02060019I
l�
cIBUILDING OF UOPERTON
CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS:
PERMIT NO,
21628 FLINTSHIRE ST
02060019
OWNER'S NAME:
APPLICATION SUB DATE
IGNATOWICZ JOSEPH B AND ELEAN
06/04/2002
PHONE:
SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
i
I.__3 LJ L.=] 1_.I
' LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hcmby afErn that 1 am licensed under provisions of Chapter 9 (commencing
with Semicon] )af DivisionJof rM1e Businers and Profcssiom Cofe.end Reens<
.moan < na erred. �f ZZZB
Licenu Cla E r o
Date co
GAZEBO DEC T6. pWApLI�L LANDSCAPE TERLLIS
e�Ya..tG'®
s D
CHITECT'S D
S 1 and tantl my plans shall he used as public recoNs r
MAR 3 1 2003
Licensee Professional
_ OWNER -BUILDER DECLARATION
1 hereby aRrm on 1 1. exempt tram the Cssionsr's Licenu Law for the
following mason. (Seaton Business and Professions Cade: Any city or county"
BUILDING
i requires cmiur
which ts Permitof t t Iter, improve demolish, <p any swment
yS` 3 0 0 0 O
.Ano to its issuance. 1 req' theapplscmrt for such Permit fleasignedsutemcnt
Thai he.licensed Ars y 10 she provisions of the Comminute, License La(Chapter9
(c "ng with Sect n AMIT of Division 3 of the BusinessdProfessions Code)
[�F'IQ ea••
or
fB1 ,?°
�t;
;(_)
Valuation
rnt
or that he is capt t1mofmciand the basis for the alleged exemption. Any violin cm
,a.tZtl:, q 1.
'
of Section 9036.5 by any applicant for a permit subjects the applicant to a civil penalty
.four inThan an five hundred drill., (5500).
101"N NN���,Umr�������
i ' i `" Occupancy Type
❑ 1, as owner of the property, or my employees with wages as their sole compensation.
FONDATI ON
will do the otk, and the saamum rs no,intended he offered for sale (Sec 7344;'
f1lusiness and Professions code The Coutowtor',s License Law does not apply to an
- '" -- ----- -PiERS
10 3 - UFER Required Inspections
ow m
r of property Who builds or hereon, and who does such work himself
+
or Through n' pI r provided]idW That such improvements t intended or
104 -REBAR
offered however.rllhe�ifot atn
no year pleton.theownmbulderwhave proving
o that hedid obldo
_
105 - ANCHOR BOLTS
improve for purpose of salol.
106 - SEWER & WATER
.. _
-c.r Mlecthe port ,. la �nf d r -torso
w
---.. _
i
202 - UNDERFLOOR PLUMBING
t th project (5 . ]Q1J B .' J Prof n. CW 1 The C trvctor's
rafeg
- License Law d«snot ,plytowner ofprop<ny who Wilds unproves me..
'....andho
�
203 - UNDERFLOOR MECHANIICAL -
tams, farsuch projects with a. comvctogq 1 cemed pursuant to.me..
