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S 2579APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY CITY OF CUPF,RTINO nuu.Dm'r. - F:LItC'rxu:,u, BUILDING DIVISION APPLICATION/PF,RMIT PLUMB N; -MECHANICAL BUILDING PROJECT IDF.N'1'IF'ICA'I'Ill BUILDING ADDRESS: logos MofNN 'DR Y - OWNERSNAME: PHONE: CON] RACE OR'S Ii LI \RCHITIiCT/ GINGER: LIC NO: ADDRESS: a G u e¢ /0.30 & reef/ Iz S3 G CONTACT: PHONE: Z66-77g� ED Consultant Fees Paid by Applicant (Initial) 1 hereby affirm Ihat 1 our licensed under pmvisilmo of Chapter 9 (commencing 0 �'L with Salion➢00).1ilia 3 ft he Btloincvvund P�fcssions Code,I it my liccnw'w h�Op in full fimmeoadeRect. Le o Lic a 5,5 Date C 'Lts, ale——�,�t'j�Colnrac ARCHITECTS DECLARATION F zooolI z I ound nndemy plamahall be used m mahlie recordx OZ C W Licensed Proluxsinnal OWNI_m exemDIiR D the Car1'ION C C Q I fill union that 1 am exempt from the Comacmr's License Law fur the 3 , U Inuowing easlo. (Section 9031.5. Business amt P,afcsxions Colt: Any city nr amnry III which arcane, a permit ,, a amona. almc improve, demolish or repair any sl aclum G prior u) its issuance also reyuims the applicant Ear such pc.I, to fil... igned statement that he is licmosed arulun uh the pruvisiom'of lac Cnn.,cmr', License Luw(Chepmr9 �IY�O (commencing with Section ytxa) niTivixion 3 ofmc Business and Professions Codi nt d k Whin he s exempth t erefrom and Inc bei, for the alleged cumption. Any violation of U. U. Secular 703IS by any applicant lot a lwrmhjats it wthe applicant to a civil Ixvully of t more than five hundred dollars ($510). FQ I, as owner of l he n C ❑ past y.mmyet intendedwhhwagdl is Inco- Sec. 044.In.amn. F- will dothe wons C d e: The outure a tors License offereddoes of apply I) an, weer of {yarj m and property mI ns Code The Contractors License law does not apply m an owner of 4i 3 his o ny emp mild, o mpm a [flat such improvements and who docs salt tinte ded or ffthmugM1 his own employeese pnlding or such mentis sold within are not intended picood for cafe.ILhawevegll have th hunimprovement issoldwithinoneycdrofcor(lvc ronn, the .r-M1uIIJer will have the hunlen of proving taw he Ald not Mhild ar Ilnpmvc fur pun puvw of ,attest ❑ I, of the pmprny, a sulurively contracting with licensed contractors it, comlaet the project (Sec. 90,14, Business and I'rafem'ions Cxly:) Tic Contract,,(', I,i- se Law docs not apply man nwnef,fpropeny who ouildsor improv[, owmoa, lad Q'ry.. wen c,,almic s tar such mIject, with u amhmmrts) licensed p T.... an ,, the Cnnotclors License law. I am exempt under Sec. ,B& 1' C for this reason Owner Date WOR KEll S COM ly IIpofamp, aSAl UN t 1 hereby alar undef pcnahr of Perjury one of Inc creme for dcackuptoWorker%Co oac ❑ I neo and will maintain a Ccri 3700 of Ile Lam self -inure for Workers Compen- nainn, as providCJ for by San:on 3]011 of the habn: (}ale, fur the Iwrfonn:u¢c of Tec work for.lub this