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00080071 (2)OFFICE BUILDING DIVISION PERMIT %-VIN J. KAG I VK''11Vr'VK1V1A'P1V1V': BUILDING ADDRESS: SANITARYNO, AI'PLICATIONSUBMI'ITALDAR /i'1Fanr�o DA Ks Cor 0 080071 OWNER'S NAME: G NIC(/1� x C/ quo I Cl.' R Y'"•ytf�( 0 � QIH/�. IZj/200QI 210 YHON�: ,•�/�tL/./ 'OLDING PERMH' INFO 11 77 ' ARCHITECT/ENGINEER • 02, a,E Zoo, 2 O — ,2 LICENSED CONTRACTOR'S DECLARATION 1 thereby aRrm that 1 licensed under pmviuone of Chapter, 9 (commencing w Job Description F=r� with Section 7000)of Division 3oldte Bomeave and Profadow CCode. my been. is �y°K< in Nil far. r.... Class acB«v� Lic.g rIq%51+0 Yom" RDD WINDOWSy DOORS DEMO AND REBUILT 3LL ate—�—�A—Cnnwc tsI f'_"YRCHI=SDECIARATION Gahs•r• BEARING WALLS/MASTERBEDRM RMDI_ to 1 undersu,A my plans Nati W mud as public reeds s.s. o° Licansbo PmeseiorW OWNER -R- fr DECLARATION C > 1 thereby dRdeal et 1 exempt exempt from the Contractors Licence Use for the 5 m O following re+ron. (Section 7031.5. Boincss and Prefrssiom Code: Any city or county Ft. Floor Area Valuation which requires a permit to crostion" alter, improve, demolish, as repair any ... prior to its issuance, also rqumsthe applicant for such permit ofile asigned statement that he is licerved pursuant to the provisions of the Contractors Licema law (Ceq.9 (commencing with Section 7000) of Division 3 of the Basun. and Professiom Calm or Number pN Nb Occupancy Pane Y Type tet he is exempt therefrom and me basis for the alleged exemption. Any violation of Section 7031-S by any applicant f.. permit rob*,, the appliunuo a civil penalty of $80000 net mor, man live hundred dollen ($500). [] I, as Owner of the property. ormyemployees with wages astheir sole compenauesm, �O Required Inspections for We. 7. Buuass t imced motional (Sa000 wdldothcwark and rheonscome is roM s era apply tm an own. of eCode: e Contracror's License Law data35708022.00 and Profeaiom Th win, bu Papery wilds or improves Nemmt.W who doea such wads, himself or through its his we employe., provided dust such impro xmemta art not inaMM or oResed f. sale If, however, the Wilding or improvement is sold within one yearo(completion, the 101 — FOUNDATION will have e Wase of proving that M did nm build or improve Nr pur- th pwbuilder ou.rofsata.y 102 — PIERS 1, n owner of the Property am exclusively contracdne with licensed contractors to the project (See 7060. Bashers arW Profeaaiom Code:) 7Ne Conereetm'e Li. 103 — OF E R omnmad cess law does and apply roan owns of papeny wW Wilds o immw. connote. and 1. Qi4 — REHRR who contracts for such projects with a connactor(s) licenard pursuant Ne Contractor's u"n"'ave 105 — ANCHOR BOLTS I am esemptuttder Sec, . B a P C for this sawn 106 — SEWER R WATER owar 202 — UNDERFLOOR PLUMBING WORRER'SCOMPENSATIONDECLARATION 1 barely alum order penalty of perjury one of the following decl.atima: — UNDERFLOOR MECHANICAL p leve.m wdl m.int,;r.c.,Reade arena.rim aB.inaurt rat wnhera cumpen. 