02010042 CI ON
UPERONO
BUILDING PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
1204 YORKSHIRE DR 02010042
OWNER'S NAME. APPLICATION SUIT DATE;
GALIN ROBERT 01/10/2002
PHONE: SANITARY NO. CONTROL NO,
n c4 ARCHITECTE-NOINHER: BUILDING PERMI'I'INFO
w— BLDG ELI: PLUME{ MECH
a 2 =I =I
Cay
z S n= LICENSED71"' CON)a,cul mni pr DECLARATION Job Description
O a_p e¢bY aRnn Ilial 1 ren IicemM under provisions of Chapter 9(commenting
Fath ,v .eamn7ton)ornivninaBanhenn.ine„annrmresnhmcmlehhnamyh«am 4 DEDICATED CIRCUITS
55 I,I Inn fma rmd elffcl.
3 a Li;nsc Cines Lic,a
to
ace
ANCII ECf' ECLARATI!
P' 1 II ell a) y plan, . I be a ed 711ic
S p O Liccn. o cmional
o OWNER-BUILDER DECLARATION
hcrcbY nlBrm that nm exanpl from Ibc Commctnr's I,iccnsc Law far the
CTa?a fol in8 reason.(Sarinn 71U L5,Business and Pnhfcssinnx Cod,Any cily or campy
WF o which reyuircm tru
,a liminal consct,nitnr,improve,demolkh.or repair any ntrucmm $800
F�' prim to its issuance.also requites she applicant for.such permit to file a signed aatencnl
0.333333— Ilial be,is fr,resed pasmm In the Tm,i,lnns of the Commerce,License law(ChoMer9 g Ft. Foor Area„ 111"
P Valuation
(cotnnimicing with Sncliolt Vg))of Division t ofthn Rnsinessano Prcfc,sicn,Calc) s", In; -+r71 ,
or Ihai he is demur Ihicfmm and the bans for the ullcbed efomPfi nA.Any viol Y t.i,, 3 6�a'0 0 8".'0 0.! �S'i.r"i 1
of Section 70313 by any applicant Into Permit subjects theapplicanl to a civil penalty N _._ .. —
,of not more than five hundred dollar.U5100). 304 ApN ROUG�I ELECTRICAL Occupancy Type
°I,as net cf the pmpcty,Lir my anployces with wags ns tneir,olc aumpor,mic a,
will do the work,and the awcture is not intended or offered for sale(sur.7(44, . ' ' '
Ba,ini and Professions Codc:'Me Contractors License Law docs That apply to an 505 — FINAL EL reeuons
nVorrof property Who builds or inToo,es Ihcaon, and who]acs nosh work himself
or through his own employees.provided that such improvements are nor intended
offered for side.IL however.the building or improvement is sold within one year of
'completion,the owner-builder will have the burden of proving that he did not build or
improve for punnrse of axle.).
❑I.as owner of the propertcontractingp
Krty,am exclusively contracting with licensed contractors to FINLED
construct the unject(Sec.7144,Business and Professions Code:)The Conlmcwh
License Low aloe,nor.,lily m nn owner of propcty who builds or inhproves Ihercon.
and who comma,.rcr,nch pmjccrs with it conrractm(s)licensed pursuant 14)the .. JAN 15 2002
C mnemes License law;
°I ore escor"mr,W,ser." ' .,B'&P C Timid, 'std
GinnerUrn BUILDING
' W RKER'S COME-EN{ XITON UIiCLARATION
I hereby al....under,penally of p'cijury nue of me following declamtions:
° 1 hove'andwill'maimmu'.a C[Imcale of wrid to self-insure for Worker's
Compressor... an prop I for by Seat 17110 of the Labor Code, for the
ilerfmamnso of Ihe'w r which( ,per m.l
°1 have'nnJin, a ke•sizo list alioih Inhurancc,as requimd by Seaihin
370Q;ai .a rrC e,fo I perfe cc milbe work for which this permit is
eJ:My Thi I artier and Policy number arc:
i.i c s ire .. . . ..
Ce¢r yNo '
CLRTIEICATION Op EX PION I'ROM WORK PRS I� lues• ) �. ..�.f ' 1_N: 4},', is a1'�li
'- COMPENSATION INSURANCIi i.'
"(th s eeclion need nor M1e ciondeted if me permit is for one handrcd ddlars
($10(1 or le".)
'sminer n k f whW subject
the
Wnrkr I
eiom i employ Y Person n any h0ri'c r become b) r I II a Warkcr, '
Compensation Laws of C ff Do!
NOTICE
rmorisTOctto the WorkmL afmrmokmi this Ccmfi%of of Lahur rode.u. yo4houlJ
0 bechwitli amp In rbc Worker's visions or this pro rd,%haof Ibc emin Code,yon nnrsl
forthwith comply with such provisions or rots pemhil spall be Jcemnl rcvuked.
71' n.,"' "": 1 CONSTRUCTION LENDING AGENCY"
a ' """'''I hereby affirm Ihar Ih'etc i,n edn.nucrinn Iendtng agency f lire perfnrn ante
of the work for which this pcnnie is issued(Sec.3097,Civ,C.)
z ...lender',Name
- Lech',Address. „
1 cctify Ihui 1 have read ilii.,npplicmian and salt 04i the abihve infornmtion is
IL I^ corict.l agree Io cumplY with all ciry'nnJ county ordinnncn nn slam laws relating
comr upons
Q V mbuildins mndmaie Ihc.cM1y:iulM1oriee mpm.anetivcsi c'ny to
the uleveincntinncJ t rry fpr' peciiim pr u
lr. OWa' 1 6 I m od andA tI < hiC 'fC rl no hgaaid
'fA liab I t c. j dg x. I A n,es h ch h ay any
gained said
(.1;� City q c' Ili g nil pe t `
slulii SRTau 11,av Srvpti rvp u1 cunfr rrNfN Poi '�•.. Issued by: Date
p ,,beans Dat Re-roofs
wi IIA/ARDOUS'MATEIi1N SDISCI OSURL
WI lli ppl t rlrcMh'IJ tgk hlLL til till lin Int ' I Type Of Roof - .
rdby th Cpcn Al cRJ CIN Ch pl 91Laalp 11 linand Safety
Cod snicrn531f)1 1 e s•r, 't 7 'QI '(• _ f
❑r ,;,,•' 1 '1 a°rvri%q if 't a ' All,r6ofs shall be inspected prior to any_ropfing material being installed.. ,.
wain nnc�anl r nt lJ s p nose kqa p6ed!ar dw�n whhoh If a roof is installed without first obtaining an inspectioil';I agree tolremove
m I hmardous o r eenm hi noon as defined by the Biy Arca A r Qutl y Manngemem
"reser '- .. ,,,, ,• all new materials for inspection. Applicant understands and will comply with
all non-point source regulations. r rt
�, 'P.I•'1
RIP,
J th Iri 1._ 1 rtmcmxu purr,6.9J OrmeC01iBrziti & to yC Ic.Sc m,2 y553Bu 25 4.l undemirml door
if me til carr Lily hanlct nl.rhir nsiblhy to norlfy thewe., Fs uitat u'whi be mel pri. cuoncc act ific.t8of
' Signature of Applicant Date
nt dosgnl , U e All roof coverings to be Class"B" or better
•;� .-.I 1.. ,. .'. .., r .. OFFICE . . , .