00070072 CrrY QS—N19R'J1" ESPLENDOR#3500070072
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
DUH.DINGADIUARDENNE, WALTER PERMITNO.07/13/2000
OWNER'S NAME: - APPLICATION SUB DATE
PHONE: .SANITARY NO. CON'IROLNO.
w O O ARCHUECT/ENGINEER: BUILDING PFRMTI'INFO
F,0 BLDG ELECT' I'LUMB NIECII
LICENSED CONTRACTOR'S DECLARATION Job Description
1herehy.Winumat 1.d,Beetled mmer,ru,sd,,n.arcnaver9fe,,mmeneang
F,nFs with Section 7IX0pof Division 3 of the limine..and Profesomns Cale.and d,3.license
,,a I- ie in full force and dbud.
_ de¢ Liecnse Classact Lic.a
O n V Dae Coto-nor
ARCHInta's DECLARNHON
r_w° I nmcoland tn,pma,chap be used u,public mend,
d da
ip o Liccmal Pailee'sionol -
a. OWNER-HIJIIAETR DECLAItA'I'ION
u�^— nemhy ufhnn mut I.m exempt Btttt Iha Cummuto:,Uncurl latw Bur The $1
E 5¢ following III flee n 7031.5.Bou mI Pmfc. ns Code Any city or any
�❑ wit eh q arc sell t t neon to der diet repair y.trrsclum
632 pra t 1.o q :thpplie tf hNunat n signed.t.tenent
that he I,licensed r t1 he froamo.litthCordrande,License Lo (ChaptedI) Sq. NMS-km446,_a0, 00 Valuation
(commencing with Section 7(010)of Div6inn 3 of the Business and Professions Cade)
or thin he is cmntpt beefmm and the III for the alleged exemption.Any vINminn
of Section 7031.5 by any appli<am for a permit subject the a,plicant Ina civil penalty
of net mon man rise hundred dollars($50n). APVun>berSEWER 8 W TER Occupancy Type
Til
property.army employees with wages as their sole compensation. -
1 2 — 1
S ill no the work,and the 4rudure is not intended or.deed for sale(Sec.7144, k� � yr� yr+q -
Businens and Professions Coda The Cordaani,Licence Law Joe,not apply to un 301 _ ROUI�IYE�l119WItIRI�ns
r of Pmpeny Who build,or'unpmvice Ihfmou,and who docs inch work hiao0t l'Rl�
ll nugh hi.nxn crado,l,,pranced Intl such inmawomeri s an u d memled t 302 — TUB & OR SHOWER -
,bra,,l Ib,xnle.B.h,wuvcr,the II or imruwetmnt'd,old within Ane yew et
tumleran,roe awuer-sadder will haae me nuldaholpru,in mot he did nal little at 502 — FINAL PLUMBING ENERGY
ntilI...p.rpt,eol J. 506 — GAS TEST
❑L.s owner of the prrpeny,um esdusi dly contmnio,with lice ood cantations w
act mae
e project(See.74,Business and Pmfasmm Code:)The Contmemr's 507 — FINAL PLUMBING
Lmtmieeme Law I Bat appy n an towner of proper, he build,or improve,thercan.
mal wh.eunnan,for,ueh f ailed,with a eraoodoold Bcetild pursuant n,the
Couh.ctofs Licenselax-. C
❑I am man a der See .H&PC tariffs mew
wner � 7/�3�"o
WO K[R'S COM"IiNSA'I'ION UIiC1.ARATIUN
1 tic mby affirm under III a artery the u1 the following de,I;oe loom /
0 1 hone and w111 Tocaloiti a Cenllicea ul Consent m sed-loon for Worker's O�
Contpen,ution, u, provldcd Ibr by Scullen 3700 TIT the Labor Code, lin the
peobrmmuec ot'the work Ibr which Ihl%Ivanii,is issued.
01 hone and will nminmin Worker',Co 4er%ttinn Insurance,to required by Sent I
371()of the Labor Code,for the rcrushmance of the work for which this permit is
.sued My Worker',Cumpencnion Inwnnec carrier and Policy handsel are:
C:udcr. Policy NI
CERTIFICATION OF Ii01361P1'ION FROM WORKERS'
CONIPENSAriON INSURANCE
(Phis section need not be enmpleed if the permit i,for one hundred dollars
(51 qp nr let.)
I lenity dwt Ia the per 0nnunmc of the work for which this permit is i„ued,1
,hull Win tnmlay ally per ally II I.,,a, ,,bectnte.ubject n,mo W,,rked
GnIIoch amt Law,of Cel llun'I..Daiann
Ap„heist
NOI WE 10 APPIACAN'II It,.his nlnking do,Cenificae of lixemption.you should
M,nme,ubjea ua the R'arker',Compe oeTh pnrviaian,of the labor Cade.you mu.a
Obullas 0t coup),with such lanai.ions or 1hi,permit shall ba deemed revoked.
Z
F` [n CTT hem is ac ons LENDING AGENCY
? 1 hereby aWimt this Mete is a construction(See. lending agency fm the pMormancc
of the work for which this permit is issue)(See.4091 Civ.CJ
6. Q Lender's Nume
.7 Z lanJcr's Address
U Q onrr 1 aeod,me I haat rvud Ihi,arplicmin I and state then the above inlonnalion is
Gs. Fy ect.I agree to rontply with 011 city and county ordiouneesled Sete haw,relating
building construe, r,and hereby Nut halmrepresemmivc,m b.,city I,ever apun
old als—a......n'eued,,,,,city Iiar'Il;,nletiou pulr,,,a,,
Fp., (WcO” h,'c,c.lnl,nuoily II keep hamde„the City m'Calcutta.llgulu,t
rn Iiubilllle,,pd,nanm,costs andes,,I whish may in any way ateme against,aid
U 7 City in consequence of the panting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Y-C Date ^C) a
SOURCE REGULATIONS,
Sigumurenf APPlicanVComnnur Dae Re-roofs
HAZARDOUS NUUTRIA S DISCLOSURE
Will the upplicam an future buildings*'curym Nen or heWle hmandaus maerial Type of Roof
us defined by the C.fardeo Municipal Cade,Ch.,er 9.12,and the Health and Safety
Gale.Section (h? ❑No
All roofs shall be inspected prior to any rooting material being installed.
III me.ppllcam ar nature budeingoanp:Im use equipmeat ordevices whltli If a roof is installed without first obtaining an inspection, I agree to remove
emit hueaalou,air cuntu...III n,nn ddined Fy the Bary Dna Air Gualhy Mnnngetmnt
Cl No all new materials for inspection. Applicant understands and will comply with
all non-point source regulations.
I have read the latuadou,Inarmiul,nquirenunt,under Ch,I 6.95 of the
California)Icahn&Safety Coda Soetion,255115,25533 and 25534.1 addenaand Ilan
if the building dawn not currently have a leant,that it is my resrymsibility n,notify the
mcupanl of the requiremenitwhich must be noel prior 10 issuanceof a nIBme of
D 7 Signature of Applicant Date
�3/DO
3wncr or aummieed.gem 1S,e All roof coverings to be Class "6" or better
OFFICE
1.