01040027CITY
CONTRACTOR INFORMATION:
YILDING DIVISION
VISIONNO PERMIT
BUILDINGADDRESSS
PERMITNO.
L -'r ff�
OWNER'SNAN11?:10675 MINETTE PL.
O,f
APPLICATION SIOLL,tIM0007
W2
PHONE, DAVID & LISA CHAN
V
SANITARYNO. 041097 LOW1
ARCHI'I ECI'A?NGINEER:
BUILDING I'IiRMIT IN['()
'
BLOG ELECT PLUMB MINCH
GI I� I.0 I—I
LICENSED CON'TRACTOR'S DECLARATION
Job Description
I hereby affil arch I red Ilccnwil mlim pmvis;nn.. of Chapmr9 (T:m,I ,erg'YALE
wim Sce'inn 7mXL,,f DIJ of Sol l ore lbnmun and Prolcn'vwnv'Cora undo �Fl�
ani
'
in tall 1'1'.1 1 attract.
Liam¢Clms Lie#
Data ARCHLIECT:SDECLARAI'[ON
G 0 6 2002 ADDITION 366 SQ. FT.
1 understand my plans vadl ne used as public records
r p 5�� GARAGE
UILo31l4�G
(NEW) 515 SQ. FT.
I,iccnscA Pn,fasinnal
OWNI,a ort Bxacalm?R IlE LARXI
no CoatiallN Lmv nom ra
1 l,erehy.(reel met 1 mil...,,tilt m.
,firom
roar, Col,Anye
following reason. (Seaton 1o3IS. Ilasim.s and d.io Code: Any city m mammy
demolish. repair any
permit ro cnn.uttet, tame improve Jemmli
which requires vee
l t fi marnswre
priermslensedalso'. qui res the visions m for tachpanni'n,Gln,c Law smmmem
issuance.
tee' he islicensede)punuannome provisionsloon he Ce Law(Chapter 9
Sy. Ft. Floor Area
Valuation
Bovines ad I'e CWq
(commencing with Ui 3illthe Ialed,,andi
liberat]q«»of
bll, I, All li simian
am mm he iv' 'hammfront alai',, beret for Ill' ",
c'A'aron. Nry
he t
31.5 h ter n perndt subjaa. the upplicnm u, a civil pcnrl'y
of Section 9f1,3I S by :urn
APN Number
Occupancy Type
dreg dont
ornotmma:o,a.evelm.deedden:+r.Is51«».
❑ 1, a, owner of ma prepense ism my amployms sante wagas as metr.ole momslenvtirr.
will do the work, and he structure is not intended or offered for sale (Secs 70o.
Required Inspections
Business and Proles ons Code: The Contractor's License Lnw does not appy to an
owner of property Who builds or Intimates thereon, and who does such work himself
;;rough hi, own oinploi.e,. rmtml.d mat ,u,Ir improt am , air ant imemlw or
37532038.
00
d for ,a, If, ho r, ma budding or Iminse an; I, old within o e yral of
adlcred
mpleinn, fire owner huilder will have the harden of pratla. Ilio he did no' build or
miilrote topmrpo,eolobef.
101 —
FOUNDATION
VL a% om net of the protwoy. am c%clusivdy contracting is illa ficiam-d contractors, In
102 —
PIERS
construct the project (Sec. 70-14. Businams and Professions Cull The Contractor's
License Law docs not appy to an owner of pmpeny who builds or nations thereon.
103 —
UFER
and who contracts lar such project. with a mmmoi.tmt.l licensed ,-ream.' It, he
Cia ,aeo„ 1.i,nua Last.
❑ 1 um c`allallied,, 'c 15 I' C for fiti, rout
'7� S Z Q �D
104 —
105 —
REBAR
ANCHOR BOL TS
Qwm.r fame _'
iiF��ttt S COMPENSATION DI IARA' ION
106 —
SEWER & NATER
I hereby affirm order paomty of parjury one onhe fouowmg deemmtionst
202 —
UNDERFLOOR PLUMBING
❑ 1 hall and will atai.taia a cer'ihea'. or coI,ana d sallar,mm lot Workcr,
203 —
UNDERFLOOR MECHANICAL
Cmnpmt,ation, a, provided lit by Sectmn 3701 of ht. Lrv)m Calm, lar he
performanee al fisc work rot whish his nn„ is issued.
