02020048 (2) OF
CI BUILDING DIVISION
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
1192 CRESTLINE DR VOROS CONSTRUCTION 02020048
OWNER'S NAME: APPLICATION SUB DATE
VOROS DAVID M AND KAMILLA C 1192 CRESTLINE DR 02/13/2002
F` 'HONE: SANITARY NO. CONTROL NO.
(408) 253-9332
m ARCHITECT/ENGINEER: BUILDING PERMIT INTO
z _ ELECT PLUMB MECH
III mo u L_I u
y«
u z LICENSED CONTRACTOR'S DECLARATION
z_ Iheretya)of Do
notn3 olthe dander provisionsof Chaper9(commencing $CrIpllOn Oq
t-c whScci on]000)of Dirisinn3ol h<Busincas end Professions Code,.and myliccnu L
x a�j is h e aq 9 3 REMODEL BATHR OMDSve
EC
_ z< Lic ienx Q�
0 6 O E Comrac
0 t- AR all be u e as RATION
t-`O inat_S 1 understand my plans shall be used as public records �%�®,
x aE
i n C 0 Licemaed Pra(esai°ml
x o OWNM-BUILDER DECLARATION
m-w 1 hereby affirm that I at exempt from the Commcce's License Law for,he,
lollowing reason.(Section 7031.5.Business and Professions Code.Any city or county
x o which requires a permit to construct.alter,improve,demolish,or repair any structure
$2500
0
nam _poor u aloo rcgmrcathe appbcamfor such pcnnPermittoBkaztgncd smmnt
acc . _ _ . - _-- ---'
ata itlicemardp uan5 to h<pf Divisionas the the Boxors License Low(ChapterCoe) ,S Ft., Area-,
L
(commencing, thScuon]W0)ufDinsonJofthcBusinessand Prpf s nsCodp '!' a Q.
Valuation
B F q Y stolaion ; Zt 4't 1 + ji4 v1.Lai.t. tL.._S
or twihna<xempi hcidrom'aad the beim tar me nnb'ea cdem tb`.`�n '`36' 2'4'036 . 0'''0
_of Smiom]031.5 by any applieam Inr a permit wbjecu roti applicmm m a civil pennlay- '
mrnot mote man racnam,ea aodan tssoo). APN Number ; or.;"r:n Occupancy Type
❑I.as owner of th< n.or my employees with woes as their sale core tion, 101 — FOUNDATION
will d the k a d h set ct 5 omended or offered for sale(Sri 7044,' - - - --._ _-T02- — PIERS --- - ..-
lBasorss and P or:.i C al< The Contractor's License Lax docs not apply to an Required Inspections ' 't
owner of property Who builds or'mprovea thereon and who does such work F mself 10 3 - UFER
or gh his an employee,.powided that sh' pcount,me not r aloe idr -.. ._._104..•— —REBAR-..._
' o(fy d'f .l H'li ever lbs bu'IJn � are Year of � _-" _�- -
8 pmcPr.,is. W Ih "' t - -
'c°mplt h n name,xnlnavrmrnamrnorp,ovaBmmneannotbaim°r 105 - ANCHOR BOLTS
improve for parpnse
1.06_.-....SEWER..&.. WATER _.
u< wms,r( p`l]i"nwner,r aP"r..g,nsco iT c 202 UNDERFLOOR PLUMBING
❑� : nn t o I I t t .._ .
npr pr°peywho ba msoedpuruaroves,ttto,t , 2.03 — UNDERFLOOR MECHANICAL
.. 5.
and wM1gconwcts.for-such projem> a coronations)licensed pursuant to.he. .-
_.._.......... ... .. . ..... ..
toil _... .__ ..
c°nate"'ors Li"n w. 204 — UNDERFLOOR, FRAME,
= o1 am.riir mptnnee,Sec." B'&Pcrormis son 205 — UNDERFLOOR INSULATION
Owner ENS "
_ - 'WORKEN'SCOMPENSATIONDECLARATION 301 - ROUGH PLUMBING
Ihereby arrn,nunder pahyofperjuyime°r,the following declattions: 302 - TUB & OR SHOWER
� I I narn'ana will maintain a'Certificate of Consent to seleimnr<for Weaker, 3 03 _ ROUGH MECHANICAL
u
orientations -provided Bar by Section 37M of he later, Code, for he 304 ROUGH ELECTRICAL
- _= Performance of work ter which his pennies issactI 305 - FRAME
❑1 have and will maintain Worker's Compensation Imanda<t as required by Section 306 — HOEDOWNS
3]00 of de iLabor Cual for the performance of the work for which,his permit is
issued'My Workers Compensation Insurance .Me,end Policy number m:" '"
_... ,.._ 30.7 ,_-.,.,INSULATION
. ....
