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12185 (3) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER AU I LDING APPLICATION & PERMIT DOREss !� 7 � r• J ` BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 12185 OWNER'S - PLAN CHECK VALIDATION NAME QTY. - - ELECTRIC PERMIT FEE �J FD yU NArvn roes / OUTLETS-SWITCHES-RECEP 10.00/1.00 :;cry (,7/Gb ilc pfyt(li� LIGHTING FIXTURES 10.00/1.00 a oNT ss T01i$ ��yy PPLIANCES-RESIDENTIAL 4.00 O• p,/( PnOrvE PANELS 10.00 DATE OF APPLICATION OqC Cr PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE v.c.NO. EN / Ir.�f"i. l`�! SIGNS TRANS. 3.00 ARCH Do A . S ENG. ASPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP TEMP. METER OR POLE INS. 20.00 APPLICANT'S A ADDRESS MOTORS SEE FEE SCH. {�,-• C�,11'' SERVICE CHANGE 20.00 ! + »- o¢ i ' r O o LICIiNS1iU CONTRACTORS DECLARATION < U U I hereby aflinn that I ant licenses) under provisions of Chapter 9 1 I H s 7 hS'S'UANCE DATE u< H (co mnu,nei0y with Seclion 7000)of Division 3 of the Business aW BLDG. ELEC PLG. MECH. w z Prokssions CoJc, JJr �.'ensc is in full for z o m - License Class Lir.Nunlhc _ o w w Uute /[� /1` Convun 11 ©l11)h ❑ ❑ " N� BUILDING PERMIT ¢ ¢ W a OWNISB BUILUIiR DG )L. RAT N VVV ' O ' LI MISC.- REFER TO ORD INFORMATION w sL r I for alliin ing I anI vSee 7 learn the Cons unors Lrnms.• r O< Law for the following rcmun.(Ser.]Oi L5,Business and Profession. - VALUATION 5/FT. PERMIT ISSUANCE 10.00 Cole:Any city or county which rnpur.a pemul loconstruct,ultra � ✓ rt2 a O improve,Jeniolisll,or repair any sinctum,prior to its issuance,also ELEC.CDNTR. LIC.NO. F:LEC. `• i O¢ requires the appllcunl for such Permit Io IIIc a slgnrd stun'mmut(fit( TOTAL w m w he is bei sed Ino...ant IR IL,pnnisinm of IF,,C'o,L else,Lirmue 1�PERMIT TO rzQ La.(C'IlapCr9LmFlulenrink will,Section 7000)of Die..loo 3ul the ¢ o Business and Prolkslons Code)or that he i.........I Ihrm on,andDTV. PLUMBING PERMIT FEE ¢ Fo the basis for Ihe.Ile9nd e.aempliun.Any ru,lafiou of Seel ion 7011.5 STORIES TYPE CONSTR. S.u, by any applwaut(01r ponnit subjects the upplirum to a civil'[(ally ALTER-DRAIN -WATER (EA.) 5.00 fit.(more thus five hundred dollars 155001.1: ❑ 1,as owner of Il,.•property,or my cInployte,with wake,a. their BACK FLOW PROTECT. DEVICE 4,00 OCC.GROUP u[s..NITS sole compensation, ill Jo Ili,work,and the slo"Nue ix not intended or eObrcd Inc sole (Ser. 7044, Businem and Prof c..ion. DRAINS-FLOOR, ROOF,AREA,COND. 5.00 Code:Thr Cauncwr§License Law docs nal apply ot all uw na of properly who build.UI innooee.Thereon,and who docs such work FIXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREACE hintsell or through his own Ings nyers.provided Ili wch irllpRlve sso norms are nm inlendcdor.11.... for sale.l I'however,the builJink GAS-EA.SVSTEM-11NC.4 OUTLETS 6.00 or hupro.ement i,sold within one year of corms,lion, the oworr GAS. EA.SYSTEM-OVER 4 (EA.) 2.00 buildrr will base the burden of pr.,in,Thal he did not build or un BUILDING USE prove forpurpose of sale.). INDUSTRIAL WASTE INTER. 