02060151OF
CI BUILDING DIVISION O PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10210 STERN AVE HENRY LO 020860151
IPkr�MPLO APPLIC 016N/ 2 4/2002
O O ARCHITECT/ENGINEER:
�Z
fF <a
Z O y Z LICENSED CONTRACTOR'S DECLARATION
Section
by 7000)
)of Divisihat I on
3licensed under provisionsPofna Ccdc9(commencing
GHC with Semion7000)of Division3of the Business and Prafcssiom Cade,em myliccme
s
is cfull force and eRest. z 6 Lice
nse Clans Lic. a
i O Date Contractor
mai 3 u. t ARCHITECTS DECLARATION
I understand my plans shall he used as public records
s O O Licensed Professional
e OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the
following reason. (Section 7031.5, Business and Professions Cade: Any city or county
�C O which requires a pennit to construct, alter, improve. demolish, or repair any structure
C ptior¢issuance, alsotequires Neapplicam fwauchpermino fileasigtcdmtemem
3m,.e:�.toih..�..n.,,:.ire.,,u,w..,.;,:a.._...n..r.._.....,._�.::.....: .....�._.._.e
(commencing with Seciion,79'a Division 3 of the Basi nctsandpmfessimu Code)
or that he ti lznnpt therefroiu'and the basis for the alleged exemption. Any violation
- of Sermon 9031.5 by any applicant for a permit subjects the applicant o a civil penalty-
Iof not marc than five hundred dollars (S500).
❑ I, os owner of the Property, or my employees with wages as their sole compensation,
' business and'Prolessmda Code: The Contractor's License Law tices not apply in an
owner of property Who builds or improves thereon, and who does such work himself
completion, the owner -builder will have the burden of proving that he did not build or
improve for purpose of sale.).
EJ 1 as owneof the property, am exclusively contracting w th hcamed contractorsto
_ construct the priciest (Sec. 761i, Busincia and Professions Cudey The Contractor's
License Law does not apply to an owner of property who Wilds or improves thenen,
.. and wha.,muracts. for . such. pmlecm.whha cammus o ad licensW.parmam.m. flue
n W
in t nde S ' t '"4'' '-'' B dt P seasonfor Nreon
._. O 0PENSATIONONLXtAT10N—
herebyadin nder perally:ifp ran
Iy,une of the following declarations: -^
of have'1 ad ;,di maintain a Cenificale of Conuni to self -insure for Worker's
Compensationr a provided for by Section 3700 of the Labor Code, for the
_ performance of the work far which this permit is issued..
❑ 1 h ve ind'will maintain Worker's Co pen atin insurance'as required by, Sectipn
3700 of the Labm'CmI, for the performance of the'work far which this permit is
issued. My Workers Compensation hper mance carrier and _Policy numb" ire:
1C m'rt 7 T,•?P.m s i,'iP Icy No.
{CClin'— PICATION OFEXEMPTIONFROM WORKERSi
COMPENSATION INSURANCE
1 tib 1'sedimn Aced not m compGiJ if the peirmil is for one hummed dollars
IS 100,) or leas.) ,
i
forthwith ccimply with such pori"ren s or this permit shall he demned revoked.
r 1 _ "CONSTRUCTION LENDING AGENCY'
certify that'I have rad this application and state that the above information
1 agree to, mmply.with ell city and county orditmncespnd cum laws relatin
Cw ,hob I fires 3vagets I% so and xpenses M1 h m y,in any way sacra gain t said
t.% z C ty l on qu ce of the gra t g of th peno
APPLICAVf, Y. A,
\NO WILL COMPLYW HALL�Ixr
son Ec (I; IONS P
`S' n wre f p t C ria r t pre ,
4.NA DOUS MATERIALS DISCL SUR i "
;'td W II ere oppbcanl fitabi building occupant note or handle harardou tnumal
'is, defined by the,C.Partirm Municipal Cade Chapter 9 12 and Ne Health and Safety
Cad Son.. 2553 (o)
"I ❑Y --"i
Is-
I ❑Yes , .., e „ T .
, A
1 M need, be M1azvd s mmcn Is rtqumrc at under CTapte '695 f dm
CaliforniaHealth & SafelyCrals. Saceohs 25 50.5-255 33 and 25534 1 understood dw
Qhe bmldmg dos not cunenlly have a t mart that res sponnhthty to notify it
'I�
,NITARY NO. CONTROL NO.
BUILDING PERMIT INFO
BLDG ELECT PLUMB MICH
NEW SINGLE FAMILY DeWE1LIVJ%L.EL
LIVING SPACE 3249 SQ.FT�CT 82003GARAGE 674 SQ.FT.
$4000
375
RO,C}F BATTENS I _"
Type 04°f RCjFt,,,IN-PROGRESS _-.__._..
'i) r3 ROG q'
All roofs shall be inspected prior_to.any roofing.material being installed.
If a roof is installedwithout first obtaining an inspection:, I'agree to remove
all new materials
for inspection.._Applicant understands and.will com_ply,with., _
all non -point souice egulaDons I,;i, ,
Signature of Applicant._ _ _ Date _
All roof coverings to be Class B or better
r V VN'JA 'I XNuired Inspections'"'
102
- PIERS
-
-- -1-0 3----
-104
104
- REBAR
_... __..1-05,
_ ..ANCHOR -BOLTS - -; -- -
106
- SEWER & WATER cm.
-.---.-----202
--'-UNDERF-LOOK-PLUMBING-------,-..---...
... ._.------
203
- UNDERFLOORn!MECHANIlCAL
204
- UNDERFLOOR FRAME
205
- UNDERFLOOR INSULATION
301
- ROUGH PLUMBING
302
- TUB & OR SHOWER
303
- ROUGH MECHANICAL
304
- ROUGH ELECTRICAL
305
- FRAME
306
HOLDOWNS------�--_.,r.:.-.----___...-.,..,-,-,...
,-
TNSiSL`AION..!" <„ L', :
l
- --308---
-SHEETROCK----
---
309
= EXTERIOR LATH
311
- SCRATCH COAT_,911'Jxx::i.`r;•f'1\1:.o:ta
---------
501
- FINAL ELECTRICAL"ENERGY
502
- FINAL PLUMBING ENERGY
503
- FINAL MECHANICAL ENERGY'['-]
504
- FINAL BUILDING ENERGY"'``'
"
_........
- - liECTRICAL__-----._.. __-.
..._ .._.... _......- .
506
GAS TEST
5
- INAL PLUMBING
5 8
- INAL H ICAL
50-
INAL
M,
510
IssuedgTy
- Date
RO,C}F BATTENS I _"
Type 04°f RCjFt,,,IN-PROGRESS _-.__._..
'i) r3 ROG q'
All roofs shall be inspected prior_to.any roofing.material being installed.
If a roof is installedwithout first obtaining an inspection:, I'agree to remove
all new materials
for inspection.._Applicant understands and.will com_ply,with., _
all non -point souice egulaDons I,;i, ,
Signature of Applicant._ _ _ Date _
All roof coverings to be Class B or better