01050128 CITY OF
GNO
BUILDING LPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10255 HILLCREST RD 01050128
OWNER'S NAME: APPLICATION SUB DATE
BILL GIGNAC & NANCY KEDER 05/14/2001
PHONE: SANITARY NO. CONTROL NO.
M otz ARCHITECT/EIJGINE[R:
w O O BUILDING PERMIT INFO
aBLDG ELECT PLUMB MECH
O,e a L�L _ LJ L_'A
S H i LICENSED CONTRACTOR'S DECLARATION Job DescriP ndnaw�
z_o I hereby affirm that I am licensed under previsions of Chapter 9(commencing "
mtw with Section 7")of Division 3of the Business and Pmfession,Code,and mylicense NEW SINGLE FAMILY HOUSE .
fail force 15f4 �r�
rximroeandeffmL
Lic.g 9002 SQ. FT. LIVING SPACE
m w a License class
O a F Dme GCLol 20
0
S 3 u m ARCHITECTS DECLARATION 9111 SQ. FT. GARAGE. k 1
aj I understand my plans shall he used as public records - 3
i a c,o Licensed tore Irinm BUIL.
Ca OWNER-BUILDER DECLARATION
'—° I hereby affirm That 1 am exempt from the Conuacbr's License Law for Ne
S?a following mason.(Smuon]W L3,Business end Pmfessiom Cade:Any city Or coutny
C G
which requires Permit t construct,alter,improve,demolish or repair any structure
6;m -Poor mu e,also requues Ne Applicant for ucn permit mfile exlgnedam Coenr
— mm na I nKa p ;nue m p vi.' ns rifle Conradms License Law(Chapter 9 S F[ Floor-Area,
x
Ironuner¢ g, thSection]0001 f Division 3 of the Business pal Profgsslonx Code) r .g 7 w,', 1-Y 4 r 1 1, 1,,.t Q,.U`,j.;"�-I $4110vAuation
or that he is exempt therefrom and,e basis for alleged eiemptfoa.Any violation
of Saturn]031.5 by any applicant for a permit subject,e applicant to a civil Penalty
of not marc than five hundred Mullins;($501)) J 6A]p Ib�O i Occupancy Type
❑La owner of the propenyl or my employees with wages as their sole Compeosmfon, i
will do the work,and the,macron,is Out intended or offered for sale(Sec.7011,
Business and Proasmioln Code:The Connor's License Law does not apply to an ].O l - FOUNDAT Mired Inspections'
owner of property Who Wilds or improves memen,and who drex such work himself
or through his own employees.provided that such improvements are not intended or _ ] 02 — PIERS
offered for role.If,however,the Wilding or improvement is sold within one year of
completion,the owner-builder will have the burden of proving Inst he did not build or 10 3 - UFER
On
arts prryoxe crude.), 104 — REBAR _)
.ax owner ro le 1 05 — ANCHOR BOLTS - ... _ ....:. .. .. ....._ .._ .._ .. _
propenr,am exclusivelycontractingwithadc:)Theo om ant's i ':I'..� r•' .�s:•License
the does
n (Sec.]to a,Business and Potany who
Code:)The venMerc is
Licenselawd«xnotapply lanowner cts,wof propertywno)Wilds
seimprovestnto Me ].06 - SEWER & WATER .
and who eonwtx for such projens with a comracmrts7 licensed pursuam to Me UNDERFLOOR" PLUMBING
- 01C.on estop,
p,wdrLicense law, - 202 —
❑Iamexemplamdrse<. ,B&Pefor this
n,axpn 203 — UNDERFLOOR MECHANICAL
O. eD01e ��/N rot 204 — UNDERFLOOR FRAME k�
WORKER'S COMPENSATION DECLARATION 'f,
I hereby affiw under Penaltyof g 2')5 — UNDERFLOOR INSULATION t ��N„Y
pednryogeonneramwin em'aradom' 301 — ROUGH PLUMBING V• O
111 hive and will maintain a Cenifica a of Consent to self-insure far Worlan s
compensation, tmn as provided for by Se37W or the LaWr Code, 1,r ,e ' ' _ 1
TUB & OR SHOWER f�
performance Of Me work for which this permit is issued. 3 0.3 — ROUGH MECHANICAL
01ha and willmom Worker',Cturnpa.4tas si requiredbys«tion 301 — ROUGH ELECTRICAL Q
3]00 of,he Lobo Code f the pert wa ce of inrk f which This Pani,is C
ixxr d My w ie co pe Soh 1unce< Ma Por y nu W arc ,+ 305 FRAME _
_ J
9F ._ HOLDOWNS _
Came CER'TIFlCATION OF EXEMPTION FROMWORKERS (. t ell's f 1, jt I•• s'; .
