00060003I. —a nU1LnING DIVISION v DVD 11.41r I CONTRACTOR INFORMATION:
BUILDING ADDRESS:
OWNIB'S
NO.
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ARCHITEC711 NGINEER:
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BUILDING PERMIT INFO
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BLDG ELECT PLUMB SIECH
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LICENSED CONTRAC OH'S DIiCLARATION
In b)aBat.lo-tl' 9(cmumom.ng
Job Description
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r'en,ed Or, provi,icr,of Cl'pie
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with See f 7(XNpof D' .t nJ flhr 9u I fie„i 'Cxf d license
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Date �50�
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.MlCH DE A A'I ION
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In ' ”` "°— �
al 2 3 2001
OWNER -BUILDER DECLARATION
neR off m Ihe. I :I0) exempt f no the Commerce. Livem,n LIW for the
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following re. (Section 7131.5,mtRusin.%andProfessions Cole: Any city orcounty
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which requires n peit to construct, alter. anionic, demolish, or repair any oratio e
IDUIL®B�PCa
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Portion's issuanee..Iso mgtiren me applies., Bouton peril while a signed.da¢mem
S FL Floor
q•
Area
Valuation
that he I, licensed purenammthe tomo,inns.ftheContractors LicemeLow (chapter 9
(c.loreadng with Section 7000)of Division 3 or .,
emins, m
nm1 Pfe„loua Cade)
or 0)n he is else n therefrom and the basis tar the alleged exemption: Any vial.....
of Scet 7831.5 by any ... Ii.., fora "amid, object the applicant to a end penalty
ofnot more than rive hundred dollars 1$500.
-
APN Number
- Occupancy ype
❑ h os owner of ,he properly, or my employees with wages as their ands, cmnrensation,
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will do the work, and the smourm is net intended or nffemd for side (Sec. Will
Business and Professions Ride: The Cenmaemr's License Law does no, apply to :In
equired Inspections
ownsi uI pro,,ly Who bnllds or improves merenn, and who does such work outsell'
or through ]its own employees. provided thin such improvements are n., intended or
offered for sale. If, however, the building or improvement is sold within one year of
10i —
FOUNDATION
completion, the ownenhuilder will have the burden of proving Pont he did not build or
—
PIERS
improve or pmpnae of sale.).
102
m
01, usrofthe ppem):m aexclusively contracting with licensed contractors to
103 —
UFER .
m,lr.e1 lee proiocn (Seenwa, nudnex, not Pmfc„Iona cope:) 'rhe Contractor,
License Law does not apply to an owner of property who builds or improves menton.
1 04 —
'
-.
REBA R
and who mourners for such receives with a ront.aons) licensed pursuant to the
C .nfmcnrs License Low.
105 -
ANCHOR BOLTS
El um c.mnp, antler See. . n s P C for nods rets..
1.06 —
SEWER & 41ATER
owner Dale
WORKER'S COh1PDNSA'1'10N DECLARATION
202 —
UNDERFLOOR PLUMBING
I fall emrn under ..try of perjury oneofthe following dedurtion,:
1-03 —
UI\IDF_RFI_OOR MECHANICAL— ,
❑ 1 have and will moan.,. Ccmream of C ... cut to aelf.insure for Worker,
204 —
UNDERFLOOR FRAME
Com".,t,aam,. as pr.>mM fanny Sect 390() of me ],.,her Code, for do
205 —
UNDERFLOOR INSULATION
rerfommna of me uork fur wnich this permit is issueJ.
301. —
ROUGH PLUMBING
❑ I have and will mountain Worker.. Compensation msur�
p nre.a,requirednysecm°”
of the Lmbt Calc nim ,he dbvnnntt of 0)t work far wh ch this pennh L
31M
TUB R OR SHOWER
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cialo"N " n`tmn`e`amer%/RZ b pm:U
earn<r:�
303
304 —
ROUGH MECHANICAL
ROUGH ELECTRICAL '
CAI_
CI?IITIFICA'r10N' UP EXEMI'TIDN P OM WORKERS'
COMPENSATION INSURANCE
_
305 -
FRAME
(This rection election he e... lewd if the permit is intone hundred dollar,
fSINBu x,.I
306 —
HOI_DOWNS
I cenify that in the perrnnnnnce of the work lit which this remit is issued, 1307
'—
INSULATION
smell not employ any Islam in Imy munnti,:. a, m became ,object 1. the Workers
308 —
SHEET ROCK.
Compensation Law, of California. Dam
Applicant -
NOTICE TO APPLICANT: If, neer nnklng this Certifies., nl H.empdun, you.houlA
30.9_—
EXTERIOR LATH
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ecomcsubject tothe wmker,compen,ationprovisions ofthel.morCode .you must
forthwith
310 —
INTERIOR (_ATI(
comply with such provisi.n,orthis permit shall he deemed revoked.
f~•e 7
CONSTRUCTION LENDING AG BNCY
31.1 —
SCRATCH COAT
51
T herehy .Won Pom there is. clucar .n lending agency no.me pedomnanee
-
313 —
ROOF NAIL '
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of the work for which Poi, permit is id ISce. 3047, Civ. C.)
ssue
aid
Lender's Name'
Lender's Addre..
501 —
FINAL ELECTRICAL ENERGY
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502 —
'FINAL_ FII_UMBING ENERGY
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1 verify that I have mad this application and state that the adowe information is
correct. I agree to and,tme law,
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comply with all city and county ordinance, relating' n
m buildings instruction, and items, noun orize more .enmtives.f thiscity l.mer ppm
503 —
FINAL MECHAN I rAL ENERGY
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meahove-m�iliaedpronmyforimfiertim,parpoms.
504 —
FINAL BUILDING ENERGY
oFi A.
IWO agree 1. live. Indemnify and keep hamdess Poe City of Coral against
bnbilioe" itdgmcut' i"
,amu r.l ose, which may in any way aecmn agama .sin
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505
FINAL ELECTRICAL
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I Ill n
nor
APPi s.'ONPOINT
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SITE
[An DERSBA 510
WILL COMPLY W
Issued by:
GAS TEST
-so 1CF -"OPONS_
_
Date
IT DOUS MATERIALS DISCLOSURE
Z Will applIT .r rrnure building ovencenl store or handle ampouls material
n delinrd by the Cu tin. Municipal Code, Chapter 9.12, Imd the Health card Satiety
Code. Section 15532fm'1 -
❑Yes ON.
dican, lir future building occupant u.w equipment or devices which
conmmimms as defined by ,he Ray Area Air Quality Management
❑ No
1 have mad the hazardous m.tenals requirements under Chapter 6.95 of the
California Health R Safety Code, Sections 25505, 25533 and 25534. 1 understand that
if the it do . coat" thmt It I, my resp. luol ily,, ami l y the
cups of h qui cants whit anuou be met prior,. issuance of t Ccnificme of
_sass_. .__....� _sass.
Re -roofs 508 — FINAL_ MECHANICAL
Type of Roof 509 — FINAL GRADE
10 NAL PLANNING
All roofs shah�s .,spec��e ,,ppr,,11,,4Qr tq¢.,, qxx((o ��1I,.n err* being installed.
If a roof is inSt5114Li1 w74P�'iirS4 ol5f�ilRhg�dII '1�Cil I agree to remove
all new materials for inspection. Applicant understands and will comply with
all non -point source regulations.
of Applicant Date
All roof coverings to be Class "B" or better