01050180 CITYBUILDINGoPERONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
19979/99 STEVEN BLVD 01050180
OWNER'S NAME: APPLICATION SUB DATE
PINN BROS . CONST, 05/24/2001
PHONE: SANITARY NO. CONTROL NO.
PO O ARCHITECTIENGINEER: BUILDING PERMIT INFO
s BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Z�' 1 herebyoRrmflus Toro licensedunderpmvisitnsof Chapter 9(commrncing Job Description
S4 with 7")ofDivision3 fb Businessm ro �nncC yolmylicense FOUNDATION.
ainfmurree tend eBen:12_ j2G�l � MIXED USE (RETAIL/OFFICE/RESIDENTIAL)
-s K Licenx class rJ Co x
K Date Contractor
j u 0 r" ARCHITECT'S DECLARATION 4 6 CONDOS
y j 1 uneersmM my plans shall be usrd u public records
T
3 O O Licensed Professionol
OWNER-BUILDER DECLARATION 1 hereby a1Rnn that 1 em,Bium s ter she Cession, T's License Law Lu the
C a
following massa(Section 7onstru Businessand Professions Ca de:Any city ur county
C l g with Smion�construct,al¢q improve,demolish,or repair any structure
whichrequires•Perntf
e,3$ pdonot ummel requ m pphcmff Con tosUmne
Nat lie le sed pdaauo thlp inions of me Conuacmis L,ttnx Law tChaga9 t Sq FltFloor Areae T' , ation
comate 00d) f Division 3 ofine Business and Professfom Cods) i_t;f1 a Fd . .. ;.!:L7 i.ti vL.O,:?-�:;:y • 1 11000
or Wt he I.cicmy,therefrom and she basis for me alleged eit mpmn.Any violation
of Section 7031.5 by any applicim fora ..it subjects she applican to e civil penalty
of not more than fire hundred dolmn(S500) 313ViV`�FbVb .. Occupancy Type
111.as owner of me property,or my employees with wages as their sole compensation,
will do she work:and the structure is not intended or offered for safe(sec.76da, '
Business and Professions Code:The Commas a License Law does not apply to an 101 - FOUNDATBMired Inspections `
owner of preq eny Who builds or improves thereon,and who does such work himself
orthrough his own employees.provided that such improvements arc not intended or 102 PIERS
,
offertd For sale.If,however.she Wilding or imProsemem is sold within one year of '- '- --- - -- '—.
completion,the ownerbuilder will have the burden ofpmving that he did not build or 103 - UFER
improve for puMmeofsale.). 104 - REBAR
: . ❑Ia.,ther of the propenFam Dust and Pimatssion,hliccnscdcomrusorm 105 - — ANCHOR BOLTS -' "�•'.'.
License the does
n (Sec.]Dian owner o and property
w ions Code:)The Consraaor c
License Low dao lice apply m an owner of property who builder imPmvu thereon. 1 06 — SEWER & WATER
and who contracts forsuch pmjmts with a commands)licensed pumant to sM
Continuities License Law. . .. .202 --- UNDERFLOOR PLUMBING_.. ._. .. .. __. .. . . .
Olam eaempf ender sec:' •" " B&PCfanhigrtax" 203 - UNDERFLOOR'MECHAN'ICAL
owner i F oat ' " 204 - UNDERFLOOR FRAME
'- WORKERS COMPENSATION DECLARATION
205 - UNDERFLOOR INSULATION
I hereby afrrm on&,penalty of paijitry amofthe following declarations: 301 - ROUGH PLUMBING
❑ I have and w;il ,oaim'eim a amEeme of'Conxm to of-imurc for writers 302 - TUB & OR SHOWER
Compensation, as provided for by Section 3700 of the Labor Code, for the
perform.nceofineworkforwhichthisPermit,ismuted,; 303 - ROUGH MECHANICAL
❑I have end will mdimain,Worker's Companutionlnsurance.as required by Section 304 - ROUGH ELECTRICAL
od for b performance f the work for which this uni s
3]00 of the lar ar,C ompe uuon lnsarance .mer end Pol cy n mbar e , 3 0 5 FRAME
_.. ,ssuedMY ar. �r6, 't ['o1cyN ,Pelglwr1l�l -„ 306 ; HOEDOWNS ,-..,,.f- _, _,._._.,_.._..... -,.; -,.._ar.
