00120026 ' CITY OF GUYF:R'PINO' -' -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: �, PERMIT NO, - s
-•0012@026
OWNER'S NAME: APPLICATION SUB DATE
x12/05/2000
PHONE: .•. SANITARY NO. -'- CONI Ro 1,NO. -
rc t ARCNITECTIF.NGINF.ER: -- BUILDING PERMIT INFO
MI;�FC}
-
C,aG
P CqW7 LICENSED CONTRACTnOR S DECLARATION -
Job DescriptionIOno I byfrmm l mrs lica,med prowimum,
fChapte 9lammwn
in Seelion 7001T.li mTarbes,and I f -i Cd uJ Pay because
is inbull fine,and effect.
ADDITION T I ON '1 4, 'REMODEL, 250 S0:'F'f
.�ea lie �e spas. '-1 a -
o m u Dut C mhactor -
ne
3 a.Ne ABLE]'I'FCI"S DECLARATION
J I mkhrwrduo,d,m,,hatlI n uwd os pubo records
�r
E5 Li"Poat I'mI I-
Oat I ca ❑mna,tI:fr DECLARATION
I herehy amrm that I am c pt from be GRATION.License Lex for the
I_'tQ following reason.ISeadmi 70315,Business,and Professions Code Any city or county. /
f mwhich requires a permit to emsra
u ,alter,imvedem
pro , lish.or repair only sure
se prior us.its issuance,shoo requires the applicum lis such pem,ino fil...igned nmement '
mat heklicensed purmammthe Pon ionsothe CentmcnrolLicant,Law(Chapter 9 Sq:Ft. Floor Area Valuation
(.....tracing with Saarion TYW of Division 3 ofine Busineand 11 f..into Cale)or
,
or taut he is esempr hambone and the Mohs for ss the alleged exemption,Any violation r Il
,if
of Semon 7031,5 by ary anflhcnnt hu rst opimtjects rho nppllennt to a civil penally
m a,,,none Into five handmd dawn.D'"(f, APN Number , Occupancy Type
01,its owner of the propery,or my engloynes,with wages as their sole compensation,
will do the work,and the,manse i5 not intended or offered On wsone.c.70W :;5P, f' s
Bminess and Professors Gde:The Cmnrab,,'a License Law dots not apply to om . I Required Inspections
caner of pmperY Whn builds nr improves menton,and w@i docs such work himself _
or through his own employees.provided that such imp mnamena ore not intended or 101 — FOUNDATION.
offered for wit,.IL howerer.the to.1 improvement is sold within ane year of - '
nnplerinn,the owner-builder will have the burden of proving that he did not Wild or 1.020 — PIERS-
, proveI purpow'doule.). , ,.
' 1.03 — UFER elr ,r I g tI I t. torxn}iare I (s 7(wu B : Pont Pf c t ) n cunnen. 101REBAR
Ld,
adnLwawamtapply rmawrt, rproperywhonam tr ,lrve.meem. ' 1.05 — ANCHOR
Rwho convicts for such r,ts with it emmrmrev licensed Fanunt m me BOLTS
Cortnocorx LicemeLaw -
-
-
, ,
❑1arnex rept and see .i1&PC lhr this..,on , 106 — SEWER. 8' WATER "
owns• _ iam 8 13 O f 202 — UNDERFLOOR PLUMBING
W KER'S.C( I'ENSA'fIONDECLARATION 203 — UNDERFLOOR-MECHANICAL '
Ihereby alrmrunder penallyolfkajmyorenthe forlworgdeelaatinma: 204 — UNDERFLOOR FRAME ' "
''❑ I base and will in urnian n Ceriniearc of Consent to sel6m insufor Worker',
Cort ipmnullon, a procured for by Section 37M of the Luton.Code, for the 205 — UNDERFLOOR INSULATION
pednpnuance arms.work on which his pemeh is issued, }• :',t ,y01' , ROUGH',PLUMBING-
D ane and.01nnlnmhtworker,CminerwtiorInmrnne,a.rnyw,edbySection 0:1 ._ TUB 8' OR SHOWER
Tint)rt the Lancer Gale,for the performance of the work for which this pemnitis 310112 - '
issued.My Workers Compeer.aeon I nsurance carrier and Policy number am;
303 — ROUGH MECHANICAL
cirri"' 04 Policy o — ROUGH ELECTRICAL
CERTIFICATION OF EXEMPTION Poli : FROM WORKERS' 3.4
COMPENSATION INSURANCE 305 — FRAME
frnis.,Iinn need Bar 1e nundned it'he permO[it is for one hundred dollars •, 306 — H FRAME
1511X11 nr mreJ
1 cenify that in the peerntnttna of me work for which this.poetan,is issued,1 - - ._ 307 — -INSULATION
1 , shall t- PI Y Y P Y n - w hecntna a Meet to tic Walker,' .._ `
AlalCarfnrn.Dom308 SHEETROCI
PI"ice""' - - '-309- — EXTERIOR LATH iL
NOUCETO APPLICANT:it,mwiniaking oris CeniBcum o[Eameyninn,you should 't
ZRonnehn1htO..rhetheLmorCduyammo,' 3.1.0 — INTER•IORLATH
ZC forthwlrh c.noply with such p...swore,or this man shall he denied mvoleJ.
