00070167 (2) CITY OF BUILDING I� N
HrN°
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: FERMI IF NO.
OWNER'e NAME: APPLICATION SUR UArR ,
10093 SENATE WY 00070167
ONE SAN]ITRY NO, CONI ROL NO,
RE TIER.
07/26/2000
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FF G LICENSED CON`rRACfOR'S DECLARATION Job Description
Z P� I hereby other than 1 sim
n licred under Povisior of chapter 9(utsisicnring .
t:Py with Seat 17000)of Doision 1 ofthe Fairness nal I'mferaionv . /'Ind my nemlva
K in toff internal e. , r 3 �y
z6 Licca:Class Li<.
3 6r' CunOaaor
AR /
CHITECf•5 DECLARAf1ON
°S1 anertaaml Ins plalt.<.<bltu rte used ponhr r<enrd. KITCHEN REMODEL C/
5L/
p p Licensed Ralesaional .170 SQ. FT.
v d OWNIII<,BUILDER-1 the DECLARATION
H,l+ '4—' I reaso af6nn on- 1 am.B sine Imm the Cessions a le Any ccense Was for the 'v O
hYa following massa.ISaninn•]onslaR aIle, and Professions Cable Any city scounD
" 0 winch I tin I plica n I ash. P' Y.Imnurc
e, Rant t alsorequiresF applicant nor M1re inti. signedChapter
's .mmh In n d n ma res Contractor's L e 1_ l....0 is Sy. Fl. Floor Area Valuation
leommnmis.asap Sanson 71n ad
ebasinloftl ieodarclips I'mfAnyvi Cade)
(intim hnis 31 5 b thertfmm and the basis lith the s the aemant it)Any violation
of not nen,thnfive kindred cantfor ancrmit subjectsthe applicant ntacis il pcwhy APN Number Occupancy e
ar sin more man five hartdrea aallm,tssan P Y YP
0I,as owner of the patpeny,or my employees with wages as]heir sale cotnnenmtion.
will do the work.unit the"nature is net intended is,ollLred in all(Sec.7044. Required Inspections $SB39
Business and Professions Cale:The Contmcmr's License Law does not apply to an y P
r of Oo,,ly Who nnilds or mtpmven therms,and who does such work himself
orthrough his awn entployeen,provided that such tri urians are nes intended or .
offered linale.If,however,the building or improvement is sold within one year of 32653049. 00
c(mrpled the owner-builder will hive the burden of proving thin he did not build or -
impnnc ZrInpurM^c of sal.).
❑I.a.owner of the ptapany anexebsivcly m...who,with licensed rammrtat"10 101 — FOUNDATION
innt the project(Sec.77(W.Business and possession,C,A,.)Thr Ovantino.,
License Law does not appy'In an owner of Property who builds or improves theienn. 102 — PIERS
and who Contracts for such painters with a emmritcmres)licensed paananl m the
Corrosives License laws 103 — UFER
01 am aempe under tie.. .it&I'C for this reason
Ocues 104 — REBAR
IVOHKEH'SCO\f I'IiN5AT10N DECLARATION105 — ANCHOR BOLTS
Iherebyafrmtonnerpenaltyofserjor,oneofthebnuawingdeclarations: 1.06 — SEWER & WATER .
1 nave aaa will invariant a Ccrlinate td Consent to.self-in.,are Inr wake„ 202 — UNDERFLOOR PLUMBING
rmpensminn, us provided for by Section 37W of the Labor Cade, for the '
s,fur res:an. wak for which mspermit is issued. 203 — UNDERFLOOR MECHANICAL
0 l have and will maintain Worker:Compensation Insurance.as weited by section 204 — UNDERFLOOR FRAME
3700.,1 If,Lnnor Coda,fill the perGrmmnce of Inc work for which Chic Isdout is
sued.Mw kr'.catnpn.mianI..amnceearnrand ynumberare: 205 — UNDERFLOOR INSULATION
' ytf ►S Pohcy..... 301 — ROUGH PLUMBING
CERTIFICATIONCOMPENSATION IINOSURANNCE N FROM WORKERS' 302 — TUB & OR SHOWER
fro, financed not he Oundeted it the peons is for one hundred dollars 303 — ROUGH MECHANICAL
304 — ROUGH ELECTRICAL
I cerffy at in the .foananre of thew k far,. n this lrrmit i.,ia.me.1 X05 — FRAME
shall not c h y to mm�nc ` rya njece tc the worker: 3
comp:nr n ee /_ 306 — H01_DOWNS
Applicant
1
NoneETo—' I: n:rkins lois c<rnh ear Exetnpmtn.yoa anawd 307 — INSULATION
Z I,«ante.abjerno the enalrnn pto<L.ior ormel.ttnotcod.Toasnarlfonhwui...iilywhhs .or thisNear,shallbedeemedre...ked' 308 SHEETROCK
CONu?NDINGAGENCY 309 — EXTERIOR LATH
ai I hereby radian that there is a construction lending agency for the Perfor rance —
anheworkhotwhid, Iii.parmhisi..ncdfsee.NN7.Cis.Cs 31.0 INTERIOR LATH
Lender's Name
Dz Lender's Address 311 — SCRATCH COAT
U 0 1 airtify that s have read this application and Lime Thal the abase Infannmion is 31.3 — ROOF NAIL
Ii. [moi .rrro.1 agree m c...nnly with all city and crarry oNinantts and state Ian's rtfour,
O U Io bandingconstrucamt,and herebynnthod,<repre.enttn'wc.arthis chymcolor upon
501 — FINAL ELECTRICAL ENERGY
the abrre-nrineused property far inspection Isrr a%e,s.
H y Iwe)agree tosave.indemnify and keep hanalosthe City ofCupeninongains] 502 — FINAL PLUMBING ENERGY
Vi liahilllie.,jndgmenes,at ,d espmsrs which may in airy way Imbue zgaina said
U z City sae ce d aI.oingofthis ,at,. 503 — FINAL MECHANICAL ENERGY
APP < N'U 'D AN AN WILL COMPLY WIT TV ON.P11 �� F EF�ERGY
So [i I 5 //(fit (16yW1: / — FINN' 131111 D1NI:
s tr—i p — :gym res m Re-roofs 505 — FINAL ELECTRICAL
Will the applca tAsf mf mS filing occuipnt inde,iv nanpeie h;ammasniatadm Type of Roof 506 — GAS TEST .'
as tabard by the Cape it .M n 0,41 Ctnle,chapter 9.12•and the Haalth and Safety 507 — FINAL PLUMBING
Cod.,0 Yeses 255]21;0 ONo
All roofs shall�LVspectFd1KjgLtoMjLyip(fjr)g Eft rial being installed.
wBtb apphcant of;nerve baim'ng nacupam use eyuipment or devotes which If a roof is-ins v iul Fun obi �pn inspection, I agree to remove
emit hvardoua air nmtmninants as dchneJ by tire slay Area Air QualiD Management
all new mater; r ins LA{ �ifptlNstands and will comply with
❑Yes CINo all non-points regia s.
I have read the ha,annar mme,ial,ralldren:rrrl1 mtder Chapter hos W Ise 51.4 — FINAL PUBLIC WORKS
California 11ca]th&Sufcty Cade.Sections 25505.25533 and 35534.1 rotational l that
it the build;ng dues urn currently have it t<nom.That it is my regwrsibiMy In notify the
eeupmn of the reynlmnrnts which rmmt rte fill prior m issuance ill'a Ccndilate of _
Occupancy' Signature of Applicant Dale
ow net or enhanced agent Date - All roof coverings to be Class "B" or better'
OFFICE