00080142 CITY OF CUPF.RTINO' . < • '`'` ,• "
BUILDING DIVISION'- '�t PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS - -- t' C PERMIT NO. f'.
ft 00080142
HIM/HAPPLICATION SUB,DATE -
OWNERSNA - ,
�5\�� : Ste'lkst2
PHONE'. J I Irl I'I I ". - r° SANITARY NO. CONTROL NO
• P a Z ARCHITECVENGINEER' q qq //' BUILDING PERMIT INFO
,6. _` ' Y�{:O$ ;��"V,0 Lit, "� SDG E CT PLUMB' MECH '
0�P.i LICENSED CONTRACTORS DECLARATION '' ,Job De$Crl tl(
:0 Ih by !firm th 11 r eB d p fns o 9( se p ,
a�W] "th atfSection 7000)amdefc -1p13 flheN JPaf Code. dn)I
�z�d¢ Lin fur aen t V1 s a - e
3µF Dateo c I I REPAIR TO:D'IDDAMS`
f S DPCLARA ION a
� I Jay
plans I be used as public recordrSV / , ' "
w?Q
Licensed
P t - 'I
OWYER BUIL ARAr10N� 1 heavy ftrt thin[',,at Pt II Contractor',L L liable
t. /
F.
6 trill, Section 9[ril 5 Business dPr l..' laC J A y ly ry
F P wh h 9 I I 'I It I p
3m pn I I e atrequiresIn a-Ed r lot suchpr a all 'y d underarm I ,e
Ell he licensed pa tire provisions oft Contractor s License L' (Clapter9 Sq. Ft. Floor Area Valuation
commencing with Secifica7000)(nDivolon 3 fflue Rusuied,z IP fe nLJe) S
-or that hes exenpt Ilonefourand the basis to,the 11co, a.monion.A'yvir l Inn, _
of Section 7031.5 by any applicant for a Permit subjects the applicant t ivll p try
ofoot mom man fiveh d dd llrsts5ao - APN Number Occup `jt `
will
d ohe
work. nd the structure
emplot intended or offered
fie sale
70,P1,
will a n .and m I I is not intended r nrrered n sale(sea 9044, ` . -
Bu' dP r,s Code Th C I t '1 I d I pply ,,ad c `1Re fired"Inspections
'S, r.f pn,pert)Wn
hundii arrad,r,amdon. d had -h work himself -
ithrough 1n,.,it ampoycers Provided 0bar men lar,ar,marent, ,imandind on
offered for l If.however the building or improssinumn is sold -m n one year of 1.01 — FOUNDAT LOB'
o vl d n Pa oe wb ' m
ldcrwlll layette banderol of vn,than hada not bu'Idor - t
imp -- r v,. p,5e.r d1e.).- 1.02 — PIERS- `
❑la'owner oflheprvny n laa coy mrafb will, do tact m I _ 1.03 — LIFER - .r -
L�, I tithe pr le I(Sea 9tWG B n dP r,: Cd )Th C f t -s _ • -
L le. I apply to propertyfn n 'Id nn thREBAR.` -
anl I t isI such prGeoswlh naeban') I'licensed sant to the - f
Contractors License Law. - 105' - ANCHOR, BOLTS
,ol amnxumptondersec!. `.B&P C fur thin reason ,
1,V3.'- SEWER &L .wt)TER `
Owner Data WORKERS COMPENSATION DECLARATION 202 — 'UNDERFLOOR PLUMBING '. .
tilchyonm nde� naerorpenanon,nrmemu gdulamhl,;: � �E,. =iO3UNDERFLOPR MECHANICAI;,
❑'inave and',vin maintain ,cemrt�ate Sr consent m relrnsnre for Worker's --.. •` 204 UNDERFLOOR FRAME _
Cnmpemmion, ax pmvidenrfor by Sectio, 3900 .f the Lubar Code, for the x475` --"'UNDERFLOOR INSULATION ..
