02050001 CITY OF CUPECONTRACTOR INFORMATION:
BUILDING DIVISIONSION PERMIT
BUILDING ADDRESS: PERMIT NO.
10150 N WOLFE RD RICHARD A SPANGLE AIR COsJD INC 02050001
OWNER'S NAME: APPLIC9TION S BDATE
J C PENNEY PROPERTIES INC 1505 N THESTA 05/ 01 2002
l IHONH: (559) 233-9933 SANITARY NO. CONTROL NO.
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{Qat O O ARCHITECDENGINEER: - BUILDING PERMIT INFO
fr BLDG ELECT PLUMB MECH
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z, LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions or Chapter 9(commencing J escription
in webs non 000)of Division 3ofthe Basin sandprofessionsCMe,andmylicorse TENANT IMPROVEM NA
- S"`
;,MJ< « ,c LE
'O a U Dal Crnim<w� O
1 3 0 y CNITECT S Artca N
.'=O 'l understand my plans shall be used c Ns CT 1. 72002
02
1at,p Licensed Professional
OWNER-BUILDER DECLARATION
u� 1 Lacey affirm had 1 nm exempt from the Contractor's License law for the
z a fallowing rcamn.(Seaton 7031.5,Business and Professions CMc:Any city m county SU1�0INC§4 2 0 0 0
SS O
which MqUiMS a perm l To Commust.after.improve.demolish.or repair any swcmte
at et print to its uanm.also requires harepplicam for such permit to flsignedstatement — - ---- - -- — - - -- -
ions of me Contractor L La (Chat 9 - -- - - - -
dommem dpuhuntt m p per .,,F3Cs& �' r.�r@y-,., P - ; , Valuation
po g thSeci ]OBO) fDivision Jof N=Bus rte. dProfessions Code) t .l YY .. +!t.hl"." tl1,
or that he is exempt thdefrom and the basis for the alleged o.4mpibn.Any violation
of Section 7031,5 by any applicant for a permit subjects the applicant to a civil Penalty
.ofnot mom than five hundred dollars(s5an. 10]AP'N ATION Occupancy Type
O 1,es owner ofm=propeny.a my employees with wagesu their sole compensation. 102 PIERS _
will dome work,and the structure is not intended.r offered far are(Sec.]Baa, 10 3 - UFER Required Inspections
Business and Professions Code,The Contractor's License Law dos not apply m an, q p
owner of propcny Who builds or improves thereon,and who does such work himself 104 - REBAR
or trrough his own employees.provided that such improvements arc nm immhded or _
,offered for sale:If,however.the building or improvement is sold within one year of - 10 5 — ANCHOR BOLTS
Completionn,theowner-Infilderwill have the burden of leaving mat he did not build or 106 - SEWER & WATER
improve purpose Of
0 1 as ownerofm=p:openy,amexcwtiveFYcamractiingwith licensed contractors to .202 UNDERFLOOR PLUMBING
anomch the project(Sat.loan,Business and Professions CMe:)The Comeactars 203 - UNDERFLOOR MECHANICAL . .
- and who
Law tract not apply m an owner of property who licensed
ice se improver t t oedn,
and wn.<amraens ror.rucn projatt with a=onto.roda7 liar d parsaatt m the -204--- UNDERFLOOR- FRAME. . . . ......... .- - -
Diam<ums e Lov.
exemphsurde Sec. ,B&PC(.,,hisreason 205 - UNDERFLOOR INSULATION
Owner Date 301 - ROUGH PLUMBING
- 'I WORKER'S COMPENSATION DECLARATION 302 — 'IUB etc OR SHOWER
I hereby are under• penany of perjury one of following declarations: 303 - ROUGH MECHANICAL o.I have rad will andamu isCenificam of Content to aelf.insure for Wmkc,•t 304 _ ROUGH ELECTRICAL
00
Compensation, as provided for by Section J] of the Labor Cade, for the
performance Of he work far which this perm is issued. 305 FRAME
❑I hoc and will maintain Worker's Cortmemation Insurance,as required by Section 306 - HOLDOWNS
3700 of the labor Code,for the performance of the work for which this permit is 307 - INSULATION
Is, d My Worker x Compensation Insur cc c e and Policy number arc.
