01020078 PERTI
it
cr TYOFGUIVISIONNO + ' CONTRACTOR�INFORMATION:
PERMIT
BILI LDING ADDRESS: PERMIT NO. ,
OWNER'S NAME:'-' APPLICATION SUIT DATE
• I11I11NI7, AK_ BILTMORE RPART-MENq SANITARY NO. CONTROL NO.
is
(Amp) A77-1i
O 1p ARCIII rEC1'IENGINEER: - 1 t1111.U1Nfi PIiRMi'IINFO
w ... BLDG •, HLECr PLUMB MECH
LICdad
Z w fire SBD CONTRALunder DF,Cn,of CION ,Ppb DCSCllptlpn -
O u,_G 1 herehy 0y elf thm 1 am of he li silk p oil revision,of Chapmr 9 rani,license
ice se
F:t_w with butfincekMnofect,1nnJnfthe BusinessunJ Pm&ssions CoJe.anJmylievnse
ay5 ' int llf JBn
ate.
tCI '1 c p
aoau Dat in
INTERIOR RE
III�'''"�W III�Co59
mall ECT'S DECLARATION
I dcoslxrrd nly irlses:enne f.ee:.
public rc,om, ,. _ ¢ `. .,-
w Ri a 0 I:. I I I.. :. - ` ` •'r - MAY 0 3 :2001 .
OWNER.BIIILDI R IN CI ARATION _
I Itche y affirm dr,I u n use I In the ConlreU ,Cnnsc Late rile the '
(=3< Adk:wing reamn.(section 7031.5,Bmineas hod Pndcssion,Cute:Any cloy ear county ;f
fx❑ ad n q p n .f t ll 1 J IvJ ilio any structure
630 Pnf t f,i....her,also resinousfl 'ills ll -h pr a file atener
died lie licensed!pursuanthn p f tire Chouracon's License Lav,(Clupter9 Sq. Pt. FloocArea" aluation
Ynunnrenemg with Section 7000)of Division J of the Entire,and Profess ons Cord.) -
or that he is exempt therefrom and the Iasis for the alleged emmpinn.Any violation
of Section 7113 I S by any applicant file a Wool subjects the applicant Rh it civil penaltyLZ
ear not form thfm five hundred dellan S50T) - APN Number - - Occupancy ' ype
❑L:n.nwn«nf the pmpeny.of nhy,nipwyecs who wagela an mer.nR amyea.:ninn.
will 1 to k ad rh schools, fintended or offered 1 IS 70.94 -
dr r. ' c 'n ( f :E : L d ttiiy nh.n
equ7aled Inspections
nft
w r fy Wl h 'ld. " p tl . I. 'h 1 k.fit II' •)
niadfiaaminhrrser,it,bhiluin, ,l:Ie,pllcnfis ddwlb � .cya; dr - '1.01 — •FOUNnAT•ION .` � . .
nnpletiun.the owner-0mWer will have the ho den of proving that be did nm buJd qtr .
,it tprnvc he pumeenrsme.). ' 102 — PIERS
��,,.,,{- her of me properly,had esclusively contracting with licensed cnnlracmn 103 — UFER
;l�«r�f0 tte project(See.7N4.Business and Profession.Cme:)'roe Contractor.. 104 — REBAR .
License law does not apply m an rte Iw .ver of property who dds or hopmves thereon. , • .
and his contracts for - h p 1 „with a r t }orld licensed pumuwit to the - 1.05 — ANCHOR BOLTS i .
Contractor's Li L, ,
❑I not c
(yl��in n/,,,III/�i/to� B&PCI (f/ill,, 1.0E - -SEWER X� WATER r
().act `i IVY Orate
16 U EI of S T DECLARATION 202 UNDERFLOOR, PLUMBING
Ihuchy
air overNh..1ly i(rrluroneorihepoll ,dcclrhradi is 203 ..-- UNDERFL:OOR.MECHANICAL '
. ❑ r h d II c w r L r : Worker's
204- —.' UNDERFLOOR FRAME•
Cicapensation, as provided r by Sedion 37u f the Labor cafe, or the 205 — .UNDERFLOOR INSULATION
pert nonce of the work for wh¢h m's pe nod is .sued.
