02060156 (2) C[eoD ODSONO
LNIIVIIINPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10912 CANYON VISTA DR 02060156
OWNER'S NAME:
APPLICATION SUB DATE
KEET AND KATHY HAMILTON 06/24/2002
HONE: SANITARY NO. CONTROL NO.
t 1 '
9 z0 ARCHITECT/ENGINEER: BUILDING PERMIT INFO
kC lu E BLDG ELECT PLUMB MECH
m<y 1_7 CJ I_ .0 L_J
LICENSED CONTRACTOR'S DECLARATION
OO Z`:G 1 hereby aelrm that 1 am licensed under provisions of Cheper 9(commencing Job Description
F=twith Sectiyy/0o0)of Division 3 oflhe Business an�mfergon,Cash,and my license KITCHEN REMODEL
7 bull(oo7hFe anJ cf f
s 6 Licc"`Class Lic.p
0 u O Dat C-2 Commcmr ryL1
3 a in ARCHITECT'S DEC ATION
1 undersmad my plans shall he axed as pan is records
a.°�°�p O Licensed Professional OWNER-BUILDER DECLARATION J
u+= 1 hereby uf0rm that 1 em exempt from the Comuncmr's License Law for the
C?< following reason.(Section 7031.5.Business and Professions Code:Any city or county yS POO
PFO which requires a permit to consumer,alter,improve,demolish,or repair any structure. t
prior to its announce,also requires the applicant fix such permit to Tae a signed sm¢mcns. i
°•3m that iS,Ig licenced Id(suNl to the pmvisnons of the Contractors License Law(Chapmr9 ., t O �eu`,Ea ` s P alUatlOn
(commencing,with SwImm 700tB.of Division 3 of the Business and Professions Code l ^f..�"t'x 3,'y_F2 Z./i�ftZ ;li_,i
or that he is eii4pt therefrom*and the basis for the alligeb esempttod.Any violation R
of Section 7031-.5 by any npplittm for a .it subjects the applicant civil penalty- pp��LL�13�S�
of pmate mthan eye hundred doners S50(h. 101 APN hDlJN17ATI ON " Occupancy Type
❑1,m ow eco of the Property,ser my employees with wages a their sole compensation,
-will do she work'and the structure'is'not Intended.1 offered for sale(Sec:7014; 102 - - - --- - - - - ---- --
'Busmess'add Ptbfeations Code:Tha Co tr s License Law does not apply to an10 3 - UFER Required Inspections
owner of property Who Wilds or improves thereon,and who does such work himself _ _ 104 _- REEAR
or through his own employces.Provided that such improvements am not intended or
r _ _.____—__._____
offered wlc.Ilhowwerl w Wildingoriden ofifinn sold C he
one year of -- t .g„
completion.thc owner-Wilder will have the Wrdcn of proving that he did not build or 105 - ANCHOR BOLTS
improve for purpose of side.). 106 - SEWER & WATER
❑1,ssowner oCthq property,am exclusively contracting withlcenud contractors to 202 - UNDERFLOOR PLUMBING' '
onswa the Meet(Sec 7044.Bmidess and Professions Code)The Ciamdector',s t
License Law dxs not apply to an owner of property who builds or improves thereon 2 0 3 - UNDERFLOOR MECHANICAL
' ._and who ommem fo s ch p 1 1 win a.coanocmr(s)licensed pursuant .,,he
Co t ecto L
gseL 204 "-UNDERFLOOR"-FRAME------
Of me pt nae-Se. B&PCbe,disreason 205 - UNDERFLOORt INSULATION
Owairr Dd1G 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
302 - TUB & OR SHOWER
Ihercbymm-odderpenaltyofFejury one ofthe following declarations
: 303 - ROUGH MECHANICAL
(- ❑ 1 have and will maintain'o Certificate of Consent to self-insure for Worker's 304 - ROUGH ELECTRICAL
Compensation, as provided for by-Section 37011 of the Labor Code, for the
perfommnce of the work far which this permit is issued. 305 - FRAME
❑1 have and will maintain Worker's Compensation Insurance.as requited by Section
306 - HOEDOWNS
