01080141 'CI BUILDING
UILcUoN
PERToNO
D' PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMFF NO.
7544 FALLENLEAF LA 01080141
OWNER'S NAME: APPLICATION SUR DATE
MCCARTY KEVIN P AND ELAYNA B 08/29/2001
PHONE: SANITARY NO. CONTROL NO,
OO ARCHITECDENGIN'EER: BUILDING PERMIT INFO
DG LE PLUMB MECH
Teat^ L
z LICENSED CON'TRACTOR'S DECLARATION
O?=O head, affirm tiro 1 am licensed under provlaon.of Chapter 9(commencing Job Description
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with,ecdon rornl ar ivision3 of'he Business anJ Pmfenions Cade.and my license FIRE DAMAGE REPAIR.
<yE i:' Nlrarteamefl t.
ares srtse Clam Li<.a
X O i U to Com.ry
F•caARCHITECT'S DECLARATION �7y
,i} 1 understood my plans shall he used as public records
i a,z Licensed Professional
OWNER-BUILDER DECLARATION
s"e 1 hereby affirm that I am coonpt from the Contractor's License Law for the
Ism following reason.(Section]0315.Business and Profeaims Code:Any city capacity ,f,/
_ which requim a permit m construct.alter,improve.demolish,or repair any swnurtaa
[/ y�2 0 0 0 0
a3 -pri t is nave,al rtq_ doepplicantforsuchperm Oofl 'gedsolsment - - .. _- _. - -
t,, p ... ....
that he n dpun ma the pro ons ofihe ContractorsL Low(Chapter Y f I.``.} 3S�, U '4'or Area' r Valuation
(co ecng th Section]OW)of Division 3 ofthe Busrne dPmr<ssioro GWe) ,-,( �D .�'}t:� l tt�
or that he is exempt therefmm'and the basis for the alleged esirripthm.Any violation
of Section 7031.5 b,any applicant far.p.it subjects the application a civil penalty �t,,g�,�S
raotmam'himfile hundrmdollars(S50o). 101'4PNE'VUNI7ATION 1 `vCOccupancy Type
❑Las
, theee'orproperty,ormy employeesinthe ifeolesmion,
will do the work,
and
the structure
not intended or offendT lesep.
J Profi CarlThe C t or%Lie does not apply to
---- 10 3.- UFER Required Ins
owner ofpn)peny buildsp ane ,ad whodoes. ch workhimself
ofthrough n. employees.provided m rn improvements am nor inrequm 104 --.REBAR ___--
_./_..•
afferlei T7.'If h Jb 'ding pm rnt i 'thWcompletion.the nc bclc will have the buNen of proving that he did not Id or 105 - ANCHOR BOLTS
m"mo """ r106 - SEWER & WATER ,
_
- 1i ❑1 owner othin proynyameacW Ire fiof mTactotsto 202 - UNDERFLOOR PLUMBINcompact the pnm'Sec ]041Business and Professions Carl The Cormmnar's
License Lawd«s not apply to an owner of property who badds or improves thereon. 203 - UNDERFLOOR MECHANICAL
_an " m p cant.,°. e - 2 0'4- - UNDERFLOOR--FRAME _..--
d M1 °tial¢f h pmj as_w m. .c muctoaa
Cn t t 1'
❑1 m r under Sec. B&P C f r th's rtason
205 - UNDERFLOOR"Y
"'INSULATION
owner' Date 301 - ROUGH PLUMBING
a„” WORKER'S COMPENSATION DECLARATION
. 302 - TUB & OR SHOWER
In by rfirm a penmtyarpej y ente off-ingaepmmmaa 303 ROUGH MECHANICAL
❑ 1,c din. sIrmo ton' cby Sec r3 Consent vnbor far wart the 304 ROUGH ELECTRICAL
_ Co pe m s;provided for by Seniors 3]tq of the Labor Code, for the
m aide iiia work rat seinen rMa a mit fiat i..aea.., 305 - FRAME
