02030031L�;
CITY
UILDING DIVISIONN�PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
21346 RUMFORD DR
02030031
OWNER'S NAME:
APPLICATION SUB DATE
PATT STEVEN L ET AL
03/08/2002
PHONE:
SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Mwpyopy
1 1 r I L_1 I I
a y
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LICENSED CONTRACTOR'S DECLARATION
Job Description
I hereby affirm that t oro licensed under provisions of Chapter 9 (commencing
S
with Section 000)ofDivision3of(lie BusinoandProad"Jor.Cwe.and myrc-
is in full force and effect.
KITCHEN & 2 BATHR ILS REMODEL.
�B
iLL
F./
L;tmu Cl 11
F INANE®
3 ;
ARCHITECT'S DEC O
AT N
I undersand my plans shall be used as public records
MAY 2 1 2003
Licensed Professional
:p0
OWNEm
to
?a
monDERDECLARATION
1 hereby .mete that l oro exempt from the Contractor's License Low for the
following reason. and Professions Core: Any city or county
!�
�ulLg @{ yt
e F o
ermdon]031.5,Business
which requires a perms to consumer, alter, improve.demolish, or repot any nrvcmm
-_T'N�'W` O O
�3 $
_pnm l0 c4vl0rtq the ¢mem
lfo smhparmr License
- - ---- .-- -------- ------
.t SQ, pj�pI�tpr a r
- f ,3L 04'1017 Ii.§ i }a\
Valuation
licand iskina
ow (C
citheslttnsedpSe cot the pro, ttonsoftheCntmctoes ad Prlawon,Coe)
(commencing
(cote t vii 3 fthelcied vsaneibn.
mtthen
Wai the
e An, iCade)
of he Is exempt memfmm cold the nnsis for the d cildcar on. Any n
_ -
Sce
-af Sectioam than it any undredi dollars(nt permit sunjenxthe nppliconuoa civil penahy
object. th l va ly
.f.an more than Fire hundred dollars (sSWh
'P .yam,
lO�PN-P'�UN�DATION
'""'' OCCU anC e
P y ']P
111. as owner of the prope ty, or my employees with wvtcs as their sole compensation,
will dathe workfand the structure is not intended or offered for 'ale '(See: 7W,-
'BnsmcWt nd Professions Code: The Connor's License Law does not apply to an
-' - -
103 - UFER Required Inspections
ow fp peay Who bores or inarmsesundoetim, and who doe ch work himself
m through his ply provided that such improommals are not infrared
-
- .._..—.._...1 O 4-,-,- REBAR
offeredr c I1'h' hetb lain i sola tn'
-- _L.
105 — ANCHOR BOLTS `''P' 'k' VI
completion, the owner -builder will have the burden of provng that head not Wild or
improve for omp°"oral`).
106 - SEWER & WATER t
---- - --- — -- .._.._....._ ...-
ueenred oenwnotsto
202 - UNDERFLOOR PLUMBING ±ci-.::':c:.'i - -
"''"
emeinthepj., (Seenyam Business and Profession.,
conswd the pmjcct (Sec. ]044, owners and Professions Cade:) The improves
does not applymanown« of thereon,
who bana.arimpm.es.m.th
: L_r
203 - UNDERFLOOR MECHANICAL
'
and-weow
and --who thponary
coUccuro a h Pr 1 ts.with o wnor(s).hcensed-purtuunt.+o the
Canuacmrs Uccn
.___. _ _ __._ ._
2 0'4 "- "UNDERFLOOR" FRAME '
Clamesempt under Sec. t' I.,B&PCfor this reason
'..a....L.. '';
205 - UNDERFLOOR'' INSULATION
owner`',•].'
301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
❑"',i
302 — TUB & OR SHOWER
hereby affirm sneer nae f ae otphe fouowin declarations:
Yp` yo ,tny6 g
303 - ROUGH MECHANICAL
C I have sad will maintain a'Cenificma bi &msedi'm'sef-insure for worker's
304 - ROUGH ELECTRICAL
.. ,
Compensation, as. provided for by -Section 37W or the Labor Code. for the
m
perforance ohne work for which this Permit is issued.
