00090022 NO
CITY Ui of `prExONNo PERMIT CONTRACTOR INFORMATION: -
BUILDING ADDRESS: PERMIT NO -
E 'RF_MODELING'• 00090022
OWNER'S NAME^ APPLICATION SUB DATE
_ tl ER ST 09/07/2000.
7ZARCHITECUENGINEER
E: SANITARY NO. CONTROL NO.
+1
iKCINEER: BUILDING PERMIT INFOBLDG ELECT PLUMB MECH
AACENSED CONTRACTOR'S DECLARATION 1hereby affirm Inas 1ant uceasedanderpmvl, ,n,orcmmter9(mmmeamngJob Description
ol',,.7000)of Division 3 ofmc Business and Professions Code,radmy license
dl force and effect _D. .e Class Lic.#
cdu nom c�- BATH AND KITCHEN' REMODEL
F �—
cmtmaetor_
a.0 h ARCI3ITECT'S DECLARA'ION f t
C aO O I unden,tnnd ery plan,mull be mind a,public nears, _
0.q Licou,ndP Ttl
OWNER-BUILDER DECLARATION `!
ae_to lerchl affiran that l an,ascapt from the Cont,cion, License Law for the
t Q loth g 11,111m.(Section 7031.5,Richness d Pr f:.'un,Cape Any county -
F wht h require, pe t t c nal T h r p le olish repo' y t scare
3 m priors' al. reclaims th apPl m n h p r nlu-I I g mm
d neat'
'
'hat he is licensed p . o thett m provisions ofth,Concrachas Lispinst,I (Chapter hr9
Bnees S Ft. Floor Ar a Valuation
(con ling Zhu t ) oD' 3 f -cJ Pf -.' is eeq'
or[fall heisc.eart Eardrum a ad the bas:R the alleged e pro Ay •ioWinal -
of suntan 7031.5 by any uppliean,for a pe if shb,ch the applicant to a end penalty.
of tet more than five nmndred anuar,N500). APN Number Occupancy Type -
❑1,its owner of the property,lir my euployenv with wages as their sole compensation, -
will on the work,and the structure Is not intended or offered for sale(Sec.7(144, 13-9 13-0 0 19 -IM
-
Business aad Profmxinns Code'.'rhe Conlraclnr',License Law doe,not apply to an . - Required'Inspections
r of imsums
property Who 1, ch,or proves thereon,and what does ch work hielf ..
it ihrmngh his own employees.provided that such Improvements are not intended lir 1.01 — FOUNDATION
offered for sale.IL however.the building or impros'emenl is sold within one year of
ompledium the owner-builder will have the burden of proving that he did not build or 102 �- PIERS
improve for purpose of elle.) _
❑I.is owner of the property,am exclusively contracting with licensed contractors to 103 — UFER . -
om
n,tct the made.(sec.7044,Biomass inc ,
ess and Ph code:)The contatn
er', 104 — REBA R
License Law does not apply rot an ownor or property who bands orimPrmces themn6, •,
and who contacts for such project,with a contraction(i)licensed Fusion, to the 1.05 — ANCHOR BOLTS .
Cor niclors License Law.
❑land exempt toast Sen. ,B&P C for this reason 106 - SEWER R WATER .
owner Dalt' - c02 — UNDERFLOOR PLUMBING
WORKER'S COMIIENSATIONDECLARATION 203 — UNDERFLOOR MECHANICALIherebyaRirmunderpmiltyofpetiaryoneofthefdowingreclusionl 204 -- UNDERFLOOR FRAME
11 have dna wdi rovided a ay e Section or emt.em m,e Labor re for workers 205 — UNDERFL-OQR I NSUI_AT I ON
tmpen,ation, as provides for by seannn 3mo'or me Labor ems, for mit �.
