00100162 (2) cITY.OF cureCONTRACTOR INFORMATION:
nuu.oruc DIVISION
story PERMIT
M. BI�IING ADDRESS: PIiR1,11I'N(1.
1171401 nAmyTil-E AV ROCK SOLID CONSTRUCTION 001001.62
OWNER'S NAME: APPLICN'[ON SUB DATE
3 7 2 CR "IGHTON PL 1.0/24/2000
UNIT: SANITARY NO. CONTROL.NO.
I F5 " :tr
Mat G ARCHI'fEMMNGINF]IR: - — BUILDING PERMIT INFO
2C[ It ELFC7f PLUMB MI:CH
u t`a O IJ CI I_J
¢y
ucemn:D coN'IRneroR's UrcLAlxnrB)ry Job Description
_C I hereby ulfm,that 1 um fmnssB under and
Prons d ns Cade 9lxa,my license F=h-. with Swfionaandetf Division lofthe Business and thole„ions Cute.and my license
;a n.0 forte oast fine` e KTCHEN REMODEL/ELECT/PBG/MECH
a ..mens'Cl:.,, 1'3 1-ih.a_ 3
Bee ia u Doe—g9�xY�0 Commmo oo 9o�r 'foi�Q.
3 e ai ARCHITECT"S DECLARATION
♦_'u-"�� dvsmnA my Plan,shall be u.aJ m public recmJx
OLccnwJ Pndus,ionul
y o._ OWNfR-BUIL"I mru Ce ContrION
1 herthy..seas,'tiro I vas exaMt Imo the Cnmmctnr's Liyenx hw for n
>- follow,up reason.(Section 70315.Business and Pfnfcssions Cone:Any city or cuunry
gD which raluine,a permit ,,etm,mat,aher,improv,demofi h,ar cepa;,any hamature
f4C�
prior tn it,moance.abo...../oas the applicanmlt P:
t for enn ntat file signed sancnt
mh
55333333 Inas he is licensed pursuanttothe ro.,kintuol heC...h nrx..crno,l„w(a,nmern Sq. Ft. Floor Area Valuation
ficommencing with Section 7108)of Division J of the Business and Professions Cale)
or that he is exnnpt therefrom and the basis for the al leged exemption.Any violationIT
of Section 7011.5 by any applicam torn permit subjeca the applicant m a cis it penalty
oras..momhalo live let mo-eJJolwr,(S50). APNNumber Occupancy Type .
OT.axnwnernf the prophn&ormyen,ployce,with wages as their wile compensation. 3 tl ?"e
will do the k d the structure not intended or offered for (Sec.70cW
Box n r:. Cid Th1 nt L L: 1 wwlylaan Requiredlnsp( ons
w hfp' I t Weh lit .......11 IMeanest,_ h kHit,&
4
�nneswn howre-P end t: f is 1. t intended or 101 — FQUNDAIION
cd for ale.If, e, willing or improvement noro w.min not ear of �(/
completion,the owma,builehe will have me burden of ren.ig that eath not Wild or ]@2 — PIERS
�
Lnpmve far purpose of.ale.). 0
' 103 — LIFERT.as owr of hepoptny.ait,v,lay,rI, onfiane,wimbhca,edroin...1xx1.
ne
canmuct the project(See.BW,Business unit Professions Calc:)The Coolowho's 104 — REBAR
license haw does not apply to an owner of pmPeny who wilds or impmrc,thereon,
cnd who muaet,torr such wmjeax with a u,atraeme(s)licensed pursuant to the 105 ANCHOR BOLTS
ad...ta.�lime,I.t.w.
O l ao emn.pt andee Set. .e&PC fo this reason 106 -- SEWER R• WA1"EPs
owner nate 202 — UNDERFLOOR PLUMBING
woRKliR•s conn•r:Nsnnary DlscLnRA'r1oN 203 — UNDERFLOOR MECHANICAL
l�
Inhrhny atlas,amass penalty of perjury one now laBewn,g detlnmam,.: 204 — UNDERFLOOR FRAME
T have and win mamtart a Cenificam te of Consent self.in,me for woke,
co.npxa,lon, us provided Int by Semon 3700 or me I.:mnr Code. ha me 205 — UNDERFLOOR INSLII_RT.TQhI
I f o,oohswokfnwh;tnro;.pt ...Ii, "..ted. - 301 - ROUGH PLUMBING
V7have and will nuinfiin Worker's Compcnxation Insurance,as required by Secfon 302 — TUB R QP, SHOWER1710 of the tattoo,Code.for the ry fficlo urce of the walk far which this permit is
;,sued.MyWoor.Catpen,afonln,amncecarr;crandPolicynumberart: 303 — ROUGH MECHANICAL
Carrier:
.5 wnfieyNo: 157.7.357.11? 304 — P,f.ILIG-1 ELECTRICAL
CEIYI LICATIO. OP Ii.KITIMMON FROM WORK17RS'
COMPENSATION INSURANCE. 305 — FRAME
ft'
(na,w,tion need.oIh.,....Bdevenhflat, 11 is atoolewndredmolla" 306 — HOLDOWNS
1510()nr lea..)