)) -
CERTIFICATIONOFEXEMPTIONFROMWORKERS" a k :'. y ," I`SHEETROCK�i--,,v, _
-_ _ COMPEN3AnON,INSURANCE.i I ....
'(rntsaecthmneed 6mb:corephtatifthep<,miesformehundredd.11. 310:;' 'INTERIOR LATH •, t,.r,l'! v. t.• =,i,t. .
rsiBo)o,l"" _ _ 3.11 — SCRATCH COAT _
in.,n' 1 rt but-The p, ",ncc onn<work for which his pemf r. ssued i - 313. . , ROOF NAIL , -
°P m� aPa3ao�e�tot h wn,kers 501 - FINAL ELECTRICAL tENERGY
Compo ytt woo
APPI c�/if
'NOTIC@3 PUCA Ir ,makingth sC Certificate fE Exemption y shame- - -502-= FINAL ' PLUMBING 'ENERGY - - _ --" -- ---
z beco compbject ly
heWorker',C rep a Provisions onn late era you 503 — FINAL MECHANICAL ENERGY
p p forth th< ply s,such provi�jmts or
----- -504-- FINAL"BUILDING ENERGY --
t
_ ..
u as a reacted ked.
r,� -. t y' CONSTRUCTION LENDING AGENCY ' "'• ' '
the by fftrmthtthae_-aconstruction lending agency(- th performance 505 — FINAL ELECTRICAL,.
W;. of th rk f h ch th perm a -i,xi ed(Sec'3097 Civ C) "
y:C - L<pa, N ' :: .... e ... . '.—.._. 506...._. GAS- T-EST. . . .-.... ...._.... _ ._..'. _ ....
=,z L<n,, , ;-It. - " 507 - FINAL PLUMBING-
0
retina.1 __. ..
V-p ,.lI anify mm l have reran hid appliraJon and sau
reacte that above information is 508 — FINAL ' 1
F age to comply with all city id counry,ordin...es ma same lama relating MECHANICAL
O U aobailafngennstmRinn,andherenyaatno,aercprtantaevt.nfhixcity to enter upon 509 - FINAL GRADE
W he above-mentioned property for inspection purposes.
o, (W) $reemsa ' d' nifyaadkeep trml 'shbCity fepenirmimioo 510 — FINAL PLANNING
Vi
liabilities.3 tlgmcros,con a a expenzcs h ch y n any y ryuc against sale 514 — NA Pd3 WORKS
C,7 7Fy city era rte gra rani..pcnna 14 O ,
S P Rll CE R.U LAtll W L COMPLY WITH ALL NO PO NT'' ISSUed b C/
r�d. Y Dat
ApplicanUC°ntmcmr j;`.
g,tHAZARDOUS MATERIALS DISCLOSURE ° Re-roofs
'-
Will the ppl c is"Cif.amebuilding accupartmrambadjoazard6maraderiai T e of Roof
az def ed by he C pen n Municipal Code Ch is 9.12.and theH alh d Safety yp -
Code Seton 255i>la7 fr 1
El Yes - +t yr.i 1t sJ c , I k � P iRnT rS f7h
All_roofs shall be inspected poor to any roofing material being install-ed. _
,s,11 th applicant fm building P t equipment devices -� -
emen If a roof is Installed'without first obtaining an inspection I'agree'to remove
emnh zaido nem nam udefnetl by heBay ArtnA Qilly Management m
all new materials for inspection Applicant understands and wY
_ill Comply with _
°Y , all non-point source regulations. ... P ,
1 h e rc°a he'linali a mat rials,cgmremcnts undc 1 Ch filer 6.95 of the
California Health&Si(ety Code Sect ons 8505 25533 and 8534 I andersaind that
7 die held E-is,:ic
cu,rentl l ve���qqquuuaa4sss!!!��'nC=hillt y tespoai b'I'ty a notify to -
occu f m t y so iCu e f a C nificae of Signature_of Applicant Date
� hpraee agent All roof coverings to be Class "B" or better•
FFICE