S 1949rW�111N�
NT-TOFILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
''(:UPh`R'I'INO BUILDING-ELECTRICAL PH]SI I NO1949
NG DIVISION APPLICATION/PERMIT PING FROG In*'1DIL1NIFIC V\ItI111,D1SG 1'NOJ5X:1'IDENf141CA'rIONADDR� 44 mss SANITARY NO. APPLICAUH) SUBMIICIALLIDXII
EYE
AMIi:�� as✓,mg I / I.q�.69s6CONI'IN(:ItIRS NAM@ LICNa:(- NIC C(1NIR(lhN
I'lIiNGINEIe H; LICNO: ADDRESS; ❑
0
CONTACT: PHONE: BUILDING PIiRMIT INFG
/ ��� �� ll� /� ❑ Consultant Fees Pail by Applicant(Initial) BLDG lihl❑!(T ME
CH
[F3—LICiNSEDCOMIRACIORS H:.CI.ARAUON Q-y Y. HLFCI'RIC PGRMI'I' FFE
1 tu,n by amnn that 1 sun Iieensed undcf pnwianns d Cbaptcr 9(comtnen,iu, JOB DESCRIP'T'ION
Z with Scaion]aX6 of Uivi.ion3 of me Business and l'mlcssitns Csdc.and my Rttn.w is RESI)ENTIAL:
WOO PERMIT ISSUANCE.
W in fu11 lirmc s coat. ❑ShT)W'1, ❑KI"ICHF,N k8h10Dlil.
aUU 4cntnc Class LIr.N APPLIANCIS_RL'SIDEN"1'IN. ❑ADDITION ElPLUMBING BIT 1111,17
1-Z W Dale Contractor
vl6a ❑MUCH.UNIT El ST
ARCIII'I_CFS DECLARATION
N y Z undeomod my phut,shall be until a. .11111 rcuttel PANIiLS MODIFICATION
OZ=C UP 10200 AMPS ❑INERIOR El CHIMNEY REPAIR
F=IT"W Liccn.If Profession al 201-I(WAMPS IMPROVEMENT I]SWIMMING POOLS
Q� 1)WNhILRIIILDIIR DECI.ARATION
C C 6 I berchy afffm that 1 ant exempt lions the Cantmnm'..License Low 0n the OVER 1000 AMPS ❑BATH RIiMODIHJREPAIR DIiMO 1IION
06 U following m n.(.Section]031.5.Itueinn and Profession,Code Any city ur count, SIGNS ELECTRICAL OTHER
11. 3 a E- wai,h rcyu rr,a rImIt,In rnmtfttrt,almcsiniprove,delooloh,or nep it any suuctute C
NO.Q.1 prix I t 'I y ' :Ih ppl tf firm.,t II 1, J.tanrnt SI I:CIAI.CIIXCUI'IIMISC. C'
E1y Y'. thah licensedPursuant tt theprovisions of fire C t t L I (CM1pmr9
ga (ctnnOcngw'bSection 7(Xbof DiIsion 3 of the Business and Prokai,ns Codc)(it TEMP MITER OR PULE INS' F4 TAI-
tiThal he is"exentpl(hotel and the hosts Ibr the allegcJ cxclnpl inn.Any vlolmiuh tf I
SLDG/ADDITION ❑DI'M01,ITION
^h lection 71115 by any applicant l neap,"Inlsubjects the applicant to a civil penalty of IV)WIiR DEVICES NI' ❑Iq)QGSIIRV1GIit ore than live hunred dollar,($500). OVEMFN'TL a.nwnu uflhe po,peny.u, l In swish wu their role cont dation. SWIMMING POOL ELECT y mop yce 6u•rtn pen R
t. II tb the worA,nnJ thestmnurc is oat mmnJcd or olTcmJ 4r,xalc(Sec.](MW.Itusincn'
Iii!-m AnJI'ndessinn<CWc:the Contractor's hiccnw law Jaen not apply In an owner of OUTLETS-SWITCH&S-PI%TURES
"prnpeny who by v,nr vided n .IIIn,and whodue,such work hinnclf onbnmgh
his own ctno Inuld,prnvidrd I,t such in and wtnctu arcnot immrdM nr offend ,h NEW RHSIUIiNTLN.ELEC:L'R ,SQ FI'.
sale.If.however,the building or inipmvcurentis sold within line year of completion.the .PI'.FI,)(BARB $/SUFI'.
rbuildcr w111 have[he burden oI pmv'mg that he did not build or improve fur por-
vor"rale.) -
❑Last owner of the prnpeny.ant exeltuively aantmcting with been-d contractors R, TO'1AL: AUG 7 6 1998
construct the project(Sec.](94.Husinmr and Pntfnsbod C dc:)The Contractor's Li-
scl.awdoexnot apply roan own"A,,I,cr,y who huadsnr impmvuss thLrcon.:md QTY. PLUMBING PFRMIT P
who cotawl%for such projects with a contmctnrfs)licensed pursuant In the Comtmetor's
Liccndc La PERMIT ISSUANC17
ants tdunder Svc. It&1'C for this u:rson `1
ALHIR-DRAIN&VIiNT-WATER IIIA) Y VALUATION
wort- - Umc �q '^
WO) KERS COMPENSATION DECLARATION - RACK FLOW FROIECT.DEVICE Z V V Q
11
III r by afEr{ur&,,,vi1lyof,,jury lino of he ltdlowmg declaration,
V" �Ilave J will mainmina CeniOcateuf Cotuent to mlf-insure for Worker'.,Contpen- DRAINS-FLOOR.ROOF,AREA.CONI). SIURII_ 'TYPE CONS'IRUC'I10S
satins,as provided or by Section 3701 of the Labor Code,lin the performance of the
work for which Ih Le permit in Issued. NRIiS-1'F.R'1 HAP
n 1 have and will main tin Wnrkcr'.r G+mpcnwtion Insurance,as required by Section
3710of the lave Code.fonhe fwdomnncc ofthe work for whichdon permit is issued. GAS-PA.SYSTEM-I INCA OUTLETS FICC.GROUP MIN
My Wnrkes'x Cnntprnsution Insurance oniric,and Policy number um'.
Carrier: Policy No.: GAS-PA.SYS I'EM-OVER 4(1iA)
CER,IFICATE OF EXEMPTION IROSt WORKERS' GREAS Ell NDUSTRI.WASTE INTERCEPTOR
COM PENSA PION INSURANCE; BUILDING DIVISION IITES
(')M1is secourtniced rod Munnplmcdit'he permit is for an,hundred dollars 1$100) GREASI?'I'RAP
m Iea.I 1'LANCHIiCK FEIi
I anilythat in l be pefform:meeofthe work to, hiIh this .un is issued,)shall SI?WF.R-SANITARY-STORM EA.21X1 FT.
not cniploY any person In any manner s...us to becmnesuhjeo to the Workcrr:Cs i,r- IiNERGV I'HE
Z cation laws of Cdifrot.Data: WATER HEATER WNENEIMLECTR
ZQ Appbi nt ' GRAVING IL
y NOHCE'H)APPIJCAN'P:It,alter making did C'crtitnam of Exemption,You should WATER SYSTEM/I'REXIINC
M bccutmc subject m the Wortues Compennatinn pmvixin o.r,1 d¢LaNs Code,you must SOILS IT[:
Wforthwith comply with such provisions or this pennit%hall he Jccmed revoked. WATER SERVICE
Q CONS'IRUCON LENDING AGENCY NI?W RESIDEN'I'I Al,PLMB SO 1'1'. PAID
V p rI
1 hereby aRmuhnro
therc is ansruaion lending agency for the performance of to RacciptX
F~'r the work for which this permit ix icrued(See.3yC,Civ.C.) TOTAL
Lcndds Nano:
U
DJ Lender's Addmc. 'I UTAK:
I certify that I have mad Nix application and sure that the AMwc infonnmion is BUILDING TIT,
F" (fid c rect ingrccmmrttply wins ill city amt connlyoullune and xtate lawn relating to QTY. MrCHANICALPERMIT FEE
V Z buildingeonvtoctiun.and hereby nithoii'm reprcwntatives tit th',oty to ensu,upm the SIiISMIC Pili
above mentioned property for inspection purposes. PERM1tI'I'ItilUANC1? ELIiCTR 'FEE
(We)ugmc eauw.Inderunify and keep htotnlc"the City til Ct"coino t"mot
adbilitiec,judgnmms,costs and ex,vul which may In any way accrue against said City ALTER OR ADD'IU MECH. I'LOMNING SEB
in consequence of the grnming of this permit.
AI'I'hICAN'I'UNDEItSTANUS AND W h LV WITH ALL NON-POINT AIR HANULING UNIT(TO IO,OA CPM) MECHANICAL PCI?
SOURCE RIiGULA'1'ION
AIR HANULING UNIT(FIVER 10.1X0)CFM) CONSTRUCfION'I'A%
5 nmurwr A,plexd/ConwOm I V Dale EXHAUST HOOD IW/DUC'D I IOU M NO M ITIG A IION 11311
HAZARDOUS MATERIALS DISCLOSURE
Will lhaapplic:mt nr into,huildingmcuparn.tom or handle haerdaus material HEATING UN IT(TO I Of"BTU)
ns depnnl by Ibr CoIR.......Municipal Gxle,Cha,er 9.12,and the I lcalth and Safety
Calc.Section 25532(a)? LIGATING UNIT(OVER 100.000111U)
O Yes (j No VI?NTILATION PAN(SINGLE RESID) PAID
)lute Rouci,n#
Will the applicant or future building occupum use eyuipmer,or devices which IOD ER-COME'1311P OR 100.IXX1111 U)
-mit baurdonn air contaninanu To defined by the Bay Area Air Quality Managemen 'f OIAL Q
Dlsaict'! I101LER-COMP(OVER 100,000 RI'ID
❑Yen ]Nu
I have mad the harmdon,rnaterialsrc n under Chapter 6.95 of the Cull. AIR CONDITIONER ISSUANCE DATE
,2553 a P
Rsmia Mules&Safetydv lesea icalx255115,2s,I, and25534.I u,until,prlhald0c NEW RE.SIUEN'I'IAh MEGfI. SQ I'IIsi '. p �/ -9
ofthengdoccnoms which have umnenp that it is,I, of a Certificate
of
CXl C-
til the myuirenwnu which moa h ma prior m issuance o(n Certitie:nc of(kcupancy.
Owner or autbomed agent Date 101'AL: ISSUED It V: 6
OFFICE