99080100 TINO
CI But OF
c mEsiONPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7540 FALLENLEAF 99080100
OWNER'S NAME: APPLICATION SUB DATE
• STELLA HERMAN 08/13/1999
r PHONE: SANITARY NO. CONTROLNO.
a O O ARCHITEC AHNGINEER: BUILDING PERMIT INFO
-"t P BLDG ELECT PLUMB MECH
FU CJ I' 1 L__J CI
LICENSED CONTRACTOR'S DECLARATION
O 5 N 7 I hcreb mrm that I am rtensea ewer Job Descripti n
O —C Y a provisions of Chapter 9(commencing
< a: sth5=tion]OWIofDi
z i
vision3oftheeuixxsandProfessiansCodcanemylicenx ADDITION/REMODEL
m y s in full force and eRm.
yib c a License Class ed s
O i O Date Contractor
W LL O t; ARCHITECT'S DECLARATION
}= 1 understand my plans shall he used as public records
Licensed Professional
or S p
OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for dm
t a following recon.(Section 7031.5.Business and PmPossions Cock:Any city or county $75000
F o
which y r
s a permit t eruct.alt p demolish, ry
pit any steturt
way; pr t al q theNPr r chM1 n
hit hik fiesnoalp rt td thismvi,mr,of she Coomiscier,Liven,Us,(Chapter 9 �(1,.� [ 0(6 rea l' I Va]UU110❑
Ic rg with Sect 7")61 Division- 3o the Businessd Professions Cade) ` 35.J,'L��:J . VU - r ,�7 �," �n
n mh h=Is exempt therefrom and the basis for me alleged exemption.Any violation
of Section 7031.5 by any applicant for a permit subject the applicant to a civil penalty
or not marc than five hundred amort(sSdo). 101'4PN '� ATI Occupancy Type
111.as owner of me propcny,or my employees with wages as their sole compensation, ing _
will do he work,and the structure is nor imended or ol@md Tor sale(See.70t4, -
tBitsiness and'Proms%ionr Code:The Contractor's License law docs not apply to an 103 — UFER Required Inspections
owner ofp perty Who builds or improves thereo,and wh does rush workhimself
ar through his o employees provided(hot such improvements ,i tended or ._104 _— REBAR--. _ t
-offered-fo 1 If,however'Im building - - " '- "' --- -
ger mpmvemOmt . m innnotbui or 105 - ANCHOR BOLTS � '+•�•
iu ova on the owner bu Ida will have me burden of proving that he did not build or s
mprove for paryose of sale). 106_ - SEWER & WATER _
DLa,owner arms propentameusinessadProcmgwimrmnaede Cmirtoom 202 - UNDERFLOOR PLUMBING
con9met the psmdoes
n (See appl]to a Bastes.azul shy who
illsCoror The Contractor's
Lost dwh Lawd«s ern apply roan ownerwith
aemanwnobulicese improves thereon, 203 - UNDERFLOOR MECHANICAL'
_Co who contracts fief such projects with a mntrvemrts) licensed pursuant m.lne
Comunscrar enc w. 204 UNDERFLOOR-.FRAME -- - -`
❑lam uempr un der Sec: ',B&PC for his rcasoe 205 - UNDERFLOOR'f`INSUL'ATION
- Pncrl' Date 3O1 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER
I hereby dram made:,,penalty of pejm'Lmie'fife following aeclmmmust 303 — ROUGH MECHANICAL
❑ 1 nave'and win'maintain a eeritficqu,of Consent to.ciffnairc far Weekes 304 - ROUGH ELECTRICAL
Compensation, as provided for by Section 379) of the Labor Code, for the
-- performance of the work for whim mid perms is issu.n., 305 — FRAME
D 1 have rind willfmninuin Worker's Compensation Insurance,as required by Section 3 06 - HOLDOWNS
37M of the Labor Cookie.for the perfomunce of flat work far which this perm,i. 3 0 7 — INSULATION
maces C m e t Insurance carver and Policy number arc.
assy Wmaces
Carrier' `Farcy No 308 , . SHEETROCK '. ',.