204 —
UNDERFLOOR FRAME
❑ I have and rill nininuinWorlat, Compensation Insurance, as required by Section
205 —
UNDERFLOOR INSULATION
37M of the I.mau CWe, fnethat per mi ance of thework for which this permit i.
issued. My Worker's Coatpea,mioa Insurance career and Policy number arc:
301 --
ROUGH• PLUMBING
Carder Poli.yNo.:
302 —
TUB & OR SHOVER
CHR'I'IIICAT[ON cep E%CMPTION I;ROM WORKERS'
COMrENsrcnON INSURANCE
303 —'
ROUGH MECHANICAL
(This wetion need not he completed if he permit is for one hundred dollars
304 —
ROUGH ELECTRICAL
(s100)m mss.l
305—
FRAME
1 eerily tore in the I+c,f..inance of the walk for which this (alai, Ix is,u d, I
,ban not easpmy any pctsoa in any all wr ,o as ,, brw,oatc subject', the Worse,
306 —
HOLDOWNS
Campemafmn Laws al Candomia. Dane
307—
INSULATION
Applicant
NOTICETOAPI'LICA VI:II, ufmntmking'hin Cenilicam of E.cmptiun, you shaulJ
308 —
SHEETROCK
frecot¢ subject a the Wold. Conic sauon provisions or the Labor CWc, you most
forthwith comply with such pnwidon, or this remain shall oa deemed resmked.
309 —
EXTERIOR LATH'
i CONSTRUCTION LENDING AGENCY
310 —
INTERIOR LATH
encer me perfi,m,;nan
I humhy alfmn mut tame i, m co.lona"inn Iending agcy I
of he wo,e b+r whin his amil i, egad'sec. 31197. ay. C.)
311 —
SCRATCHCOAT
Leader, Name
Lender's Address
313 —ROOF
NAIL
I canify that I hawreaJ,vis application a ad, late that meabove int....mim. is
501 —FINAL
ELECTRICAL ENERGY
.orreca. I agree m comply with all city and county ordinances and state laws mlating
to building conorubion.and ntarebyauthomn r.p... lawavc,of'his city memermpar
502 —
FINAL PLUMBING ENERGY
i he abov..mscononed properly for laspoeion porposc,.
(We)agree,, still. mdctmsify,md keep breech„fire Chyot cup.riao again,l
503 —
FINAL MECHANICAL ENERGY
liabilities, Iudgmems, [.,I, and expense,�!'�'h`h h t i in any way acerae .gains' ,aid
City in tl,.,aduc..e mora k
5144 —FINAL
BUILDING ENERGY
' APPLICANT GUIDERS' ACDs A, a W'll MPLY WITH ALL NONPOIN'T
SOURCE REGUTATIO� - O j//o
Issued b Y'
to
Re-roofs 506 —
GAS TEST
Signature of App aratmeomm. Oat.
R
HAZARDOUS MAITRIA.5 DISCLOSURE
Will he ttppnc.n, or alma tahmagar.imam.... eonhandle baardmt,m.terial
Type of Roof 507 —
FINAL PLUMBING
as all by't'e Cupenim,\1mticipal Castle. Chapter ' 1.) 2. nnd'hc Hcahn and Safety
Code. Section 255320)?
❑res xa
508 —FINAL
All roofti shall be cted
MEC ANICgL
Rr7 ting material being installed.
Walme apphcaut or mmme budding oce.pmll use egmirmcm ordevic,,-hien
boards”, aircontammam, twdedir,d by,he Ra, Arca Air Qudity M am,gmnem
IParoof is install thous
�,
[$ a ion, l agree to remove
Y[ H!V/V
emit
(
all new materials spec
Lo
o❑ I c ds and will comply with
I Di,ricr �,�
on, Pr„
all non-point souwW4guffiti6-nWA
Lv PUBLIC WORKS
1 have read he hmzrdom neserias oaRicenicats under Chapter 6.95 or the
California Health & Safely CWc, lection, 255115.25533 and 25531 1 undeomnd that
ifthe building docs na'cumndy uv amnanL'hm i, i, my re" ibili'y., at fyde
occupant of he reyuircmcnu Ich must be m., prior m i,munee of a Cenilicam of
'
°"° any'Signature
of Applicant
Date
oS 'Ti-
All roof
coverings to be Class "B" or better
o,-nctam amt Ddu a ., d
OFFICE