Yk76� IrDA✓ l)<y r�a�c,a 308 - SHEETROCK-
ceRT;, r 1,FEX 0 WORKERS', Y:�� +309 r'=�'EXTER'IORriLATH: t
_ COMPENSATI NwsURANCE - ` _-. -- -310-;:—:;INTERI'OR -LATH-...... ---
''. (This union nae nm In eomplaed ihhe perme is for on=hundmd eo0ars 311" SCRATCH COAT .
($104y.,less.)
1 ccnify ihm in ecion in ny m of the work Tot which this permii a issued.I
313 - ROOF NAIL -
shall not mmploy any f California..n in any manner to as m become subject m the Workers' 501 - FINAL ELECTRICAL"ENERGY
Cnifica atiafi lawn of cUlm - 502 FINAL PLUMBING. ENERGY .
Applinnr -
NOTICETOAPPLICANDIf:after making this CenificaleofExemption.you should 503 - FINAL MECHANICAL ENERGY
become subject to the Workers Coul'our uon provi'mm of me Labor Cade,you must
Zrrnnwahcomply with such provisions aethis Permit tnauxaamedrcvnk=e. 504 - _FINAL BUILDING ENERGT _
Ln CONSTRUCTION LENDING AGENCY 505 - FINAL ELECTRICAL
.5: I hereby affirm that mere is a construction lending agency for the Performance — n
.f me work foe which this Permit is issued Sa.3B9],Civ.C.) 506 GAS TEST
i O lanlfN
Lande,•s Address 507 - FINAL PLUMBING'
U.z .... . .. ..
U O II timm mm l haveally read N1 city fid on my ante mm me.nave maws minus 508 — FINAL MECHANICAL n
W E., 'chrzect.1 ngrce m comply with all city and county nrdinnnas and smte laws relating
509 - FINAL GRADE
O U to building construction,and hereby authorimrepresentatives ofthis city toenter upon 510 - FINAL PLANNING
ti W the above-mentioned property for inspection purposes. /
-S IWU.grim to save,indemrdfy and kap nartNess the City of CuNnino against 514 - FINAL PUB IC WORKS
Z liabilities,judgments,casts and expenses which may in any way accrue against said /
U.7^. City In,..aipatum of thegmnr anh�:rerm�t. �.
A)PIL Nl'UNDER$$'IA ANDWILCCOMP.Y WITH ALL NON:POINT'` Issued by: Date
501' f, EGUI ATL�i'S' y' /
ignamm.f Applican mOractor r " Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE ''
Will the applic sof fumrtb lding occupamsmr<mllsndle hazndims mmcdal Type of Roof -
as d ft c0 by the Cupen M pal C d Ch rt r 9 12 o d rh H hh and Sa(ay ,
Code Sat.a 25532(a)?< t.- �. r, ,, '4 ! 1 o I
t c'S'Fi ` a All roofs shall be inspected p for to_-any rooffng.matenal being installed..'-.
wont pylic t r t buddi gocc p t rcw vin=nn.,de�icerwmm If a roof is installed without first obtaining an inspection; I agree to remove
the b contaminants dfined bythBay Aria Air Quality Management
ui to a �. all new materials for inspection. Applicant understands and will comply with
(:;;0 '
({ } o ,Y all nori-point source regulations. - -'
"47' 1 have rcM the hazardous ma¢nals mpairemems under Chapter 693 of me
Cali(omia Health&Salery'fode,Sections 25505.25533 and 25534.1 understand Nat
if be 'lding dot not.unemlyh .tenant.that it is my sponsibiI rym firmly the '-
amu rf the regmormenm w h must met psi ro ix a of a Certificate of
{ °` "fi`y Signature of Applicant Date
�� -� All roof coverings to be Class"B"or better
weer or authodacd J. s" s Dam'.
OFFICE - '