13286 (5) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
BUI LDI NG PROJECT I DENTI FICATION, PERMIT NUMBER
BUILDING APPLICATION & PERMIT
AooREss
` rvSTc'vEit/S CCreK BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 13286
WNEH'S PLAN CHECK VALIDATION
NAME
"� OTV. ELECTRIC PERMIT �:,� FEE
CONTR LTOR'4 r
.A OUTLETS-SWITCHES-RECEP 10.00/1.00
L LIGHTING FIXTURES 10.00/1.00
CNTRAcTOE 5/ APPLIANCES-RESIDENTIAL 4.00
AO` PHONE PANELS 10.00 DATE OF APPLICATION
RCI ECT PLAN CHECK FEE P.C.NO,
oN. PANELS (OVER 200 AMP) 20.00
II
, �4 , L / ur' a. L SIGNS TRANS. 3.00
Aoeess ENa SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
slap EMP. METER OR POLE INS. 20.00
APPLICANT S
OORANTS MOTORS SEE FEE SCH.
SERVICE CHANGE 20.00CC4�V����
w0F2 LICENSED CONTRAC TONS DECLA RA TION Ir tip ( I:JVJ
< U IJ I peachy affirm that 1 at,,licenxd under pmvisiaiu of Chatter 9 ISSUANCE DATE
yHommenein with Section 70001 of Division 3 of the Br,ine,,and -_
Q 5 T. PLG. MECH.
Hyl PTUf 'e Clas, d' yyyu ly,yji ullsc'''ti III�Ifyl�s .11� lIR4�t�tr�.�4�
t o w- Litense C Is Li Nu nb t G ti']� -
9 w f w Oett Contr' t f)% /
st r E CJI / r l u� �!,.%1G�/' < BUILDING PERMIT
2 w a OWNI R RUILDI IL UI CLA ItA'I N / - -
a o a u INFORMATION--
w ; m 1 hereby all'ina that I urn unapt train Os Cunlrulnrr License MISC - REFER TO ORD -
.. 0 4 Luw nor the Ullowing rcmon.(See )031.5,Omin...laid Pro],,na, PERMIT ISSUANCE 10.00 VALUATION 5/FT.
�- Code:Ally city of county which requires'a Pelnlitmmtutruc L cher- L;
Q D improve.Jen¢llish,or re Pair Any 4t mchl¢.Prior l0 ids rrSrLlCv iku EIEC.CONTR. LIC,NO, ELES. G.
o la requires the APPiicant for such pennil to file a siµncJ statemcut it TOTAL Ki
F.
m �, he is licensed pursuant to the provisions 0I the Contmcwr's Licnuc l_ PERMIT TO
rz >
Law(Cllapter9(Cuarnientlllg with Scclul 7000)tit Divhlou 3 al din
4 Business and I'llill"ions Code)'it diLl he isexem pt themliaal end QTY. - PLUMBING PERMIT FEE ^I
. 10 o the bits..for the alleged exemption.Any rndatu n al Section 703 LS STwilES T VPE CONST R.
n ; m by vtry Applicant for itpermit subjects the uppliaunt to a civil penally
ALTER-DRAIN& VENT-WATER (EA.) 5.00
of nut more than five hundred dollar 155001.P.
❑ I,usownerofthe property,e my, ad It, with wugc.m BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES,UNITS
their sole annpcold let
will(S the work,wIJ the sd P1111 sum
:mended or.](cold for sale se L 7044, Bowness and ll ownsi,.11 DRAINS-FLOOR, ROOF,AREA,COND. 5.00
Code:Thu h. boil lois License Law does nod apply to mh owmr of
himsproperty who baths improvesthereon,and who doesStub work FIXTURES-PER TRAP 5.00 SU FT FLOOR AHEA . TOOL ACHEAGE
Ovals're not
his own employees,provided that Sul;h i mprove
menu ore not inlenJeA or offered for sale.If,however,the building GAS-EA.SYSTEM-I I NC.4 OUTLETS 6.00
',_I0 or urpm a nanL is sold within one year of canine Hart'
anin chart, the owner. GAS- EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE
builder will have the hw'dea of proving thin he did not build or all RES IND CON PB oomr
Prove for purpose of valet. INDUSTRIAL WASTE INTER. 30.00
❑ d as owner of the Progeny,ant exclusively contracting with ❑ ❑ ❑ ❑ ❑
,ad P,d contractnn to construct the pmjecl(Sec. 7044, liminess LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL N0.