203 sad ion. as provided for by Section 37W of the Labor Code, for the perfomurre of the 204 — UNDERFLOOR FRAME pok fee which this permit is issact. lhave.tdwillmeamainWorke.sCompensationmrondox.inasnhmbySection 205 — UNDERFLOOR INSULATION 3700oftheLqbm for the K ce ofde woh for which this permit isl..wed. My Woher�C,� curs. man Policy number a2: 301 — ROUGH PLUMBING catKer:�'^l`—CERU EMPTIONMOOMWORia3Rs' 302 — TUB & OR SHOWER COMPENSATION INSURANCE �p3 — ROUGH MECHANICAL (Ibis sectimansuin. he Completed ifthe Perot is foromhu baddollars(SI00) . Iess.) 304 — ROUGH ELECTRICAL 1unify that in the which Nis sawed,)awl oas trookTor the no employ any Canon in any manner so as w beurme subject ro Ne wmhen Compeer- my 305 — FRAME cation ewe of California. Date 306 — H01_DOWNS NOApplicant NOCETICE TO APP LIC ANT: If, after making this Centric.. on,youaeuls, 307 — INSULATION. the Lidoir becosa subjects. Ne Wahcra Compemarion provisions of Ne Labor Cade. you muss forthwith comply with such provisions in this permit shall W doemed revoked. 308 — SHEETROCK Z 0 CONSTRUCTION LENDING AGENCY for dice 6. 309 — EXTERIOR LATH 0 Z eby arm door is. comoss,don lending agency rce of Ih.affirmor V the w.it for which this pmatitisissued Scc.3097,Cis. C.) 310 — INTERIOR LATH h E" G(, Ledder's Name 311 — SCRATCH COAT UndelAddna 1 certify this 1 have read this application and attic died the aW,c infomaaon is Lr7 313 — ROOF NAIL a D Z cartct.l.gra to comely with VI city ern county otdinsteea ab ata lawa elating m building construction, and hereby suNonu represcnatives, ofmis city to emeruped the 501 — FINAL ELECTRICAL ENERGY 0 U. F, abuvemcrumned romped, for inspection purynas. (We) agree to ave, indemnify and kap hstmless the City of Caper irw against 502 — FINAL PLUMB1NG ENERGY C V Iiabihues.judgments. casts and expenses which may in any way seems against said Cay 503 — FINAL MECHANICAL ENERGY y W 0. F- V)Sou inconatiu,oceofNegranungofthis period. APPLIC INUF.RST'ANDS„DWII.I,COhtl-LYWITHAI,I,NON.illyl' 504 — FINAL BUILDING ENERGY �z — .iitl ATIONS. -fjL� �•/d•l�ai 505 — FINAL ELECTRICAL sig namt/c ntr err Date 506 — GAS TEST RDOUS MATERIALS DISCLOSURE J appli dor fumeWilding ..'orsmaabandlehavNmismaanal Re -roofs 507 — FINAL PLUMBING asddey he C1�?uno Municipal Cade, Chapter 9.12, and Nr, Health and Safety Type of Roof 508 — FINAL MECHANICAL erSecdi ❑Yes [I No Williydre applicant or [INo. Wilding.cupwt me equipmem or devices which All roofs shall beMezd2fi r tHPWFroQpf'ing material being • conterm dsas dented by to Be, Ana Air Quality Management ,mit hens installed. If a rociAMinngtafE �ith5tl IN kiEtaming an inspection ausait I agree to removeFalPmew �rI>ttLPitiall� iil�pd�flBiSSApplicant non source regulations. 1 harardousnuadatargoirtnenuunhrChapter 695ofdeCash- understands and will comply with all point forma IN d Safe Code, Sectiom 15505. 25533 and 25530. I uMerM that if the Wild' Bd.sera cu nrly M1aveenn ,Own it is my responsibility in notify the occupant or mryirtnenu 'eh masted prig to lauance of a Cenifrcate of Occupancy n/1-- f • O J Signature of Applicant Date .gen Dau All roof coverings to be Class "B" or better OFFICE t „I I O LT-> b I I ' .,I f ' ;1, {, �•, ��• ,'?I 1150, rl nlrt 111•.1 I, 1 , r r'.01 •6 I'ti.l' r: i. 1