Cwn," CERTI'�XEMPnON FROMW R ER ' 1130•rI L—I�'INSULATI GN" q t
1 COMPENSATION INSURANCL' P k " -
y „_--„_3'0 8,':="SHEETROCK•... _.
sen on'n dnof be complm '. ,. •.• ��, :Ili '1'. r . . .__
cd,f the permn's for one hundred dollen . .
dslrojo Im>, _ ,, 309 - EXTERIOR LATH:
1 anif the in the ",mance of the work fn which min 31 O' ' ` I'NTER'IOR- LATH
Y min pemdtaissued;l ,•I_ �;y!,ing.•.
Com lice employ anyoflif m any mennerso'w to become subject m the�Workeri 311 - SCRATCH' COAT' '
ComApplpensation' Iowa ofCalifornia.Dam
NOTICE
I. 313 ROOF NAIL. .. . _ _ _. ._... - 7--
Z -- -
NOTICETOAPotheWoTI' ft making thinsit f fE eWr youchoulJ P - ..,
bcbmiffico subject kdsCompensation -previsionsofsh lobo Cvoked, must 501 - FINAL ELECTRICAL ENERGY
ZTann .ma ropy with liprovisions arm permit shall Wemmed aka.. 502 -. FINAL.. PLUMBING ENERGY .
CONSTRUCTION LENDING AGENCY"
'1h thereby rirmNatthgeaecaiswcuonIa,d' gageaf thefedafmanm
of 503 - FINAL MECHANICAL ENERGY
Nc k f which this em
no issued(Si3
c. 097 Civ. ) ,
,pW,a'q Lander .-.-.'. C �'. ._ 504 FINAL ENERGY
s Name _ _....
U O Leda Address 505 _ FINAL ELECTRICAL,,,,
I cenify that 1 have read this application and state that the above information is 506 GAS- TEST
tT+'(.. coned.I agree to comply with all city and county ordinances and"a laws relating 507 - FINAL PLUMBING
�.V to Wilding couwcio dh by author represcffiveafdus city to ter upon
}.W din ishawt,-inernituoul property far impi,cumdPurpo 508 - FINAL MECHANICAL
F,S es,j egrcemsea ndemn fy mJ keeph may harmless City fCpen no cetera
-rn IiabJhes3udgmrnfec t pensee Inch may any y Cli against 509 - FINAL G E
U:Z Clim cons ence of the gen ting" pcsm t
APPLICA 1NDERSTAND IkL'COM� PLY ALL NON POINT 51O N NG
s413Rc Issued Date
Sio'harfa' ,Will the applicant w(� G Re-rooMO - ROOF PLYWOOD NAIL
Data
reo App o nuwf �� - e ,a
US MATERIALS occupied
DISCLOSURE t VVVTQQa T/61
W lding ocmp tafort or MtMi narasdma mwmal Type of(W3f- ROOF_ BATTENS .- .. , _
es defined bythe Cupert oMu`s�i,d Cad Chaptrn912adthe Health and safety i IN-PROGRESS
cede s❑ecYaosn1.255J11e)o y �Ns:' - , ;,'f.. 'L"! 1' 16 Q4 7"r 1�R00F g ..
Y�" All roofs shall.be,inspected prior.to.any-roofing matenal being installed.
Will she aPplicamtut.t.Wilding.,.Wt uxaqup t umieaawh,m If a roof is installed without first obtainingan inspection, Ira e'to'remove
awn hauido air contaminants a t defined by the Bay Arta Air Qu slly Management p
Diana all new materials for inspection._Applicant understands and willcomply with
°YeS " ; all non- oint source re la ions.__ ,
.' l P g
1 he e e dale he dosis materials rcquircmenu undo Chapter 6.95 of doe
if, tie Healthi Sat ode,Sections 25505,255JJ md255341undennnd the
if Ne buildin does. curie I havcafrnam,mat is ism responsibility '—" -- --
Y Y ponsibilify fonmamid,
accu � ft he requirtm u c muss be mei priono issuentt of a Cenificam of
Signature of Applicant Date
o er orou unced V Date All roof coverings to be Class "B"or better
..-I , ., .. -... . OFFICE.