01030161 CITYILODI.IN('D VISIONNC CONTRACTOR INFORMATION: i
PERMIT
BUILDINGADDRESS: - PERMIT NO.
20956 HOMESTEAD RD ' SHELTON ROOFING 01030161.
OWNER'S NAME: , APPLICATION SUB DATE
1988 ' LEGHORN ST 03/29/2001
ONE" SANITARY NO. CONTROL NO.
99
❑K Y ARCHITECTAPsGINEF.R:
ler°° BUILDING PERMIT INFO
k �^ ELECT PLUMB MECH
yai
Z I)mLICENSED CONTRACTOR'S DECLARATION
I hereb10b Description y_C y aRlnn that 1 am un
licensed der powWors of Chapho!)(cermrs,r ng -
C� so
ilhSaloon 70oa)rnD'vc 'inane en dPmfe„'inns Cada end n,yl cense
gg s in lull a anday,ag .• - T'/O B. U. R. W/CAG SHEET ADD B. U. R. W/Cq
alit (d..�� c l� I r .'�t
C °a 1 anapownd my pmn se�li n t„ea a pin Bn�Iom, 14*k 77,90
e. .. V
a`4p x Licensed Prob,"i of ..
OWNER-BUILDER DECLARATION
—
on I hereby office,that 1 am carrier from We Conente a'-,License Law far the
C$Q following reason.(Section 7031.5,Businev,and Pfe
rossions Cecil Any city or poorly t _
P ❑ whiph r,mae,a Not I to con"oll ,alter,improve,demollsh,or repair any smmlurc
3 m Prior to it'issuance,also rtquims the applicam touch pernat fdea,i,md,Is1 meal
Ill.,he is licensed Pursuanna the provisions of the Carboni License LuwCarter' S ['+(, PIOOC Area(colonialist ng wish soft into 70bbol'DivisionI or the Business;,ad Professions Cadet 9' Valuation
or thus he is exempt the,nfre,i prattle hasis for the ehegul cxanption Any vialarim, 7
of Section 70315 by any oppliwnl for a permit subjects theatpplicant m u civil penalty
orad'mor16nflehouamadalmrs(s5on).- - -APNNumber ' .Occupancy Type
❑1 x fm i pay rye Ply tl g: .the l pn.mon 2
IIId Ili k pill the.tut t me 1 - lookedf 1 fS . to
-
09061
_Bne t e P re.s( Code:Tl c t t 1 1 1 t rely to elf Required Inspections' '
w r,f,his
Who bonds nr'improves atthereon,and who does such work himself
or "
oribmaghsalewnemployees. buildinmat.apoh„pmvemeolerenalareyearof 101. — FOUNDATION
impofferov for sale.IL however,the building or improvement is sold wimin are year of s
annplerims,the owner-builder will hove the mad,n of proving mo,he did not bund er 1.02 — P I E R5
improve an Pumwc of dole.).
❑ha,raw nor of he mullein,.,,Itocinsiady commpafit,with licensed contact...1e 1.03 — UFER O
ca s mal me project(Sec,7044.Saline',dad Pool,aion,Cedea The Cmaetar, -104 — REBA R
License Luw dyes na apply to as o oppl et property who build,or improves mconar,
dad who er,mracis nor such project.with a contractors)licensed pn...oup to me 105 — ANCHOR .BOLTS.
Conan ml's License Law.
❑lam r.ampt ander Site _ .B&P C for his ploom - 106 — SEWER & WATER
°wnef 202 — UNDERFLOOR: PLUMBING _
WORKER'S COMPENSATION DECLARATION
Iwo,byamrn,tmdcrpemmyafpa�aryonenffrebillowing declarations: 203 — UNDERFLOOR MECHANICAL
204 — UNDERFLOOR FRAME
cele dna will man,mi„a cby Sopti nr consent to srLania,e mf workehe ISULATI ON
cempeasoeen, as Pravmpd rm by season 370e or me Labor Cwle, for mo � 205 — UNDERFLOOR 'Ili '
pefram,ancearmework In,whichl],I, seranitisissued. 301' — ROUGH PLUMBING,.
