00030076 'CITY ori C uPv RTINO' CONTRACTOR INFORMATION:
PERMIT ,
BUILDING AIIIIREss'. p6har NO. ,!
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OWNERSNAME: f APPLICATIO.'. `A P07''
ONE ?•• - SANITARVN <N,
❑.Z. ARCHITECTIENGINdF.R� - - "'- - BUILDING PERMI f INFO ,
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1 LLCT PLUMB MFAH
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LICENSED CONTRACTORS DLCLARA910N Job DeSU'Iptlon
Z O ti� I h by of d t l licensed d p f ChaplcrJ(containment, f P -
?� wth Seem 7030)of D' time B, dl f: 'Cd " dnyl , ' - r n •"
s f llfr J effect
s L ,
"` G'. " 473E LIVING SPACE 468 GARAGE
are._
r - - .c I I
ARCIIITGC'I S DECLARATION I.
1 mercrmd mY pl n.shall be used s p hl r ruts _, - M - ' ' e ,
Was
wdt�o0� Lie d Poor,siraul
f
OWWNER, p'pDl ER t f h pATO'N
1 hereby effort I I exempt from the Co, ta
'L f the
(Section711s0dPI Cde An,
rnr
fmh h capi... permit tconstruct,clP Ih,(it abipairady structure
fit,',, d threatthathe iS hCerstatur4rautl n p ttI c t lorc . Law(Cluder9
Sq. Ft.. Ploorh'A
-rea ,'
r S�-
.' —Va
I a-
tiod
(canumenscurigwith Section tai'DivisionootlaBuiie dPnaGnde)
or that he is esembl dicarefrome and thebass for the alleged exempion.An, u
of ;1a315by anytoplon far mt subjects Elan oppliconuourivilLpaluby
of but more mon me hnwlw dollars($500).
"
-
- e- ',APN Number OC pe ,
11 1,d, rtheproperty, Y employees Ith sea,.a thems&L conlovinsition,
will do I k and de,drat,dratual is not mended or offeed f (Ser.7044,
.Ba." and Prnress'ons Code.The Cot cmr s License Lee,does not apply to an
t]lllred inspections
own Iproperty Wl n lds s
pr tn n dwh 1 h workn self. •or Ihr gh his ply :.provided that ch inproveiricals air not intended or
affebcdr ole.It, [lot building WE al p rancor I, d vinhin aa,'y.cof ,. 1.01 — FOUNDATION •<,
completion,the aw terbnlder wit have me burden of Proving that he did not num or
' mprovefrpnrpomor,ale.) - 102 =' PIERS '
Z/ 'n offl n propery,nexdue IY' t tag ithlicensed' 0 , m' 103' — UFER
cum t t thep j t(See 7044,Burnie, 1 Professions Cd )TI C tr I f s , - ' - -
'Lieeu.eLitdoes ars road,a.anus,ternfpmpu'lysial bi"Ids or npo.e,mereon'� 104 — RESAR
and who contracts ton such projects-whoa onhaaogd licensed or aid to the 'p.,' }
Cervarlors Lrrn.m Law. ., - 105 --` ANCHOR'BOLTS.. •.
❑lama oderSIre. 9'&Pctrain,reason 1.06 ' SEWER i' WATER
Onto are
KPENSATION DECLARA202 UNDERFLOOR PLUMBING
. F.R', dTION',
n ly'-trn d > library nn ru 'del r x'203 — UNDERFLOOR MECHANICAL
/ ;204 — UNDERFLOOR FRAME
I h J II , Certificate F Consent I f'n ra for Worker's �- � - r
t Co n r r pw 'd d f by sr 37IX r In Ln r Coda, f de 20S —' UNDERFL.OGIR' INSULATION
"erf,rmen e f the work for which this s pcentral s's cd. t
Efitave;Idd wiu mnmlaln wna;u'a Compensation laanrnnee,its required by seaann 301 , — ROUGH PLUMBING • ,..
