01120066 (2) OF
CITY
I BUILDING DPv SIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT N0.
10280 PHAR LAP DR HIGHLAND CONSTRUCTION M D PLUM 01120066
OWNER'S NAME: APPLICATION SUB DATE
GERRARD & GI'LLIAN RUTTER 20073 NORTHCREST SQ 12/14/2001
PHONE: 4082411858 SANITARY NO. CONTROL NO.
O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
CC BLDG ELECT PLUMB MF.CH
I -I IL3
LICENSED CONTRACTOR'S DECLARATION
5 ? Job Description
1 in= 1 hereby atlirm that 1 orolicensed under provisions of n,C Charier 9(commencing
=t� with Scaion]WO)of Division3ol the Business and Pmlcaionv CeWe,vntl myli<ense 2 BATHROOM R L
Ial is in full force and effect �<78'SZ F11M LED
?C 6 License�C�a�s��7 Lim.p ✓ O !!!!! ! Psi
Date L�N�I� Camra e
i-n ARCHITECTS DECLARATION �L
] y 3 I understand my plain shall be used as public records MA �7R U g 2003
OO Licensed Professimml
OWNER-BUILDER am 0mpt from
DECLARATION BUILDING
5 I hereby.(Sinn thin 1 oro exempt(ram the Contractor's C License Law for the
F z a following reason(Section 7031.5,Business and Professions Cwle Any city or county
$3_500
S O which requires a permit to construct,alter,improve,dental ish,or repair any structure
til3 ..•prr r t suar Is q theapplicant for well } 'tt f dnmmmcnt' .. �. t .. .. .._._._ .-_._.._.—
L _. __..__ __....___
perm signed --
tcommin m g with S p Pmihe pro rsions of the he a,v hn License l.aw(r,crag 9 f z t' 't, Valuation
or t ncls a with Section 7000)nnlamd the basis
3 of the alleged
.nJ Piro.Any vi Code) r •1, }����&��•��Z'z15 i:1st 'v � '
or(name is exempt Ihertfmm end the basis forubjecet the ezeicant t.Any violation '
-of ron mar]Oban iv a u dred dant for a permit subjttb the applicant m a civil penalty p y•ryp
of not more man five hundred dollars asooj. 101�PN DATION •""" " Oecu ane e
❑1,as owner of the property,or my employees with wages us their sole cecon,m mein 1 0 2 -
-
will'dothe'work,and the structure is not intended or offered In,sale(Sec.'70t4
'Business and Professions Code:The Contractor's License Law does not apply to an 103 - UFER Required Inspections' -•' ''
ow
r of property Who builds or improves Inirion,and who docs such work himalf
or through hisW wc,rr,es,provided that h rap em I: in intender or 104 REBAR _
off cd o s I If however wibuildng o improvementa within one Year of ` _
' caro lmran,theawner. 105 ANCHOR BOLTS.._.. � •. � , "F•
p hu lderw 11 have the borsch of provmF that he did not build or
impraveforpamasaafsale). 106 - SEWER & WATER
_ - .❑1:uownenoflhepropenYamexdusivelycomtaningwith licensorcomracmrsta 202 - UNDERFli00R PLUMBING-:,;a—'�t.,E_{.:?,?I_ , _... .._ ._
construct the project(Si 70,14.Business and Professions Cade)The Contractor i
License Law does not apply to an owner of property was Wilds or improves thereon, 2 0 3 - UNDERFLOOR MECHAN I CAli" T
. . ..and whos License
for such projec0 wire a connotations)licensor pursuant m.he. _. _ . .. -204"' UNDERFLOOR'FRAME--
- Contmnor's License Lew. . . .._ .... .._-
❑lamexemptunder Sea. ;B&PCfor this scrom 205 - UNDERFLOOR 'INSUIIATION
owner ' Date301 - ROUGH PLUMBING
WOR KER'S COMPENSATION DECLA RATION
.f302 - TUB & OR SHOWER
I hereby aurin under pi rally f,,j.,one ofthc following declaretions: 303 - ROUGH MECHANICAL
0 1 have ad will maintain o'CmiEcate of Consent m self-iurnme for Worker's 3 04 - ROUGH ELECTRICAL
Compensation, as provided for by Section 37W of the Labor Code, for the
'perfomnanoe of the work for which this permit is issoed. 3 05 - FRAME
Yhove and will maintain Worker's Compensation Insurance,as required by Section 3 06 - HOLDOWNS
of the Labor Cl for the performance of the work for which this permit is
1 CERTIFlCATION OF EXEMPTION FROM of n ronin a r
carrier and 307 INSULATION
¢suctl M;Works Compensation
emrmr�'ryL rv�OMPEN5AT10N INSURANCE' 23 UI. 308 -' SHEETROCK;
IrA3'
•Pdmy No WORKERsp r y P?i�irT 13)b4""1 'EXT-ERIOR, LATH
E' ._..._.. - __.-.._ _
.e_x - ._ 'ae.:. =-';INTERIOR--LATH- •-. ---;
fThrs nron need nm he completed if the permit is for one hundred dollar
($100�arbes.); 311 - SCRATCH COAT
- - 3-13-- - ROOF NAI,L.•.