I certify that in the Wih,7ano of me work mm mix permit isissued,) 307 — INSULATION
for mI
.hall not employ any enol m any o,ita xn:, e h, he Workers 308 — SHEETROCK
Co...."ali I ha"oI Cl.bino.a.Data
Li
Applicant — 309 — EXTERIOR, LATH
NOTICE TO APPLICANT.It,after making this Cer ilia',of Excmpfion,you should
became subject tome Worker,Compen,aaon no,itum,acne Labor Code,you..a,. 310 — INTERIOR LATH
p fortimcotnplywith such prov;x;onxorthis stinitxnmlbeclaimed resolved. 311 — SCRATCH COAT
FCONS'IRUCTIONLENDINGAGENCY ^i3 — ROOF NAIL
'Y 1 faint afro,that there i,a constriction lending agency fur the perli ni an3ce
W ol'the work far which this permit i,issued(Sec.3097.Civ.C.) _
y 'q Lewer,Niat .501 — FINAL ELECTRICAL ENERGY
u zz L`nd,,fiddar, 502 — FINAL PLUMBING ENERGY
l«rtdy that I
comply read this application anationnty state thmthe awvc Laws afinn;x FINAL MECHANICAL ENERGY
0 Fx toemev 1 con to comply with all city and county ordinances ,city law,enter
upon 5@rr —
[� Inbuilding eonsn..cal an 1, cai amhoe;rc rep,nvcmmives nr this city menmr upon —
A. n,hang(We)armee1. a,ndemittyandkepuep„x�. 500 FIh1AL BUILDING ENERGY
A. es.judgmemmvc. and ctlyunJ whihumayinthe City y.,me nro,ain't against —
U) IiaM1iliticn,judgment,,cn,u and apnwx which may in any way..erne.,ain't ie 505 FINAL ELECTRICAL
V Z Ciry in cu of the 6'rmf,g of l' ..seat. 50. - AS TESL”
'••' SO fA 'T ante I b ). aNIJN L O YWITH ALL NO PO T Issued by: — rk Date LCA^Zu—u�
SigtmmremApplicant amor 1 to Reroofs508 — FINAL MECHANICAL
HAZARDOUS MATERIAIS DISCLOSURE
Will the appi no or future w;hW,g acupa.n sore or handle haran oax mateaal Type of Roof 509 — FINAL GRADE
a,defined by Ihh CUWrtinu Manicipal Code,Chapter 9.12,I.nA Ile Ilealth and Safety
Code.Semon 25532(,)' 510 -- FTI(IAl_ PI_Ahlh INL"i
Dyes 0 N All roofs shall`,h inspect d( to- o }��y being installed.
Will me appfcumor future building occupant uxecicipmamordeviaiwhrah If a roof is ins al�e`�l wi[h�u[4Sftif'ob�ag� nh'n.T�S$Ctioh,, I agree to remove
Vmi1 haxunlonn,it con annina rex detailed by the Ilvy Arca Air Quality Mnnugcmenl
wren all new materials for inspection. Applicant understands and will comply with
OYe, Ova all non-point source regulations.
I love read the haxalloo nnttedms requirement,under Chapter 695 of the
Cnhfonuu llwlth.v 5alcry Code.Scalion,25505,255..unA 25574,f eadc.,luvd thin -
it'mcbuildingdnv..tot currently have a jkle,oh0d,ithmy rexlamabilify urnotifv the.
'occupant of the requirements whi h t ,t be met per r to issuance of a coif Ie of _
oann Signature of Applicant D Date
cup=
�
0. - — —-ate— All roof coverings to be Class "B" or better
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