.pedormanne or me work r which this parfait .' d. _w '
y��I'n„veand,�nmar' w k c pe -I 1. -9 Inrs I 30i. .—.'`ROUGH PLUMBfNG
�d9Bo
cf hic Lab Code
.Af be sarfimldzthek iswhich his pe t is
es O My Worker',Cdfes Inn Immri - I Policy ?j
2 TUB 8OR SHOWER
ROUGHMECHANICAL
crier: him Immune.
Alel'k, 3O
CE "ROUGH PTION FROM WORKERS' ELECTRICAL
COMPENSATION INSURANCE ( '
'
`
This aennnj a t b•reordered l the form,is r tie hundred dollars 305 `-- ".FRRME - -
(SIEf 1 ) 308 HOLDOWNS- -
' 1 cenlfy hot,in the perfnrgruoe nl'the work for which this permit is'sn
n ,dl 1 •: ' ` 307 =° INSULATION
' shall not employ any penon'in any,rommer se as to became subject m the Worknrt , -
cn ,criterion Lows ofC er ia.Darn - ,. 308 SHEET'ROCK. .
'Applicant
NOTICE TO APPLICANT II II' ak gth Celfc to CP pfm you small309 '-, EXTERIORLATH -
C 'became lmrdl ,tire Work,,,ConEdirratioup ' ns of the Lubar Coda diinmo
rat,nwmnnnplywith provisions othis part;tshall bedenntndrevoked. 3.10 INTERIOR LATH .
CONSTRUCTIONIENDINGAGENCY I o 311 '— SCRATCH COAT
II by ffleading agency
ntl til .t I - _n3fm kr n1tr p „rsissuedSe, 09rCry C.)• 31 '
,ROOF NAIL`
z r;addrns,ame
501' FINAL ELECTRICAL ENERGYzi !,
. u oalymatL have read idapplfnatmnand slmothat the above i,G,mm 50^. — FINAL`PL:UMBING ENERGY
correct'I agree to comply rwith all cit d county ordinances' and talo la almins
5t03'�•—'
FINAL 'MECHANICAL ENERGY
mb dgconstraint, ado nymah t.rev - Ilseflh: 'lyt topn
(he ab mentioned Property r inspection,Purposes, FINAL •BUILDING . ENE ROY
(We) g I . dm fy ILed,h the Cly 1Cpertm against 501
liabilities ds nr n ad nn y art,way dagainst slid
S05 `- FINAL. ELECTRICAL
C� City sytence ofd.gaoadg of has voodoo. ..°
APPLICANT UNDERSTANDS AND WILL COMPLY,WITH ALL NON.POINT . •Issued by: 508- T ,GAS TEST Date
SOURCE'REGULATIONS.
sigimrrjra ofnppr'HAZ f t D' Re-roofs 5�8 FINAL' MECHANICAL,
HAZARDOUS MATERIALS S DISCI GSGRE '
Will 0tified t or t ard building p nstore or handle h._.,d material •Type of Roof O
iscarrieday the Caw nor Municipal Code Chapter 9.12,. I tie Berlin and Safety �j'0J —, FINAL GRADE % '
Code,Sann n 25532(u)? - ' r '
`
Cl Yes �° All roofs shall balA4pedtbd,$m>�:p4fm.anlLg- AllgIrI i trliaaI bleiing installed..-
Will tb pplle t -[t b Idi g p t u' equ pm til lev'ca. h n'. If a roof is�inst&11 1*itimuff&i'9't fAtaiRbon 9RMpiF f4 FI,•6ag"ree to remove '
�hnmtl b coo c ..•fin dM1y thea YAreaA Q IIyM ng I
DLt IoY all new materials,for.inspection. Applicant understands and will comply with
° all"non-point source regulations.
I have read the hazardous materials rcgnirom.iux under Chapter 6.95 of the
'Calf ni Health&SfiyCM S t 255115 5531 d25534.1 1 t dtht r <<� �. ., '.
if the building d of currently have ate tit that t':_5 P nlh)t nlfy the'
u
u-p I t tha requ r r- h'ch must h t I m s ane r t Cenifc I of -� ^�IVU 0 A, - h
Orange°`y Signature of Applicant"' � ' Date
�AlLroof coyerings'Co'.be Class"Bit or better
owner m mthor:ed agent, .b ,Doe
OFFICE.': `