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01070009 (2)1 CIDCSONO CONTRACTOR INFORMATION: BUILDING IIVINPERMIT BUILDING ADDRESS: PERMIT N0, 21681 COLUMBUS AV 01070009 OIIlgHsfaimYUSUKE AND YUMIKO APPLICATION §UB DATE 07/05/2001 'HONE: SANITARY NO. CONTROL NO. : ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG 5ECT PLUMB MECH - LJ IJ LJ LICENSED CON TRACTOR'S DECLARATION lob Description 1 hereby office that 1 am licensed under provisions of Chapter 9 (commencing with Search 7000)of Division 3ofine Businessand Prof=ssions Cale. and my homes, BDRM. , WINDOWS & is m full force and effect. License Class Loc. 4 LIGHT FRAME RF.ON GARAGE. Data Contractor ARCHITECT'S DECLARATION I undersand my plans shall be used as public records Licensed Professional j OWNER -BUILDER I hereby (Sam that I irm he RATION License Law for the from ,h= Co,ions l ! �/ . I.S.=Bump, : following reason. (Section Cods: ]a3LBusiness and Professions Calc: Any city or county t resit any ewaurc : which requires salvo re uirnwct. alms improve, demolish, file ,. Pro i issuance. 1 9 for .L d statement - - .. .. .. S Ft �•!. tl' FloorArea) -�1.1 .I Valuation Conpermuofl e p isionso thathe sr withwd r, thep smnsn3o ceBusir �e L onsCor9 (c with Sava Division J of the and Profess ass Codc) `s I, a or runt he is exempt thcrtfrom and the basis for ,M1e a11egN exemption. Any violation mon in l allied , -� y ry ;, } - - -' of Section ]031.5 by any applicant for a permit subjects the applicant to a civil penalty or act more than Face hundred calla", (s500). APN Number l: Occupancy Type 01, asownesofthe propony.ormyemployees with wages as their sale campansetfon. 101 - FOUNDATION will do the work, and the structure is not intended or offered I.,sale(Sec7,u4: Business and'Frofcsaln., Cale: The Cmamiamr's License Law does not apply t° an 1 O 2 — PIERS Required Inspections owner of property Who builds or Improves thereon, and who does such work himself 103 - UFER orthrough his own employees, provided that such improvements are not intended or -,offered for sale. I .however. the Wilding or improvement is sold within one year of - 104 "- REBAR- eompletoon nwnervbuilde"will have the burden of proving that the aid not Will or improv rparposeorsaley 105 - I' ANCHOR BOLTS : 1. "asowner.1di Prooeny��m�xd�ri:•elreo�i:�rni,gwuhu�=�aee�o�tr�.r�iotsln ._ -..• .-106-- 1__ ._.. .. ....__... __..... __.. SEWER_ &­ WATER from the projeet (Sec. A14J, Business and Professions cod=:) The Contractor's License Law does not apply so as owner of property who Wiles or improves thereon, 2 02 - UNDERFLOOR PLUMBING ' ' and who amit.a. for. such.p"aje<ts with ct a commm(s) licensed pursuant .,the ..... 2 03 -.....UNDERFLOOR- MECHANICAL' _....._ ....--- CnmmctarsucenaeLmn' ❑lam esu , B & P C mnhis mason 204 - UNDERFLOOR --'FRAME i : % o Date' •% — Tj 205 - UNDERFLOOR INSULATION WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING Ibeacbyafrm, under penaltyofpea,myone ofinefollowing declarations: - 302 - TUB & OR SHOWER 0 I hco( and will malmdin a CeniR<nle of Censer, ,n saff asure for worker's 303 - ROUGH MECHANICAL Comsma:ign, as, provided far by section 37W of me Labor Code. for the perrorman<danneworkmrauchthispematsi„ued 304 - ROUGH ELECTRICAL 01 have and will mainuin Wakes Compensation Insurance, as ma uirc l by Section 3 05 - FRAME I]W of the Labor Code: for the performance of the work for which this Permit is 3 0 6 - HOEDOWNS issued My Workers Ca pe f In.ui e, and Policy number arc'. Pai <r Na Curt•I.r 3CERTIFICATION -307,,•'-;_' k 308 `•SHEBTROCK. IN_SU_LATION - - - -= + '� ~ OF EXEMPTION MOM WORKERS', COMPENSATIONINSURANCEa _._-_.. 