A1 base andtw6l;naimain Worl Compensaron insurance;as required by Senior ^.t
ll) If the Labor Cr.m,for ala mon alar,of the work Tar which nam,d a pa1, � 302 - TUB & OR SHOWER 'a
stood.My Work to 'stiionhas...le a,nier dad Policy nanma:'^ro' 303. —ROUGH MECHANICAL ,
Cartiv �"�--policy Nn:57�����/ -
cERTuT AT1oNorESEMrrIONrROMWORKERS304 — ROUGH ELECTRICAL
COMPENSATION INSURANCE 305. — FRAME
This section need not be completed if the Iormit is for one dollars -
($10oh m,sa a - �. 306 — HOLDOWNS
1 really that is the p rlb...ounce of the work to,wlach his cam,i.lssnad,1 I 307 — -INSULATION
shall not century any parlon in any ationer so ism become,object to the WorkerK 3Q18' — SHEETROCK
-
Cmnp tws of C
1 if 'a Dal
App' 309 EXTERIOR LATH. .
NOome la l It APPLICANT:l B raking this Cep l pine of Lampar os you most -
Qz heecmarobjenmmewahprsm,olnr, aasPa Illlansobedronp]orno,yomm�,l 310 INTERIOR LATH
Q fonnwitM1 unnply with such provisions or this pennil shall be Jmmed revoked. '� � •
F " 311 : — SCRATCH COAT
CONS'I'RUCPION LENDING AGENCY
a 7 I hereby affirm mal mere i,a consonclao landing agency for the performance 313 — ROOF NAIL
ofdtewoN,it Tor wMpn ll,I, cep is isatna(s .3(N7.civ.c> 501 . — FINAL ELECTRICAL ENERGY
q Lrnaedn Noma
Londp,:,Address
»� 1
z 502 — FINAL PLUMBING ENERGY
rtlyt H1 d'his ppl'at dst
thinin b e- f atm'
Qw N coral I gra t comply id, n city ndcounty e Inc:laid ,t law Ing 503. FINAL MECHANICAL ENERGY
f„) it,bulUngc a t andhourly auth p coat ftlsity.t enter upon
Ck m1 n aP"p tylinspection paha 504 — FINAL BUILDING ENERGYL%��
�y a. 1w) gat : d ti keepdn .a City fc 1 tagainstid 505 — FINAL' ELECTRICAL --
F. Ol ran t lady l: t a estimates which ay , any is., e rya nand
Cly ,eyaeme of the nl ng al 1F s Perm"
,rer
APPLICANT UNDERS VU. AND WILL COM PLY WITH ALL O OIT t 506 — GAS TEST S� 0
SOURCE REGULAT �I Issued by: - Date
11 s,goamre arnPphratmce�u,t or [)are Re-roofs '
HAZARD US MATERIALS DISCLOSURE 508 — FINAL MECHANICAL
wulmeapprpamorfranc builmngaccapanlgarrahurdle breach m.aaacrial Type ofRoof 509.,c— FINAL -GRADE
as drained by the Copan an Municipal Cade,Chapter 9.12:and the Health and Safety
C.dr.Section 25532(a)'?
0yas All roofs shall 510 ecteF NQA o P AD I$ j q Sing installed.
Will me apphram of rtnnre naadine aprapam LL.p ennipmem of de.ia,which If a roof is insta'tI�rPCvit71o5t htE [•II�a 'iTfs ,�} il agree[o remove-
mnit all, ,In us air real: rint,asdefned by lire Bay Arens Air Quality Mutmgemem g
'°t"ate all new materials for inspection. Applicant understands and will comply with
❑Y: ZJ`t"r P PP P Y
all non-point source regulations.
Ilan - 1t1•h t,l Js y t W Ch pt R95 fmc '
Cul It H h IIh&Sffety C J S T l bs5a5 SH1 a 2x534 f ir 1 t me I] � --
[pleb IJ gd cep tlyl ul na t❑ I I y asp .bl'tyI ifythe
Oen P, t Irl y ' nl which :I by tp' I '.,ue,ecifu Cenl cote nl
Signature of pplicant - Date
Owncr,a,oamor,e a, t All roof coverings to be Class "B"or better
OFFICE