02090098 CI BuOF
DPERTONNO
DIVISION
PERMIS CONTRACTOR INFORMA N:
BUILDING ADDRESS: PERMIT NO.
10355 MORETTI DR. 020,,90098
DATE
Mffl"TA L E N C I A APPLICATION
/ 17/2002
PHONE: SANITARY NO. CONTROL NO.
BUILDING PERMIT INFO
O 0 zo A0.CHITECf/ENGINEE0.: BLDG ELECT PLUMB MECH
'
CL—i CI L.1 L>
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0 ad H_ LICENSED CONTRACTOR der p DECLARATION Job Description
o�-o c,i.7 )of Division
lam of
heedunderp sisionsofewpme.add mmecense HVAC SYSTEM (ATTIC)
ng
F:tw is
Semioretand of Division Jof the Busmez. nil Professions Code.an,l my license
ayf; isinfull ch-Il and ertect� Y�II VC��IG®
�z�a Liccnu class O Li.a
Kn V Dam C , or
da R.
O G ARCHITECT' ) LARATION
g 1 undersmnd my Plam shall be use on ublic rccoNs
S } DEC 2 2002
a.E o O Licensed Professional
OWNER-BUILDER DECLARATION
woo, I hereby affirm that 1 am exempt from the Contractor's License law for the
t Z a following rtuon.(Section 7031.5.Business and Professions Code:Any city or county $4000
Y€o which rectums a pmmitm consumer,alter,improve.demolish.or relief,any umcwre BUILDING
ad prior,.its issuancaaWmgsiwasiheapplicam fursuch Pumiuo Fileaxiewdn.temem - - - --- - -- - -
is. tmm�eiandentee.pq;tiap_mJ,eilmmsiom or thec.nmumraLidenmlawfchapmr9l f•-k - t 3'7,§4 b '�gorp'}r'ear , „ .- .Valuation
(fomm,nciog�w\th Secuon71�00)of Division7of Mc Business and Professions Code) ..,4 .1R'r3'.. .>y..i's S.rk'114)ri;
or maFhe'is ex'tmpt thetefiom and,hc basis for the allege)exemption.Any violation�
-of Section than , any applicant for a permi,mbjttn Ne applicam m a civil penalty
ho4nm more,bort five hundred Jogars(ss(IB). ! 2 04 APNi4&J9IPR'FLOOR FE'"°'"'"t'" Occupancy Type
❑L asowne,offlePropeny,orm'yemployee,with wageaaameirs.leeompen.arnn.1 301 - ROUGHMCT
-wile do the'work,-and-th,amcam Wad intendedor'OReted'for'tale'(Sec.7044." ..-....__. ._
'Balrrmivard Pfofess ons Code The Comnunm s License Law does net a,,Iy m an 1 303 - ROUGH ME�bE�BNddQIAsTpectionsl' ` '"" '_
owner of property Who builds or improve,thereon,and who does such work himself 304 - ROUGH ELECTRICAL
orr through his own employees.p,.vidcd that such Improvements art nm intended or II for _.-_______ —__--,-._-_.___---,_..._
-.'Ortartlefim.the owhotatilethilhase _._e _ tnsold loitdidno, Wev or', _ -
em I t the win nave ho��naemen r 505_-_.FINAL ELECTRICAL';_ a+"•:.I' -, . ::f:L'.:'.
i' peion, pmving,hat he did no,will on
mpnver.rP.tpomeraamd. I 507 - FINAL PLUMBING
- -- - - ------" - - - - - ... - -5'08--=-FINAli MECHANICAL--- -
-tJ l:as rw,er PTJrc propenY•am exclusively comrac,I,with licensed contract.to P.CII h.CG t•r';...i
- - r construct-the Project Used.7(1 Business and Poddisimw Code:)The cemmem,s_ 514 - FINAL PUBLIC WORKS"" LILE, 1 1 \Its
4 .
License Law does not apply to an owner of property who builds or improves,hereon.I
._and who.conhocb.focsuch.projecu.with.a.covtracmrtsl-licettsrd.pursuan,.he-dri __
: C1 me
,LPicense law., ,. .i` _ , .__.-___-__.___...__.._.-_----
Contractor',
._.—_..—__._.._..__.-__.._..______.—._._._..
Olam,sere tawersa:,l .^F ba...,.,�8,&Pore this rcaxpn
_ Olvner ,''I"I' "Damir
c
"WORKER',COMPENSATION DECLARATION
I hereby alTrm under,penalty of p2rjury one of the following declarations.-
[k -O 1 have'dnd-.Lill'roeinmin'a'iccdfilum of Conicm'm self-insure for worker's
Cumpcmotion.-ac Provided-for by-Section 1700 of the taw, Codd, for ,he.
performance".f the work for which this permit ix issued.
