00060008 (2) CITY
of cuU"M I�
No CONTRACTOR INFORMATION:
tE+4SY�a`MaNROVIR RMIT 0006000e
lie I LDING AID DRESS: PERMIT No.
KIRTLEY STEVEN AND DEBORAH 06/02/2000
OW'NER'S NAME. APPLICATION SUIT DAI'li
PHONE: SANITARY NO. CON IROLNO.
M 5 Z ARCHITECUENGINEER: BUILDING PERMITINFO
fit OyO❑ BLDG ELECT "LAMB MITCH
G� WHIRLPOOL Tq% ffipi{j�i�Cn WOOD FRAME, ETC.
LICENSED i s licensed
u OR's DECI.A RATION
O z_E
I hcrebr mllirm Iha I am licensed under Pn,ri,inns of CbaPter Y(mmme¢ing
F n,hw all Section 70XX))of Division 34me Busine—ml Padeoions Code,and my Iiccasc
in full lime ill effect.
a p ac V License Chas Lic.p
XK Dole
ARClS ASALAc O 1 understand my Plans shall be,Lisel as Public recdd
see
a p O Liecnad Profcsaional
OWNER-BUILDER DRCLARATION O
'Ku=to 1 hereby allimt that I am ctempt front the Contractor's Idoca,c Law for the /
t!< following mason.Isbell....7031 5.Bminesx and Pn,le........Code:Any city or county
x G which requires a Planar n,cen,mt¢L ultnr,improves demolish,or repair any.structure 25mm
w5m priormbs issuance,also requires the applicant for such Permit m,file asigncd statement
Ihathe isaccn,cdpunaamtothe pmv,aonso [lie Comrecvor'aLicemel.1w(ChiL,leo Sq. Ft. Floor Area Valuation '-
lcuanmcmeing with section 71100)of Diskion 30 the Busines,and Prefesxinns Code)
or hat he is exempt merefrum Land the basis for the alleged exemption.Any violation 35623021. 0m
or Section 7031-1 by any applicant ILa a Iwrmil nub,scss(lie appl'v'.an to a civil pamlty
of Cot more mat five hmodred dollars D500). APN Number Occupancy Type
❑I,a.nowner of the property,nrany cmploycc,wish wages as Iheil L,lc c'ontpmuation. 101 —
FOUNDATTnJ
will do the work,and[lie structure is net intended or offered for sale sec.7!144.
Ru,iaess and Profesdon,Code:The Contractor's License Law does not apply m an 102 — P I E RSequired Inspections
orr o1'anpe,ty Who hoods of improve,baboon,LtmI who tutu,a ch work hi ell
through his owa emno,res.Provided that such map s are aot intended m 103 — UFER
offered for sale.If,hubsever.the building or improvement i,sold within one year of
maplemot, he owaeahaa�der will the hanson if proving that he did not hold or 1.04 — REBAR
"ttProvct PaTt"ol'Llk.) 105 — ANCHOR BOLTS
Xi,as owner(it'(he n.own,on exclnively contracting with licensed comroemrx to 7.06 — SEWER & WATER
Loarimsm the pmBusiness and(Sec.7044.Buand PriaRo.vions Code:)The Contractor's
icense Law does not apply to:n owner ofpraPertywhobuilds orimports,themon. 202 — UNDERFLOOR PLUMBING
and who conuucs for such pro,lccas cilli a soniramnr(9 iwl,awl parwanl to the
�a.c1rs LI^ Lie 203 UNDERFLOOR MECHANICAL
lamcxc t der$ Il&PCli,nhi.reason
Gas I, 9pye 2/ d/� 204 - UNDERFLOOR FRAME
RKER' .Oh1I'ENSAly.ldDECLARATION 205 — UNDERFLOOR INSULATION
. IharbyaMinoorder pona4y.ofperm,blic,Idwfall"ingdeelaration.: 301 _ ROUGH PLUMBING
m
❑ 1 have and will n intoin a Ceoc,te of Consent to sell-in,be for Worker 302 TUB & OR SHOWER
Cnmpersuii. , it, Provided for by Section 3700 of the Ldlwr Cada Ibr the
Performance nnhewalk for whikhthis pcmilisi..trd. 303 — ROUGH MECHANICAL
0 have Land will maintain Worker sCoiniansationInsurance,asreyuir.dbySection 304 — ROUGH ELECTRICAL.
