00060049 CITY iDIIONO
tii VINPERMIT CONTRACTOR INFORMATION:
HUILWN"2042t N. TANTAU AVE GORDUN—PMU INGrI:RNur'.
OWNIT14 SOOMPAQ 124 AITL1CN Ee
PHONE. t 65 — SAN'I'TARY NO. CONTROL NO,
ARCHITLCr/eN01NIir:R'.
HUILIJING PERMIT INFO
O� IILUO LEGGY I'Lt1Mli MliCll
om�
G¢�
Fy^ LICIihtiEUCON]RAM
under p o,ion,RATION O)�qb p�r,�C,f� uon
00f-0 1tion anorohmlan,Imcm.aJunder-ndProteofChapter 9Rumnsndng TENANT IMPROVEMtNI"
f–ca with Section](XI(H of Divi' Jnf me Business and l'rnle Cale and my license
a ka= is in full fort m cR«t.]� f� 1
'3i' .tee m�jl�.y{ /{wx ,l Lic.a_�f ( _
Uaen_(0/_�/ c 1 Conun«or ��
a II �'1RCHI LCS'ti llliCl.nR '10'
F wLLy� I TAdu ylyyq.lh: -used as public med,
6, Lim d )W'NHIt-b UlI.DER DECLARATION'a I e,nut I am exnnpt lion de Contractors License Law far the /
t-?¢ hello ing reason.Scene.7031.5,bmine,.and Profession,Code:Any city nr county
s= which requires a permit to construct,after•improre,demolish,or repair rare annum
aim prior m permit its issuance.also requires the applicant for such permio File a signed indent
that he is licensed pursuant in the provisions of the Contractor's License Law Chapter 9 Sq. FL Flo rea t
Imnm,ereing with Sooner 71 XXH of Division 3 of the Ilr,ine,x and profession,Cuba)
or that he is exempt'here from and the basis for the al lamed exemption:Any violation
of Soctloo 703 15 by any uppliear,for a Panel Subjects the appLeart m n siva pard ty
nrnntmnremmndie hm,dredJailer,ON10). ATMMir9ef.;1. 00 Occupancy Type
0 i,as owner Orme propene or my employee,with wages a,Ihcir,nle con,pemsmiot,
will do the work,and the structure is not intended or offered for sale(Sec.Tedi.
Business and Profession,Cade: Late Contractor',License law does not apply to an 101 — FOUNHkI{TiilaNnspections
orr of property Who builds or improves thereon,and uho does such work himself
though his own employee,.provided that such improvements are not intended or 102 — PIERS
offered air sale.If however.the building or improvement is sold wimin nee year of -
ontp etion,the owner,l a'tlder wilt have the httnlen at proving that he did not haild or 103 — UFER
tnprnveCar p..p....at ,[a.), 1,04 — REBAR
O La, ,war,of he pro)eay.art,exelaxively cmnranin,with bemused eonra,dr,to 105 — ANCHOR BOLTS
caremet the prefer,(tier.7614.Hiram,and Pmie"im"Critical'I he Comment,
Lice,.elaedoes mmappya... aitempropert, he build,orhnprove, he«ar. 1,06 — SEWER & WATER
and who carriers for weft project,with a comment(,)licensed pumumm as the
Conmeter,License Law' 20^e — UNDERFLOOR PLUMBING
01 ren exempt under See .H&P C far this mason
Odor Date .203 — UNDERFLOOR MECHANICAL
WORKER'S cOMrENsnrlory ullcl.nennON 204 — UNDERFLOOR* FRAME
Ihereby nfrrtnunder enaltvofperjuryLure ol In following ded:'mien,: 205 — UNDERFLOOR INSULATION
0 1 have and will maintain a Certifiable of Consent to,elf-insure for Worker 301 — ROUGH PLUMBING
Compematien, as provided for by Section 370 of the Lor abCrile. for H
iie
performance of work fart which this permit is issued 302 — TUB & OR SHOWER
