02030036 (2) CITYBUILDING DPERTONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10432 NOEL AV 02030036
OWNER'S NAME: APPLICATION SUB DATE
STAHARA STEPHEN S AND JACQUE I 03/11/2002
Il rHONE: SANITARYNO. CONTROL NO.
9 Q ZO ARCHITECVENGINEER: BUILDING PERMIT INFO
kC W BLDG ELECT PLUMB MECH
ai� U CJ
t ms.
i LICENSED CONTRACTOR'S DECLARATION Job Description
i Z L G 1 hereby affirm thio I am licensed under provisions of Chapter 9 taommencing
withScction]1gglufDrvisinn3oftheBusinessandProfcx,iansCnde.andmyliccnu REPLACE BATHRM CABINET/TILE SHOWER.
in full I'nr nJ effect
m�6 a Licen.e.� Lic^E��
a Dad Co v
G �[ ARCHITECT'S D LARATIO
O g I urW mm�J mY plans shall h used as public raonls F I N Al+Vp E
r
I n p O LittnseJ Professional
Dad I on aUILDErom he RATION APR
1 hereby offint thio I rot nctnpt from he Gmbas Coo License Law for the 17
r100e1
C Z 0 whcfollowing nnc,. (Section]oil 5,Bunions and improve.
de oli Codi,:Any city amutim / L L
E o which requiterae.als.os eunshuehalter,improve,demolish,ore.,iranyurvand $4000
primtoits licimma purosotequires thovisioso for mehpcmit mBleasLw(Chapter 9 Valuation
- -(commencing
co he is cing wit pursuim to the provisions Divisi of the he Busmri License law(Chapter cad) $p, j, {O ��I Ik�/� Valna[IQn
Rthathe ingwith thomi'7B(Iandthe basisor thealegedamniptirofeaxy vi lade) li (3ZfD /.�J��S1tla�D�1Y Vl':'„
or that tis ii rumps thererrom and the basis for the alleged nunpuDn.Any violation
of Section 7031.5 by any applicant for a permit aubjats the applicant o a civil Penalty
of..,namethan five hundred and..($500). 10:. PN lv '"DATION " Occupancy Type
❑1.as owner f,ha proven, cmy cmployec,with wages as theirmle compensation,
will do the wmk:'and the annotate is not intended co mffrred too'sale'(Sea:71114:'
Busines,s and Professions Code:The Contractor's Liccnsc Low does not apply to an 103 - UFER Required Inspections
..at of property Who Wilds or improves thereon,and who Joe,such work himself 1 Q 4 RE BAR
or througgh his own employees.provided that such improvements are not intended or -
-ffeied ION salt If,how thethudding or im e t n sold within one f - - -- ' - -_.__... _ -_.__. _
°fOVr "`" 105 - ANCHOR BOLTS
'�dinpletinn,the owner.nmdaer will have me barren or prnv ng that he da not ba la or
improv`for parp".seatsole.), 106 - SEWER & WATER
_.. _ ... -
• 177asowner+dthe pmpenyamncluuvdycontracting with licensed contractors t° 202 - UNDERFLOOR PLUMBING -'' "i '
uconstruct the Project(Sm.70,W.Business and Prokssiona Code:)Thi,Contractor's ,
ansetawdoesnotapplytoanownerofpropertywhobuildsorimprovnthemon. 203 - UNDERFLOOR MECHANICAL '
and who controcts.ror such projects.;m a coronations)licensed Pontoons to the _ _. _..._.2 04 - UNDERFLOOR- FRAME---_,,.. -- _....._...... . __.. _.._.
Contractors License Law.
i. ❑lam exempt under Scc. '.B&,PCfonhis reason 205 — UNDERFLOOR' INSULATION
owner Data " L I I301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
302 — TUB & OR SHOWER
Ihetrbra(rrmund.arpenayyo(pmpdy,oncofdmfollowing deslamtions: 303 — ROUGH MECHANICAL
' n%,i sad will maintain a Cenircate'of Consent to self-inxam for worker, ROUGH ELECTRICAL
compen,ation, as providad to, by section 3]00 or me Labor Cade, fm the 304 -
perfom,vrce afore work fm whim this pam�n.i,issued., 305 - FRAME
-' 0 have and will maraud WorkersCompensatiohlnlurame,asrequired by5atlon 306 - HOLDOWNS
ro r be ISW'Case war'.n performance of me work r which m pemtn is 3 0 7 - INSULATION
issued.My Worker's Co pensit on Inxumrme c mer end Pol y robes ere _
308 , = ,'SHEETROCK':,
Pa I
CDRTIFICATIONO4ONFROMWORKERS 309 ' —f iEXTERIOR •LATH'
COMPEN ATION INSURANCE _
310-:—--'.INTERIOR- LATH. _ _ . ....-.
