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S 2971 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY F.RTINO IIUILDING.ELF.CI'RICAL PERMI r No, (:TTY OF CUP BUILDING ERTIN APPLICATION/PIiRMI'1• PLUMBING,.MECHANICAL. BUILDING PROJBCr IBRNI'IFICA9'ION BGILDINGADDRESSI SANT"GARY NO, A'I'LIC 'rlOa Sf fhl DA'rli __2)_ a 2s S OW iR'S NAMIiNIC CONTROL# : PIIONIi: C(INTRACI'IIR:S NAME: LIC NO 1 1 AHCHI rI:CrIE%GINEEW LIC NO: ADDRESS: ❑ CONTACT: VOONF: PLILDING PERMIT INFO ZS E] Consultant Fees Paid by Applicant(Initial) EE ELECT' PLBMB nff❑CII wnh Sc Itherr ...t,ltInn3UdcenBaines. pAwkimis If Q'PY ELECTRIC PERMIT FEB LICENSED CONTHACIOR 1 ncreb�afOnn that 1 Ian Iiccn,cU undo pnrvisions of Chapmr 9laammenciog 106 DESCRII'I'ION owz - and PrefeWI,Coll ,nudity license is .O RESIDENTIAL F PERMIT ISSUANCE -1 in lull l'omelmal elect. ❑511101. ❑KITCHEN REM(llliil. qU~ Liccntt Class Lic.N a U APPLIANCES-RESIDENTIAL ❑ADDITION ❑PLUMBING k&I'll'13 I-Ztu Ilatc GolltDECL mQq ❑MULTI-UNIT ❑MODIFICA]IO AHCIII IEGI'S UEChARA'I'IUN f-Oti PANELS CHIMNEY R1ON O Z=7 I unJcrsmnJ my plan.n.ball he uwJ us puM1lia mc d, UPT021NIAMCS ❑1N'I'Iik10R ❑GHIh1N13Y RIiI'AIR I:�,t:ad LicensedP eainnal 201-1(NK)AMPS Ih11'ROVF.MIiNT hYN NG OWNER.1{UILDER DFCLNtATION OVI?R1000AMPS ❑ItAlll RfiM(ll '1 M I� UI�'I' Iz m¢ I Imem,atnmt that I on excaipt I.ma van Contractor',Liecm.e Law fill the 4 3 F following rea>on.ISmtion Jtp1.5.Bu,incas and I'mfes,ionn Calc:Any city or mm�lY SIGNS ELECTRICAL ❑OI'I{I?k y which reyuim,u peorn ,,coolluct,all,,,arap rova,dcmolielt,or repair any,are m e 1„q0� n Onal,ion... alkom,uim,he ji,,leatf ,a,h Ilf-migan 11 le I SPEC IA L C I RCIJI'1'IMISC deal I d. a ab p f he Contractors LLt.(Chapter 9 uc 0 faint 6 with Section7000) rD a 3Ih B ." IPro .Cole)... TEMP MITER OR POLI:INSII COMMERCIAL: U 0.,:2" mach gthcml Isle b.i,t h alleged e pt Ay l' Ptanaf ❑NIiW BLI]Sp .�]DF: Q�.1�'J Y+t/ X^'q 5ccunn]IIJLS by any opplmum fora pe�ntsuhRastheaPPl tam mus vlpen�lty ret I.OWIat DEVICES ❑'11?NANT f —431 14 SI(R 'e not more than Eve hundred dollas(S5o0). ,=0Las ownar of the n IMPROVIih NT ❑ P 11 il Y teen : 'til 'g:as tit ' : Penna m, SHIMMING POOLELECTRIC ❑OTHER 1.. waI1J II A ' III I - flute IJ II Ilia"I IS JIUJ,Bn: W _ tPIy on -SWICI{E oTI I1X 1'URI35 0.3 pmpenl h b Ida In coo h J . such kit of though lis a ply ,pare 1 I that '1 mpp t:am not illendal r d!J for NEW Rh,SIDEN'rIAL F.LLCrR SV Fr. anln.ll:hw onxathabuilding lar intps"cn c is,nlA within nuc Ycnndanauplcdnn,file SQ.19'.FLOOR ARBA YSQ.FI'. owner-builder will have the Murders of proving that he did nm tmilJ or improve fur pur- LD 1 01 wle.).ancr oI the Property,a xclanisely contracting with awe e'd conosellons I, construct they eLathe es not (See JWB.owner II„and Pmf ho bei ds or Tho vet thereon.Li- whoamewdoe.notapply nun with acepropenywnobuilptnrlmpmvIe thereon. QTY. PIAMHING PERMIT FEE who«mtmari for such projecd with o enmrumorfs)I Icen.ed pnrxuam m tM Commemfv License Iaaw. PERMITISSUANCE ❑I am cdempt under See .B S V C for Nis Pen non ALTER-DRAINS VENT-WATR - VALUATION Owner Slam WORKER'S COMPI NSAFION III iC1,ARAI ION MACK FLOW PROI'CC'1'.DEVICE Q 1 hereby affirm under penalty of Perjury one of the following declaration. "❑I have and will maintain a Certificate ofCunwntlo self-insure for Worker's Compact, DRAINS-FLOOR.ROOK AREA,CONE, STORIES I'YPECUNS'1' UCr10N ,allot,a,provided tar by Section 370wrme Lamar Cale,for the parfamtance of the _ orkl h hflao ..t . ' d. IIXI1JItliS I'I:N'1'RAI' 4/ Fl 1 h d II t %Y kr'.C Pc i Insurance. 