00120060 CITY DINGmy SION\O
t CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS: PERMIT NO.
10565 GASCOIGNE DRIVE 00120060
PUCKET: APPLICTION SUB DATE
T FINAL.ED 12/ 08/2000
PHONE: SANITARY NO, CONTROL NO.
APR 18 2002
q,-,. ARCHITECT(ENGINEER: BUILDING PERMIT INFO
kL" B1 ''�D BLDG ELECT PLUMB MECH
Y
z ING
LICENSED CONrRACTOR'S DECLARATION
z 5„h Job Description
O l - 1 hereby affirm tat 1 am licensed under provisions or Chapter 9 and
mmene;ng
p I-m 1inlllforceand fDivision 3ofineBusinessandProfessionsCodc,andmylicenu SFDWL
a = is in full forte and
of License mss L;n.x .rsysil 6 LIVING 1800 SQ. FT. /480 GARAGE SQ. FT.
O w U Dom .$amrac or M / N
a I-n ARCHIT rC7f'S DECLARATION
t- 4 1 un J an be Dud a public recoNs
a-
wea
s Licen mfessional
E a OWNER-BUILDER DECLARATION
I hereby a«rm mat I un,cxempi from the Commcmr's License Law for the
C?4 following main.(Section 7031.5,Business and Profes;ons Cade:Any city or county.
z D which regn perm t roconstruct,area, to,owa demoli h o p any structure
�,3. -p o m u'. ,also req me appl c m fa such peen a fl grim m¢ment. - - _
that he I sed Port lt theprevisionsof the Conuvctor Lice Law(Chapter 9 S ,Ft Floor Area a Dation
(commencingw,h5 t 71Np7 fDiv 3 hheBusiness and ProfessinnaCodel far: A'e-a,ais. .,,tl.... e_+:4,-+.,,')sAi1�31't: i
or that he A excmp,iheretiom and the b r the alleged eke pilon.Any violation
- no
of Section-7031:5 by any applicant for a permit subjects,he applicant in a civil penalty-
Iofno,mo¢than file hundred dollars(55001. APN Number Occupancy Type
°1,as owner of the property,or my employet,wins wages a,theirade compensation, 101 -
-'
will'Ao'me'work:and me"so'ucmrt"is nor intended it,offered"for saleIScc:'7N4,
'Business ant Professons Code The Contractor's License Law does not apply m m 102 - PIERS Required Inspections
owner of property Who Wilds or improves mcteoo,and who does such work himself
or through his own ena,a,ces.prosnded shat such improvements ere nos intended or 10 3 - _UEFA _ _ I
-,-olrcrtdfm tile:IChowuilde,iWilling mimeniff,eni is sold within one year of 104 - REBAR -u"'
comjletion,the
ro'e.falem will have the M1ureen ofpmvintl mmhe JiJ nai build 105 - ANCHOR BOLTS
improve for purpose of sale.). i -
_- .--.-____._....._-_._._-_--___...._.-.____. __... _ ___1___.__
- cid L7Liu nworrNthe am exlusivd etmuac' Wliceaud eoouaoweiW ..__....____.....__._.__.._-___._._.
- psot7, y ww 1 .6_.._-SEWER & WATER u.
construct she pmjmt sot 7044.Business and Professions Cafes The Comheron, 202 - UNDERFLOOR PLUMBING "'°" '
License Law does no,apply to an owner of pooPcny who builds or improves thereon,
nI liceiaed.pmauun
- ' ..------. --___.._-------.end.who.cotma-for..mchpot,00_wim,ucnuacmrst.m,he. _ -203 ---UNDERFLOOR-MECHANICAL _ ..-,.