Contractor's License L
2 04 = UNDERFLOOR '
❑lam ptmade, See' a&Pcfor this mason205
,FRAME
- UNDERFLOOR°'INSUliATION
/Owner WORKER 'SCOMPENSATION DECLARATION
�I
301 - ROUGH PLUMBING
r
hereby alErmontlerpenaltyafperjtifymumofm<followingdecmimfons:
302 - TUB & OR SHOWER
"'
303 - ROUGH MECHANICAL
❑ 1 hack and will maintain a Cendiotdo of Consent to self -insure for Worker's
Compensation, as provided for by Section 37M or the Labor Code, for the
304 - ROUGH ELECTRICAL
performance of the work for which this permit is issued „
305 - FRAME
❑ 1 have and will maintain Worker's Compensation Insurance, as required by Section
306 - HOLDOWNS
37M of the Labor Cede; for the performance of the'work'for which this permit is
ins aMyw kerac P�q r� Irtau r R aPl<ru x
307 - INSULATION
QF EX
3 08', _ „SHESTROCK,
{{ :,ITION ON PROM WORHERS t
' ' 'coMPENsn N INSURANCE : � •
y
3 O 9 °'
. 'Cm.. r'nneW not b< completed if thepermit is for one hundred lunars
_ .. _LATH
310 '..=-'(INTERIOR LATH , i.c.lr t 1
311 - SCRATCH COAT
1 nit'r peri roe rtofar issued,I
1 --= ROOF -NAIL
,,., ewnmm ctto.tt
mpl
cn II t play dor p,. n' r n e to become subject to thew kis
Cumpc ton Laws rcffuma.Date,
t
1.' E 'I
501 - FINAL ELECTRICAL ENERGY 1
Avp1 t
NOTICETOAPPLICAM If aft k yin Cnf t f& pi should
.502' ---'-FINAL' PLUMBING -ENERGY: ___ ._. ... ..._.
.•.
,you
be m'. ijeyotoW k aC 'pe t pr AorthLan Code too nmu
fotth th comply with h provisions or,h,, perm t shall the recommit revoked.
,
503 - FINAL MECHANICAL ENERGY
504- - FINAL BUILDING -ENERGY
,CONSTRUCTION LENDING AGENCY
1 hereby th t Then, -construction-I e' g u8 y fo ine rfom c
pr
505 - FINAL ELECTRICAL..,.
bokwhichm Pe 't ireec3B9]a..ej
Kiform; ___..,.
._...._..__.506 .-...GAS TEST.........
a Add
507 - FINAL PLUMBING
1<n at to a tt mato above fu mronrs
508 - FINAL MECHANICAL
etocom city
toner 1 get ,1y with �11 dYba ty d' ive a.late mwaermining
d
to b g n o and h by urno m p e t t sae of th ry t nm
509 - FINAL GRADE
Aon
pon
o
m<Wementionedpnp<nyr i.pett prpuse
(w)'6'm c d' fYnAk ph IShcCq fCUP n'ioag-fist
510 - FINAL PLANNING
liahlte jag nrx,c t nr It n. o I h h mayInany y « gain,t.ad
\PP neo\ ,ND£RSTNI DfWILL
514 - FINAL U WORKS
OMPLYNITHAU NQYP
soL - I "Ions
Issued by: Dat
Re -roofs %•
Signaiu colApplicarOCommmon-,.'^ , Dt
-.HAZARDOUS MATERIALS DISCI.GSURE
WII'h applicant or ouwm holdingoccupant 'ince orh dl hizask mated-[
i
.._,Type of Roof__.
e f ed by Th C P<n Mi P I CW Charter 9.12. d theHealth d Safety
_
.... _.._.. ...,„_.,.. ..,... . -, ._...�.,.
Cod Set n 255} f 1 -
❑Y - IN 1,i°.
t
L. I I -
,i
wn
All roofs shall be mspected.prtor to any roo5ng,matenal being installed_
. za11 m PAI fit t F building find by a nt Bay c c,i prQ t e anci n
doth d noncan-a'tlf dbym ByA A Q Icy hfa :gemem
If a roof is installed without first obtaining an' inspection; I'agree to remove
°” 'oY'
all new materials for inspection Applicant understands and will comply with
'source
1 ha {a rte h pn mer Is 'q rcmenjs and Chapter 695
all non-prunt regulations•
of me
Cahfamm Health & Safety Cod, Section 25505.2553} and 25534. 1 understand that
i fthobtfildingificesnot cumetllhave. to am that it ismY rcpo.'b'I'ty tin omify he
- - - - - -- -
a�upa t of the q m t. h mor t P to is ce fit C vifcm- f
P
-
_ Signature of Applicant Date
.. in _. .
All roof coverings to be Class B' or -better
Ow a oozed sig 't Da¢
.. .. .... . .........OFFICE_-_ .