37W of the Labor Code,far the performance,of the work for which this permit is
issued.My Wormes Compensation lnsunswe earner and Policy number art:_ 307 - INSULATION
er�LLW ' %USI Fi•.<Pal'VVyyNyI..: r 1RgS�33SI 30$ - SHEETR0`
'I:'; CERTIFICATIONOFEXEN FROM WORKERS" �fi� T30'9 `-`_EXTERIOR`'`LATH' �^
z" COMPENSATION INSURANCE' `
3Y• ' (Thiidection need not be camplctW if the permit is for one hundred dollars
(5l0)rorla.a) 311 - SCRATCH COAT
_...•.-Ic'enify tthat intha lzrrPmsegce althe work-mar.yhien`thia Permit is"is.�ee:i .. . 313 - ROOF-NAIL
shell not employ any Person in any manger so as to become subject to the Workers' 501 - FINAL ELECTRI CAli't ENERGY
Coink ainLesofC if Dte
-Applicant - -502-- - -FINAL--PLUMBING--ENERGY- - -- —
NOTICETOAPPLICAN.,hcWeTIfafter ktgthsCenfateofEemptony should 503 - FINAL MECHANICAL ENERGY
became h o a the W ch pr Co pen at pr t e .of the
h lab Cnae you must
Q O faun the ply 4th ch pro nxmth pe.it.nae Wa a eked:
. 504. -- -FINAL -BUILDING- ENERGY .-- .
Z
F, v� :•,' t' •Ir'
CONSTRUCTION LENDING AGENCY e 505 — FINAL ELECTRICAL
yconstruction letting age cy(r the performance
1 hereby term that th a --ed(Sec 9097 Civ.C.): s `
a Linddersbadma) y 506 .--- GAS ,TEST -..__.
of the ark for which th h t$
507 FINAL PLUMBING,
V � : Imilifythat Ibutw oil!thisapplicationandslatethattheaboveinformationi.s 508 _ FINAL MECHANICAL
10kt_E. correct.I,agree to comply with all city and county ordinances and state laws relating 509 FINAL GRADE
iV to building emi,maction:oad hereby duthmize repretoina.ves of this city to enter upon
W the above-menthmedpropnyhriinspeatitegurposes.,- 510 - FINAL PLANNING
t y:q (w'c)3grce io save:indemdi(y and keep harmless the City bf Cupenin'o ugainu
.� liabilities,judgments.costs and espenus which may in any way accrue against said 514 - FINAL UB C WORKS
U,.Z, City in consequence of the granting°(this permit.
"'+ APPI PANMUNDERSTA. SANDWILLCOMPLYWITHA t'O�- I.Vf Issued by: l a Date
S CE - ATIr .,
_
mon- pime. camow� - ,Dmc,'t Re-roofs
ZABOGUS MATERIALS DISCLOSURE
Ill time pp cat an(t Wilding occupant stom or handle im aranaa Material _Type of Roof-.---,-.
as de an. by!he C pert°Mu pppgipal Code.Chapter 9 12,and theHealth d Safety
'� " ' ••-•" + - '` ...
Codi acYcn2553 (a) ( ;a[`N - I _ s ra . i ,�)P ♦ [-'. 'v 71'. ivt' a .. _
m'/{s{\1 - i' _ All roofs,shall be Inspected poor to any roofing,matenal.being installed.
wrathpplkaotor lure building m pant use equipment or devices which If a roof is installed without first obtaining an inspection;I agree to remove
emit hez rdo rcomgmmana es toed hl the Be,Area rO Quality Management
Distinct? - all new materials for_ins inspection. Applicant understands and will coat I with
aY. .. ,. PP - PY
• all non-point source regulations'. ,
1 hava'read'the lutra dons materiels requirements under Chapter 6.95 of the
California H.11B&Safety Cude,Sections 25505;25533 and 35536.I undecaand that
tter'odi dawnlmon1entlyhuveost tenant.bemhatitismYreuance bilitytonficat the
"-- - -
'occupan[odium mquircmpntn which most be met prier to issuance of a C<niemm if ' '
+ t
ret
i auopp
..Occupancy. Sign
t - -. . f Applicant Date
- .. _, .. .. ._.
mor amhn zeds ate. All roof coverings to be Class "B" or better
. ._ .. ,. ... ._. . . OFFICE - . . - - ... . . .
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-711