB DATE
THE MARIANISTS NOVITIATE 02/26/2002
PHONE SANITARY NO. CONTROL NO
C O O ARCHITECTIENGINEER BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
I= LICENSED CONTRACTOR'S DECLARATION Job Descri lion
I hereby affirm that I um accused under provisions of Chapter 9(commencing p
_y_2 war Section 7001Dnasion3of the Boi s.and Profession,Code.had mylicense ADD 3 ARBORS .
tx<J ful�l�ff,t(( endef 1
o c_6 Lie nse�s^
L LL N 1 _ Z
A Cyuy
RCHITECf'B u UEnlreC RATION FINALE®
C`) 1 underzmnd my p6n.shall he used as Public recoils
r
c O Licensed Professional'6 o ON'NEft-BUILDER DECLARATION MAY 0 8 200
m I hereby affirm that 1 am exempt from the Contractor's License Law for the
?Qfollowing reason.(Section 7031 S.Business and Professions Code Any city or county
which requires a pemat to construct,nlic,improve.demolish,or repair any structure 2 0000
t� w -Prwrm as oodawd.dm rcgmmnheapPhmmat for such pcmuuo fit...i'ncd su¢ment R
Or lie is,nan.ea Sectiolt7 the pronsision3 the c°musmess cen.ewwonsCe9 , r. , tVpQ /❑( ,pk' oQr-a,�s.-r 6a7 ., Valuation
(comtmncrngaalh Section 7")and the basisottneB3dciandp Professions Any violation Code) �,};a .,�.34'ZYy{V `�-`{;, {.::'.s`
or(hat Section is exempt Irary applicant om and or boos for the cts th tl eiempnt o Any maty
or not mo 7031 5 by any hundred udders ror a 500) suh)ens the applicant m a crvJ penelry p N� 1� —
olnotmorcthanf.ehuadmdtlollars lSSW) 101 pN F U DATION ' Occupancy Type
❑I,d the work.and the structures my s is notae tended ogees.offered sale(See wuoo. 1'3 V 1 sHi\v
will Emmet,Ihe'wnrk,and Ina.manure as not antendN or.Reran far sale(Sec ]o a. - —
ndrofand ennyN Ina ewe The C esdimm's ucena Low does am apply to an 103 - UFER Required Inspections -
.1 thr of phis own Wilds or i provided that such,and ano aces such torte himself
or
or mean n ms own empmy«a pWidin toed mpri:carent meol are not one or ._._.104..- _.REBAR.....
sale Ir,enholde the building or burden ofpmv n sold within ono Wild of
completion.the owner-bwlder will nave the harden ofpmvmg that he did not bold or 105 - ANCHOR BOLTS
Improve for purpose of sale 1. _ 106 - SEWER & WATER
01;as owner of the pin n am .. -g t__ - - - _--
pey.ameawaveladfrmltmgw,t Coda.)noonlmet°txtn '-. 202 - UNDERFLOOR PLUMBING '
conswa the pmlect(Sec.7W4,Business and Profesaons Coda.)The Comranor's � '
License Law dre.n°t apply to an owner of prepen>who bada.°r improve,thereon, 203 - UNDERFLOOR MECHANICAL*"
" . and who contracts for such pro)ects.wnb a.ommuctorls).1ieensed pursuant to the _ ._ .. - 2 O4 - UNDERFLOOR FRAME
- Contractors License Law.
Olam exempt under Sec a&PCfor this reason 205 - UNDERFLOOR INSULATION
he' WORKER'S COMI LN'SATION DECLARATION 301 - ROUGH PLUMBING
Ihcrcby affirm under penalty Of parlay one of the following declarations 302 - TUB & OR SHOWER
303 - ROUGH MECHANICAL
❑ 1 bursa will provided a Cby Secti of consent to ¢U-insure far NforA the
compensaaeai as work ror by scum, n6o of the Lm,°r code, for me 304 - ROUGH ELECTRICAL
perrarman<e airthe work ror which,his permit I,issued
305 - FRAME
01 have and will mamuin Worker's Compensation Insurance,as rcgto ea by Section 306 - HOEDOWNS
37110 of the Labor Code,fur the performance of the work for which this permit is
Ismcd My Worteers Compenation laid, cc cm r and Pitney number are. 307 - INSULATION
ic, IFIC ' : OFEXEMPTION P i308i3f,'SHEETROkt'ATH
N ON TION I INSURANCE
WORKERS' s_a
(This section need notMPENSATION INSURgNCP." I ' ; 309 _= ' RXTERIOR_`'_LATH'_ '
r A
CO
W�dmpleea rr me permit is for one hundred donors
310 =. INTERIOR LATH i.. . '.