And,, owner
J Cole The Contmtdor i License Luw dues nm epply
to a,,dcts for
ouch pano"stUtba conirinpns)luehcreon.cndwhn LAWN SPRINKLERS-OV ER6 (EA.) 1.00
contracts ibreuchpmjoc tswith Aeon HActmisl limnaJ punuunt to SEWER-SANITARY-STORM EA.200ft/10.00
the CHntractor's License Law. TRACT NO. PARCEL NO.
rCJSUn
❑ IAaIvXCmpt LUaer Sec. ,B.&P.C'.hFIllis WATER HEATER W/VENT 6.00
Owner nate WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO.
WON//yy/,Ii �CqOOpIPT [II Q�N neJJe-ARAI]ON WATER TREATING EQUIP. 5.00
I her Yul�il:utdph py. yry'oaten IH tell-usum.
or a tBfITwA
Ira
CampeAA''tlton 1l�I�t an44 Ur A"'In¢d ZONING ENG.SITE NO.
copy ISea.3400,l.ab.l".).
Policy NoNo.. camranr-f=%�Cr+2fiN1_
O ❑ FIRESPRINK ENERGY T 24
Z 2 ❑ Curtilied ; ry /1'Ic with the 'Iy acT,lit-n dl,Auo' MISC.- REFER TO ORD.F- p ApPI1CAllL / y ❑ N❑ y ❑ N❑
CE I ICA'I'1:0 [Rh.�Pl�1 liCffiTt�'o It l.: s' PERMIT ISSUANCE 10.00 FLOOD ZONE A.t_ ,C.
LU 1 CUAI NSA"IIONX SUIIL PLC CONIH. LIC.NO. PLG.
= Z 11 0 17Ihi. .•coiln need not be tJunn-lctcd it the Vcnnit is for oI TOTAL Y❑ IN Y ❑ N❑
hundred Julian IS 100)or lass.) -
U O 1 certify that I,I tire I....oanee of the walk far.Meld this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL f mit is issued, I shall nut allPluy any '111.1l In I ul:umerw ILA n.
Ow become suhjedmare\Yurkni Cunlp.nuliuu Laws of CuliTln,
Oam I' am BUILDING
} tail N'O'1'ICIi TO AI'PLICAN'T'. If,aver nmking Ilus c,,iE aa,of Ee- ALTER OR ADD TO MECH. 5.00
Z emption,you Should become subject to[tic Worker:Conlpensaniuo APPLIANCE 5.00 PLAN CHECK
provisions of the Labor Coat, you ilaUt IOrtlhwilh comply with FEE
U such provisions or this permit Shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00
CONSI'NUC'I'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10)000C.EM.) 6.00 SEISMIC FEE
I hereby Afinn that there is a construction Ieuding ugvnty fol EXHAUST HOOD (WITH DUCT) 5.00
the performance of the is t wh¢b this Permit is issued(Sec. MICROFILM
3097,Cis.C). ,� 7 HEATING UNIT(TO 100,0008 J.U.1 8.00
Lender's Nome B � HEATING UNIT 100.000 B.T.U.)9.50
Lender's Addass ELECTRIC
I cendy that I have read thisapplieation and state that the Above VENTILATION FAN (SINGLE) 4.00
infonnution a coarct. I agree to tontply with all city and county BOILERC.OMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING
es 'I'd sate laws 1'1111.1 to buildinb cUnatnutiun, vitt
he«by authnrid rnprrsen Wtives of III, city lit enter upon the BOILER-COMP IOVtlf 100,000 BTU)SEE FEE SCH. MECHANICAL
abuve.tnenliuneA Property tier wags Bath purposes.
(We) ague to save, indemnily call keep haurle, the City of MISC.- REFER TO ORD.
Cup rt to agansl II II'f judgul nt is and xp n cs which CONST,TAX
may ity En
id Cly in cm......race of IIIc PERMIT ISSUANCE 10.00
gr of p' MECH.CONT. LIC.NO. ht CCH
TOTAL
XLAI
TOTAL
Applionrsu or Late
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