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3155 ^' CITY OF CUPEIM110 I11SPECTIOL' RECORD (Office Copy) 315-5- ze PCPMT N0. SANITARY DISI. NO. LOT No. ADDRESS —TMA RazZ�+2r PROJECT OWNER JOB SITE P11014E NO. PERMIT ISSUED Date ELECTRICAL Ruildi_np, / -y3 Date Insp. 1:1e_ctrical Power Pole_ 1,Lumbinr -- — ---- Undcr licchanical, Rough Wiring 'Temp. (ins/1?lcct. Ila U.s _-- Solar Cciling Fire S rinkler Fixtures int/Ext _ Sign Hotors Grounding Hisc. Temp. Power _ FINAL. IUSPECTIONS Not Approved _ Date Insp. r'`s PLUMBING Electric Date Lnsp. 1'Limbin . Backflow !1echanical Underground Solar Underfloor Pool Partial. Rough �y Gradin , Rough Complete I'Lanning, Solar Rough Fire Dept. Water & Insulation Health Dept. "fain Drain Building R/of/S Drain _ Otlier Gas _ Other BUILDING Not Approved Date Insp. Pad Certification 11ECNANICAL Foundation Date Insp. Pre-GUnite Underfloor S.M. Slab-Hembrane Ducts & Insulation Bond Beam Fire Dampers _ Underfloor Girders Fireplace Floor Steel Grease Duct & hood Tiedowns One (lour Shaft Di_aphrams Condensate Drain Seismic Bracing Equipment Anchorage Ual.Ls-Panels Flues & Comb. Air Frame 2-/7-93 Other Lath d Not Approved Uallboards Int/Ext . Firewalls Other )Not Approved APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY P oIBU I LDING PROJECT I DENTIFICATI ON PERMIT u XaVILDING APPLICATION & PERMIT I [5 ADDRESS 110130 930 5-t ra •T _ 15 5 7' fIcYY` ��/Jn�l/ BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S -- _ - - _ PLAN CHECK VALIDATION NAME u. o (fr� /^j'n QTY. ELECTRIC PERMIT FEE �DiT AJ „ CITY. CONTR CTOR'S _ NAME (/.�F� -Iq UTLETS-SWITCHES-RECEP 5.00/1.00 �'i urN LIC.NO. �O�Y LIGHTING FIXTURES 5.00/1.00 -CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 AOo Ess C r PANELS ° 5.00 - DATE OF APPLICATION ARCn ITECT SIGNS ' ' - - 6.00 PLAN CHECK FEE C.NO. OR ENGINEER " uc.No. SIGNS TRANS. 3.00 ARCHEOR ENG. SPECIAL CIRCUIT - -5.00 PERMIT VALIDATION SS ZIP ITEMP.METER'OR POLE INS. 15.00 ' aPP eEssTs �. MOTORS SEE FEE SCH, SERVICE CHANGE _ 10.00 Woo LICENSED CONTRACTORS DECLARATIONF. C r� 0 rt u u I hereby affirm that I am licensed under provisions of Chapter 9 1 LIPS N ur (commencing with Section 70001 of Division 3 of the Business and ¢z n BLDG. ELECT. PLG. MECH. O z Professions Code,a my license is in full force an 1. ❑ z O'$, - License Isss r 'Lie.Number ��[(-- p« _ - ©C� a, H Date CL of mctor_Tg11? R I, We a m f -a - - - t BUILDING PERMIT ¢ ¢ a OWNER-BUILDI7R DECLARATION , o is ° MISC.- REFER TO ORD INFORMATION E: ; LL N 1 hereby alfrm that I am exempt from the Contractor's License VALUATION S/FT. H LL O a Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 6.00 Code:Any ci y or counly which requires a permitlo eonstruet,alter. a � ELEO.CONTR. - LIC.NO. a M ¢ 0 improve,demolish,or repair any structure,prior to i6 ivuance,also ELEC. / - - d y o¢ -requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO w m he is licensed pursuant to the provisions of the Contructor's License p S. HZ> Law(Ch opler9(commencing w i l It Sect inn 7000)o f D iv is it)it 3 o lt he Rr'>'9y/t,„ Rue; 4 o Business and Professions Code)or IIfat he is exempt therefrom and QTY. PLUMBING PERMIT FEE v W H $ the basis for the alleged ex cm pt for.Any violation of Sect ion 7031.5 1 STORIES TYPE CONSTR. i ; - by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN& VENT-WATER (EA.) 4.00 of not mare than five hundred dollars(S500L): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 2.00 OCC.GROUP RES.UNITS their sole compensation,will Jo the work,and the structure is not - intended or offered far sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CONIC. 