person is iswd. E] I hm'c and will mainnoin Worker's Compensation Insurance, as required by Seetinn 39000 he WMor Cotte.I'ot the parlbrnmmce of the ,,,it for which This permit is hewed. s, (, My Worker's Compensation Insurance Cartier and Policy number am: Cartiuc Matti Policy No FROM RKERS (� CLR1119CA li OF E%1?A1PPolic PROM WORKERS COMPENSATION INSURANCE (To, scab. pacul not h completed HIT, crn, iv for ooc Inn lred capon 01(0) or le,,.)I certify taut in the performance of the work or which this permit N oxaed, l xbull not employ any persm in any manner so as to hectic stmect l,, Inc Workcc2 Contpen- 0Zon n Law, of California. Dae Applirtnt Z N NOTICE TO APPLICANT.. It, after making tui, Catilicam of Exemption, you should become subject ro the Workers Compensation pmvi,ions of the Labor Calc, you must foehwull comply with such proviso m. or llis permit shall he deemed revoked. U0 CONSF atthem is c JON LENDING AGENCY U O I hereby allm that I is a um.Sex. 30 lending agency for nae pertihrmance of Ule nder furwhichthi, permit is i,.ucJ (Sec. 31199, Civ. C) Q U Lcnde6 Name rIl] Lender', AMlrens 0.1 I wrle tum have mud this applicationanand sum Lem the above information olatioo a U N correct. l ouxur I,, comply will, all city and county ordinance and scare law, rup in the U z abo-.... wnst...I tiers berthyxuteonfa nrpreumnuvo ofthis city to enter upon tM1c nbovu(We) agree to Save rindmpmuonpump 11, ha Ise)giumnave, indcmmilyand hich hay in antheyaccoy If quips, CityIinNl'nic., juJgnrcnt., costs and expenses which may in any way accme agaiml sail City in mcgoeneu If lac "ninny of this permit. APPLICWI' UNDERSTANDS AND WILL COMPLY WE rH ALL NON -POINT SOMEqu% Signature ,I Appllc:mhCummct,,r Dam I IAP.ARDOUS MATIiR1AL5 DISCLOSURH Will the applicant or lab r, building mc'cup int store or handle hazardous mmcrial as defined by the Copanino Municipal Civil. Chuptcr 9.12. and the Hl and Sully Code, Section 25532(x)' �Ycs ky+s�o win Ine apPlicam mr furore building occupant use nonlinear or devices which ' nit he.arduu. sir amtnmi nano as Jcfinud by the lily Are., Air Quality Ishmae mem Diwderr El Yet, 2<o 1 have hand the hvurhaw mamnal, requhements under Chuptcr 6,95 of it Cali - t I,, Ilan, & S.,fety Gxlc, Sroion, 25545, 25531 and 25534. 1 mNawmd Inn it builJinnoy�9�vlen:mPt cis my te,Wroibilitym nrnily the occupant of the uncus a mtFt nn -m+/ m i,mance of a Certificate of Oveni aneY. Owner or au ifirl agent Date ELECTRIC PERMIT PERMIT ISSUANCIi APPLIANCES - RHSIDF N -HA. PANELS UP'D) 21X1 AMPS 281.1010AMPS OVER IONIAMPS SIGNS ELF(CfRICA, TEMP. MISTER OR POLE INS'1'. POWpR )FVICpS SWIMMING POOL ELECFRIC OUIj - SWI DCHCS - FIXTURES NEW RISIDEN'I JAL Fi.I Cl'R PLUMBING PERMIT PERMIT ISSUANCE A10 Ek - DRAIN & V IiN'I - WATER (EA) BACK FLOW VROTFCr. DEVICE BRAINS - FLOUR. BOOB AREA. COND. FIXTURES - PER TRA' OAS-IiA. SYS'I'HM-1 INC.40UTL1;TS GAS -EA. SYSfEM.OVER 4 (EA) GREASEVUH)USTRL