01040145 cl of cuPE
BUILDING INFORMATION:
xun, rvc DIVISION
slory PERMIT
BUILDING ADDR IPly, PERMIT NO,
10852 ILKINSON AV JUST WATER HEATERS INC 01040145
OWNIiR'S NAME APPLICArION SUB DATE
AND AVIAN 7.764NATIONAL AVE 04/26/2001
PHONE: SANITARY NO. CON'I'ROI,NO.
(510) 293-9901
o z Z ARCHITECIA: GINEER: BUILDING I'LRMI' INFO
w O O - HLIK ELECT PLUAIH AfECH
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FF N j LICENSIiiI CONTRACTOR'S DRCLARAIION Job Description
70 O I hialEmn dut I um livvm,ed under pookiuns mCltapler 9 kommucncing
F Z4Z wish Seclin17000)it Dwivinn]oflhe Basin,,and l'rufi,,oar,Crai and my liven,,
infuuforecanee°eel. REPLACE OF 40 GALLON WATER HEATER.
O w U Licc .,clue.. 1.ic a
Dale cymatemr
ve 3 a it ARCIIIFECE`S DECLARATION
$G'=C, 1 undenend Iny plan,,hall be used„public records
ase :.
A
z p C Liccn¢J 1'ndesaional
OW'NGR-RUILDF,R DECLARATION
re— 1hurbynaso.(lien on a; anpt tem the Cnnvnon,s Coe Licmutt city
o fur clearly H T�' which re uiavow(Section 7031.5. r,alter,and Pe.darn l Code:Any city or ucame
f O wh ch 4 peon t consumer,t she 'sop J oli h p any strvaure
i3m pr t t, ".it 4 Ih ;ppl It hpemilt fl 'lied,lalsound
din,( licensed... II the",),!... nla,c t "ar Licerre lu.Charter Sq. Ft. Floor Area Valuation
lmmnoteneing with Smmnn MIR)Cf Divimon 3 of Ibe Rusin,,and 11..fesslon,Code)
,it that he is exempt Ia crefmm and the basis nim the alleged asc n,lum.Any violation 39
of Section]1111.5 by any a,,ILv,t fora pennil wnjcct,the appllcton on civil penalty
of not marc man live handred dohmr(S500), APN Number Occupancy Type
❑Lev -0r1u, o,.,ry,n my mnploycv wlln luno rclheir sole cannpenuuion. � -
will do he weak,and the sbanure I,not intended nr obarcd fur sale(Sec.]UYt.
business mid Pmfc she,Code:The Comrucmrs Licence Law does net apply to an Required Inspections
issue,of pcpef,Who build,or Inmprovv,durcon,and who dues such work himself
,it through his own cniployee.pmvidcd Thal sudor improve 1,ere nm intended m 502 — FINAL PLUMPING ENERGY
offered for sale.IL hmvever,the building or impmvmnenl is sold within one year of
e.
oupli,lion,me evow,budder x;d have the ha den of NuE that he did nm buildor 506 — GAS TEST
improve for purpose:of sale.).
507 — FINAL PLUMBING
❑LavO me of the property,(Se7044,it
et c,,ly contorting Pole,mgnimadenue,Centocorc -
iceumcl Ibu project(Sec]to a, ov nerof and property
who W I&orilfhc Centocor,,
nor vac Irl does not appy to an projects
w of prnpatur who hulk,sed proves dualism
and who«nitons for such pmjcct,with a comemogs)licensed pursuam to me
01amexe exempt under F1NALED
❑lam,x,;npt ummr se,. Jsh retort Ibis ra,mr
Owner
D01CJUN 2 0 2001
WORKIIII'S CIIMPENSA'1'ION DLCLANA'1'ION
I hereby aflimi under penalty of per➢uy one of the following declarations: t�� -
�> 1 have and will maintain a Ccnifere of Conwm to cif-insure for Worker, BUILDING
Cntngenwfion. us provi37Med for by Section 3Aof the Labor Code. for the
"Holo unar of Ibex work for which IM1Is permil is issued.
❑I base and will maintain Worker',Curricular..lennncc,as repaired by Section
1700 of the Labor Conk,for the saturmmc,of the work for which this permit is
iwucd.My Worker's Cluopen,mion Ino, nue carrier and Polley autnhcr arc:
Carrier: Policy No.:
CRR'I119CA'1'ION OF I:XEMI'fION IfrOM WORKERS'
COMP12NSAnON INSURANCE
1Th s seer i need uni be cotnplemd if the permil ly for one hundred dollars '
(511X11 I,he".)
1 cuuny than in the perfoomma,e of the work for which this permit is issued.1
,ImII no(employ any purl,in nny our at,n a,I9 bee,nne cable”Ie mu Workers'
Cempcmation Irws of California.hale
NO[ICH sit
N e.stra bj AI'I'L W.. 11:alter nuking soh oslo ,id a LAW,
you should
Mrome nunject blue,Lander,Cnmpcnvminn pmvpsinm of the Laser emitted.you muu
Q O fral comply with such provisions or]hi,permit shall M deemed revoked. .
FCONSTRUCTION UrNUINGAGENCY
I hereby of iner that there is a construction lending agency for the pa fomanm
Ed Ise work far which Ihi,Per 1,'1,i„ued(Sec.YAO.civ.C)
Q tender';Neale
Z Under''Address
U O 1 cc,td,Ib,I Nava our, In,up,junuou and mum,h;n me"how reformat,,i, _
corms.1 agree to,comply with all city and county ordinances and slate laws relating
Q (� mo Wilding construction,and hereby uutnorine reprewnative of this,city am enter upon
R] he an;w,.;it...Its c,l pngwrny fora"elfinl mm�yses.
y two)anrw w see.imdenamify and keep haul„”the City of Cupcnln"agaimt
.. fn liabilities,judgments,costs and expenses which may in any way actual against said
Ca.Inco.-qua cant the grantinnof this permit.
APPLICANT CNDERS'I'ANDS AND W II.L COMPLY WI 111 ALL NON.POIN 1 Issued by: Date
SOURCE RP..GULAfIONS.
Signature of APPIIaanpConnrecwr rule Re-roofs
HAYARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occulpard store or handle haiardous Witerial Type of Roof
as dcfnW by the Cuperdnn Mink ipal Code,Chirac,9.12,and the Health and Safety
Code.Section25532(a)'1 pNo
All roofs shall be inspected prior to any roofing material being installed.
Will the appfcamt or moan building yccupunt use cgnip;ectmt or de„toe,winch If a roof is installed without first obtaining an inspection, I agree to remove
snit haiaNeus air clmnminanu as defined by the Hay Arca Air Quality Managenenl
District, all new materials for inspection. Applicant understands and will comply with
❑Ye, 0 N all non-point source regulations.
1 have read he hna dull bout h myuimmemu under Chapter 1,95 of the
CaWinnia Health k Safay Code,Semi,25505,25513 and 2559.,1 understand ihw
if the building does nye cvnenfyr hwea lemma.lhul it i,my mrponsibilhy In notify the
part of the requir,mcnts which must be nem prior u,issuance of a certificate of
°attupan”, Signature of Applicant Date
Owncryramorritedl it Date I
All roof coverings to be Class"B" or better
OFFICE