❑1 have aid'will•m6intain Werker's ComPcasaiion Inihmn&,t rcquirtJ by Section
= 3700 of the Libor Code,for me', darmence of,hc'..rk'for which this permit is
Issued.My Worker's C mfe t o 1;_ser cam a d Pot y beore:
�. -_
umer� 'rnudy - T' OW1VGl II/5�'/ I/ r - t,.-.i tllf !}Mal(� t! �yiJ..in,• )D
1 'j CERTIFICATION'OF EXF.M ON OM WORKERS ` t 1C et,' t �. is. . , t a•. 3`�3 1
\'"""`'a"COMPENSATION INSURANCE' �'R
___,� t.l .• l ail?' �` I)
(Th,sem nn'n Jnm h.....PluW if the crIrit is for hundred dtllars
.licc, IM1,i Ic pertmulaoce-w.(the kr', hichth .Penn, ii. N,1. ..-.. .. J-1 i' f 1.(;�l ii�.. aypT-y•,....,.. , .v:.
fiboll not employ any is, n,n any manner so as to become subject to the Workers'
NOT nnu."APPLI of Califnmm Dae
Co sat P Ws' s
a
Applcant � - _ __ .. __._.__ .. _.__. . __...___ __ ..--------------
-IN
_-_ _ s •n\
CANT if aftermakingth'.C rldwate OfE pion you,Mouk]
Fee rM- bjttu ,tie Werke C peni t p nz of tM1 hum CN yo rose.,
0' forth th' 1 th ch i n.callusperm, halt be deemed k& -_
_ ....... ... . ...... ... ...._ __. ___. ..
"z^ � s,l -) '.p CONSTRUG(ION LENDING AGENCY-
'a `' 11 bY,ff th t th t n1 n IenJ_gag cy f' th Pvf nn
...__. _
Gil .. of th rk fl ti ch thl p t t d(S c 1017 C
=iZ J:e dors AJJcs s� li,b ) .� I:LJ::
O cit 1 n fY thin 1 M1 ve read,hit aPDI ton and sum Na tum sumo,inform tion x
_ W F., ren:1 agree mpomply wiln ell city'ond coumy oNinunces and gm<laxs relating
:Q;U ,mwildingconswaion,soil hereby SutM1orim mprcumhtives'of,nis city me car upon
}Ml ,M1e awsx-mcmionW P,mpcny for inspection Puryoscs., _
F„ y fae)agree m"sa.e5indemnifr aw kdp hardtless m�eity of C�anino seams
_ Qty m mnuqucncc of the grunting.f,hu p'namnhus, a1na said
U1Z11
(APPtICpNT f4\DERSTANDS`A.�'D W NPLYµ7tH ALL NON 'OLYI's Issued by; Date
-r t ct7Aprbca UCo t nun„ '. - i jl,Date'.,p1 Re-IOOfS
cannedit he lid nm m it C Chper912 d to Health an ma` 'Type Of ROOF
i HAZ RDOUSMATERIALSDISCI.OSURE
r h odic hmmd, - - ...,,........._........_
Y Pe P J Solely
-_.f _.-,vr ...._
'Codes t n 1 tis s r y r 1 1 i
' All roofs.shall be ins ected.pnor to any-roofing material-being.installed.,,_,_ ,-
' V Ill, a�ppli tr f t rcw:ldngmc pat . eq 'pmem rde tt.wnch If a roof is installed without first obtalmitg an inspection; I-agree ro remove
h21 t cot _-s -J Bred by the Bit Arra Q lay Management arm,District? _ all new in for inspection. ,Applicant-understands and w_tll•comply with.,
OYe -' 'rr n' ''8''� all'non-point source regulations. , , ., _,� r . . .
°i j..have iezd mchaiva.us�material,rc,nmmenu ander Cies 6.45 of @e s.
rCulifornia Health&Safety Car,Sections 25505.25533 sad 75534.1 undnsmnd that
if the bitilJin doesnot cunen0 has'eamnanL(hmit ism bilis to not]f me
•oclp t TES9 rc cu hch mutbe p rd my
W f responsibility
ic of -•
J occ Pan y- :' a
Signature of Applicant Date
- rAll roof coverings to be Class B",or better
' thogzcd g t I1I .Dau.. v.
's" •., .... ,,,.. .,.,