WAS 117 LNTEHCIIPIQR GRFASE'I'RAI' 12- `t ins ❑1 ENERGY FEE GRADING FEE WATER HEATER WNFE TTLECfR BUILDING PERMIT INFO FEE In, ELECT I'LUMIt MECH WATER SERVICE FLI' JOB DIESCRIPTION RESIDENTIAL: ❑SPOWL ❑ KI'I CHEN RFMODI;L El ADDITION ❑PLUMBING RE -PIPE 0MUL1J-UNIT' ❑SIRUCPURAL MODWICNI ION ❑INTPRIOR ❑ CI II MNEY REPAIR IMPROVEMENT [ISWIMMING POOLS ❑ BATH RLMOU171 IREPAIR ❑ DEMOLITION ❑ OTHER NEW RESIDENT IAL PLEB, SQ, FT. )arc Receipt a 0"=RIC TOT . COMMERCIAL: ❑NEWBLDG/ADDITION 0 ENANT IMPROVEMENT ❑ o ETIER ❑DEMOLITION ❑ 1'00[) SF;RVICF EE QTY. MECHANICAL PERMIT 1'F.E F. PERMIT ISSUANCE lili SQ, FI'. FLOOR AREA C—}D ALTER OR AUDIT) MECIL $/SU PT. ,UMBING FEE FEE STORIES lam urvv rctru nm � vN ,,.123 2,C Z Y - cl BHB.DING DIVISION IPIiS ( _ 1'LANCIII!CK I'lili � \ -- SIiWER-SANITARY-STORM EA. 21X114. ENERGY FEE GRADING FEE WATER HEATER WNFE TTLECfR WATER SYSTEM/rRLA'1'ING WATER SERVICE NEW RESIDENT IAL PLEB, SQ, FT. )arc Receipt a 0"=RIC TOT . I, IAL: EE QTY. MECHANICAL PERMIT 1'F.E F. PERMIT ISSUANCE lili ALTER OR AUDIT) MECIL ,UMBING FEE AIRHANDLING UNIT ITO 10.00X1 CFM) trNIANICAL ITE AIR I IANDLING UNI'I'I OVFR 111,000 CPM) CONS tUC'I'IONTAX EXHAUST HOOD (W/DUCT) HOUSING Nil'I IGATION FEB. HEATING USE p (TO 110.000 BTU) HEATING UNIT (OVER INJAX1 BTU) PAID VEN'1'II.ATION FAN SINGLE RESIDE Dvlo Receipt a BOILER -COMP (31IP OR 100,000 BTU), Tf : 5 BOILER -COMP (OVER 110.000 B U) Alk COND1'I'IONER ISSUANCE USEE NEW RI:MDFNT1A1. MELEE. SQ. 14. OFFICE IOl'AL: APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY CITY OF CUPF,RTINO nuu.Dm'r. - F:LItC'rxu:,u, BUILDING DIVISION APPLICATION/PF,RMIT PLUMB N; -MECHANICAL BUILDING PROJECT IDF.N'1'IF'ICA'I'Ill BUILDING ADDRESS: logos MofNN 'DR Y - OWNERSNAME: PHONE: CON] RACE OR'S Ii LI \RCHITIiCT/ GINGER: LIC NO: ADDRESS: a G u e¢ /0.30 & reef/ Iz S3 G CONTACT: PHONE: Z66-77g� ED Consultant Fees Paid by Applicant (Initial) 1 hereby affirm Ihat 1 our licensed under pmvisilmo of Chapter 9 (commencing 0 �'L with Salion➢00).1ilia 3 ft he Btloincvvund P�fcssions Code,I it my liccnw'w h�00 in full fimmeoadeRect. Le o Lic a 5,5 Date C 'Lts, ale——�,�t'j�Colnrac ARCHITECTS DECLARATION F zooolI z I ound nndemy plamahall be used m mahlie recordx OZ C W Licensed Proluxsinnal OWNI_m exemDIiR D the Car1'ION C C Q I fill union that 1 am exempt from the Comacmr's License Law fur the 3 , U Inuowing easlo. (Section 9031.5. Business amt P,afcsxions Colt: Any city nr amnry III which arcane, a permit ,, a amona. almc improve, demolish or repair any sl aclum G prior u) its issuance also reyuims the applicant Ear such pc.I, to fil... igned statement that he is licmosed arulun uh the pruvisiom'of lac Cnn.,cmr', License Luw(Chepmr9 �IY�O (commencing with Section ytxa) niTivixion 3 ofmc Business and Professions Codi nt d k Whin he s exempth t erefrom and Inc bei, for the alleged cumption. Any violation of U. U. Secular 703IS by any applicant