01110120 BUILDING mvsONO
iiNPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT N0.
1093 KENTWOOD AV 01110120
OWNER'S NAME: APPLICATION SyB DATE
UANE VOIGT & ABY HO 11,28/2001
i
PHONE: SANITARY NO. CONTROL NO.
O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
h 2 E IC_-1 I..._1
5N: LICENSED CONTRACTOR'S DECLARATION JobDescri tion
z- I hereby offmt that 1 am licensed under provisions of Chapter 9(commencing
HC with Section 7000)of Division 3ofthe BusinessandProfcssionsCode,and myllcense INSTALL SUN ROOM.
e m I is in Poll force end effect.
152,o License Class Lic.a (IN REAR YARD)
i 3 u. Date footman,
ARCHITECT'S DECLARATION ��� O
=a ao aj 1 understand my plans shall be used as public records �2
Y
1 o o Licenxed Professional 20
OWNER-BUILDER DECLARATION
rn 1 hereby affirm that I am exempt from the Contractor's License law for the
t?a following mason.(Section 7031.5.Business and Professions Code:Any city or county
F O res a pcm,it ro construct,after,improve,demolish,or repair any stmcmtn
C po hrcgnt L��I�(
3$ pct t s mua ce,al mgf fr rm uemumcm . ---------
that
._._._
tivrhet a<erepdia ntwheProvisions of Contractors Loamm Law(Chapter
q S Ft. Floor Area., ff l.- Valuation
(commencing with Section 7000)of Division 3 of the Bujmesi q Profess ori.Code) s.{.i.�i t V YC9,l l v kA X.,_, , !Y].Y" 3.i r14t
or thai he is exempt thcmfrom and the basis for the alleged exemption.Any violation I
-of Section 7031.5 by any applicant ho u permit subjects the applicant toe civil penalty
of not more than five hundred dollars(s5W). APN Number e=.,1. >;" Occupancy Type
0 Las owner of the ppeny,or my employees with wages as their sole compensation,
'
'Will'do't a-amirk,-and the structure is not intended'or ofrercd-for"sale(Sec.7014,- -- - - ;-
Businas'aid'ptdTessiens code:The Contractor's License Law docs not apply in an 102 - PIERS Required Inspections 1
0caner of property Who builds or improves thereon,and who does such work himself
or throw h his own employee.pr y Led that such improvements arc notintendedr 103 UFER
;compleffendor sine ower rthell la t p omen,ng tha wind naeymor 104 - REBAR . . .. �.:r;',L,>, '.c•. ; ..D.o_
'compinton,the owner-builder Ider will have the burden of proving that he dltl not build or
improve mr purpoae n(:ale.). 105 - ANCHOR BOLTS
alesownervthepm my,ameadusivelycontracting with licensed connectors m T06 - SEWER' & WATER ' —
construct the project(Sec.7844,Business and Pmtessions Cade:)The Contractors 2 0 2 - UNDERFLOOR PLUMBING ' "f
License Law does not apply to an Owner of property who builds or improves thereon, "'`' "
.p. .and.who.comracts.for.such.pnijects.wM a.commnogs).licensed pursmia m.tbe- .._,..__...'-'2'O3""--_..LTNDEi R,I'+I,OOR--,MECHAN,I�:AL'- y
cot t r License L. - _... .. .s.. . ._._._._
s ❑1 exempt under e'&Pcfar this rcmen 204 - UNDERFLOOR: FRAME'':'
0 e Data N�[(4� 205 - UNDERFLOOR INSULATION
_ 'WORKER COMPENSATION DECLARATION 301 - ROUGH PLUMBING
-Inereby,rfirmunder Penalty ofp juryoneaf the fallowingdeclarmlons: 302 - TUB & OR SHOWER
01 have'and',Wl'mainna..Ceriintme a('canumlo self-maum for wn,ker's 303 - ROUGH MECHANICAL
\` eompniarnn, mimokfar Tor by Section 3]011 of the Labor for be 304 - ROUGH ELECTRICAL
c _ performance of the work for which,his permit is issued.
0l have'end will maimifln Woikeri Compivaiionriniumoee.as required py Section 305 - FRAME
3700 of rhe Labor Code,for the pcifoanance of the work for which,his permit is 3 0 6 - HOEDOWNS
e c c e a e Pohcr numhe a
same Mr wok r Compensation rl Pn I E307 " '.IN.ST,JliATION.
I
came,
1x CTRTIFICATION OF EKEMPTION PROM:WORKERS k.t..:,rS ..3.0B A._f.SHECETROCIC 1 't .
