00120083CITY rERN
G DIVISION PERMIT
CONTRACTOR INFORMATION:
Bt1u.MNCG ADDR I IS].
PERMIT NO.
873 HYDE AV
00120083
OWNER'S NAME:
-
APPLICATION SUB DATE
HONG
12/13/2000
PHONE:
SANITARY NO. CONTROL NO.
IT tltu-' — 2 14
ARCHITEC (ENGINEER:
BUILDING PERMTIINFO
BLDG ELECT PLUMB MBCH
C—
LICENSEDCONTRACTOR'SDECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
Job Description
p
with Scapha 70")or Divvinn J clam Business and Pmfcrsionr Core, and my liv,am
is in (mroae rad 0laxt.
Liecto em„ Lie a
T
ADDITION
I ON -
5
- Ore SDEC A
ARCholl C1" DECLARATION
p
rte+ vv l.�U 4�
E�
5 I understand my plans shall he used as puhlic martdx
AUG 0 6
2001
Lmen.edPminsamtal
_ (JWN[WBUILUBoom the RATION
I herby .(Sect on I am exempt Pram me Cnntmcmr's License Law for the
o Code: Any city mmunty
ollwhich
arson. (Section 70]15, Business andimprove,
1 which requires a u, c ehcn impmve, demolish,
ve, de s
repair any mmmure
BUILDING A
eankh
ams the,
pdore,s issuance,alranotoaslncnpkan,ritfnr Couponer milcav, iLaw(Chstatement
1, Iran 1 fi
'H L
tumanianc,with Sli ammm Na)'If Dilsi.m 3f lamruato.. andnre Lawler Code)
see(ef J of 11 in... erne)
(commeeeis
Sq. Ft. Floor Area
Valuation
or that he is exempt therefrom and e basis e a
the balls for the alleged exemption. Any
Imry.p m ion. Any vi
$ 46952
of Semon 31.5 mq
by any applicant fora pectic suhjms Nc applicam m a civil (nabs
l penalty
than
,,fuel roma than (v,; hundred ..liar' Its(gB.
A PN Number
Occupancy Type
❑I, o—ol, fine progeny.wain wr1r, a' theirsolecnmpnrmion,
37541004.00'
worn,maplorces
will do the work, and Inc suucre is nal intended or offered far .sale (Sec 7(HG,
Required Inspections
Business and Professions Cude: The Contractor's License Law does not apply to an
oamar of pmpny Who builds nr improves @croon. and who does such work himself
or through Ills own employee,. provided that such improvement% are not intended or
101 —
FOUNDATION
offered Ila sale. If, however, the building or improvement is .sold within one year of
ion,
102 —
PIERS
completIna nwnenbuildo will bloc me ballon al Nin Ile did not hulld or
improva nor pto, we or'rile.).
103 —
-
UFER
❑Lmvans, orthe pmpnyum exclusivelydP.IfIingwithadenuhe Cmacmnm,
104 —
REBAR
Cndor)hapr ves tmamr''
oat ow ones
(Sec. 7Wi, Business and Prly who
and �n'h l.aw doe. inn, .ply to on owner mf pmprty woo hour'ror impmve, mto ba
and woo ror 'don (crier' won a nantmmort') hoarser pntaaunl b, dao
105 —
.
ANCHOR BOLTS '
r,LiWas
01 mex mpaunde Sec
O I nm exempt under Sec. , P h I' C for This .salon
1.06 —
SEWER 8• WATER ,
owner Data
202 —
UNDERFLOOR PLUMBING
WORKBRSCOMPENSATION DECILARA11ON
203 —
UNDERFLOOR MECHANICAL '
Ihereby alrnttunderpenaltyofperjurycare ofthe following dcvlarmmdn:
204 —
UNDERFLOOR FRAME
I o 1 have aad will mainam a Certificare or Cooled or c)f-inrtta ror Worker'
205
UNDERFLOOR INSULATION
Compnmtion. as provided for by Section 37N) of Ibe Labor Cale, rar the
_
pRramouraannewi.r
mk for which roe' permit i' .ue 1.
