02080001CI
OF
CONTRACTOR INFORMATION:
BUILDING DIIVISSIIONNOPERMIT
BUILDING ADDRESS:
PERMIT NO.
19161 MURIEL LN
DAVID & LYNDA MIGUEL
02080001
OWNER'S NAME:
APPLICATION SUB DATE
DAVID & LYNDA MIGUEL
19161 MURIEL LN
08/01/2002
0PHONE:
SANITARY NO. CONTROL NO.
00ARCHITECTIENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSEDCONTRA OR' ECLARATION
Job Description
I M1ercby affirm that 1 am licensed u vrdnns orchapler q monrmenning
cathssssppua�����17000).fDrvision3ofthe it and Professions Code, and my license
rrr,na cream.
UPGRADE SERVICE PANEL F'As�LE
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"all3 ARCHITECT'S D[ ATION
1 understand my plans shall be used as bitrecoNs
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Licensed Professional
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DECLARATION
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1 hereby affirm that 11..Barone from rhe Cessions CCs License Law for the
I am exempt form
following mason. (Section 7031.5. Business and Professions Cwle: Any city or county
B%9ING
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which requires a permit to construct, alter, improve, demolish, or repair any stricture
~prior to its issuance, elw textures the applicant for such permit to File a signed wxrtwu
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1 OCy��pa- -
' i'S:• • 3 /J jj�J Jj,®;.. ;[Jv ` ]i "_i i 11
Valuation
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that he ieGarixdpussuant'o❑repgsisiomoftMConvacmisLicerse awfChWor9
fcommgocio w th «tion ]ODtl f Division 7 of the Business std ProfessionsCode)
m that he iiexenipisthemfrom..3 the basis for the alleged cie npti°n. Any violation
of Section 703 k5 by any applicant for a permit eubjems the applicant to a civil penalty
of not more than Five hundred doll. (S51)(0).
304APN � rI ELECTRI
AL``"'I"'°' Occupancy Type
°1. as owner of the Proem, to my employees with wages as their sale compensation,
rol _
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505 - FINAL EL&Qa1It11 S�ection5l'
--will do the wark; and the 'smrcm a isnot' intended ar offered-for In (Sim-70,1,t,
Buiiheis'iod'Prbfeasi°ns Code: The Cammcmr'a License Law does not apply to an
owner of progeny Who builds or improves tremor, and who does such work himself
archon one ded
orthroughfor
his own employhowever.the
-.. .......... __-._.___.....__ ___ ___ ._____._-._-
Wiidcdthatsuchimpmvement
ca,7.r
e one year of
n ;old 'he
-"dlfcaa.i.n. mem
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did
the ower-builder will have the WNcn of proving that he did not Wild or
the riOne6wefilder l have me h of ow
oprovei
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far
improve for purpose of salc.l.
_
° I wner Of,Ne n , am exdusrvel tenet n th 1'censed c°mrem" m
p(SecY gw
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_ll.. , �, N.f l\bU
and
comwci the pmjttt (Sec. Business and Professions Codes The
timmem.
r o'. U! iiLf r r -, 1'3 x4
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wes
License law trace nm apply m an owner of propel who Wild,or Improves thereon,
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who convects forsuch.gojaB.wM.e.comracmrts),Iicenxd.parsuavL[o.Nc...-._
K1t . ct License La
pt nderS -,' .i:'!l'I N .•"B&PCT this mason
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WORKERS COMPENSAT[ DECLARATION
•• Ihereby affirm under prinkyrof peruiy to, of the fallowing declarcum,'
❑ 1 M1dsk'ana'will'maintein' o' CCrOacate'of'C°neent to self-insure for Worker's
Compensatin.. as provided for by Section 37W or the Labs Code: for' 11
- -
perfmonamce ief the wort for which this permit is issued.
