00040093 CITY UIOFNGUPERTNNo PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: 1•17RMI INO,
00040093
OWNER'S NAME. APPLICATION SUB DATE
LOtJ NFfU �N /L-PJ'`. Itr0414✓2000
Allowl
14 {ONE: — SANII'ARYNO. CONTROLNO.
o — 5qo — -5zq
❑-Z AHCIII'I'I!C'I'll!NGINIiIiR: BUILDING PERMIT INFO
o
b.) ELECT PLUMB MECH
w T K COL,E F-PiGritieeelocr Ag 'ATE
rtzaa
S i LICENSED CONTRACTOR'S DECLARATION Job Description
O
ZZ--G I h,eby:df mf Inco 1 nm life....I and.......won.,or Chapter 9lcn'nmenring
y t•w with Section 7O0pnf Disicinn 3of he felines and Profession'Cede,madlny teams
— -I is in full Ibme and effect.
dzwa LieenwCla.. Lien NEW SFDWI_, 1643 LIVING SPACE, 440 GARAGE
O U hale Comranor
Se.y ARCHITECT'S DECLARATION
y
I undccamd my pl:mh
s. all he nscA as public recant.
w d o O LianacA l'mic,.innal
OWNI!ILbUI1.DIiR DIiChANATION
u to 1 hereby ifi int that 1 em exempt from the Contact Licence Law fin the
following mm,on.(Section 7()31.5.business and Professions Cale:Any city orcounty
f 2C whch 4 M IIt.............a1w, utpro,,.J 1'.1 p y.t structure
3= pnmt t 1. q tb ppl'a If ch pe n f1 s N.t t tem
that blicensed p . t to the ransonar,of n Connectors L I..(Chpter9 Sq. Ft. Floor Area / Valuation
c froneacia,valf Seen i 7001) I Do,iki.n 1 1 if,Business and 11 fic,oam,Cud,)
or that heis empt therefrom and the basis bar the alleged exemption.Any�iolat on / $110000
of Section 703 L5 by tiny applicant fora pennh%objects the applicant to a civil penalty
or me lmtm man live h, dad dollars WSmB. APN Number /O Occupancy Type
❑I,mowncndfhero,,"y,or or,employee,,int wage%as their sole eorr,mation. '3 .SFd
will do the work,and[lie structure is not Intended or uttered Int sale(See 7194. - — - -
Bus d Profession,Cade:*Me Contractor,License Law Joel am apply to an Required Inspections
lac,insanof
t,pmpwny Who builds lir imp , .a
rov" thereonnd who docs,such work himself
or trough his own employee..pro,hned that such improvements are not intended or 1.01. — FOUNDATION
offered for sale.If,aware,the building lir improvement is sold within one year of
iample,ion. heowne,htrndcrwill have the numenofprovhtgfour hedid not build or 102 — PIERS
mprove lar purpo,e of sale.).
❑I.a,owarr nnhr)no,my,ata euw,ivoiy cmm�a,firg with Raft,rd romrae.....to 103 — UFnEP%
construct he project(Sec.7IWl,Business and Prnfc%siom Cat The Contractor's 10-4 -- REBAP
Lirmw l.aw.alt's n t ply to anowner of pmpeny x ho builds or improves thereon, 1.05 — ANCHOR BOLTS
and won c ntmcts h. nm pmjeas with a contractor(s)Ifcen.cl parnLamf to me
Contractor Licen Iv .
