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01040079 (2) crrv oH cuv�e���rvo nuu.uiuc orv�sioN pERMIT CONTRACTOR INFORMATION: IiUI1.UING AUUNIititi: PI?NMI1'NO. OWNIiH'S NAMIi; AI'PLICATION SU0 DATIi � J �1 IONf:: � tiANITARYNO. CONTROLNO. ❑�% ANGIII'fliCl'IIiNGiN1113N: tlUILDIN(11'13NNI9' ) x�� . 01.UG GLLCI' YI.' . M[CH Fj� O I� 7 CI �dc z�y;� . iacianson con�rancroirs nec�nHrcnoN Job Descripliun _ I I by II 0 i l� I :J 1 p .� : I Cl�p� J l mrn�ing ��F� i} � JINNq D P � f il B ' J P 1,/' -CpQ�u� y licrns �p T �;�«� ��cK �� `Q � " �'1��� COPPER REF' PE WfaTER SERVICE WFaTERHE �3 LL „��� � r � , , , �, , ��«������� ,������k�,��N t'� ? i��e��.a,�m �ynm, .n,u�.�.en.owni.«.��ni. � �� ` LiacnwJ Pmlcuinnal - t�/ � �a e x OWNFN-Pl11LUliH ULCI.ANA'i'ION ' �/ �/ 75=`' i i�,�i,y u�n,����e���i,�����,����m r,�,����i��c����:�.��„.u.<�,n.u�w r��,�i�� { p z Q ionowing revnni.tswuon vo.t L5.unntncsn nne rnd.xdonF codc:nor div����owiry O 5 2 O wM1ich reyuima a pennii io con.amci.ul¢r.inipmve.Jemolieh,ar rc0air xnY swcmrt / a3� �nonoii.ic.uance.alwmquinsihcapplicamforeuchpemiiuoflca.i6neJna¢mrn� m,�n��..r����a����:�����m�rN�;,������nn�a,���.����,.i.�«��iAwicn.,rrer� Sy. P[. FloorArea Valuation (cnnnnencing wiih Scmion 90iNp ot Divi.inn I of ihc Iturincr�und Yrofc.vion�Qulu� air�hul hc iv inl�l�hacRmm�nA ILc buv'ix lin Ihu allcguA u mnplinn,Airy vinlminn � rsn�il�m nni�s ny miy urvrcnni em n cennL vnni�a.monrntivum io u dvl re�ney „rn�������mmU�r��n��an�ae��nU�izsan. APNNumber Occupancy ype ❑t.,.��,.���.��r m�r«��nv.��,��y�mrmy«•<..��nn H��s�.,.m���.�i��������x������. � wtu d„n��w��n.����e in�.iti�������.����������,a�a����ima•n m�w�i��su.nua, m�.����..a�,a N,��r.�.,.ma�c�m�:�rne c�����.�n���.�.m���.�i.ow e�K���„����iY�a���� � � eqmred Inspections �"�n,or np�ny wno n��m.�,.�������.,m.�.e„�.��a wn„a�K.w�a�w„�G n���Mu �Fnm,�w�.mvmr��..r�„m�amo�.��rn�mr��,<�������m�„�m���w�ao, 10E — SEWER &� WATER onerca rnr.alc.Ir,nuwcvvc�nc buildin8 or imrmvcmcm i.znld wnnin nnc yca o( � n`��o�i.�r����.m���w�.�,.n�nn�,w�nn���m�m��a��,�rr,������,uimm��mn�����n�na�„ _ 202 — UNDERFI_OOR F'LLIMNING ��„���w r,p��,n,,.�„r.w�.�. - ❑i.,.���«orm���,��s.����,�w,m�ir.,���������Fw��ho«�:.�����iN�����„ 301 — ROUGH GLUMHINC� i��..�N��m��mim��su.�uu.���.��.�,.,�e rryr�..����,c,.��:��rn�c��m�.«�,. 302 — TI.IB & OR SHOWER .����•��..c i.:ww d«.���oi�pvq w,��ow�e.„r r.,��.�nr wm�n��m.�„�mp����.m���a��. ��n wi��� ,�i��.i.m�w���i� n�,�i.w7F w�ii���.���,�.on��.c.i r.a,.,.e�,�n����i�<�m� 50� — F I NRL PLUMB I N6' ENER6Y Cunlmciar's Linnec Inw. ❑IummcmO�unJcrSa. .UkPCfnrthi.reamn ' SQ�f] — I�]�IS TEST �w�=� o��= 507 — FINAL PLUMBING WONKHft'S COMPF:NtiA9lUN DLCLARATION , Ihc¢hynliirmimdc��xnahynfperjurynncaf�M1etnllnwingdeclnrwinm: � � , 1 �uvc anJ will inaimain n Crnifcmc nf Conscm io ulGin.urt fnr N'arkcd n���n����u��. ��,. n�o.wed r��r ny sur„o a�iu or m� i.ono� c�,�e m� m� p�7foruwmm�l'�hu wnd fnr wliicM1�hi.