00110002 CrrY or culamrINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING A[)DRELSS: PERMIT NO.
WATER QUALITY PLUMBING 001. 1.0OV12
OWNER'S NAME: APPLICATION still DATE:
111, 1 Prr MR 1860 LMADEN RD 11./01/2000
ONIi: SANITARY NO. CON'IROL NO,
p z i ARCIRTEMIENGINEER; BUILDING PERMI IINFO
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w BLIH'i ELECT PLUMB MUCH
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F-�� LICENSIiDCON'rRACI'f IR's DECLARATIONJob Descrl tion
4 1 hneby uui in that I am liaised under provisions of Chapter q m
(comencing P
yWilli Section nlllnc HpsyC1`rufecJun,Q�anJ my license
is infail tnrtt d /�•Sr/ / REPIPE
O n O Date contaemr
ARCHarcr SD1iCLARA'I'[ON
I Wndaxand my pont,malt be uwd.x public ro„td,
�'—
w ce�
Licensed Rafmiowl
c d Oat I too 1,u,noluE,,a,DECLARATION
o,wou
= I heresy.(lieu;nm 11. esusir from m,Cnmmemr'n Any c ty o lin the .
C 2¢ %hichfollowing rtlua(Sectionu"ne1.5, ,aitKs aM rve,d rnoli Cute:Any city or county
e p which ran issu a pct..m .i...p6 ahcv in,prvve,1, orn l ,or repair s6 amaum
�3^ thiurmhx i,au;mcc urweint,e fla, now
wchractor License
Law xtmancm
that hreew,Wrlpursuannnmep fDivisinf m,the Contractors ad Pr Lawln',Co Y Sq. Ft. Floor Area Valuation
(u tell he ing with Suction]INp)of Division J tree Business end 14nfAn, ')Cale)
or Sec he is exempt any ap m and bun nnsiv Ibt the Os the umnpnt to Any l Penalty or as Section ran S iv any dreg doll r,a permit\.Bias,the applicant In a aVR penalty
urnm m')rc man fisc hundred dollar,(.es)s APN Number Occupancy Type
01,as ow net of mo property,or my employees Willi wages as their vole comlwevation, �cir
will Jo the work,and the.noncom is not intended or offered for sale(Sec.7(w. — - '- ——'
nus and Pulex ns code:'rne C')ttr�
rt')"x eahw I.W.ma.,nu,apply ,,lie ,Required Inspections
uIp pert Who h IJ p ,oes,h d IoJ h khimwlf
owner
through his ')ply, punished that sh unproverricas am notinlmled to 106 — SEWER R WATER
tale four sale,II huoveter.the holding p t is sold llo year of
completion. n -1 Id will n c mend fp i,gthe,lie didno(build(It 202 — UNDERFLOOR PLUMI3TN0 up...c
tr puryme of sak.l.
❑1.-nWncrof lie cu,wnx;nte,au,6ely a.umacfin,will,licensed eonptuas to 301 — ROUGH PLUMBING
construct the project(Sec.7(144.Business and Protsswn.,node:)The Contractor. 3102 — TUB R. OR SHOWER
License Law docs not apply to an owner of property Who build,or impmvc,mere').,
m1 who ,tract,roe Well nolee„Wim .r aua,bu,) Beamed pm.uant,s,the 502 -- FINAL PLUMBING ENERGY
ctntmame,Licenw Law.
O la in emmpl under See .B So PC for this moron 506 — GAS TEST
Owner C. Date 507 — FINAL PLUMBING
W'ORKER'S COMPENSATION IM CLARAf10N '
1 heaby vffinn under penalty of perjury nnc of,he following declamations:
have and will muimvio a Cenilinne of Consent m self-Inxnre for Worker's / r�
Compensation, as provide) For by Serino 1701 of the I.uln,r Cote, for ,he A%-�J`
,d....cc older work for which this pennon is issued
❑1 have and will mnotion Worker's Coun,olvation Imurance,as required by Sccllan ///
3700 of,hc Labor Code,fur the performance of the Work for which tis permit is
Issued.MyW eke t Congwn,1 Inwmnev courier
,at PPull'oyy�ourrrrhher Ire:
Calricr._�,r 'IjICAnON oFl%FIMI'TION 'T WORKIiR.'
COMPENSATION INSURANCE O
(Thi, roion need DWI M aonnplacd if the permit is hn one hundred dollars
61W)wI„x.s -
1 certify char in the perfonnuncc of the work lot Which Ihi,penton isWed.1
weal n I employ any pmsun in any innnna'su avn
ax u,be .uh'lelt no,h,Workers'
C...e,nnminn Laws of California.[)am
Applicant
NOI'IC17 1'0 APPLICANT'It,:dmf making his Ccrtificam of Cxcrnptinn.You should
hectare wbjcm to the Worker',Coupennuioripros,i m,of me Luhm Code,r..oma
O O forth vim cmnply with such provisions Irani,veteran%hall Is,deemed mocked.
F fin CONST RUCTION LENDING AGENCY
1 hereby tuirm that there is a consnuaiun leading agency for,he performance
of thew')m for which this permit is swed(Sec.11197,Civ.C.)
L Q Lender's Name
7 Lender's Addles,
U O 1 cenili that I have read ani,xpplinnion and state Ilut the above intonation In
correct I lint,to comply with.11 rily and cc utny ordin cul and state laws rolling
O U Inbuildin......ruclion,and h...by aaborire representatives of this city to enter upon
ry me ubovmmcn,toncd pmpa,y mar mq,ccbon pmpnsux. -
L (N'd agree m:v,inJnnnify and AaphurndcaslM CilY of Cupcninn agoing
IinM1iliticx,ludg�nem. nsu otJ,�y�.Rfifiich may in any way acerae against wid
U AIPPI,ICA r c raDS ND WILL COM DISCLOSURE\LTH .
yIn c')nnc is 1nnc, Pmmil -
S ❑ ALLNONPOINT Issued by: (� `'� Date
ami c Date Re-roofs
t I LA7ARIIOUS MATERIAL
Will he arprean ur mwr,hdldhhgowcup:mt.qom or handle ha.:noes material Type of Roof
as defined by one Ctq,emm,Muni,ipA' e.Chapter 9.12,and one Health and Safety .
Calc,Section 2 5J2wr
C vex All roofs shall be inspected prior to any roofing material being installed.
Will the applicant nr ramal nal ng oeopat use eceipmenlnr d,vim,which If a roof is installed without first obtaining an inspection, I agree to remove
�nil hiocoon,:or uimuminanu a,d nen by the nay Area Air Quality blunagen,an,
I„rica all new materials for inspection. Applicant understands and will comply with
°}'45 VIi all non-point source regulations.
I hove read the hovardoes mamrinas requlmmtnns under Chapmr 6,95 Wi the
calif...ia Heahhk.' eyCwc.Sections255115.255}Janrst
J 3514.1 undeandnhal
if hebulldinget of urenty have a tenant.man it is ely responsibility it)notify the
n
uped t q hale,wl int amt be mc,Prior m ieol or;,Cenlfirn,e of '
He Signature of Applicant Date
d I All roof coverings to be Class"B” or better
OFFICE