errmmtanae mfthewnrkfrwmen lois permit(x e„am.o 301 — ROUGH PLUMB.ING_-
rsoanawrilmmntamw�rker,colnl>r�xaannln,amnee.n,regnirmnysection 302 — 'TUB' & OR ,SHOWER
J7W of the Lnhar Code,forme perfonnanec of oto work for whsn this permit is
issued.My Worker,Compensation In....n se carrier hod Policy number are' 1.303. — ROUGH MECHANICAL
carrier:S7flTe���� PrcrN��!`��413-00 304 — ROUGH ELECTRICAL
CERTIFICATION OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 305 — FRAME . . '
This xceirnrroad act becomputedit herecruit isforms,hundred dollar, '306 — HOl_DOWNS
($IINry mr Ier,J. ,
'1 certify that In are perfermmee of the work for which tat, 't is issued,I 307 — INSULATION
,hall trot cotploy any person in any /palm 308 — SHEETROCK
Compensation Low,of Califards.Datenncr m av m oceans object m tnc Workers'
nal 309 — EXTERIOR LATH
NOT t _.
NOTICE subject
TO APPLICANT B r king n Certificate theof Diracion ,y ubmuld 31.0 INTERIOR LATH
Z been hco pl the W k C pe cart p :: ll be dLabor Code, must
�OO noon 'tit comply wilts nprovisions' ' or at p 't heron a«mm revoked, 311. - -SCRATCH COAT
r^� CONSTRUCTION LENDING AGENCY ' 313 — ROOF �IALI— -
a I hereby front(hut there is u construction lending agency far the performance -
Lenof e 'sNamrk rwmen unix permsial„med(seer3897,civ.c.). 501 FINAL ELECTRICAL ENERGY
Q Lend Name
z Lend Add : SO2 — FINRI_ PLUMBING ENERGY
u Q greeif Y n,t I cona Jana ityand tntematn n rnnminnig 503 — FINAL MECHANICAL ENERGY
0 U correct 1 greet comply 'tl II out hurl county rativee.v d same law.v enter
mining -
O u th stainsnnnxhunhon,:meheminspectionttriemreprn,emahve;mhas city loenlerupon `504 — FINAL_ BUILDING ENERGY
ty 0s the eh i n Is e.nde indemnify
p harm ,.
y Iiahil'i(sl)dbn ll .a dd nndkeph yinany the City aCpn'nnngainxl
expenseswon ymanyway accrue againstvnW 505 — FINAL -ELECTRICAL
V
City mconsequence TUNDonhvgranting DWIPumt 506 — GAS TEST
UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
.souses REGULATIONS. ' Issued by: Date
stgneam lir Appbnant/cmmraemr Date . Re-roofs 508 — FINAL MECHANICAL
HAZARDOUS MATERIALS DISCLOSURE
Wil the heCp teantmrrutureblImr,oda,ant.ammnrhandle hazardous material Type of Roof 509- — FINAL GRADE
us define)by the CuP"Iino Municipal Cade.Chapter 9.12,and the Health am safety
Cape,Section25532(a)z - 511 ei FINIAL. PLANNING
LI Y,, ❑No All roofs shall be.eiff ected r_ pr��an f ng installed.
WIII IM1cu ..cant or future occupant use ul '•""� �19V L r��r+�
pr. 1, 1 q pment orde,ia,which If a roof is installed without first ootainm an inspection, 1 a rue to remove
emit hnmrdous air eonlmmucal,a,defined by the Buy An.At,Quality A1anagentem g p g
Dlxblms - all new materials for inspection. Applicant understands and will comply with
°Ye5 ElNo all non-point source regulations. PP p y
I have and the,toad!...muNria.s requirements under Chapter 6.95 of the _ ..
California Health&Safety Code.Sections 25505,25533 and 25534.1 undershot that
If the building does not currently force lanan6 that it is my responsibility totality the "-
coolant of the requirements which trust be net prior to issuance of a Certificam of
Occupancy. _
_ Signature of Applicant - Date
Owner mr summi,ad a. - 9e O All roof covering's to be Class `B"or better
OFFICE