lot a lwrmhjats it wthe applicant to a civil Ixvully of t more than five hundred dollars ($510). FQ I, as owner of l he n C ❑ past y.mmyet intendedwhhwagdl is Inco- Sec. 044.In.amn. F- will dothe wons C d e: The outure a tors License offereddoes of apply I) an, weer of {yarj m and property mI ns Code The Contractors License law does not apply m an owner of 4i 3 his o ny emp mild, o mpm a [flat such improvements and who docs salt tinte ded or ffthmugM1 his own employeese pnlding or such mentis sold within are not intended picood for cafe.ILhawevegll have th hunimprovement issoldwithinoneycdrofcor(lvc ronn, the .r-M1uIIJer will have the hunlen of proving taw he Ald not Mhild ar Ilnpmvc fur pun puvw of ,attest ❑ I, of the pmprny, a sulurively contracting with licensed contractors it, comlaet the project (Sec. 90,14, Business and I'rafem'ions Cxly:) Tic Contract,,(', I,i- se Law docs not apply man nwnef,fpropeny who ouildsor improv[, owmoa, lad Q'ry.. wen c,,almic s tar such mIject, with u amhmmrts) licensed p T.... an ,, the Cnnotclors License law. I am exempt under Sec. ,B& 1' C for this reason Owner Date WOR KEll S COM ly IIpofamp, aSAl UN t 1 hereby alar undef pcnahr of Perjury one of Inc creme for dcackuptoWorker%Co oac ❑ I neo and will maintain a Ccri 3700 of Ile Lam self -inure for Workers Compen- nainn, as providCJ for by San:on 3]011 of the habn: (}ale, fur the Iwrfonn:u¢c of Tec work for.lub this person is iswd. E] I hm'c and will mainnoin Worker's Compensation Insurance, as required by Seetinn 39000 he WMor Cotte.I'ot the parlbrnmmce of the ,,,it for which This permit is hewed. s, (, My Worker's Compensation Insurance Cartier and Policy number am: Cartiuc Matti Policy No FROM RKERS (� CLR1119CA li OF E%1?A1PPolic PROM WORKERS COMPENSATION INSURANCE (To, scab. pacul not h completed HIT, crn, iv for ooc Inn lred capon 01(0) or le,,.)I certify taut in the performance of the work or which this permit N oxaed, l xbull not employ any persm in any manner so as to hectic stmect l,, Inc Workcc2 Contpen- 0Zon n Law, of California. Dae Applirtnt Z N NOTICE TO APPLICANT.. It, after making tui, Catilicam of Exemption, you should become subject ro the Workers Compensation pmvi,ions of the Labor Calc, you must foehwull comply with such proviso m. or llis permit shall he deemed revoked. U0 CONSF atthem is c JON LENDING AGENCY U O I hereby allm that I is a um.Sex. 30 lending agency for nae pertihrmance of Ule nder furwhichthi, permit is i,.ucJ (Sec. 31199, Civ. C) Q U Lcnde6 Name rIl] Lender', AMlrens 0.1 I wrle tum have mud this applicationanand sum Lem the above information olatioo a U N correct. l ouxur I,, comply will, all city and county ordinance and scare law, rup in the U z abo-.... wnst...I tiers berthyxuteonfa nrpreumnuvo ofthis city to enter upon tM1c nbovu(We) agree to Save rindmpmuonpump 11, ha Ise)giumnave, indcmmilyand hich hay in antheyaccoy If