00090126c1TaUor\ -
CONTRACTOR INFORMATION:
l DIVISION
PERMIT
BUILDING ADDRESS
PERbrf1NO,
INCO00901.2E.
OWNER'SNA470404 MELISS
PETER -
APPLICATION SUB DAIS
rat'PARYNO.
09/20/2000
PHONE: CORRICH GEORGE
BAINT—REE
SANICOv ROLNO,
AIICHI'I'EC'IYENGINEER _
`
BUILDING I'HIt MI'I'INFO
BLDGiLECT 'LUh1H MECH
J -=
LICCNSEDCONTRACfOR'5DECLARADON
Job Description
I herchy nlBrnt Inco I am licensed under provi,iun, of Charter 9l1ummencing
ehSection 701XBnf 111,kam l ofth Easiness ndP (..ions Co,dc, ndmylurc
m allf Icrl�
7—Ya
c �� AI; "
REMODEL KITCHEN
)'n�I
ARCHIL C'I S DI CLARAIION
phi' ,Ns
1 olderNmodul, plan—lollBUIL
/
Licensed I'rofr,iuwl
OW NER-BUILDIiR DECLARATION
I
contractor's Law for the
1 herahy affirm, than 1 con eo:nnpt harm Inc Comracloi a LiAn,
following antero, (Sminn 90.,LA H. a
and Pm(den... Code', Any city
.deo ore
wldmn letno,e, a 1enlnn hI eotn,uttel. neer, ia,nwa. eamol�nn, m repair any sumaoe
alle,
,
pdono I,, is,.; alto reyuirn the n,pl leml I li peon. m file a sig:ted nlmetnan
,he, he i, called ptloaall In he motmon,ofih. Cmnntmcmr', License lyw(cha"ef')
Sy. Ft. Floor Area
Valuation
(commencing with Section 7000) of Division 3 of the Buri ness and Professions Cn1q
I,, that he i, exempt therefrom and the anis for the alleged exemption. Any violation?
APN Number
Occupancy Type
of Section 7031.5 by a,,, applicant for a permit subject Inc oppliconrto a civil penalty
,if out on man face hundred dollar,
a
❑ I, as owner o1'Ihe propcnN or my eanplayees with wages us the it Note mmpensminn,
- t-
G
ReCIUIrCd Inspections
w111 do the ..oaks and the ,ruclar, Is mol intended or infused Ibr sale (Sec. 7044.
Holmes, and Poll ... I.., Code: rhe C.l factor's LianNe Lnw don nal apply to an
awmcr or,o,.Y Who builds or improves memmn. and who does such work hInl,.If
.
or through hi, own employer, provided that such Improvemm�t the our amended ur
FOUNDATION
offend for sale. If, however, the building or improvement is,uld within one year of
101 —
inmpletion, the owner -builder will have the burden of proving that he did not build or
1 02 _
PIERS
mprove for putrywe if Tale.>.
❑ I, a, own. of Inc Polpeny, am esebtively conlraeling with Iwen.ed contractor. ut
1.03 —
UFE R ,
Lm..me Ille pnj.ct (see. 7(44, Bn,im.., I:od P... ,atm. Cm1e,) Il:, enmmcnr,
1.04 —
RE@A R
issom Law consent apply let en owner ob property woo nand, or impnwe, merenm,
and who cnmimcls to, such prnjau with a con......(,) stied I,uestemt to the
105 —
ANCHOR BOLTS
Commerce s Liam- Law.
❑ lata exempt under See. . II R IN C Rollo, reason
10E, —
SEWER & WATER
Owner [)am
202
— UNDERFLOOR PLUMBING
WORKER'S CUMPENSMION DECLSRAHON
203
— UNDERFLOOR MECHANICAL
Ithereby All ml ... d,,Pell:dtynfp.,jl,up,othehmnwingd.elaradnn.:
204
— UNDERFLOOR FRAME
❑ 1 have rad will maintain a ccrdm,m of convent m anf-In... e Int Wookey,
Compensation. a, provided be bySeenon 37W or he Labor Cede, fm the
20S
— UNDERFLOOR INSULATION
performance of the work for which this peril is issued.
30i.
— ROUGH PLUMBING
1 have and will nuimain pe Cumpeace N t eworkf r requited by Satins
cede. to, m me „,ink for which ad, peril i.