0 l have and x ill maintain Workerre
Worker',Conn, atinmw
n raneyeire ae,as JbySection 301 ROUGH PLUMBING
302 — TUB & OR SHOWER
issued.
ear the Labor Coda,tint the perfonance c once work for Which this permit is
laced.MrWmkrr,con:rtn,atnnmPolicyNo.:eand Pahrynhnmrare:
' 303 '— ROUGH MECHANICAL ,
Currier. � Policy Na: � � 't • '
-CERTIFICATION Oil EXEMPTION PROM WORKERS' 3014 ,= ROUGH ELECTRICAL .
COMPENSATION INSURANCE 31D5, FRAME -.
('Phis"lion need nal "ninip fad iftnu pr,n I is kilo one In at ..Jnlli '
Behan ear leas.) - 306 HOLDnWNS
I,mily that in the pedbnan,e ear lie work for Which his permh is I....d,1' 307 - INSULATION .
shall bol employ any perms in mry manner sl,as toecom
he sunj,cl In cr
the Work '
Contpen,inicl Laos of Calhornia.Dale 308 — SHEETROCK
NOTICE TO APPLICAN'Dif,after making this Cmideate of Exemption, ,in should 309 — EXTERIOR LATH
O GMta nor nubjref to the W'orker's Canape provisions of the LanCode, u mm, 31.0 — INTERIOR LATH
ftudy.4hcomply.eREsuch plosti.ionaorthispcnni, hall he deemed revoked' -
.F C4 " •cDNSTRUCIION1.17NOINGAGENCY ' 311 — SCRATCH COAT' '
C > lherbyaft umatthreeisaconstrucdnnreadingagencyfmdmIterla....area 313 — ROOF NAIL .
ar the work fila which this pdnnit is issued(Sed.3097.Cis.C) _
z 1cidfiNi"'r 501 — FINAL ELECTRICAL ENERGY,
ZD Fruiters Address
U O Iccror that r I,fae'malnhenhnvchlia ai„t,1, 502 — FINAL PLUMBING ENERGY
w H elf l Iaffect,v illy ill ” >I, d ,y' d d " ' fhg
U ,,h
503 — FINAL MECHANICAL' ENERGY
OtlJg construction, dl by tl p tie, 1tea city it alder c,.
arW lie abuse reminded!property f 'n'I
e. pm
C. (We) grc t le Ty dA ph ,,,heCry fC pen
504 — FINR_ BJILDING ENERGY
Vliabilities I dgm t. t ad pe n h nay man
recent, i aid 505 — FINAL ELECTRICAL
fJ z Ciry m cnmcyucnre n(thc gmndng of tln,pcmnt. .. 1
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALI.NON-POINT Issuedb - 506 — GAS TEST
SONCH REGULATIONS. y Date
Sil,ohecear A,pIuardCONrncmr Dare Re-roofs
HAZARDOUS MAT'I RIAI S DISCLOS(IRI 508 - F I NAL MECHANICAL
WIIin.hTF1 t 11,fiflure fouldhol,occulcautv or hi havardoric.maci'el 'Type of'Roof t '
sdl ih, [ Cp r M - I'Ir 1 d
ChtuM1.12.nt H ,Id IUr.p � � 1509 —'' FINAL GRADE sass
C le,Si,climil,254]2(1'
❑Y: I'D No All roots ehall'be in54dcQted'plFioTM!ny %11�h1 Wal being'irntalled.
Will the pile t rotfoure n Id ,, p t use eclopencon rdaor If a roof is installedFA(houtfiFs4t lilliaLA lin;RCillA,9VlFrec'IO remove'
,oil hmanlou,air,achamfwmn
. .dein d by the Bey Arco Air Quality Mvn nuge no
• Didn't? ; ' ,all new materials for inspection. Applicant understands and will comply with
0 Yes 0 N All non-point source regulations.
1 have mad the It cry r( us mmerisls myui 25533 a under 4.1 un 1.95 0/the
Cuiifomiu no h&Sa[ery Gale,Sections 255!15,25544 and 35]4.1 understand mel
if the M1n' es mr curably h:mcmm�xnf,film it is my rc.rym.ihilifymnolify the -• '
.` x t n I- v rcyuior n whidnn."he nwt prior m issuance : Ce icer ear
`I''a� �G� :Signature ol'Applic:mt ' . Date '
'en- Gwnermumm ///D;O/`' All roof coverings to be Class `B"or'better
OFFICE.