301
ROUGH PLUMBING
❑ I hmrand will national Worker's Compnmlion insurance. as required by Section
302 —
TUB & OR SHOWER
7M of [b
TJW of the Lehr Code, for the perlarataacc of the work lot
perfuourac niance f the whichmourbethis
which this (noir insorte
Workers Compensation er d Palin
303 —
ROUGH MECHANICAL
Carrier Poli, No:
304 -
ROUGH ELECTRICAL
C1iKI1FICAl'ION Oh EXHMPUDN It ROM WORKIiRS'
COMPENSATION INSURANCE
3
`105 —
FRAME -
flTissectionneednotbecomplcmdifinepennitisforonenundreddollan
306 —
HOLDOWNS
1s(kBlole".j -
307 —
INSULATION
I certify that in dm perf annoc of Ne work for which this permit is issued, 1
mull not employ any person in any manner so as to income subject illthe Worker'
308 —
SHEET ROCK
emmpm tmnLwaorclaomm.n°t`
Appbe.m
309 —
EXTERIOR LATH
NUI'ICBTO APPLICANT If, after looking 'his Cenname of Exemption, rar sbuild
become,uhjoo m NC Wnrk ex Compmulion pmvi,ioa, of th. [..h,,, Cube you most
310 —
INTERIOR LATH
forNwidt Comply wldi Inch pooixir r this pemtn.btu be demmd revoked.
311 —
SCRATCH COAT
CONSTRUCT ION LENDING AGENCY
313 —
ROOF NAIL,
1 hereby af(rm Ihm thea is a consmunlon lending agency for the perfnmunce
ofPermit i. " d (sea. 3007q civ. c.)
woNmwhich Ni, ( i
enm4
501 —
FINAL ELECTRICAL ENERGY'
1e
6eni1cr'A`11fe"
502 —
FINAL PLUMBING ENERGY
I certify that l have read this application and sate That the above infvrrndion is
503 —FINAL
MECHANICAL ENERGY
eo„rcllgagree mcomply wiNanaryand county amitivesoand smtemw,eruion
.,mora. of this city m eater upon
,h building construction, andherebyfor
504 —
FINAL BUILDING ENERGY
unnosenmtives
the ahnvcancmionnl property far impminn purpnssw.
i
(we):tsree to,ove, it annals unJ kccphnnnlen' the City of Capetian against
505 —
FINAL ELECTRICRL
liabilities, judgments, cont. t expo es which may in any way necloe against said
City mcnn'q.enecof he s f i, mit.
APPLICANT UNDERY D A ) I . CO '1 ' WITH ALL NON -POINT
GAS TEST
SOURCE REGULATION'
� 12-D�
Issued by: - 7 t.—
IZ Npt DI � IM IN@ate
Slavonic or A,ficamrQnllloaor - Dote
Re -roofs 508 —
FINAL MECHANICAL •,
IIAZARDOUS MAI FR1ALS DISCLOSURE
Will Ne applicammboom Wilding occupant sore or handle hazardous maerial
Type of Roof 509 —
FINAL GRADE '
a,re(nadby11CupnNOMmdapmCode. Chapter 9.12,amltneHealth and Salary
Code, Section 3552(/)'!
510 —
FINAL PLANNING
❑Ya %/I No
All roofs shall be 4511c¢ted-plpl poplgy pL)ft IgteWgjAft installed.
Will theappheam orrum eWildmgmc.pammaegtnpmemordevice,which
emit hamdous air contaminants at defined by the flay Area Air Ooalov Managemem
If a roof is installed without first obtaining r an inspection, I agree to remove
p
District?
nYe, �,�
all new materials for inspection. Applicant understands and will comply with
Y �"
all non -point source regulations.
-
I Imva read the hanminux nwmri:Js resryirenwntx ander Chapmr 6.95 of Ne
li Ili... hd Snrny Crdc, Sections 155115, 2553) and 255JJ.lu"brou'd rum
he tarda I dire 'y here. man .th I it is my renponsihility to notify the
rc
ury n o rhe mens hick man W mH prior ro issuance of r Ca....a of
der
Signature of Applicant Date
All roof coverings to be Class "B" or better
ownccr'Iraumanzeaagent
OFFICE