'r, Y .COMPENSATION INSURANCE' . . 1 f.._ __.____ r-------
"y").
---_.
309',:-. :EXTERTOR'-L'ATH „-e..
flits uaron neem not be completed d the pemdt is for one hundmd dollen
fS�001 pr lesa.) 310 - INTERIOR LATH
-� - -• — ' -�°— 311 •°- ° S@BATCH COAT
.,,, s I c mfy th i m th,pert mance of the work f r cab ch th perm,is
issued,
a1
.11 t 'mp ny any x n In any manner so'as in bedome s b)em coin Worker's' 313 - ROOF NAIL
C. I. On Lewx of Cal tomo Dme: - 501. ..—._.F.INAL...ELECTRICAL-_ENERGY._,._____- ____....._...
N Icon, -
omcETO APPLICANT If B king@ Cem,fct ofE mp,o y should
Z. beco s 67emtoth W rker C mpe a npro so s 7thelaboreal y u s, 502 - FINAL PLUMBING ENERGY
r 0 lith nh comply ohs ch prov sons ar this perms hall be deemedre ked 5.0.3-__ , FINAL-MECHANICAL.-.ENERGY_-
r'a Ico3vsraucrloNLENDwcAcervcv 504 FINAL BUILDING ENERGIt `D
�i 1 h r<hy affirm that,be 'gen= fo m
n ncrae t a
w:" nrtn� nkrr n,chwspermu " sd�ets< io9i �r:.cly �"p"f505 - _FINAL ELECTRICAL
p Z Iineers Aaamss .. 506 - GAS TEST
U O slcenfy.tnetl'hmreadthuepplicetionandsmmthauheaboveinfonnabovis507 - FINAL PLUMBING' 1' 11
'Ir?[s cortect.1 agree m comply with all city.and eoun,y�ortlinonceaan:i,smmiaws
Witting 508 - FINAL MECHANICAL
O',.p to buildin6 conmrdction;and hcrehy umhnrize Fcprcsen,ulives d(thiicity,o en ter upon
,fi�rs W [he abo.x.m�nhrnea Pmp<nr f�r.imPecenp purpnse�._ 509 - FINAL GRADE
G.:6s (w)agree io save demai(y end kttp harml ss thi C'ty f C penlno'aga nut -
44.wr p� hob I t a 1 dgmen,s,c is end expenus xh ch may my ey accrue egoim,Clod 5 1.O FINAL PL ING
U :� City m comequrnee of Ne gam g o(thls person "
SOUR ANT :uDERSTAND�p WILLCONMLYN'I'fHA1.LNO1J.P01NT'"" 514 �. N WORKS
mutnee licant or ruwrc Gum p Issued
fs Date
ac d f W he Cu moo M 1 C RIALS DISCLOSURE " 1 Re-roofs
:7 4SOURCER 1IATIONJ
Un
r Slgwmre o}e� IcanVContm I', ,Dam
I' NAZA�ATE
pp goccpmtsmrcorhaadleHeeltandStenm _,TypeOf.Roof
q' pe W od C- t r 9 1] end the H alth end Be(ty _ -=
Code t. m`Yes 25532fa)aa e 0 Not - q 1 ,-1 i+ t lfir. \ 'i AY i s y:.a: _�t3,,,' i t 4 �1 ]:o;,.
..
"p ' __All roofs shall .e inspected pnor-to,any roofing matenal being installed._ _
canon pai_, t -f t building Orcupaniuseefmpm t rde ice,which If a roof is installed without first obtainin an'ins ectio'n,,I'a ree.to'remove
it hezardo contaminants asdefined b)the Buy AreaArO Quietly Manugement g p - g
Dian " all new materials for inspection Applicant understands and_will comply with
z, ❑rel Y ,r q' os :'' ,...; all non-point sourceregulauons' -
1 ham tend the haxereous ma¢rials rcgmrcmems under Chapie 695 df the
C51if rota HWl,fi&'Sa(cty Code Sections 25505;2SSJJ end 25534 Pundernand ohm
filiebu len em now��ca¢w t thatwsm noon of.c otom
„y Pot yf ib rc rem t wh mustbemt n ii'uenc ofeC nf<ute of
Y
Oc a I
�t y�r�- Signature of Applicant Date
.. ._. ._ ._.. — .. _.
rte r�a a.g nt 1 D, All roof coverings to be Class B or better ` -
.r •. .1 A . , ., _
!4 FFICE'
y. , fie li '1 _ Li,a