ITh s set on need nm be C npleted if the permit is for one hundred Jollats
ullw)a�le,s.) 311 - SCRATCH COAT
p. rams anmany ', ..,313 ROOF NAIL,:. . .. . .,. -_ .,.. _..
1 Genf,that in the perfontiance.(me work fan which this permit is honed.I J
,hall not emb manner vwag ro heeome subject to the Woekees 501 — FINAL ELECTRI CAlii'ENERGY
Compo maid
" C of California,Gone
Applicant - " 50'2 - -FINALPLUMBING- 'ENERGY" - - - - --'
NOTICE 90APILICANT If ufi klgm Cnlct fL rapt op-y uxhould.
z n
becomesubjecatheWorkersCompensation provisions of the IaWrCode.you must 503 — FINAL MECHANICAL ENERGY
z O (anhwimtompywith such provixmn,armi,peema,naBbeeeemedrcvoked. . . .5.04 .-- FINAL- BUILDING ENERGY .
^ . . .
�- " ',CONSTRUCrIONLENDINGAGENCY'- - 505 - FINAL ELECTRICAL
E' 1 hereby u0'mt that them construction 1 d ng agency fortheI".once -'
w � ofthe mkfar ishi,lithis parim, Cis.C.) 506. GAS_TEST
.issued 309
Z),z Lead Ada,.,: 507 — FINAL PLUMBING. . .,
U O Icamy that l has read this application and some that me above indartaiun is 508 — FINAL MECHANICAL
cmareciI agree to comply with all city and county,Ordinances and state laws reining 50 9 - FINAL GRADE
O V to building constriction:and hemby authonai,repreunutives or this city to enter upon /
ItheaWve-mentiogea,propsnyforinspectionpurpo,n.. 510 — FINAL PLANNING
.y (We)agmat save indemnify a ad keep harmless the 191 fcopenino against -
n
liabilities.judgments.t .t d expense, h'h,may.in y t a against said 514 FINAL PU IC WORKS
V.Z Gtr yuc : rte gm this arm pdmY .:
- rPLpPPLICANTU STANDS AND WI THALL NON POINT
IC 4 r �� Issued by: Dale
naureof Appldm.a1Cmd a Re-roofs
HAZARDOUS MATERIALS
WII theapplicant fire building
DISCLOSURE
g ap st
, ore«handle hazwom.,am.] Type of Roof .. .. -•-- .
as d f d by'heCupen Mu c p Cod Ch is 9.12,a d th Health and Safety
Cod Set 255320) til �.'.. Jt-} ,e - h 1 ' I '. 1 .
El Y., ' All roofs shall be inspected.prior[o any,roofing,ma[erlal being.installed. . . _
1, Will the ppli,sonorramremild agOccupant use equipment "'ams
If a roof is installed-without first obtaining an inspection,I agree [o remove
ma hazy don n ict as d f W twine Bay Arc A Quality Management
Di,ma all new materials for inspection. Applicant_understands,and will comply with.
r({ ' p?'' all'nbn=point source regulations.
R../ t o 1 have ,ad the hive.ads mamnaL rcyu r bots under Chapter 6.95 o1 the h,
Calf H'lib&S'f tY Code S tions 5505-255N d 25534.I and .land that
if theb Id ,doe oto cmlyhuh,
ate tlht r� yocp bltyt nrufythe ... - .. .. .... - - ..
iz p nt f oh rc o t h' an w meth its,a f iiC hcme of
mSignature of Applicant Date
—TA rK or mannai, a .. - 3 . . All roof coverings to be Class "B" or better
.. .....OFFICE.. __..._ .-.. ._. . . ..__. . .. ....... ..