302
_
— TUB & OR SHOWER
o,Worker
pfNl ler me L;IMn the rlenimmnama
3
i„loot M o'nmp-n,am,nn nl,ur:mae:, ler m ere
, /%,�Nn f�
303
—ROUGH MECHANICAL
canief�o
A+l'�N`O`r�iaw:MrnoNEROMwoR I:Rs'
304
— ROUGH F_LECTRICAI_
ceRlurl
COMPENSATION INSURANCE
3�0/,5
— FRAME
(Illi: Nation need not be, completed if the peril i, far one hundred dollar
'
4'Fl
_ HOI_DOIJNS
($10X➢ m Ir,.)
Lenny hat in pernmonna of lee„ark ho wlneb nos Permiti, ed:1
.fid
307
— INSULATION
aanel' No as to h..Into "bleel In 'he Workcn;
,elt nal ploy any pc „on ill Irony Im«
tem
308
— SHF_ETROCN
coul'awhm[.aw,"ICalifornia. Lane
Applicant
309
— EXTERIOR LATH
NOTiCETOAPPLICAN”r:H. after making this CenihcaeofEsempdon.you should
the wbnrCode,
LATH
become subject to the Workce%Coopen,aerprovisions ofynamast—
be domed
310
INTERIOR
both„'III comply with such provisions III this peril shall revoked.
— SCRATCH COAT
CONSTRUCTION LEND I NG AGENCY -
311
1 teach, afros had mere i, a consume IIm Iendngagency In, ane ja:Hnnuah,,,
313
— ROOF NAIL_
of the wad lor„hicn Ibis p:mdl I, n,.mcd (,See 3097. Ci¢ C I
Lendc„Name
.
501
— FINAL ELECTRICAL ENERGY
Lender's AJdres
i
502
— FINAL PLUMBING ENERGY
Icenifythat Ihave mad this apprcnionand state that the Noeinrormiuni,
tract, l agree In comply with all city and county mdiwne nces and same laws relining
503
— INAL MECHANICAL ENERGY
to building construction. and henry authnrut, tepte,cnlmives of this CRY to Care, npnn
tint inspection
5
— INAL @I- -DING ENERGY
the almve.mendomd properly parpmw,.
Iwe) ag:ce to Nllve, iodennM1ty amt bre, hamde„ Ito Gly of CaPenmo-papaw
iIlabivae,, rydgmeas, cava, amd e,I lNcs which pray loamy way accfue alainl,t said
05
— INAL L _CTR I CAI_
Cit eonayucnee of 11¢ 6mmi. • of dais permit.
LICA I EST 1. A D WII.RCOMPt.Y WITHALLNON-POINT
Issued by: 50P
— Date
OURCE RE' /
Re -roofs
508
_
_ FINAL MECHANICAL
AI ,���
/4
f unto
.Signature of ApphcnnVtommem
HAZARDOUS NAn IAI.s DIscLosuxE
WiII the appccaot or battle building asCoiam Gore or handle hasardou, mm,nal
Heart Satiny
Type of Roof ' r
509
— FINAL NAL G1R(A(DE
, deed by the Culenino Municipal Code, Chapter 9.12, and the and
alet
Cork. Ocd4Io 25$]21:U^ . O Nn
� �
All sl • II be insZte�
jj �t,��((��
nil being installed.
p F0 iihjrI111W ean,installed.
ri<T1s�/�1n op
Will the applicant or future building occupant use equipment or devices which
roofs p y
rr� t
If'a roof is instal leffi1ii11hout tl_rST VLRI'Ninifl -Id I11itS�RCr10nR1 `g roe to remove
emit hmardnu, air coulaminam, a, defined by the Bay Ana Air Quality N1 ... Scmem
all new materials for inspection. Applicant understands and will comply with
DhuictO Yes ❑Nn
all non -point Source regulations.
I have all Iha Nvarrinu, nuaanial, nquimn¢nly under Chlpncn' 6 9 lel Om
Cullflumn Health N Scly Gde. S.c'mns 25505, 25532 nn 125534, 1 made ca;aid Ilam
if the hu`i�lJ�ingng Ane, nnunrndy Hary mm�anl. that it isntyn.pondbili,Yh) it, the
whit n n,' lee m prior ,, i...once of n Cera In of
Signature of Applicant
Date
All roof coverings to be Class `•B” or better
o„non morned agent Date
roe
OFFICE