FICATION OF E%EM PION FROM WORKERS' 3'09 '— 'EXTERIOR'-LATH': '
COMPENSATION INSURANCE '
..'..
(Thissectio .- .. . .__...
310-l-.=C?INTERIOR-LATH--,need rM1c pcnmit is for one hundred dollars _
(51000oelesnl . 311 - SCRATCH COAT '
313 ROOF NAIL' "
L 1 ceit g that the pedistea a of th k f h h th pc t s issued.1 - ---- •'""' - - -
scan smolt rm abapm bjegiodim woem 501 - FINAL ELECTRICAL' ENERGY
I p I L .f Can a.Date
-'App'''^' - -- -- -502 - -FINAL PLUMBING ENERGY --
'NOTICETOAPPLICANT If ❑ ak ,d CnfamotE pt youshoule
Z -
503 - FINAL MECHANICAL ENERGY
Z 2 plywm M1p so ion permit shall xdeemed revnked. 5.04 -.-. _FINAL BUILDING..ENERGY--._.
.
O fonnwmeo
CONSTRUCTION emisac 'LENDINGAGENCY 505 — FINAL ELECTRICAL
W-' e v Isis for Which that there is a consauoien lending zgcnty for the perfomunce 1 ,.
W:� ohne Nato Which this permt . issued(Ce309].civ.C) 506. — GAS TEST .
Led xNm - .. _
� Z [imp ru:Aee507 - FINAL PLUMBING
r.n.
V-_O e I cenify that l have read this application and state that me above Infom,anoa is 508 - FINAL MECHANI CAL
corredt.I agae to comply with all city and county oNinincea and sure laws relating 509 - FINAL GRADE
0=C;1 aWildo,construction,and hereby amhorire mpmscom1htes of this city memo aeon
E,.Q. me boa t n=ap pen for_ iryant pa ma 510 - FINAL PLANNING
[y:G (W) b tie. J ifyundk ph Icn�'the Ci fC penin'against
rab'rf. ids =cat, r d p=as n n may'a Wm y .,area, aid 514 - FINAL PUBLIC WORKS
City in tsence of he U 61 this .it,
APPLICAN'TgUNDCRSTA OS AM1D W111COMPLY WITH ALLNON-POLYT
SOURCE REGULATIONS.," ' ,. Issued by: 9= 2 Date
Sigwmrc-fApplicanyContractor, " - �; Dam Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
T e of Roof
W'llmee applicant orfm Wildingeoccupantstore handle health s S.Ceal -Type
asdf defined Cpn Ma pICJ Chapter 91 0th Health and 5af.ty
Code Section 25-5.12(d)?'
°Y No - ' Allroofsshall.be inspected prior to.any,roofing,material being installed
wd she spin^ ar I n Id' occupant ,e ego p t o a ie"„hien If a roof is Installed''without first obtaining an inspectiori, I agree•to remove
emit h, b u ms av&fi.ea by the ByAmaA Q 1h,Management a
Dist all new materials for inspection Applicant understands and will comply with
Dye. , r r DN.
all non-point source regulations: , t
1 ha e.rmd the kidN men Is qu,rcments u e Chaps r 6.95 of the -
California Health&Silt,t5 C d Sections 25505 25533 and 2544,1 understand that
ifthe building dues tat cumcmlYhave a tenant.that it is my...sensibility to amifyihf - - "--- -'- -" - ---
Occb
-
bttepapansm opythe aqu uctram s which must ba e mprior to mucancc of a Ci,nificate of -
^
l ... -...' _ signature of Applicant _ Date
•-. .-. . .. -. .. . .-
Dwn=rorgamora=da m Date, All roof coverings to be Class"B"or;better
r:-'...; .. OFFICE