quips, CityIinNl'nic., juJgnrcnt., costs and expenses which may in any way accme agaiml sail City in mcgoeneu If lac "ninny of this permit. APPLICWI' UNDERSTANDS AND WILL COMPLY WE rH ALL NON -POINT SOMEqu% Signature ,I Appllc:mhCummct,,r Dam I IAP.ARDOUS MATIiR1AL5 DISCLOSURH Will the applicant or lab r, building mc'cup int store or handle hazardous mmcrial as defined by the Copanino Municipal Civil. Chuptcr 9.12. and the Hl and Sully Code, Section 25532(x)' �Ycs ky+s�o win Ine apPlicam mr furore building occupant use nonlinear or devices which ' nit he.arduu. sir amtnmi nano as Jcfinud by the lily Are., Air Quality Ishmae mem Diwderr El Yet, 2<o 1 have hand the hvurhaw mamnal, requhements under Chuptcr 6,95 of it Cali - t I,, Ilan, & S.,fety Gxlc, Sroion, 25545, 25531 and 25534. 1 mNawmd Inn it builJinnoy�9�vlen:mPt cis my te,Wroibilitym nrnily the occupant of the uncus a mtFt nn -m+/ m i,mance of a Certificate of Oveni aneY. Owner or au ifirl agent Date ELECTRIC PERMIT PERMIT ISSUANCIi APPLIANCES - RHSIDF N -HA. PANELS UP'D) 21X1 AMPS 281.1010AMPS OVER IONIAMPS SIGNS ELF(CfRICA, TEMP. MISTER OR POLE INS'1'. POWpR )FVICpS SWIMMING POOL ELECFRIC OUIj - SWI DCHCS - FIXTURES NEW RISIDEN'I JAL Fi.I Cl'R PLUMBING PERMIT PERMIT ISSUANCE A10 Ek - DRAIN & V IiN'I - WATER (EA) BACK FLOW VROTFCr. DEVICE BRAINS - FLOUR. BOOB AREA. COND. FIXTURES - PER TRA' OAS-IiA. SYS'I'HM-1 INC.40UTL1;TS GAS -EA. SYSfEM.OVER 4 (EA) GREASEVUH)USTRL WAS 117 LNTEHCIIPIQR GRFASE'I'RAI' 12- `t ins ❑1 ENERGY FEE GRADING FEE WATER HEATER WNFE TTLECfR BUILDING PERMIT INFO FEE In, ELECT I'LUMIt MECH WATER SERVICE FLI' JOB DIESCRIPTION RESIDENTIAL: ❑SPOWL ❑ KI'I CHEN RFMODI;L El ADDITION ❑PLUMBING RE -PIPE 0MUL1J-UNIT' ❑SIRUCPURAL MODWICNI ION ❑INTPRIOR ❑ CI II MNEY REPAIR IMPROVEMENT [ISWIMMING POOLS ❑ BATH RLMOU171 IREPAIR ❑ DEMOLITION ❑ OTHER NEW RESIDENT IAL PLEB, SQ, FT. )arc Receipt a 0"=RIC TOT . COMMERCIAL: ❑NEWBLDG/ADDITION 0 ENANT IMPROVEMENT ❑ o ETIER ❑DEMOLITION ❑ 1'00[) SF;RVICF EE QTY. MECHANICAL PERMIT 1'F.E F. PERMIT ISSUANCE lili SQ, FI'. FLOOR AREA C—}D ALTER OR AUDIT) MECIL $/SU PT. ,UMBING FEE FEE STORIES lam urvv rctru nm � vN ,,.123 2,C Z Y - cl BHB.DING DIVISION IPIiS ( _ 1'LANCIII!CK I'lili � \ -- SIiWER-SANITARY-STORM EA. 21X114. ENERGY FEE GRADING FEE WATER HEATER WNFE TTLECfR WATER SYSTEM/rRLA'1'ING WATER SERVICE NEW RESIDENT IAL PLEB, SQ, FT. )arc Receipt a 0"=RIC TOT . I, IAL: EE QTY. MECHANICAL PERMIT 1'F.E F. PERMIT ISSUANCE lili ALTER OR AUDIT) MECIL ,UMBING FEE AIRHANDLING UNIT ITO 10.00X1 CFM) trNIANICAL ITE AIR I IANDLING UNI'I'I OVFR 111,000 CPM) CONS tUC'I'IONTAX EXHAUST HOOD (W/DUCT) HOUSING Nil'I IGATION FEB. HEATING USE p (TO 110.000 BTU) HEATING UNIT (OVER INJAX1 BTU) PAID VEN'1'II.ATION FAN SINGLE RESIDE Dvlo Receipt a BOILER -COMP (31IP OR 100,000 BTU), Tf : 5 BOILER -COMP (OVER 110.000 B U) Alk COND1'I'IONER ISSUANCE USEE NEW RI:MDFNT1A1. MELEE. SQ. 14. OFFICE IOl'AL: