01110008 CIBUILDING DPvON
RTNO
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
22221 BITTER OAK ST 01110008
OWNER'S NAME: APPLICgTION SyB DATE
ANNIE M SCHULTZE 11/ 01/2001
PHONE: _ SANITARY NO. CONTROL NO.
ARCHITECTMNGINEER: BUILD PERMIT INFO
w C BLDG EC
PLUMB MECH
ban ur I- 1
y z; LICENSED CONTRACTOR'S DECLARATION Job Description
rL I--o ction7'0)ofDhaln 3 licensed under prndPionaorns Code9(romy Heemg KITCHEN ELECT. REMODEL.
L(=w with Section7000)of Divisihnl of the Business and Professions Code.and my littnu
m w 6Q is I.full force and cFen.
?O6S License Class Contractor
onti
Date—
ARCHITECT
111G GG�V•YY
7 a O ri<, ARCHITECT 5 DECLARATION
Y J 1 understand on,plans shall be used as puhlic records
o o Licensed Professional APR 16 2002
OWNER-BUILDER DECLARATION
I hereby affirm that I am eampt from the Character's License Law for the
t a following reason.(See,,..7031.5,Business end Professions Code:Any city or county $10000
a, o which requires a Permit to construct,aher,improve,demolish,or repair any swaure BUILDING
i
3� _prih , ,. also requires er
be for such pmit fl igned.troman. _ _ - _ _ _
that hG frl ceased pursu Ito the ph ns of Ne convectors L sell (Chaper9Ar — Valuation
tan g to s«r I�000i r D- .tan 3 none Businessa d npr .code> (:(1;.;'i k3 A' Dis i I•I�3".s,.
or that be 1.exempt therefrom and The basis for the alleged eilmptloa.Any violauon
-of Section 7031.5 by any applicant for a pend,subjects the applicant to a civil Penalty
of no,mhre man m _,.e hundred dollars ISM101APN 1p' 1 AT ION "r' Occupancy Type
01.ns owner of,he property,or my employees with wages as their sole compensation, 102 - PIERS
will do the work,.and-the'sm,cture is not mended-or offered'for ale'(Sac.7044'
linineu'and Professions Code:The Commnor's License law does not apply to an 103 - UFER Required Inspections "' s,r.-" r
owner of proper,Who builds or improves darem.and who does such work himself 104_ - REBAR _
or through his own employees.provided that such improvements are not immaded or '
,or
farsale:If,however the building or _-_emend is sold,-1,hin one_. - _ ----- - - -------------- ---
the caner-Wilder will have Ne burden of w year-or - -
completion, proingmmneaianatbaue r 105 'ANCHOR BOLTS ----':
.,r
impose fes se oracle.). _ 106 - SEWER & WATER '
--- - ---- - -an --- —..
n .naawrKrertbeproPert,.ale.awamelyennvandngwitnroe�u4monvsutnrs,e ___ ..-.2.02___ _UNDERFLOOR -PLUMBING`--_--'a.: ....•.+�. . - . .-..._..
e armed me mcieer(Sec.nue.Badness d Pmfim,mr,Code:)The Contractors MECHANICAL
2 03 - _.UNDERFLOOR 'CAli''1
License Law docs no,apply,o an owner of property who builds or improves thereon, r
_arMwha.contracm.for.sach pmt«ts.with ecantncm4s).Beensed partaam.m.the
Cont1JNDERFLIOOR--FRAME—__....
actors License Law. -----------
'_ � ❑Ince mPI e< cc(L ";.B&PC for this meson 205 - UNDERFLOORS INSULATION
liate` - �% �-o 301 - ROUGH PLUMBING
ORKER•SC PENSATIONDECLARATI N 302 - TUB & OR SHOWER
Ihereby at ran corer pe,mhyaIperjury one mifollowing declarations: 303 - ROUGH MECHANICAL
0 1 h-oe end'miil'maimein'a'Cerificae of consent to self-imsum fir wakes 304 – ROUGH ELECTRICAL
Compensation, as provided for by Section 3700 of the Labor Cade: for The
_ S Perrarm rune of me work for which this permit is missend, 3 05 - FRAME
01 have and will'moint5in Worker's Compensation Insurance,as required by Section 3 06 - HOLDOWNS
-' 3700 of!be Labor Cade,for the performance of the work far which his Not 1,
hsued.M'.Werkers Capco'sirton insurance caddie,and.Polity.camber am:' 'a:_ ....._-...,._.-..3�? -
_ INSULATION _ ,_
: , t5 / lie w 308 SHEETROCKm
r CERTIFICAT10NOFEXEMPIONFROMWORKCOM RN ERSM' t3O9` �fEXTERIOR=
ON NsuanrycE,
Ir_ . -- -..---
AT
mn uon nerd no,to compltd ifh
eethe permit is for one hundred dollars c fit}
(sloo)gneaa) • 311 - 'SCRATCH COAT
- _ 3.13 ROOF-...NAI•L-` - - _ ._.