o 1 n fy Nat in the perfarmance o(Ne work for which Ih s perms Is Issued,I q r
"shell not canipoy any person lin any manner so as to become subject to the Warkers'
�
If aft Data
' e .
S O 1 FINAL ELECTRICAL ENERGY'
Applicant -' - - : . .502 FINAL.-PLUMBING -ENERGY-
NOTICE APPLICAN T nakmgthis C rmof yoasho it
z become s6be t totheWorker's Compensation provisions MtheLab Labor Come, most
503 FINAL MECHANICALENERGY
O foithwth comply tsuchp provisions or lhrsparms hll6edeemerevoked
--. .
, . , 5.04__.= ..F,INAL-BUILDING_.ENERGY .. . . ._ . _ _
CONSTRUCTION LENDING AGENCY 505 - FINAL ELECTRICAL, 1,71.
> 1 hertby arctm thin Inert ti s coned(Scan lending agency for Ne perfonnantt ..
a oioewbrkmrwhiehmispeimitisiaweafsm.3rnzCiv.ca 506 - GAS TEST
'a.Q Lcnder's Ndme-...�.. � ,._ ..._ :.:...... s ... ... . .- _ ... - _._ _.. _-..__........... .._. ._ .
,p.,Z LgidersAdgaPesx 507 - FINAL PLUMBING
.I certify thnt l have reed @is application and stain thin the above information ix 5 0 8 - F I NAL ME CHANI CAL
W,F kminor.1 agree to comply,with all city and county ordinances and state laws selling 509 - FINAL GRADE
U ;to building tonin. lhcsf and hereby amhoriie opresmtdtives of this city to enter upon
'red theabovamentloned,mpanyrarin,,,allonparposes.•, 510 - FINAL PLANNING
Q.- Afilbflit
e to savu,mdemriify anJ keep hamdcss the Ciry'o(Cupenino'againn
e costs and pensee when may inanywayuamme against said514 - FINAL PU IC WORKS
C„) r2' rte the ti got dtis permit. "DE 1 Wf NO WILCCOMP,Y,Ai H'AL' 0. OINT Issued by: r Date
Sis ✓Cantmmar fface Re-roofs
AZ RDOUS MATERIALS DISCLOSURE - -
"'`I Will the oepb6at or furore budding occupant store burh dl normal man I. Type of'Roof.
as defined by l25321
5h Capenlno Municipal Cod Chapter end Ne Health dSafety, Y /'
6A, Saone) +' Y' s ',+''a J -rt ::::.1
a li r t F Afy y af: *Hr
. ..All roofs shall_be,.inspec[ed,prior to any-roofing.material being installed.
em .Will the applicant of future building occupant use equipment or devices which If a roof is installed without first obtain in an inspection',- a I, red td remove
it hazardous air contaminants as defined by the Boy Arc.Air Quality Management g pecg
Carrier! :; : all new materials for inspection. Applicant understands and will comply with
❑vea. - ; E)No I ; 'all non-point source regulations
j l have read Ne tieznrdoui'mamrials regmrtmems under Chepler'6.95 of be
'
.Coli(lint.H Il &Safety Code;Sections25505.25533and25534.I understanddrat
,fifth pildi does al'.." o¢nant.that it stay responsibility m notify the
' ddc r 'req 'rc t- nose bemet f
O lira issuance Ceaifcm f
121141 o
Signature,of Applicant - Date
r. ' o n . Ina a ganr, Cl
Pate - All roof coverings to be ass"B"or better
OFFICE