01080145 CITYILDING DIVISSIIONNoPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
11683 VINEYARD SPRING CT ALTON AIR CONDITIONING & HTGO1080145
OWNER'S NAME: APPLICATION SUR DATE
SALEK MOHSEN S AND BEHNAZ F 45300 INDUSTRIAL DR #4 08/30/2001
PHONE: (510) 490-5655 SANITARY NO, CONTROL NO.
U?O O ARCHITECTIENGINEER: BUILDING PERMIT INFO
I- BLDG ELECT PLUMB A H
rU w LJ LJ I__I I _I
in 8i LICENSED CONI RAC90R'S DECLARATION
„ 1hereby,firm that 1 am licensed under prm'isions of Chapter 9 lmmmencing ` DCSCCIpIIOn
Z with Senlon]arolofDivision 3of'he Basi ro"a asprnfe,.ann,Code.and myIcem.e A/C UNIT 4 TON
is in full rose a Rea.^�
z s a LicenseJ� Lic.p
Be
O a D DamJ Cuntnmmr
ARCHITECT'S DECLARA'I
1=ro¢ I undeataud nsy plans,hall he used a,public re
iuY,
i mO O Licensed Professional
w e,H OWNER-BUILDER DECLARATION
1 hereby ofirm that 1 am exempt from the Conducmrs License Law for the
h Z< following mawn(Section 7031.5.Business and Professions Code:Any city or county
$2350
E o which requites a permit to consumer,alter.improve,demolish,or repair any sursanure
ad a �.prior.to its Issuance.alkwequire,the applicant for such permit to rile a,igned Catumort- "- -- - - - -------- ----"-----" --- -- - - -
thin he is limns,pgnwnoaM
uprovisions of the CanLicenseor's License law(Chapter 9
(J \ � r
7YV tY.VV yc-a-,, • _i -„ , �, - Valuation
(commencin&with Section](100)nf Division3of the Bgsitess,and Professions Cale) .3 -U' s-
nr that he is escmpi thcrifmnfdna the bu,k for the alllgaa m
cneptioh,Any violaion
of Section 7031:5 by-any applicant for a permit aubjeccs the applicant to a civil Malty-
.rfnot an.11WrEvehundred dolmL,(550% 303APNt151503R MECHANI Ali" " Occupancy Type
01.asownerofthe pmpcny,or my employees with wages as theirwlecmr,smalm, R01704 El ECTR I-
wmaiii] a worn andlne ode:The i,norm,elis Lided eoffered Law fofsae apply
10 An 5 05 - FINAL EI3��3)R(tMAjSSetionsl
Bulido t eW ork. otth Code:The is n t inter License Law Jas nota 1 to 4.
owner of property Who Wilds of improves memon.:md who doe%such work himself, 508 - FINAL MECHANICAL
m through his own rrb,oydcs.Provided the such improvements are no,intended or __, —
comple for sulci If,owner
-ovier,,he bidding or improvement en ofproving
sold tha within one Year of - „`.i, ' ,
complaion,the preat a saw.),will have the burden of proving the he aid not huIIJ or
itrtprovc fn pury.a.or s.k.k .
.......Ptolemy.am
_. selyc .._..I
OLasoxnea ofthe p(Secny,am exclusivelyd Professions
with licensed
a:)Fie Contractor's
Lindner the project(Sec.]to a Business and my who GMaI mpo Contractor's - t „. ,
>' LidenxLaw a«sum apply to owner of promiLTwoo) Idsor seimproves thereon
aneaho.comraes fo h pmlen..With.a comranonq hanxJ pursuant,o the. ... ._.. __ ._._ _. . ./ ---- _._ _.__ _....__.. __.- ____
Cuntrucmis License La Z�
°I am escmpt smile,Sec &
n :BPC!.,, reason
ll/ / ,ll f.�
, Date all t . ., O Z
WORKER'S COMPENSATION DECLARATION
I hereby mEnn under Penalty of perjury otic of the following declarations:
{w r
01 have and Will'mainuin'a Cenifcrld mf 6.mnit to x11-iname for Worker's
{ 7 Co.pen.w,ion, us,provided for by Section 3]00 of the Latin, Code, for the
n
'pe,foodurne bf,hc workfor Mind,this pcmlit is issuca.