I cwfy th t n,he pirf rma c f,h work f which,h Permit I, sued 1
snail , plyanype y ' d smbccomd binin;the Workers 501 - FINAL EEECTRICAhOENERGY
Can,Pcn t las ore 1 f D,e. -
._. . _ _.-. _.502. _ _F.INAL_PLUMBING..-.ENERGY. _.-.._.
,NOTICE TOAPPLICANT'Matter Thai gth CrtT t fE p[ y should
z beta ubl«i to thewokeesC p art p stehiaftn labor Cod youmus, 503 FINAL MECHANICAL ENERGY
ooh mplt" "P° or This bed e 1.d k d' 504 -.7-FINAL -BUILDING
_.ENERGY
mroy pc ,shall
CONSTRUCTION LENDING AGENCY
a � Ihercby affi -Thinuh : construction1erM g g yto m performer e 505 – FINAL ELECTRICAL '•' ` –
of the work for titan,h pc ,is
s,. See.3(NOc c) 506 _ GAS TEST
y Q LendersName -:vl — _ ..,-.:..._ .....
- 507 = FINAL PLUMBING
� z
Lend e Add sz ---
V_O �y,,r, I ndy th t l ha e d Nrs epplica,on and Par Nath W mfornuion s
508 - FINAL ME CHANT CALi(f) _
coed I all To comply with aR city and countyordinances and state law's relating - 509 – –FINAL–GRADE-
.O:V 1.building construction,aad hereby amara representatives hfihlschy lamer upon
yrw heaWve-mentioned property forin.spectionpaecant. 510 - FINAL PLANNING
tt y — (We).,.to saa'ndemnity and keep harmless theCty of Llperfnbag`ams, - - -514 - FINAL PUB IC .5'
Fr Vi
liabilities.judgments.costs d appeases which may in any way a gainsti said
U,Z Cityy n s y coca of,he min Nis mut - - -
_!-_ _ APPI U?DERST, S W 2 r N• )TLC\O\-POINT r" -- -- - - -
= , so cc N �''��- •' Issued b -t -
// Y Date
< gree TApp.t nuc ntractor .. .. ., - r C .. lot .- --Re�roofs'
` the HAZARDOUS MATALSDISCLOSURE "
r Will appERI
licant o flare building necapand store a handl harardeus Trauma -Type of Roof
:.
as der Nby,h Cupen Municipal CodeChapter913 and,he Heahit ad Safety —
Cmfi Sad on 2553200 •' ;
. Ipv ' - ' r ❑Nn I �-ip't - r'k r�' fk f c. to . ti�>< 'k i-_<r v: ! '
-:- .-_All roofs shall.be inspected poor to.any-roofing material being installed._
t W 11 m ppl'enm future W Idmg occupant use equ p t d v ces which -- -
mi,h'ard ntamtnant,aseernedbyTheBayAiaaA QualityManagemen, If a roof]s Installed without first obtaining an inspection;I agree:to'remove
Diitri i7 _- all new materials for inspection. Applicant understands and will coin 1 with
❑Ya , ;,r; kl °." r 1 -. ._..- " _' .._ .. _P,.. . PP_.� .. _. ._ Py_---•-- '•
ta.r all non point source regulations,
1 hi se read the haardous aamdals regaaments and r 6iiPie,6.95 of,he
Celifomia Health&Safety Coda Sections 25505,25533 and Z5534.1 underctand that
If the 1 gd notcurrentlyh a amount,that it is my , Lle -
occ pant a eripme m h st b< , 6o t ssuc f a Conti responsibilityBcam of
uP S / notify- - Signature of Applicant Date
g .;.,,° .. " .Dam
Owner rnatnareae ,e , ..1 All roof coverings to be Class "B" or better '
tk.; _ .. - ..�.. ... OFFICE