Loading...
S 0824 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY FWNIYI F CUPF.RTINO IIUILUING-4:LF:C'1'HIG\I. PI}4Nu"I'No. 0824 8 2 4 ING DIVISION APPLICATION/PERMIT IH.0 %[NG-MECHANICAL J L IIUILUING PROJECT IDF1N'I"IPLCAT[ON BUILDINGADDRESS: SANITARY NO. APPLICATION SUBMITTALL�DAII ZZC�o E. PHONI?: tfaSp CON'IRACIOR'S NAME: LIC NO: N/C GON'I Rol.k wn¢S w+l o q�-Qi43 Kuss�y eaa. Sx We i ❑ ,ARCHIrECT/ENGINLER: LIC NO ADDRESS �'v.�l,Cft.dvlt� SL1�l.C. CONTACT PHONE: BUILDING PERMIT'INFO ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUMB MECH M r. k 33 lo+�&eS ❑ ❑ ❑ LICENSED C(IWI'RACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE JOB DFSCRIPI•ION 1 hemhy affirm Nat I am Licensed under provision,of Chapter 9(commencing "Z with See, 070)B)or Di ones 3ol the Bu..ire,,and Prmfessi,n,Conlaand my license is RESIDENTIAL' Woo y PERMIT ISSUANCE ❑SFDWL ❑KITCHEN REMODEL as full twee and cffc , ~U~ hlcrneu Clvs, s_�'© 1. - b AI'1'LInNCI?5-RESIDIiN'r1A1. ❑ADDITION El PLUMBING RB-PIPE °a.4 d Uate ')-"rah Cnmrmur kms'— ss'�`� ` ce) ARCIII'1'IiCI"S DECLARATION ❑MUUFI-UNIT ❑STRUCTURAL PANELS MODIFICATION OZNZ LunJentmd my plan,shullRuncJ a,public records UPTU AN)AMI'S [I INTERIOR QGHIhINEY REPAIR r.14 L.ikensed Ptofasional 2(11-11XNIAMPS INIPROVEMENT [3 SWIMMING POOLS �Yf,� OWNER-BUILUIiR DECLARATION OVER INIOAMPS ❑BATA REMODEUREPAIR [3 DEMOLITION CQ I hereby affirm Nm 1 am exempt from the Contractor's Licerce Law for the OTHER at 6 U following reason.(Section 7(131 S,Business and Pmfe—o ns Gde:AnY city ter county SIGNS ELECTRICAL W 3 LL 1- which require,a permit In con.wor,,nee,improve.demolish.or repair any,um ucre 0^ F u'0¢ prrt I: : ale 4 rc:th PPIi tf hp mitt fl .6 Jrammcm SPHCIALCIRCUIT/MISC. .] abash n:Jparw n th p 'nn: fan C t err I Le.(ChapterY COMMERCIAL: QO linon,riouncowillbSo,il....7111X1) f Diowou 3oflle Birsibell.rd1 f:: an,Caldor FEMP ME11 Tat OR POLL.INST. a Y e C that he is exempt Merchant and the basis far the alleged exemption.Any violation of ❑NEW BLDG/ADUI'DON El OIiMO1,ITI0N Section 7031.5 by any applicant]Or a permit subjects the applicant a civil penalty of POWER DEVICES �TIiNANT El FOOD SIiRVICE not mme than five hundred dollars 1551X)1. IMPROVEMENT SSC ❑ L as owner ofthe propery.Or MY employees with wages as their sole compensation. SWIMMING POOL ELECTRIC ❑OTHER F. will Jo the work.and the structure,is not intended mothered for mle(Sm.704cl.Business UMLETS-SWITCHES-IIXTURT•_S 6 3 ac2 and Professions Cade:The Cnmmchn,License law does not apply m an owner Of prepery who builds or improve,thereon,and won does such work himself ar through NEW RESIDENTIAL ELECTR SQ his Own employees,provided that such impmm vcen,am not intended or offered for FT.FLOOR ARITA VsQ.PT. sale.If.brwcvea Ne building or impmvcnrent is sold within one year of completion,Nc ownsir-builder will have the harden OI proving Nat he did not bull or improve for Pro- Of soled. 'TOTAL: ❑1,as owner Or the p o,ory,own cschr,ivOy cantraraog with liecnwd cmtrnano to ormu et the project(See.7044,Resoness and Probessinns COTM)"rhe Contractor's Li- PEE serse.Law does not apply m an owner of property who huilds or improves lhemon.and QTY. PLUMBING PERMIT whir contracts for such projects with a carman,(')licensed pursuant to the Contractors L,.me Law. PERMIT ISSUANCE ❑Tom exempt under Sec. .B&1'C for this reason ALPER-DRAIN&VENT-WATER(EA) VALUAI'[ON Owner Dom WORKER'S COMPENSATION DECLARATION BACK PLOW PROTECT.D12VICE 1 hereby affirm under penalty of penury one of the billowing declaration.,: I