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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