305 - FRAME
-
C I have and will maintain Woikers Compensation''Iniumnce,-aS rcgliited by Section
306 - HOLDOWNS '
_ I,
37W of the Labor CWt,, for the performance of the workfor which this permit is
ax des ..c-ci erhndPolyd mbcra
307 INSULATION
t ^^y Glc xI;C'mpensattnIt
/ nc4 sea a, G;pa1 y N." stA
.-
3'0 8'''r
) WOR
t l cr TK
FJCATIONOFEXEMPfI PRQMWORKERSI
1DA;�e
4" X130`9°' ''EXTERIOR•LATH'
_COMPENSATION INSURANCE`
'
--
31O,t ". `INTERIOR LATH �. ; C'k; 1. -I it ;i 0�
hundred donut.
"(lids Benton Bead not be eompleiw if me pent) is fm oneun
(SIM] nes..(„ ...
,.•_
-
311 - SCRATCH COAT
. "I nfY that in the pfS to (thew kr n'<b n Pem,t' is
3'13 ---ROOF NAIL—--- 1 ., t.jI� - -.--^
.hen not endilpd6y'any 'Period y mander so as to becoamsubjecttotheWokers
501 - FINAL ELECTRICAL' ENERGY
Compcovation Laws of C bf D it
_ _
-:Apel c t- -.dno - '..
.'502'---' F-I'NAL -PLUMBING ENERGY---- - -
Z
nO
C o you u mind
NODCE TO AP Lhe Wms If oft making N o si T s o [of He Labor
beco b)«notht ions set od you must
fouhwnhcomply
L - .
503 - FINAL MECHANICAL-"LNERGY
sichprC
thiscancul
with oucherovstonaor th+s perms she. be deemed remked'
504----FINAL-...BUILDING_.ENERGY—.-..-.. ...._...-.
i
CONSTRUCTION LENpINC ACFNCY
11 crchy nffnn thank o co s in lend 6 6 CY f the perfnrmanc
505 - FINAL ELECTRICAL., n
0
permitd si
..LendI'arkm -kali this rml`te e.yga(sen 3W] ov e) •._
Leaden Name-
a ranedrc
506 --„ GAS _TEST__
507 - FINAL PLUMBING
leanfytha11ha1. Ve read this application and state land the above tofnionationls
508 - FINAL MECHANICAL
t,
correci.I agree to comply with all city and county ordinances and stale laws relating
to building cm
ouurtion, and heraby amhoriie'm represemmiv<s'of this city enter upon
509 - FINAL GRADE
-W
, L
theaboemear.peny far inspection prop. es„
(W) agree no as e' ndemnify end keep hannl s +he Cdy of Cupenmo ata nxt
SIO —'FINAL PLANNING
V]'
Imb I t e; Iudgm ms, cost d expenses which may in any ey mins said
514 - F INA P C WORKS
1 Z
Cny m sequence of th gn ung of lhispennn ' -
APPLICANTU Eke AND f PLY w'ITH ALL NONPO
Sf unc Rp
Issued by: Date O
�Ajfftrm Ap icandC ntraciro! ^ i) a
Re-rOOfS
'-` HAZARDOUS MATERIALS DISCLOSURE
;, Will the applicant o Tum bo Id np «dopant store or handle haxasdoos material
_'type of ROOF. .._ __. ....�..._ .c. ._. ... _.
.1
adef W by the Npen vo Munw put Cad CIts prat 9 l i a d th H I+h and Safety
Code; ,1.. 2553.W
;-
t t' t '.� ! .i
.12,. ...
1 1 IT
°Vci'
t
_-All-roofs shall-be,ins ected nor to an roorm material being installed.
1,1 N'illtneepplie tritium building«cupatnuse equip mentordevices which
If a roof is installed'without first obtaining an inspecticoA agree,to remove
ems haveNo r cam t vi defined byline Bay Are. A Q Y ty M..... stem(
Diana
new materials for inspection Applicant_ understands and will cornply_with
°v h ,'” .; r " •
.all
all non=poinCsouce regulations -
' ' 1 hive.rted'lhe hazardous maicrinls ¢gmremnns under Chapter 6.95 of the
Cabfomie Health & safety Code, Scctiotn 25505:25533 and 25534. 1 understand list
-if building does not cumene se a that it is to responsibility lolimiel the
"" __N
, —" '-- -
en t,a
p Q _ anL (B CtnlflCata Of
urine a rem met nm m ia�
f
Pct
rice nc ..,
177 1
Signature of Applicant Date
-'-
All roof coverings to be Class "B" or better
a eeatent :.' '•' ' '; ' ' ..; t;;, Date, ;
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