3O9--i,;-EXTERIOR--LATH-' (This section need not be complctea if the permn ,s for one hundred dollars ISIW)o leu.) 310' — INTERIOR LATH _ • " see 311-- SCRATCH COAT 1 err ihi ,he per c "the k for whichto p' it''Is 1 shall not employ any piarcars'in any man as to become subject to the Workers `° 313 - ROOF NAIL'; " Comp Com a ns ensation on Laws arCalifornia. Date . 501 - _FINAL.ELECTRICAL...ENERGY 502 - FINAL PLUMBING ENERGY NOTICE TO APPLICANT, If, after anaking ams C=nircn,a of E.ampnaa. yaa snov1° M: come subject to the Wurkcr4 Ctin,pensa,ion pmvi inns ofihc Lima, Code, you must forthwith comply with such provisions or this Permit shall bedcemed revoked. _ 503 _- FINAL MECHANICAL ENERGY ' 1 hereby affirm that Inde is'a'cond Ib'cOn•sTRUCriONLENDING AGENCY the lending agency for the Paronnance 504 - FINAL BUILDING ENERGY - ••` - - .. . , (Sfm. tm,permitLsinsurefsrc.x. cm. ca 505 - FINAL ELECTRICAL Lmbworkrnr -1 Lender's Name .. .. ..: ... .. .... _... ._.. .._... loader's Address I .. 506 n-- GAS TEST have 507 — FINAL PLUMBING I cattily that l "cad mi, appEcatms and viae that me aeave mm,manan is <oradt: 1 agree to emnply with .all city and county ordinances and state law, relaamg 508 - FINAL MECHANICAL ,o W ilding cismrractich. and hereby autbono, representatives of this city to enter upon theabone-memimmil pmpaty farmspca,mn Parposcs. 509 - FINAL GRADE (We) agrce1.mve; indemnify wad keep harmless, he City of C.pe-mossmamst ease jadg�n=nts.rosta a wad, maym any war <cmc again„ said - 510 - FINAL PLANNING in cane=yuenee o ,mating is perm'u,'I§ M, 'ILL COMPLY WITH ALL NON -PONT - - NA U C WO klaabiliov,. R .UI Issued by:4 _ G 1 _Date .. ppl'manvcm :a �� .• Date Re -roofs HAZARDOUS MATERIALS DISCLOSURE Will,he applicant or is. Wilding otcupanuroie or handlehazvdaos material, :Type Of ROOT.. •. .:. ,... .. .. - as defined by ,he Cimen Municipal Cal Chap, 9.12. J th Health end Snfe,y '; ' r e '- - -^ ^• .3 _,, :.. Cad Section 2s53'O - 11 Yes I i • N rt , ..• + , -- _._.All roofsshall be inspected prior_to any. roofing. material being installed. Will mepplier toff m Waldi gwas-Prim aseetu pai, m1delier, which ani IM1 z' d . a t m t. -, detimd by ,h Nsy AreaA Quality Masncmmcm - If a roof is installed without first obtaining, an inspection; I agtee.6 remove o °i "e' ❑Y. 11 No' all all new materials for inspection, Applicant understands and will comply with. PPP PY ... non-point source regulations_',.:. "- I : u. mmenals reyu{25533smnder Chapter ti.95 the I have read the hly Cd California Health k Safety C We. Sections 25505; 25533 and 255?4. 1 unJcra,and thm d 1111 a building d cnaa1, thm h is my raspo...mility m nntifY,hc - - -" - - - a-- - - - ace v , of m mq ,z arms e, prior ro iuonna of a Camps.. of u .. .... 6 3 . -. Signature of Applicant Date w "aumsnz=seas=nt '�' _ Date r All roof coverings to be Class "B•' or better OFFICE