�wnni�in IeancJ. ❑I have unA will muinuin N'neAcr'c Cumpenwiinn In.vumnee,u.a myuimJ hy Stttion 1p1 d Ihe WMrt C�vle.lia�Le�rformvnce n(Ihe wnr4.(or xhich i�ie parmi�i.� �, '�Y�h�,���,�,��„7���m�,�� C��./� CIiRI IPICATInN Of LXIiMPI ION PNON WOR� ���i/' COM1IPf:NtiA'I'ION INtiURdNCG (ITin.cciion necl nm Iw ann�plemA it�hc�nnnii i.(nr nnc hmdreJ Jollan ($IINp ar Icxc.l I amify ihal in ihc�rfominnm uf ihe wnrA fur which ihi.�nnii is ismeJJ fhull nm cmploY+�Y IKnon in vny munncr m m io Ikcamc wbJmi�o��e WorkccP Cnm�moiian laws o!CaGfamiu.Dmc Appll<am N(YllCli'CO API'I.ICAN9':11',nfl<r in�king�Lld C�+iiGcnm��I'L'xcmpiinn,you ehnulJ - Q Qhcrninc aM1jaci�o iM1c WnAcr'.Cnmpen.��Gnn pnivi.ion.of ihc L�Mr C�Nc.Y��u mu.� ' lonhxiih aomplY wiih mch pmri.iom nr ihi.�m�i�.aM1ull be dccmcJ mvoAvd. z _ F ^ consreuc�rioai.r:NuirvcneeNcr CG 7 I Lemny:i?rin ihw ihere ix u connwaiinu Icndlnb�gen<y Ibnhe pclm�inuncc � ol'�hc wnvl fur xhich iFia pcnnii iF is,wc�[ticc.lfM)].Civ.C.1 d Q I<nJchvame � 7 IanAcr's.Wdms. U O i an�rr mm i n�.���c��n nd.��,i�r���a„�����a.wi�o�:��mc��n���o�i��.����v������. �+ (r n rin�t I uprcu lo mniply with ull viiy mW couniy ordinnnace nnd�taic Wwe rcluenµ Q [� iobuilJinganurvclinn.eMhmcFyumM1orirtrtpnxnuiivc�ol�hi�ciiy�nnilcrurym } i Ille uM 1 1�!rff1Y 1 f� �Mflit �1 1�M:.. F... a (K 1 6 ��nu J (Y Jk ph I::�heCryofCupctlmoa6+�n4 V] IuFlie. �J6 �,ea i il pv .ee 1 I �y n:urywaYaamv:y'inM<mJ V � l' . I o I y�' i h fihi.vl i ��I �� - .:U�'CA Gl� �� SNDSANDWILLCOMPLYWITIIA�N�POINT �StipC(IbY: � DBIC �� } ,—� �i, �:��✓c� ����,��� ��� u��� Re-roofs IIA9 ItUOUti NATfIHiALS DISCLUtiUIiI? wwn, nppliami<-fuwrchuilJinS^�'�'uPumsumorhanJlchwmxluuvmnicnul 'ryPeofRoof un JefncJ by ihi n Municipal C�dc.Chnp�cr 9.12,nnJ the HeuliM1 anJ Safny Cnle Scnion 2SSJC(ul' ���v �"°' . 'All roofs s I be inspected prior to any roofing material being installed. . w�u m�:�i,i,r.�����,�,���������i����ia���s,�,�.���,�,�,�..�.•,i����i,���.�������a���.���.,,a��.�e If a roof is ins�alled without tirst ob�aining an inspec�ion, 1 agrce to remove �nii hueurJnun mr aomaninonu u.a JcfmcA hY�h<Iluy Arca Air pualiiy Manupenmm ��„��rr all new materials for inspeclion. Applicant understands and will comply with ❑v�, ❑u„ all non-point source regulations. 1 huvc rcuA ihe huiurAou�inacrinlx rrynircnrentn unJcr Chnpicr G95 n(ilm 'lifornia llcu h N�tiufciy CnJu,Seciinnn Y5505,255�J unJ 2553Y.I nnJenwnd ihui uilAinF� ' nntcum�nilY'havcumwn6ihati�i�nryrc.Mm.ibiliiYwnoiily�hc cupa f iM qui �.xhich mun tc mm priar m is.uanm a!u Ccnificau ol rtlne � p, I �� � Signature of Applicant Date . W��, �b�,,, 1 ��„� All roof coverings to be Class "B" or bet[er OFFICE