Cmuracmr,Licene Law. „
❑Ions eaempt under Sec. - " � A&PCfonhisrcaon 204 - UNDERFLOOR'1'FRAME'-� '
p = °' - - ' "ort ""'I' 205 - UNDERFLOOR INSULATION
< WORKERS COMPENSATION DECLARATION 5 1 301 - ROUGH PLUMBING
Ihereby affirmunderpn'I!yofperluy ne,gnneralmw ng declarations! 302 - TUB & OR SHOWER
❑ 1 h'ave'a„e'wiil ,tu(nlnin'"u'Cenidca,e'bf Co,asent'm'self-insure for Worl 303 — ROUGH MECHANICAL
Corryersomion, as;provided-for-by-Section 3700-or she LadWr Code,-for she
prmrn,an«nen warkrorwpmnnmpn,ls;,yw.,.,. 304 - ROUGH ELECTRICAL
_ 01 have n6e will i Worlot C;fnpsoLdiiri IrSU'Mnce'as requirtd by Scction 3 05 - FRAME
3700 orm I-abor cede;for me, m peaomtance of me'"k for which tis perm;;is 306 - HOEDOWNS
sued My workers Coinpenanunn Insa nc car and Policy numbs n, ,r cc
Zs c ic.�'e� 307 --, -INSULATION' u
n S L t tCE IFI XEMHEON FROM WORURS � �1, 13 0 S S SHEETROC& I ' '
_ COMPFNSATIONINSURANCE d _ _
st vl. fDus scnion nese not b<cnmplemd e Knotius Intone hundred dollars f
309 '.Yi` .EXTERIOR—LATH {)ka� 1 t
if
181001 lass _ 310 INTERIOR LATH
),lien fy,lunnshe perfm ce finew-k( h¢hW perm;;uis urAl .� LCOATI
j . 313 - ROOF NAIL""
Im3 C.fti aD1,a,
it It s apt perso p y evens r Isecome b s r ,he works ra`
Cnmper.a num plto anrcalr r ,Dn _-,_-,.____.501-. ---FINAL-ELECTRICAL-ENERGY------ -- -
--^PPI c s , .. ..
,�N(J'r0 TO APPLICANT It,after uakil; lC rl,fc'�e ftx< p,' 'yo, h le -
O Cnec m bf«tl theWorke c nPemt p safineLoM edd you502 - FINAL PLUMBING ENERGY
mrth hh -_r, m hprovisions- m Permit____anhcd«medresulted. _ _____50.3_.r FI NAL__.MECHANICAL__ENERGY__.
- colvsraurnoNLENDINcncENCY 504 — FINAL BUILDING ENERGY
rchy,Blrmhal m nt a eintl 6 Yfrthe Perri m a ,.I •r, +'P •,�•
afm klp wemn,hl.pennu '�- dls 31N7ctv.�1_,- ..,., 505 FINAL ELECTRICAL ,.,
- "
y p Lmdr Na 506 - GAS TEST -„ . -- - ---------
:;)-z
— — -- --
. Lente sAddrcss.. - , .. til` .P,:❑
UO ,I ,IemfythatIhavereadhisapplcalionandstatethattheaboveinfomutions 507 - FINAL PLUMBING
- e -F w,resen l agree to comply,with al chy:sed c'omny ordinances and state laws relaing: 508 - FINAL MECHANICAL
Q W To building .tmclpr and h r hyoum axe rep t ive of Iris uymemer pin' 509 — FINAL GRADE
;., & m ba meagre cop pend Tarin.peer pure,acs
ks d es.j g -s a demnipennd kttp harm) the CisY fCupenino again,
r Vi liab hu rydgmems,costs and expense h ch may in ny y gams a 510 - FINAL PLANNING
U Z C y o o.P a the sr ung fm, per il
'AFPI ICA NDERST NDS AND IVILL OMPLY WITH ALL ON-POINT Issued Date- NA C WORKS Date
SUU R(” GULATI +a 1-+
t re rAppbc OCanR na pa.= Re-rood-03 ROOF BATTENS
- HAZARDOUS MATERIAL$DISCLOSURE
k„ wens nlpi'wua'ri n le gang t f ' nal 1 e' m, 1 ...Typeo@R6of- ROOF IN PROGRESS..- _ ...
'as dernml by,he CuPen i ICod Chpr912 nd the Health and Safety ., .I s1�.+1. - - ess i:tdElf --- "°
.Cala Section 2351 ( 1 sY + I 3 .'e
t' " ` P _ All roofs shall be inspected prior_to,any roofing.material being,installed.._------
the
Wlln0phc t r t r n id g wpm : eq „ nt
deviceswhich' Jf a roof is installed without first obtatmn an ins ectlon +14 d ree to remove
en t h d r con,m toed by th B y A'ea A Q hiy hlunog m nP g P g
Y N r T all new materials for inspection,_Applicant tinderstands and will comply with.-
+,. + „ , I ' t r' all non-point source regulations,..,,,,, ,I Ir hi„
tiave ieadahc hazalloes moven 1-.regmremcmi and r Chapter 6.93'or th=
Calihimin Heulm&Safety CddeJ Sections 25505,-25533 and 25534:1 understand that, '
act
c bu bftheeesn _p,lyb sus i nshili to tis poi'bd not,fy ih
a pant of me gmrtm a hmh must h metprior,dn Dories of Cott B s f
Occup ncy
Signature_ofApplicant_- Date
o roututure m l ` ' , All roof coverings to be Class B or'better'
"
i
OFFICE-