37W of the Labor Code.for the peri rmanee of the work for which mix permit i, : '302;'- TUB '& OR SHOWER'
bar I MI WE her v C p a i on hurourno carrier and Paley n tuber ire:
Carrier - Poll Y n . - 1
1.
3�i3r — ROUGH MECHANICAL.
CERTIFICATIONOFEXEMPTIONFROh1WOIt KERS" 304 ROUGH ELECTRICAL
.COMPENSAI ION INSURANCE . :,. I - "
(Th hn,,eeddorbeemnplete"ft permit sBrain,hundiulad s - 305.=FRAME`
rsloo) ules> 366HOEDOWNS,
I'couny that in the nedormaure of ate work hr whi2h avis permit it aa,I d,i 307 r INSULATION ' a
shall nut cam,luy any patron in ony manner s6 as to became.rubjeal to the Workers' - -
componsntmnLawnorcttliromiuDale 308 — SHEETROCKt'
nand tro APPLICAlicant NT Ir h k bur C Ifcal fFerfu n ) - hold - ' _309 - EXTERIOR. LATH
z he M (I IbuW k C p t p r flub Labor cod Y net _zp " .C h,nf 'hh radiantly such pr�- ,n,, m p ort.,hon n d ed revoked. _ 31.0 - . INTERIOR LATH
CONST RUCTION].ENDING AGENCY '31.'1'' — SCRATCH COAT '
I hereby affirm that mere k a emname,mn lending agency for the performance
a'D nItincwork for which this issued(See 313 - ROOF NAIL
Ca
Lender'sL` nidus P 501 FINAL.'ELECTRTCAL ENERGY
Z,
if 4
"502 — FINAL PLUMBING ENERGY ymlIn bud this application that at n
co g t ply In 11 n> a y rd' d r :rll s
' s ' — FINAL MECHANICAL' ENERGYmb IIbumsomad bah... theyloenerupm .503
men r neap prtyr p p p .
'-'•
504' FINAL BUILDING ENERGY
F ri
z Iiablde,,mgn m' t.aide
pets,kehphbay in my way secy of ure agneoinno gi uid. c - -
v 7� cit ve,lnenee,Im boarngofly ( t 505 FINAL 'ELECTRICAL . c.
SPPLICE REGU UNDERSTANDS AND WILL COM•P`LrY WITH ALL N-ON POINT Issued,I7y: 506 T GPS TEST . 'i Date
K:s
c I n sIf Re-roofs 508 — 'FINAL ,MECHANICAL
HAZARD MAI'h RIAI S VISCI OSURT
.. W'll th pplc t
In I ll g p' ,.k ,,h dl functions neutral. -_: Type of Roof.,
aeel dbyt CPn an, at Code,Chaptrr�.lz, do 11e,hhanpsatetY 509--=FINAL GRADE . . -
Code Section 25592(.)^ .•
Err, EJ No All roofs sha,ffig QnspeLfeF1l� �t(W'kcfy RUi bpnate'rrpial being:installed
'.I Will the mpliesat or future nulld' g ,scam,are eq i, n�ok'device which If a roof is l 511Ned witl`bl Mit o thl0b910 i Aq, l Bgree'to remove i
mit hazardous air contaminanav as defined by the Ray Area Air Quality Management
pnirtowes 'oleo_ all new mate4W)Efor-insglyljgtt:�p�lygnc�itppds and will comply with
all'non-point e reg s.
,— o BATTENS
I have ad the ha. J s c, I - 1 is 1 Ch d 695 f the
L Health&sFtyCod s f 255o5'25531- d4ss3L1 e m dura,. :604 —ROOF, TN—PROGRESS % '
uilding does nor ....ally have o tenant,that itsay,rcponsinillymnotilYme 1 nt of the requirements which must ne met prior Iovxuunceof a CcniriC.tle of
ySignature of Applicant . bate'J. t'or unlrmuecd agent . , . . -
Date Al] roof coveririgs'to be Class `B"-or better-