30.00 HES IND CON PB Omar 13s I, owner of the prspery,sou CXCILNIoCly.m,rreilig with ❑ ❑ F1 ❑ ❑ licensed contractors In construct the project ISec. 7044,Bo.incss, LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 A55E55oR5 PARCEL ND. and Professions T Code: he Cunt I.,',1J,,n,r Law Joe.nut.,ply Io en owner of proprnp who builds or improve.Ihercorr.and who LAWN SPRINKLERS-OVER 5 (EA.) 1.0D cont...(,Tor wch pojerts with II.ons reun..(,I I'marurd ILIHIJ n to Illi Cunsnnor's Licans.•Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO, ❑ lam exempt under Scc. ,B.ml'.('.IOI This"alml WATER HEATER W/VENT 6.00 Owner U.Im -_ ��/ /�yy/ryyQQ WATER SYSTEM 5.00 Acc.DAN; Acc.FILE NO. Lp•sg� IPyN--ell N' ALARA'I'IUN WATER TREATING EQUIP. 5.00 1 Irnrchy ullirnl Thal I lane a eerlil scam of comm(no.,II-home, or a certificate of Worksri Compolnytion Insurance,ot a cefified ZONING ENG.SITE NO, copy there.(IS,,.3800,Lub,C.). / /�PM 14/r ['.]try No. ComPauy •����] O ❑ Cedili,d agsYi h®rbIl"(1, ' a NE SPHINK ENERGY TI4 Z Z ❑ CerliQrJl iOr m nspe.t jun dnnn.nO ApplicantL ` MIS..- REFER TO ORD. Y ❑ N❑ Y ❑ N❑JJJPERMIT ISSUANCE 10.00WFLOOD ZONE A.L.U.C. CI7Crll9CAT'I: OI WURKfRS'W COAIPRAN.[ PLG CONTR. LIC.NO. VLG. Z (This section need not be ..In,lewd it'the Penni( i, lin on, TOTAL Y ❑ N❑ Y C3N❑ hundred LulluLull...(5100)or less) U O 1 eerily for in the Pvd.nuan,,.1 the work lot which This pr. QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mil is ivued.I xbdi nm employ any PrnuII in any mm�uel w a.it, 0 ED U become subject m the Workers Compeluatiun Laws ul Calil'oina, n Dal` Appll`aolALTER OR ADD TO MECH. 5.00 - BUILDING >_ to NOTICE 1'0 APPLICANT: It.after,raking this Cmifcule of F,- )... Z implicit You should beCmne subject w(hr Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions u1 the Libor Code, you Least I'.Filo uh comply wish U FEE such provisions or tishpermit shall be JeumeJ re.okul. AIR HANDLING UNIT ITO 10,000C.F.M.) 4.00 CONST'RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby aftoll that Ihurr IN corosunioo Irndan,ugcncy for EXHAUST HOOD (WITH DUCT) 5.00 the perforrnunca of the we which this penoit is issued ISCC, MICROFILM 3097,Civ.C.1. T HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lenders Nunn_ HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC LenderiAddie.. I . 1. erns( ural I have r y a e I a this applicat ion and state ly and county VENTILATION FAN (SINGLE) 4.00 i ordinances n cornet. I spree In coulply wish all city and county PLUMBING ordinances and stole lows relating m building conslruniull, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby nodule o cpre,,,ubn ,, of III city to ether upon the above-mentioned properly for inspection purposes. BOILER-COMP IOver 100000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep hannles:'. IIIc City'ul MISC.- REFER TO ORD. Qymnino apo ul liahilitie.,nm�&5' iudgulvnn, mit1 un.l ca penu3 which CONST.TAX nay m y aid City ill ojly I fLy©�m PERMIT ISSUANCE 10.00 gra MECH.CONT. LICNO, TOTAL Signature ulear Uatc OFFICE C:7PY