-
Cl I have andwitl'iniinam.Wolicrix Com,swcom"Inscrance, as rcqulled by Section
37M of,the IaWr Code, for the performance o1 the' work 'for "which this permit is
iJiu ❑ N My WOMEN Cmir,mcnion loan rdri' < d P cy tier areI `
_ w• •• ��_ •_ �• •w«
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:}9 f. iSsto„� t
CERTIFICATION FEXEMPTION ROM WORKERS
'COMPENSATION INSURANCEic sets sr.
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31
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.... ...
I
Itr ri d"(Thsxnronrieed not bccompleicd if the permit is far one hundred dollars-
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is l`'• .. t,�..'a7. 1.. Il�/
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IcnfythnnJrepeff eofh ortfo hichth pcmut issued,
.. �..-: - --___--____-..-.:-=__-.tor. ": ___
j, t yv if ! T ({'.I ,
not pl y' Y.Pe o �rs a, t tie vu Buhl el t thelWok
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As
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Nall
70ctushoAVT Fite mak�g sCn c¢afE puonyou should
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bca b7tti mth Workcf. C rope sat pro of the LaW Cad y°um n
hh.h 11 be Jtt ❑ led.
f�ompc
ply thu<hpo' n. tib pc t.h
r
t',lil!CONSTRUCTION LENDINGAGENCY
a:;
' ' - ' I hm by c(firin 0a[ Oren is a conswnion IendiriB agency for the performanm'
r''
Of the work for which the emit s ed (Sec 7091' Civ,
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Lender N m ' _ J '�..-.l
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;D
Lend Add t^
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I c tidy. that I have sed the applicat on and sm'e in. the aWve information is
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Fie:
cormctd-,gree to comply with W city and mumy oAinances,nd,sate laws relating
'o Wilding construction, and hereby5mhonze representatives of this city to enter upon
fy
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the above-mentioned p peny f -pec' p p
(W')ayee iota dennfy and Ime, hamdls,x,ilic City 6fCfcmrbagainst
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liabilities,judgments. ' d xpe set which may any ay accrue against said
City n seq ce of rhe gmm hg of ihr 'nott ' '
((]fy
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APPLICANT A\ WILL COMPLY WITH dLL� V'p01]T"'
Issued by: r Dale
SOUR 'REGUCA�•- _"'' ��-!�
Re-roofs
of Anginat I f Date.f
" HAZARD S MATERIALS DISCLOSURE
' i L W II the ppl ca t bef Wilding pot tore of handle hit N m t vl
Type of Roof._ _. .- .___ ._. _ _ ..,.. -...................•............._........
as def ed by the Cupenin0Municpal Cpdc Chapter 9.12,and too HeAm and Seely
•s, f `.i I 1 J r ` roll.J d'i..t
Cheer. Section 255324} 4 r f r f r. l r,( v p
❑Y= !"' t �'°'_ - •
k^
S t s .� x' r 4.s a. it t.` ";
Allrod prior to-any roofing material being installed.-„
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W 11thpplam f t build mI,Occup tit q t ' device which
emtM1 ardouContaminantso-def ed by thea A A Qal'y Mnnagem
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If a roof is msialled'without first obtaining art inspection; I agree to'lremove
o
for inspection Applicant understands and will comply with
Diann L.
all new materials - _ __ _
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,t
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-
all-non-point source regulations' f- I ,�1, 1,
Il have mad d',Ne h , .'oue t I. 6 95 of the
and 25574. I unaenunt Net
505.2 533 and 255 4. 1 un
y 25505:
ColifumidHcalih & Safe' Code: Sectionsn
if the Wildin a mcanemly have etenanethat tits my r<sponsibilitYmnotifY,the
t it is
th
Can pant f ,equineIt hi h must W t p o 'o iaswn t Cimficam of
y ��
I.O�g
i natureofApplicant. .
'w
-cfS
_Date
_.__.._
All roof coverings to be Class B" or better
steam ag e t I; „Dat=,•
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OFFICE