Efin CONSTRUCTION LENDING AGENCY 311 —
SCRATCH COAT .
I herehy ommn incidence is r coram[lion lending agency for the perumbunm' 313 — ROOF NAIL -
�' oft he work for which this permit is mind(See.3097.Cie C.) '
a c I<nJersNat.a 501 — FINAL• ELECTRICAL ENERGY
Lrmkr',Address
�.0 mrrnearint. readthi.a,;plieramearJarmanmttpp nneeirr<r,ntrimei. 111502 — FINAL'.RLUMBING ENERGY -
w i~ onW.lagree toounidywill,all cityinto County ordumaceaandsumlaws relrtthg 503 — FINAL MECHANICAL:ENERGY
U in buildingeonsrnmiun.and hereby uurhorike repmsenmtivesofthis city fnonler upon
y W me alave.tnenbonedproperryin uspaedonprrpow,. 504 - FINAL BUILDING ENERGY
1, . (Wo)agree to save,indemnity and keep harmless the City of Gtpoino against — ,
rA liabilitim,judgments,ensrs and expenses which may in any way sccom against said 505 'F I NAL .ELECTR I CAL _ '
t.7Z City incan,equeneeofinegnntingnl this peon .
APPLICANT ON ND IS C(�IPLY W� ITH A,L�L QNROINT 506 — GAS" TEST Z ( 3•-
SOU C, oN.,_ Ts �13 O� Issued by: It Date
signateere nrnt nets P.6c Re-roofs
. HAcaauoui MnrElalA_ Dlscu>suRL - 908 "— FINAL MECHANICAL '" +
'wume PTI... t union,sodding o,,oustn,mm or Panic h ndmedal 'Dope,of Roof 509. FINAL GRADE ,, r
N linouldby Im Cpn M ll Ode Chptcr,9.12an,[ fIleell1i and Salery
C It,Seat....25532(a)? lilt
0Y C1 No- All roofs shall be tr�s113ri
Veted MP[myPrIK ph lhS ','�.',1[Clllal being installed.
worm apnl-am ft build'ngnccuwma=eewb t J :wncn If a roof is.installe� ffhout IIFrohl8F&nRV&irkpeditQRVArce to remove
4,1 emir bawodous an conummums as del by the Bay Am Air Qa.d ty Mangemenr
District? all new materials for inspection. Applicant understands and will comply with
CI Yo, 0No. all non-point source regulatioris.
1 hove read the miardohs materials requirements under Chapter 6.95 of the `
Culilornio health&Safety Code.Seniors 2.5305,25533 and 25534.1 understand that
if the building does nor ot.m nay hove a mman6 mar it my re,p unihiln"n,mtily the ,
PCI.Isarl or h quarenuol: tuusl h rte... e f� Cam cat f .. •r a .. -
Oe CD Signature of Applicant Date
„ r, 10 All iogf coverings to be Class4"B"or better,
n.nmonzcd'gent nu• g
OFFICE,.