4 mJ by Section (� 17001 oftn Labor C s for the Performance of the work for which this permit is issued GAS-EA SYS ITM I INC.J OGTLITS _OCC GROUP !-/AVIS My Worker,Cot. a.vm of ltwranaet-'e JI ley arab ate/ �l p Ca.nen Policy No.: GAS-FA.SYSTEM-OVER B(13A) /` CI;RI'11TCAI I:OF EXCMPTION FROM WORKERS' GRIiASU1NUUSTRL W'AS'Iti INTIiRCEPIOR C(lMPENSAI ION INSCRANCIC ❑UILUING DIVISION lTIti (I111„dtior need not lm eontplelal I die"'nil is lore c hundred Jnllan($IW) Ck13ASETRAI' -� or less.) PLANCIIIiCK Plili I certify that in the permmance of the work for which this permit is issued,Ishan SEW13R-SAN]TARY-S'IORM EA.200 IT vol naamloy any per n any. neer,,,as to bea.mc,IhJeerto the Worker:Ct.....l n- ENERGY FBE z ,Z srtion leas,of Celllnmiu.DaleWAG Ii1111EArr1{W/V13N'I'Ad-ECA R GRADING F . Applicant tall CC'r0 AI'I'1.1CANr:If,after ranking this Cnnamina of EumPtion.you should WATER SYSTEM?REATING N SOILS FEi F� neaaao nuhjcca In me Work"I CeloPe nation Pillion"'oflhe Lahor Code,Yon must lS1 " Iimhwith comply with such proviann,or this pnnnit shall M deemed melted. WATER SERVICE 0 CONS'fHl]CTIUN LENDING AGENCY NEW RES1DIiKf1AL PLMIi. SQ,17 PAID I hereby ulllna Shit Nem 1,1.sal ou"i....l"Idn"aguney fonhoperfonnacent ale RmciPlN (Uta F the work for which this peri it is issued(Sec.LIN)].Civ.C.) IOIAL. QLemar'.Name lU Lender's Address T(]"fAL: }' p� I caddy that I nave mad mi,liptuiealion:od,mtr mal ate a...rotor amOr nt i, By DI F h correct.l agree to comply with all city and county ordinances and state laws mlatine In QTY. MECHANICAL-PERMIT FEFW�U-10141�'AX UZ huilJing con."mction,and hereby amtnrim representatives of thiScity pa emnrUp'n the Ao..nwall Il ,a.,,ny l orin,P.,I purpnnes. PI3HMI'I'ISSUANCE. (We)agree w,vvc,instantly and knep bar I...the City of Cupantno again" FEE Iiabilitis,pli6menu,sem,and expenwn whlebnmy many waymeam again"said City ALTER OR ADD TO MECI{. APPLICANT NT NthegSIANof than pc WILL APPLICANT IINDERS'I'ANUS AND WII"I.C(lMi'LY WI'1'II ALL NON-PUIN'P Alli HANDLING UNIT(10 IQIXNI CIM) MECHANICALITE. SOORCE RP UI.A'IIONS, 0�A It1 'al`I AIR HANDLING UNIT(OVER 10.(00CPM) A% SignnwmofApPlicanUContmmor Doc I EXIIAUSTHOODOWIDIJCq 71 r HAZARDOUS MATE 1AI S DISCLOSURE Will theapplicast or future handing weapantanamn,handle tw.atJous mwarial BEATING ON]I'j0110.00 BT G) a,dict ned by Na Capcnine Mun'alpal Code.Cba,mr 9.12,and he Health and Solvay Cold,Section 255320)! H13Ai'ING IJNI'I'(OVIIH 100,000 {'1'U) r"� r 0Yna �N.. V[NIILATI(IN PAN(SINGLE RESID) PAID Ilmc HttciPa Will Na air contaminants a building by the mymca Air mualfig areg and BOILER-C11MP(3HP OR IINLIX0 IL'1'U) `smit ha/uNous air ammminanln as defined by the Bay Arca Air Vuulisy hlu�agcmcm Militia? ROILER-COMP(OVER 100,010 BTUs ❑VuaNn Ihal,c read the haraNausnaueriab reyuimmmrit.under Chapter 6,95of the Cali- AIR CONUI'ITONITR ISSUANCE DATE fomia health S Safety Code.Section.25505,25533 and 25534.1 Interisland that if the NEW RESIDEN'HAI.MECH. SQ.ET. .2 -� Noldne'Ns uN.....wady ha's.'enaot.that It is lily rmpnisdility vat notify the nnvpamt ofbhe ire silt.which ain't lease,priarm issuance of a Cenhaaam oI Ocenpancy. Uwnaa lir tat rat cd abort Dn to 'DYfAL: ISSUED BY: OFFICE