-"; 641ruve dud will maintain Wvmkcr's Citmpenswiun Insurance,m required by Section
377x)of the Labor Code:for the performmto<of he work for which this .it is
issued.My Wooers C, pe i Insurance canner and Policy number arc __ _ _
.,._. p. 1— ..-. .r .. ... - _
Ca 1 RTIEICATION OF EXoEMPHON F M .0 KLRSH L i ' t 1
COMPENSATION INSURANCE _ — ... _-----__-._.......
rrid, Ca on um1 i bddompleted If the pcmut is for one hundred dollars
ISlfpjcar less.) .. „ : ..., .. .. ,. . .. . ., L., ..._....,, .,. .....-... .._ ._..... .. . _ ._. .. _.. .. ._,-.. ..�...
•I cenify,,haf in the perfonnann r(m'"wod - . ., _._......-... __._.._ .. _...,.,._._
-' ;forwM1ichlhis tis issued,I
chars cmpiny Laws
ofcnnn in any.,C.'-F so n>to necuntc•.wbjen to the Workers'
Cmmpenwtion Lars rf Calirmm'ra.Dae: "" j
.-Applicant '.• :' .. _..•. :.' : .. .� . . . . ..___.._. __ ._.._ _ ._ . . . __.L_.\ _,__ __ ...__._ ._ __. _ .
NOTICE TO APPLICANT If after mating thisCn'feme of Exemption.you should "
become p bject to the W rk r Cripenia a p ns of the Labor Code must
ust
Q Q forth W th Comply with our,h provisions or the pic noul shall be dee Ned revoked _
t ''CONSTRUCTION LENDING AGENCY
I h,eby H'rm that th a Cons w, Ina g ager y f the p<Immame
rf1rWnkpm1flChmi,peribk ii,mcd(Se 309] C r..C) I-
L � Lender's Name` r
Lender'sAddresi
'f..I I dean ify that I nave mel this application and smm than the above information is
w[.. donees.I agree to comply N'ith all city and county ordinances and state laws relating
0 U mWilding ronswaion:and hereby hu,nbnxc repr<senmtives of thdicity to enterupon
;as the bo m< t - .pen p rpo
.r iffy and keep hurml stheCty !Cup num agnmst
c p open) nexpcnx Which may to any y accrue ,area said --
V] Cit liabilities,, dg tan.fCosts a g ofd pe i, --
L y t ) CeNIRSTc an ANDNILL'OMPLY'WITHALLNOM1POINT Issued by e - �7 ^-w / ��Date I r- I
W
U Z 6t q g t
APPLICA� ODER SDS
SOI CF t �
8. G[
sig rAppl antic mad, I ,D le I., Re-roofs /1110 �]
IIA2ARDOUS'MATERIALS DISCLOSURE 'v1 AUG 3..,0. _
WJlme applic torfame Wlldingoecupan,s,ae w hmldl lvaWus rnait” . Type of ROOF -
msdfned by th Cpcn no Mun ,p lCoe CM1 pts 912. JtheH ❑h and Sfry �t !- •k 1 �. _.) ,
Cod SIC, 2553 ( 1 2. n .. ...t �• , n
All.roofs shall.be.inspected.prio[to any r�ofing.ma being Installed
wn the avpue t future building z p t . equipment devices Which If a roof Is installed without first obtalmng an-in ci s:a' re's to remove
Di th M xarco, t s byth ByA ArQ I'ry Management
Di std, _ all new materials for inspection. Applicant understands and`will'comply with
t! °Y,, ° _. all non-point source regulations.
Me- " 1 have read the hararEous ma,en Is red,dememu under Choplei 6.95 of the
Cdifitini.Health&Safny Gide.Sections 25505.25533 und25534.1 undersmnd,naL
if the building docs not currently have.tenam.that it is mv,esponsibility to ramify the
6cltruo of,hi e9 ree,il ch must be t prior IDI issuance of C nificate of
y - 2 U Signature of Applicant ",. __ - Date"
'ow,er r nun;e spq,. V 'v ,e All roof coverings to be Class"B" or better
OFFICE .._ . . . .. .. ... ..