❑lama aaurrs B&11CIt,,hl,maw 106 - SEWER •JATEP,
()stns �Pm ` �00 - 202 - UNDERFLOOR PLUMBING
OHKI?R 'CO 'IiN$AI IONDE ANION
Inemn rrmtunder hrnr � '213 - LINDERFI_OOP, hIECI-IANICAL ,
ya_ pen. pe,j.grawofthefollowin,declarmion: 204 - UNDERFLOOR FRAME
❑ I have :hod -11 noun a Cerircale of Comenf to sell-in,u.e to,Worker. 205 - UNDERFLOOP. I hISULAT I Ohl
Ctrmpen inion. as pmvidaf for by Section 37M or he when Cale. rot the
perrnrnlenrc of he work for which Ihi,permit is insucd. -
301 - ROUGH PLUMBING
O I have and will maintain Workers Compcnmion lammnce,as acquired by Section 302 - TUB 8 OR SHOWER
lir Ibe Lalahr Code,fo.the Irerfimna,we or the wn,far which Ihi.pern..1 i,
wad My W'orker`sCom{wnsmlon Insurance carricr:md Policy number am: 303 - ROUGH MECHANICAL
Can;": PolieyIsh, 304 - ROUGH 7 . EI_ECTRICAI_
CERTIPICATION OP EXEMPTION FROM WORKERS'
GIIMPHNSAI'ION INSURANCE 305 — FRAME
anis section act not be completed it me permit is far one hundred dollars 306 - I•IOI_DOWNS
($1Ory lir Ic.,.l
I ccoify that in the perfamfanee of the stock for which this permit is issued.1 307 — INSULATION
,hill not employ any person any(mons.,o as u,beeonfe subject m the Worker: 308 - SHEET ROCK
Com.....it ,Unt of Califnn.i".Dune
Applicant 309 - EXTERIOR LATH
NOTICE TO APPLICANT:If,art,,asking his Certificate of E,earmlion,you should
herolnr,ubject'.life Wnrr.ers Compm
oaato Provision,of the woo.Cole.y.ulnn,1 310 -- iNTERIf1R LATH
Zz0 high.ahemaltyw;msuch pm.i,inn,orrhis Permit%hall nraeemedrevoked. 311 — SCRATCH COAT
PVi CONS I'RUCI'ION LI!NIANG AGENCY
� Iherebyabi.mthat them isaam,huctionleradmi,agency fono ernmmunc, 313 - ROOF NAI I_
,if In,work It,, lod,'fispernnW
'n i.." (Sec.1097,C,.C.) —
4LiI p Imder.Name 501 FINAL ELECTRICAL ENERGY
Lender',Address
u z0 502 - F I NAI_ PLUMBING EhIEP,GI
1I agree that I have mad this%application and ante thw foe d rate
ilia.,mion i.
w orrcctng..ccmcnm.mull,nllcityendcoumy,craminenehi,cryoemern,en 503 - FINAL MECHANICAL ENERGY
OV ttbulTg olfaction. r nyathor mmtes%rn1 . tyf Ierflnhn 504 -• FINAL BUILDING F_PJEROY
the ant a mem d pmpcny r inspection p m
F y IW 1 6 I s J 'fy JA PM1 Ih Cty fC pen again,t
yr Lnnhr' i 1$ I r I I .., n 1 y tr 'r"' g���%I,aid X05 - FINAL ELECT�L
C.7 Z City mnnseyucnc of th gmnttng of mi.pennm /�
'—' APP( CAVI'UNIQRST. NDSANUWILLCOMPLYWII{ ,L NON-POINT �Ar�. FG
Issued by: � ��`''rJ��lx�G. Date
S
onure..fAlsl lr'IIALANUO SMA'IiR1A1,SUISCLOSUItIi 1Ja1i Re-.0015 508 - FIttlnl- h1ECHAPIICAI�
Wll rbc licant or tenon FullJing rccurym are or hartdlc havaNtws material Type of Roof 509 — FINAL GRADE
h,AafiueJ M1y me Cupeninu Monicipul CuJc.Cln'PnT 9.12,unJ fM1c HcultM1 unA Sufcy
G,de.Secmm 25532001 Slur — 7htAl- PI_RPII 11'
❑Ye% ON. All roofs shall'be inspect d,Pnor to an� r o It1g 4 a[eJ'�y'tLbeing installed.
Will he applicant orfummbuilding oveupantuse equip'ncmordevices which If a roof is installteil'wi[hc�tk lobtpin�n f{-in.�t`Iep�.7(6nyI agree to remove
emit hard air contaminants as defined hyhe nay Arca Air Quality Marmgantent ` +s�'ti pO� 1-I-% t I��dCf4lIIflas and will comply with
Di,ricl7 all new materisSIMr iris ELt W kopllc
O Ye' 0 N all, no point sQBV9 regulRWOF BATTENS
I have mad life Mvnrdons nout,oul,requacnhend under Chapter'6.9.1 of he r
emirs nig Heahh Safety Code.Section,25505,25533 and 25534.1 underumJtha, E '4 RLIGF Ihl-I�P,OGRFSS
if thr milJingdr n<urrcmlyhuveumnuna tlrn itnmymsgnfsiailiry'wnotirY the lox �'
ant of Ibe yul mun'u which nnsf he mat p''ior nn i... c of a(.inilichm of
Sigiflature of pplicantDate
.%.lie au,1 td,edagent - 11-1 0 o,r All roof coverings to be Class"B" or better
OFFICE