II base and will maintain W'orker's Congersation Insurance.as Tarot red by Section 303 — ROUGH MECHANICAL
)of the Labor Cole,fur the performance of the work for which this permit is
,lard.NI A'1,er:cmntle":�renl'. : ccc...� �eacr 304 — ROUGH ELECTRICAL_
,arricr:ftCOn/) polity No D 305 — FRAME
CdKI'i19CAT ION CON1PE SATIONEXEMP IIN URANCE FROM O KERS — HOLDOWNS
(This section need not bw contplemd it the permit is for one hundred dollars 307 — INSULATION
308 — SHEETROCK
I cerr y that io the perfermaace of the work Ins which this pemdt i,issued,i
o- not entpiny any neuron i.,any n,aitor as tL bee,n wbjee m tea Workrt, 309 — EXTERIOR LATH
pe•rrl tion l'twx Llcttlire`"i °Y1C 31.0 — INTERIOR LATH
,orrice TOAPPMCANIf.If. after making this Ceairerd,of escrepae',yrs..hold 311 — SCRATCH COAT
hesitant subject to the workers Con per,ano r provision,of the LuM,r Code.you must
O hnnhn ith comply with such provision,or this peorno shall be,deemed revoked. 313 — ROOF NAIL
F � CONS1RUCTION LENDING AUENCY 501 — FINAL ELECTRICAL ENERGY
> i hereby affirm that them Is a construction lending agency for the performance
w of he work for is rah his crinIis ond(See 3E9].0,C) 502 — FINAL PLUMBING ENERGY
c. z Letder,Nante LcnJcr's Address
a z 503 — FINAL MECHANICAL ENERGY
U g 1 certify that I have read this application and%late that(he abuse infatuation is 504 — FINAL BUILDING ENERGY
Las E.•. correct.1 agree u)comply with all city and county ordinance,and state laws relining
0 V mbuildingconstruction.andherebyumhormerpresenmtiresofthiscityInenterupom 505 — FINAL ELECTRICAL
>, y the ab rce.menroned properly for inspection purposes,
(Wel agree to save.indemnify and keep burmle,the City olCupeninoagamst 506 — GAS TEST
Ur/] liabilities,judgments,mot,and eepen,e,which may in any way name against,aid
City on,er'eam it le,granting of met Noun. — F I NAL UMB I NG
OUR AN DLRST )S AND WILL COMPLY WITH ALL N. INT Issued by: Date
Sign air I fA ,licam(Cim icam ( b)am Re-roofs
IIA%ARDOUS MATFRIMS DISCLOSURE
Il the applicant or furore building recapat same or handle hveNoos material Type of Rof
as defined by the Cupeaino Municipal Code,Chapter 9.12.and the Health unit Safety
Code Semon 25532h0? 508 — FINAL MECHANICAL
0Yes CNe All roofs shalt-. nspecfe jN�r tlGRp4 El`mg material being installed.
Wilt dmnpplicmn or train,banding Lcuupnm use equipment er devices which If a roof is in, wit�j9µt��k�9t O 1 pl•CtlOn, 1 agree tll remove
nit bamnlnusuirenn, unmr,apdefined by the Bay Area Air Qmdity Munagoncm f" lIVHL� MIVIVI
til,lrirrr all new mater��rr s or ins kk�1�3, n d�;� and will comply with
❑Ye, door"
all non-point sal e rept i8h1'- V,ell l
1 hoe mai the hamrdous ma«ia1,rearmament,under Chapter h 95 of the
California Health&Safety Cede.Sections 255115.2553]and 23534.1 under,al that
if the building does not currently have a tenant,that it is my reg,msihilty r,notify the
e a act of rhe - u wM1ich,nut he me prior to issuance of a CeaiOcae of
"`y' Q Signature of Applicant Date -
on,eri ernea aye,,, (0�0� All roof coverings to be Class "B" or better