COMPENSATION INSURANCE,'' ' �' _ U / INSULATIONE - ' `� �
3,_
SHEETROCK _. . . ._.. _ C � \
fTh s r<c inn aeed nm W completed if the permit is for one hundred dollarm I t {
($100)or less.) _ 309 — EXTERIOR LATH -
I certify mat in,e ir6ance of the work for which this. ' 3 TO — INTERIOR' LATH- ,
., r .. d5!f perms Ix issued,l
shall not employ any pe,.a In any manner so as m become subject to the Werieri ? 1.1 — SCRATCH `COAT
Compensation laws of CrEfoolu'Dem' -
Applicant ROOF NAIL
NOTICE TO APPLICANIIf.after makin,his Cemficmc of Exemption,you should ;13 — p
becomesubj«iso,eWorkermCompensationprovisionsofthelaborCode,yen must ;')1 FINAL ELECTRICAL ENERGY
O z0 mrtnwi,<omplywi,such pmvixionmormixPermitxnmlxemmedn,voiea. 1-102 — FINAL PLUMBING ENERG`� .
E^ 14 CONSTRUCTION LENDING AGENCY _' � O 3
oc > he nyafrontat More I$acommuconnlending agency hormeperformance — FINAL MECHANICAL ENERGY
{sl of,e work ror which this.pewit is honed(see.3097,civ.C. t- _
y. q T<nderkName'- " ) 501 . ,-FINAL BUILDING ENERGY
�'Z ""diva AOdrc:'s, - - 505 — FINAL ELECTRICAL;
�I Cwmfy mum i have'real this application and sate that he above information is 50 b — GAS- TEST
[.n, Correa.I agree Iri comply with all city and county ordinances and stem laws relating r_
O CJ to Wilding eonsweeon:andherebyInahoriteorloemtativeaormiacity roenter oprn - �7 - FINAL PLUMBING
>, ria heaWve-.Cmnned,Pm1nyfor irr,nI mpurposes' 3 FINAL MECHANICAL
E., 9. (We)agree to save,indemnify and imp harmless the City of Cti,am,b against -
Z) liabilities.pilgire. ,crisis aM C"O.eawui h mar in any wry aceme against snim9 FINAL G E
V z City in consequence of Me granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON:POINT I�ri fl r N NG
SOURCE REG TI s�• ly�il O Issued byi.. _ Date
Signnmrc of App-h(can 'Mors,mL Duke RE
Re-roofsi,j
HAZARDOUSMATERIALSDISCLOSURE ROOF PLYWOOD TATT.
- : Will Jin applicant or publow Wilding orepentstom haM hirudousmmtew Type of Roof ROOK. BATTENS
as defnW by theC pen Municipal Code Chapter 9.12 iodine in Heal,and Safety
c�Section u532( n ) I I ; •)'rvr,-n�s •y'l,-'e 'ROOF-1N-PROGRESS
All roofs.shall.be.inspected prior.to any roofing material being installed.
- wnm rp'oant rutsyW Wilding eBayAtion use oAlequipment e ices which If a roof is installed without first obtaining an inspection, I'agree to remove
emit hazard taw ant defined by the Bey Ara Alt Quality otyM
Management
new materials for inspection. Applicant understands and will comply with
ar„_ O Yes ON.
D'R�1 all non-point source regulations.
I hive read Me hazardous mmerials mquiremenu miser Chapter 6.95 of to
Califomia Hca',&sefny Code,Seetioms 25505.25533 and 25530.1 u^dersund that
tithe building does not currently have a tenant,Met it or my n,sponsibility to notify Me
m pant.1 the requirements which must Wren prion,Issuance of a Certificate of
e` 0«parey.�:
y / Applicant
of Signature A
g PP Date
uwnma."`nataed agent D.m•„ All roof coverings to be Class "B"or better
OFFICE -
_ e