_ ❑ ) ve'vnC will maintiin Worker's Cmpe is;ion InSumnce;as requirta Iry 5enion 306 - HOLDOWNS -
3 fthe Labor code.f ,M1 perform ce f Joe work far which mi,perm,is
d M,y W k C vol r be 307 - _INSULATION
c.,reu J—�aa- Tr' Palm y- �9 �7� U/ . 308. -'. SHEETROCK
,. M.WORKIE St -
n \I I (CERTffIL.COM EXEONINS ANE ` 309 I t�EXTERIOR_' LATH '
COMPENSATION INSURANCE"' - -- -„- -
t (Th.sicton neN not be complaeJ if the permit is for one hundred dollars 310 ', ; INTER IOR _LATH
311 - SCRATCH COAT
l"or rym,''the peri , nn kr 'n nm - '31'3--`ROOF"'NAIL_" --
'Coll t plywsofC aynan tobecam bjccunthaW°k 501 FINAL ELECTRICAU'ENERGY
Compensation La of California Dac,
- APpI...... _ _ - - - --. ...502--- FINAL -PLUMBING -ENERGY
'NOTICE TOAPPLICANTIf,after making m Ceaurcme at—Ese-poom you did. 503 — FINAL MECHANICAL ENERGY
Z
forthwith
rn 'bl n ant W k C p s t p hs obeli ah Cod.you must
Z �
's m ply nn nth near permit:nallxa d ked. _504 FINAL-BUILDING-ENERGY-- -
_ - --
F;> '( - 'CONSTm is a'a NLENDING AGENCY ".a ,
a.� In hereby R n 'm pr lending age yr n peegnnaape 505 - FINAL ELECTRICAL „
W 309] CivC,
r„ Name 506 _GAS__TEST.
p z ._.. -
- '
- — - ---
I:chder Addms - 507 - FINAL PLUMBING ;,(
_ U Q Iretail,'hot Ihave read'his aindication and s,am hot'he abovcinfonnodmais 508 - FINAL MECHANICAL
Iy fie amread:1 agrta to comply,with ail city and county ordinances and vac laws relaxin
to buildingconsmption.and hereby'authmizcieprewmativcsofthlicitytoenter own 509 - FINAL GRADE
meamve-mentiaapaFoppery,
(or,Inspection,Purposes,.• 510 - FINAL PLANNING
(WOagreelos demtry sadA phaal.sthe Civ rCpenim against
1 Cg ts. I d thenars h h m'3 in any y against said
liabilities514 - F BLIC WORKS
Ci q 4orm y- t ¢of thi perm' -
10.NT,UN T ANDS AND WILL COMPLY NITHrALL INON-POINT 7 O
- _ Sr c RECL AT1ONS:, ''-: ';, Issued by: Date !i
i amreurApp�¢mdcanira<mr+.,;'': ,:;,,
Data l: Re-roofs
w - HAZARDOUSMATEftIALS DISCLOSURE -
nd,e pplpa t rpt buldmg pa t.t h, h,'narwN'snaterr.l --Type of Roof-
asdfndbyth Cpcn M pICW Chpr 9.1 Jth Heal
to and Safety yp -- - - - --v- �
CW Set 2553'_(al t w - .a,
_ -
+or 5 - :❑N ''. ' y 1,'' •. } H `,All roofs�shalLbe i ected.prior to.any_roofing material being installed__ _
em twBtb air
to future bundngoc thea t eegap ora ate awn<n If a to
is instal I without first obtaining an inspection, Fagree.to iernove
m t h zaN cone 'tont. refined 65 theBay A a A 0 1 ly Manage nt e
'❑N _ „all,new,materials for.inspection. Applicant understands and will comply with
all non-point source regulations..
a:.
,i. 1 have read)toe hvzallo materials q remeni ahider Copper 6.91 of the
,C-lifursh Health ASafe',Cial, SeaSedim,25505:25533 ad255U.1-rd .tardthat
-dth building J,:-1 dyh t ' tn ' p 'ill r notify he ... . ... . .. ... -
u
a t wide requirements which must be MCtPTiorrDiSSLeiscofaCertirienteof r _
Signature of ApplicantDate
•• All roof coverings to be Class "B"or better
:_, 4 wncr r,autM1orizm agem.v;. .: .;' Ua'e � - . ..
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