01070097c1BUILDING DV SONO
CONTRACTOR INFORMATION:
IINPERMIT
BUILDING ADDRESS:
PERMIT NO.
10873 W ESTATES DR
MORRIS DAVID W AND BARBARA
S01070097
'A6W 9 DAVID W AND BARBARA S
07/23/2001
PHONE:
SANITARY NO. CONTROL NO.
p/J
-41os: ,/ - % - SO Q
zo ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
❑
BLDG ELECT PLUMB MECH
Ct3
L__I L J LJ I—I
i LICENSED CONTRACTOR'S DECLARATION
lob Description
Ibon by affirm700(of ma lam (kens Busies ptosisiores oftest Chapm,9(commecense
m with Section ofect. un3nfine Business and Protestors Cade, and my (rani
ADD 2 CEILING FANS & 1 WHOLE HOUSE FAN.
and
is in full force anJ cf&ct.
U License Class Lic. k
Dart Central.,
N ARCHITECT'S DECLARATION
g1 understood my plans shall he used as public Emend,
`
OLicensed Professional
pre, OWNER.BUILDER DECLARATION
1 hereby of . that 1 am eacmpt from the Contmc.r's License Law for the
< following Marm, (Section 7031.5. Business and Professions Codle: Any city M county
$1500
O which requires a permit to conswct. alter, improve, demolish, or repair any swctute
. prior is its Issuance, ala requires the upplitaid ruralist permit to life a signed sta¢mem.
�„ t �.1f\s
3b`7fLt �.''j'4_�/.:
s Valuation
- that heisliormsedpatomem to Bic provisions Of the Con,.&, License Law(Chapter 9
(commencing wish Sltalom7BW) of Division 3 of the Businea mad Professions Code)
or that he is exempt the¢fram and the basis for the alleged e`cm'ption. Any violation
) C1YY,9a s
- 2ction 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
tmoreshmrvebatWrodd.1as(5500).
304AI?NM9#3H ELECTRIAli
'' Occupancy Type
m
as owner of the ppeny, or my employees with wages as their role mmreamtion,
O - FINAL ELECTRI
AL EN
w ue me wPrkfxsion, Camctufe is nm mm's Li or offered ifbrame (see 7o5
and Profession, Cala The Commnor'x License law docs ret apply . an
B Ur,
_
505 — FINAL EI�$q' GA*
IT.I�II CIIOIIS
uwne of erry W
r ofh builds or improves thereon, and who wink himself
his own are O
m through his own em la res. mvlJ
em dor
_ 8 employees. provided that chimprovements t' t ,Wed or-,,,_--
',offered"f th .If ' th building P t Id th ye.a of
e,
'compli 6 Idc 'll have m WN fp 8that hdid ,build
trop Trp p rlwe fsale.).(
.. l Owner f property, I IY contracting ' licensed o t tors to
m
... .. _.. _
co
coat et theproject IS . 7014 B add Professions Cod 1 The Central
License Law d tw fp pent' M1 builds. P thereon
I
�. V jII//t
h t is fo ch P olcnmtrmm
h. s.wM rtsl.l ttrsursm
d Puuant the
Cm t aor, La
❑ I m cst,p der S9c- B A P C for this reason
.. _.. - _ _. _. _ - .. _
_ ,,
0/
- W'ORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of Perjury one of the following declarations:'
❑ 1 have'aral will maintain a Certificate of Consent to self-insum for Workds
_ Compemsatinn:-as provided for by Section 37W of the Labor Code. for the
performance of the work for which tris "it is issued „
_ 111 h SE'ruie will ouintaiti Worker's Compensation Inommea, as required by Section
370() of the Lihor'Code, for the performance of the work.for'which this permit is
'I issued. My Wo Set Compensation Inmiance carrier and Policy number art:
"Polley No
IEZ. 41 CERTIFICATION OF EXEMPTION FROM WORKERS
;
COMPENSATION INSURANCE _... ;. ,..
.__'.._ ...._....-. ._.__. _.-
I^ s ' (Thiel se�kioti necd'not be completed if the pe,mit is for one hundtN dollars
.._-...._,_ .r_
- ' � � --- � s _' _� � ��-_-
r
(SIM )it, lessJ
'
thePerformance
fshalStill that iworkf s l
t mol Y Y Person in y rtppall so t bcroll.Subject t me Wadierr
_
Compenat n Law' ofCal Porn aDam
NOTICE TO APPLICANT: r making this Cmin of E on, you shMuld
became.su the Worker'seompenehtion
Co or
provisions o abor code, YOU must
Mmmly
fonrwitti comply wire such Invision, or this permit shall be Deemed revoked
_ Irilhdecried
._.,- ..___ .— . _ ..
._.
r
i t'Pit"vsCONScr Uiia lONLENDINGAGENCY'
Ihtett iia could!(See, lending age dfor the perfarrmme
hich,hatm
b this petmii is issued (Sec 3097,Civ. C.1
which._.,.
ender, soName .. vim.. �_u .. ....._�.
Lender's Address'..
r I,cody that I have read this upplicaion'andxmta that the above information is
ricer I agree ao comply with all city and county ordinances and state laws relating.
to building construction. and hereby oomoriee representatives of this city to enter upon
the alcove -mentioned prop,My f pen -
(We) g tris ettde ti ft' dkeep hr I.dthe City ofCpert-nagmnst
7 liabilitial, judgments, t nd Pe sea, h ch My -n any way accrue against said
:ply, 5 que�ceof thego gftntapertnt"
API 1/ NT UM1D[RS GIa s U WILL COkIPLY NTI'H ALL NON PoM1
' so )R GUL s
Issued by: Date
ll 29 0/
Sign, fAppucanUe non :. Date -
Re -roofs
HAZARDOU MATERIALS DISCLOSURE.
Will the applicant or futurt bold og rectiIinip t handle haturome, mmenal
Type of Roof -
defined by theC,r Manc aICod Chapter912 and 'heHahh itSafety
Cod S t
'. '. '
n255i (ol
'r ❑Y 1 s�e 1
✓`.0 s .I1,
_ t
All, roofs shall.be inspected prior.to any roofing. material being installed
cant
,, carom Fn contaminantsi ant ,e bu'n'ny occupant ,t yAaequipmentdevices,.men.
emit rat Nas denting bath nt orhick
------
If a roof is installed without first obtaining an inspection; I- agree 'to remove
use Area Air Quality Mawgw ent
Dist ores -' Na ,, f - ;,, "� ,
all, new materials, for inspection,. Applicant understands and will comply with
--
1.)'6'- t
all non -point source regulations.
I have rcad�tre hazardous materials mgfiimments under Chapter 6.95 of the,
CaliSnin Heulih & Safety Code: Sections 25505. 25533 and 25534. 1 understand that
iGtpebT�Iditmsn rte tyh circ tmattsmy re-po bliY to noafyiho'-
occ p quire e�i. or,t he m t p . isk m e of cromr, am of
(JJJ�/
Signature of Applicant . - Date
All roof coverings to be Class "B" or better'
,own ro mtnor,angasp t ` ;; 1 . : :.Dae
a \ OFFICE - - -- -