4.00 Code:The Contractor's License I.uw does riot apply to an owner of property who builds Or improves thereon,and who docs such work _ FIXTURES-PER TRAP 4.80 S0.FT.FLOOR AREA TOTALACREAGE himself re through his own employees,provided however. such Improve- mentsareno,inlendis or employee sale.provided that suh,building GAS-EA.SVSTEM-11NC.40UTLETS 4.00 'or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA.) 100 BUILDING USE builder will have the burden of proving th . . at he did not build or im- . RES IND CON PR Omer . prove for purpose of sale.). INDUSTRIAL WASTE INTER. 2000 ❑ I,as owner of the property,um exclusively contracting with ❑ ❑ ❑ ❑ . ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of Property who builds or improves thurcon.and who 0'� RS-OVER 5(EA.I 1.00 contracts for such projects with n contractor(s)licensed purstant to ' the Contractor's license Law. Y-STORM EA.200ft/8.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,L&P.C.for this W/VENT 4.00reason Dale Owner .4.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION G EQUIP, 4.00 - .. I hereby urinal that I have it certificate of consent Io sclGinsure, ZONINO ENG.SITE NO. or a.certhicate of Workers'Compensation Insurance,or a certified copy thereof(See.3800,Lab.C.l. -7 lP)t• Policy No. Company ❑ Ccrti Gcd copy is hereh'(umishcd. FIRE SPRINK ENERGY T44 Z Z k CertifiEJ will the c�tY inspenimt division. - Applicunt MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑ ~ rn PERMIT ISSUANCE 6.00 �'- CERT P I: I: IN FROM WORKERS' FLOOD ZONE A.L.U.C. W _ M1IPF.NSATIOM1'INSURANCE; PLG:CONTR. LIC.NO. PLG; Y.❑ N❑ Y C] N❑ CL (This section recd,not be completed If the permit is for one TOTAL Z hundreddollars IS 100)or less.) 'V O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shill not employ any person in any manners.us to U become subject to the Workeri Compensation Laws of California. ELI Dare Applicant '- ALTER OR ADD TO MECH. 4.00 BUILDING 3` a } N NOTICE '1'0 APPLICANT: If,after making this Certificate of Ex- F.Z emption,you should become subject to the Workers Compensation APPLIANCE ' 4.00 PLAN CHECK - provisions of lire Labor Core, YOU runt forthwith courtly withFEE CJ such provisions or this Permit shall he dccmcd revoked,' AIR HANDLING UNIT(TO 10=C.F.M.) -3.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0)000QF.M.) 5.00 SEISMIC FEE ,fa I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 2.00 the performance of the work for which this permit is issuer(Sec. MICROFILM 3097,Civ C.). HEATING UNIT(TO 100,000 B.T.U.) 4.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)7.50 Lender's Address ' ELECTRIC , - I certify that I have read this application and sv:to that flat above VENTILATION FAN (SINGLE) 3.00 ablarnatlon is correct,I agree to comply with all city and county PLUMBING vdinancrs and state laws relating to building ConSIRIClion, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 4.00 1ereby authorise representatives of this city to enter upon the BOILER-COMP (over 100,000 BTU)SEE FEE SCH. MECHANICAL ebovc-mentioned property sin •,tion purposes. (We) greet sav n emn fy nJ keep Imrmless rhe City'of MISC.- REFER TO ORD. Caper ra I 'a "i ,jud 1s, costs and exp, ses which PERMIT ISSUANCE .3.00 CONST.TAX may n I iWt S' I City in cons of Luce I 'tile Stan rig, n -,S MECH.CONT' a�. LIC.NO. MECH. ' 7(/I/�Yw f' T TOTAL Sign to, A lican ntracka are Lif ' OFFICECOPY