37W of the LUMa Code,for the Wrfommnce of the work for which this permit is
My work....coanpeasatioa,tux"mace corder L Poliey..amher or: 305 — FRAME -
carrier: Pou.yNo.: 306 — HOLDOWNS
CIt.RI'IPIcxt-ONOpE IiMPfION FROM WORKERS'
COMPENSA'T'ION INSURANCE 307 — INSULATION _
tiIii,,bedioaineed aIbeeonifiendifhelwomaisfotone hundred dollars 308 — SHEETROCK
(atwnole.,.) 309 — EXTERIOR LATH
I ,mfg thnl in the Nr,ornaanm Lit'Lhe work for xhich this permit is Noted,1
shat]not employ any penon in any mam,er an a,m he.ome xd jcel in the work,,,' ..31.0 — INTERIOR LATH
Cnmpematio.Law,ofcalimmia.Date 311 — SCRATCH COAT
Applicant
NOTICE RD APPLICANT:It.after mak'ar,to,eenificale or ;aettmion,'on'I nwd 313 — ROOF NAIL '
M1ti
ernme,subject the worker's Compensation prossila,of the Labor Code,you must '
p C llubwlntcomplywall such pr"vi,ioatxorthis remit,halIbedeemedrevoked. 501. — FINAL ELECTRICAL ENERGY
F m
CONSTRUCTION LENDING AGENCY 502 — FINAL PLUMBING ENERGY
!Yi ? I hereby mTnn telt there Is a construction lending agency for performance
of he work for wlishahis boil„issued(See.3(Q7.Co.C.) 503 — FINAL MECHANICAL ENERGY
0. c Leader,Name
Z bender,Address
504 — FINAL BUILDING ENERGY
UTOr Ireality that Ihave read this application mil chat the above information is 505. — FINAL ELECTRICAL
ca,reel.I agree to cabby win,all city and county ordinance,and nate laws relaxing
O U tobuilding con, edon.a ad3tOrby mall ire reprcrvawtive—I this city to marc at at 506 — GAS TEST
} 4s. tao
he above mentioned properly for inspection Purposes.
F„ a (We)agree tos abmcaanifyandkeephdraae..theCityofcolLemboagam,t 507 — FINAL PLUMBING
e� Vi Imbilitic,judgments,costs slid espenw,xhich maty in any way accrue against sand -
z city'meannirmiceW helaaramgnlpermil. 508 — FIhIAL 'HRNICRI_
r SOUIRCCREGULATIONSNDS AND WILL COMPLY WRH ALLNON-POINT Issued by: Dille
Sigre re of A,,InanUComramo Dale Re-roofs 510 — FI NAL PLANNING
GAZA Will the applicant rcRlmoae bulding ocujantMre.iandle hamud...n.renal Type of Rod$14 — FINAL PUBLIC WORKS
Is defined by the Ca nine Municipal Code,Chapter 9.12.and the Health and Safety
Code.Section 25532007
ID Yn' ClNo All roofs shall be inspected prior to any rooting material being installed.
Will the applicant no battle haillin5(........i"seegta'aryaena dcvlacswhich If a roof is installed without first obtaining an inspection, I agree to remove
emit hvallom air ronmmial as defined by the Huy Area Air Quality Atanagemcm
1)....let? allnew materials for inspection. Applicant understands and will comply with
0Ya` °N” all non-point source regulations.
I have read lee hazardous materials requirements under Chapter 6.95 or the
Caliliania Heehb&SN'cty Cade,Sections 25505,25533 end 25534.1 nndcmmbd mm
if the building drcs not currently hose a Lemont,that it is any responsibility m,notify the
occupant ry
of the ruiremems which om
abbot he et prior b im'
xxtae of a Celli Beate of
Occupancy.
Signature of Applicant Date
ownerin.,at i.cd.goal Dale All roof coverings to be Class "B"or better