huvc and will mninwin aCcrtificu¢nl Con,cr to self-insure for Worker',Compam- DRAINS-FLOOR.ROOF,AREA COND, ST IES 'I'Y 1'ECONSTRUCDOI erion as providctl lir by Section 371X101'the Labor Cost,far the porkrnrvnor of the 11X'I'USES-PFR TRAP ,Oak tar which his permit Ls issued, J;ir a and will maintain Workers Compensation Insurance' a,required by Section GAS-HA.SYSTEM-1 INC.a OUTLIi15 OCC.GROUT' APN 37W of the Labor Cada for the perlomemea of the work for which this permit is tasted. MYnrkut Cnmpcnsntinnlq umncccumcrand Polic n %1. S-Iiq.SYSTEM-OVER4(EAI Carticc ` savor 9�-a Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' r COMPENSATION INSURANCE. / REA. NUUSTRL WASTE IWITiRCIiPfOR BUILDING DIVISION TEES (This section need nm be coadeled RNc pernit is formic hundred dollars(SIUB) � GREg$IVT_RAB PLANCHECKFEE or less.) I edify Nct in the porfonnancoofthe work fnvolush this pemtit is issued.1. AI/ f`4Wl;µ�� [TAR STORM EA.213 ITT ENERGY FEE rat employ any person in anymanner so as m become mbjmt mthe Wick,,'Co one Z soden Laws of California Dare M1171 IIIiATERWIV IICIA GRADING FEE y z Q Applicant t tut d WATER Ky,I TMToK TI NC soft icE"r0 APPLICANT:Ir,alter nuking this Cend ce Or Eswintui^m oto [TEE 1� become subject to the Worker's C,nipeasatiam provlsimm,f Nc Elan Gde,yea m funhwith comply with such provisions or this permit shall be leaned revoked WATER SF:�V� W'Rf51UENTIAL SQ.FT. INN 4' CONSTRUCT ION LENDING AGENCY Date Rcedplp V Qthereby affiant that hcre is construction lending agency for the performance of the work for which this permit is issued(Sec.309Z Ci,C.) U TOTAL: O Vlender,Name TOI'AI: {37 Lender's Address BUILDING PEE I sentry that 1 have rend Nix applicuu"n and etre that the above iahmanadon is aHy y loorlo. agree to comply will all city TOM county ordinances Emit.state laws relating to QTY. MECHANICALPE'RMIT PEE SEISMIC FEE V buddhoogenmtmction,and hemby air 0rcpresenmtive,of anis city mcre'Mun the ^ abwomentimned prepery,far impclla m pmmom. PERMIT ISSUANCE IiI.EGI'RIC F (We)agree m save,indemnify and keep bmanlca,the C'ry of Capsicin,against liamlid ,judgroems.costs and expenses which may in Tiny waynccrve aguinst,aid City ALIIiS OR ADD TO MECH. PLUMBING FEE Intense c of the grumingof this pamdi O APPLH NDERSTANDS AND WILL COMPLY WITH ALL NONPOINT q1µHANDLING UNIT QO IILII(XS GI'M) MECHANICAL lilt SOURC t" aLAT10 iqe) AIR HANDLING UNIT(OVER 101000 CPM) CONSTRUCTI(NTAX 'Slgmmn f 11,Contract", (• Dote 17XHAUS'IHOOD(W/DUC) HOUSINGMITI 'HONIEE HAZARDOUS MAT13RIALS DISCLOSURE n With op Icefor liamrc building Ocsvpvnt,bnc ur handlchn,mdonsmrc,ol F IERI'INGUNI'NTO100tXXIIi'1'UI [� D ire defirr d by a ma nina Municipal C de.Chapter 9.12,and the Health and Safety IIEA'I'ING UNIT(OVER Ig1.(IX)B'I'U) CWc.Seclum .32(,77 PAID I]Ycs 0 N VCWI'II.ATION FAN(SINGLE RESID) Date RccciplN Will the applicant or future building mention use equipment or device,which BOILER-COMP(3HP OR had,00I BTU) emit haeaideas air contaminates as defined by the Bay Arco Air Quality Management District, BOB.HR-COMP(OVER 1011,X00 IIT U) Yes 0 N AIR CONDITIONER ISSUANCE DATE 1 have read the h ore.S s nontrial, 5,25533 a s under 1 tuner boos of the Cali- OF �f NmiuHealth i,does&S...re Corfu.Section,25bati 2s cry 2553J.I to noru the Ibar itthe NIIW RESIDES DAL MIiCH. SQ.I'I'. / �� 2, l ( V/s buildingJimore ,wlitlybast.[scene,.That it is my m,panxibilityermrlryccuacupunt of Ne,•gairemem,wenn mast ire met prim u,iasaanm al cnrifiewo nroeeapaney. Pea Owdeamauthmized agent Date TOTAL ISSUED BY: �� OFFICE