HIM)orl`x" 311 - SCRATCH COAT
Form.in it j�hnn ast�cryne.a�.,t�to'he _._ .—�-_
1 dairy that m the parr°manna ar In<worn for wni<n aids cermrt is rs.tim,I 313"- ROOF NAIL ' -
com°°t`t��liAa°y cmtrmmiay ' `W°'"r' 501 - FINAL ELECTRICAL ENERGY
Appl at 3.. m g !,'rnv`°�caime�nPC e� - 502 -- FINAL PLUMBING ENERGY ----- ---- --
N ICE APPLICANT.If,after matem ah You.hould
Z bceomesubectmdr, .1Aer'sCom nsaoon yumm�sl • 503 - FINAL MECHANICAL ENERGY
O O f nthwhh comply wills such provisions or thrs pcmm.hall be deemed rtvoAeJ
am Leader am-'- CONSTRUCTioN LENDING AGENCY - FINAL BUILDING ENERGY - - --- - - -
.7 today a rte that Inert rs a construction leading agency for the performance 505 - FINAL ELECTRICAL
of the wed for which(his perad is issded(Sec 3097,Ov C) .506 _GAS._TEST _
U Z LendcrxAad,es• 507 - FINAL PLUMBING
w FO Iccmry bar lna'aonal Has application and state that mean°veinformau°nis 508 - FINAL MECHANICAL
. cement 1 agree to comply withal city and county ordinances and state laws relaung
O U m building constrction.and hereby auibonacmpoesentanvesof this city to enter upon 509 - FINAL GRADE
} Z. meabmWO)agronedpropeny for
chu'dy inspection pmrosax 510 - FINAL PLANNING
Z. WO)agree to e ravee mdcmng of diteeepharmless ltic City Of Cupcnino egama
m liabilities,ivagmenls.cows and expenses which may in any way alma against said 514 - F INALyp PTTR•FTT C WORKSy7///
V � Olymconsequcnce of the granting of this pcnnn � � � ��/
APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT" I{
S 07 GULAT10 Issued by:/J,p .�� Date
5agnatur2 of APPlicanVCOmracmr - " Date -
..'y, (, ^ - HAZARDOUS TERIALS DISCLOSURE t Re-COOTS
! Will me applicant or future Wilding occupant stole or handle luseadous material ,'type of Roof
Code,Sectiodrm C.pe)arm Municipal Code,Chapter 912.and he Health and Safety -' --' - -- _ - - -
Nq All roofs.§hat
e toed b the 32 )' v
as oOYci ..:, ., 0', .: ,lri).r.ii,:t" a .: i I': lt: Y NSA la •1
I be,inspecfed prior to any.roofipg material being installed.
will the applicant n-,U tnrhwrt bmmmd by'he occupant use egmpmemmeMandia which If a roof is insfalled without first obtaining an inspection, I agree-to remove
emu h,Will the air cnmammane ax defined by Inc nt use eq ipment or devices emcm g p 'g
Dr`vicB all new materials for inspection. Applicant understands and will comply with
OYcsNa . . - :'
9: 1 all non-point-source regulations.
1 here read(he haunrdovi'ma¢naH iequiremenrx under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533 and 25534 1 and...nom chat
'if the building dos not currently ham atenant.thin it is my responsibility to notify the
occupant of the requirements which must be met poor to'issuance of a Cemfcam of
Sign__ature of Applicant Date
a mnnrwagenl- �- `'L°ate All roof coverings to be Class "13"�or better
-. OFFICE