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00080171 (2) ` CITY OF CUPF.RTINO ]BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERNIi INO. OWNER'S NAI10889 N WOLFF_ RD ALLENAPPucnnO. . Ak ,HONE: MUSIC VIDEO ] C SAM INtYnO V3 1'24 teNAgRo. pzZ ARCIIITECI'IFNCINCIiR: (408)280—bZD1DVJ BUILDING PERMI r INFO O O BLIIC - ELECT PLLISIB MFCII - su— v U U I =1 LI L= 1-1 LICENSE)CONTRACT OR'S DECLARATION Job Description I herul :Jona that I u;n Ecen..d under Oo"innx of Chnpmr9¢..;..,.among FBI_--W wilh Sec,inn]UlNpor Di,oinn J attire Huxin,ssmid Profession.C:ds.mm my license z ¢ LI'm roll force nen I eifyJ. e� Clm,p 4 r� Lic,p J. aLLy °a1 nT�CFHTIICrsniscnunn , CHANNEL LETTER SIGN/ MUSIC —VIDEO F-y se0 S 1 andenwnd my pians.hall huamt m punlie ree da .ap O Licensed front..ional r a. OWNER-BUILDER DECLARATION vol I horahr dilrm,hat I n cretram n the Connector',Li caou Luw fm me following reams.(Section]03 L5� pt Busines and PineWon,Code:Any city in county. _ F O wM1id y N. 'I t , It d m f h Iv 5 t <ture ;_ em far t '.. y tic pl' ,lot d,hperdol Ble a signed ou mal — that lie is licened Prompt to the prow i,ions of the Contracaut License La (Chapter 9 (, ttlereithwlliSeet ttnux0o1Owv,i 13(if heHt,tne.,andPmfc,:(n.Cade) Sq. Ft. Floor Area Valuation or that he i,exenlpl durefmm and the nasi,for the alleged exemption.Any virlalion of section 9031.5 by any applicant for a pontis snbjcnx,hl,applicant Ina twit perelly ornol man:man rte hundred doua;,Mix)). A'PN Number Occuptnr8 e ❑1,u,ownerol,in,p,o,so,mnfy,anpiny­wi,n wags,as Ineir.olc...... a,atisd, will do the work,and the sminure is not intended or offered for.ale(Sec.7041. 3,160-5053.Business and Prore..ion,Ca oelc:The Contractor',License Law ds not apply to an Pquired Inspections owner of property Who build,or improve,tberemn,and who does such work hlmmlf .. or through his awn employee..provided that such improvemnns are not intended or off e:<d In, al,.It.Iwevar,line sodding or nnprovmtlmtt is w,thin one ,in of 304 — ROUGH ELECTRICAL completion,the owneoFuildef will hut,the burden of proving that he did not build or iropm.e lin pur,to,e of,ale.). 501 — FINAL ELECTRICAL ENERGY ❑1.asowner othe proWit amexcla.,elvcontracting with licensed eonammnto 505 — FINAL ELECTRICAL ,n.tc,IIIc pmjecl(Sec.9044,Ilu.inna and Po*,,ioa,Ctxle:)'ille Conirucurz. License Law docs not apply In an owner of property who boom or improves Iheram, and who ,,kens lie such projects with a nmtmnoga IiccnxJ pursuant m me 01 am co's License Law. ❑lam axemp,under Sec .HR PC far his releort Owner Doc W'ORKER'S CO WIENS ArION DECLARATION I ncmhy anima mall,,lrc,rally of perjury one of tale fall,-ing declarations: ❑ I has, and will radiation a Cey S.fi a 3700 i t sd Labor lin Workere Cnmixnsainn, as pnrvidal for h3- Scuion Atp of me Labor Colic, for the VVV Performance of the work lin which Win permit is i.wtud. 1 have mrd will mui;nuin Wnrkcr'x Cnntpunsatinn Imuom,u,n,reoryired by Section 3 N)of the Linear Code,lin the performance of,he work for which[hiss permit h i.aucd lily W'orker's CCpompemuhnn In nonce carrier and Policy nntt r are: Carrier:yi���IAalicy CRRfIPICn9' )N f]IL IiMirr'I,IN pROhI WURKB s' COMPENSATION INSURANCE flids malarnced urn be entnpl,rcd if the permit is fol rend hundred drilon, (s Hp) 1 cunity Ill.,in the perforan ince of,he walk Ino which min permit i.issued.I .hall not employ any person in any manner s($•IQ,1+�� In to the A"unicN Cnmpen.aion 1 -Coli nniu.Up;__Q�G`F � Apphcanl NOTICE IDA PLICAN"IL ;liar making th'w Cenilievne of 8ncntptinn,you,haul) hcmnx subject me W'mk Compcnsaion Pmvisionv of the LutonCode.gnu must Q O ronhwi@ comply with such previsions nr this pe uld hall be d«mca,evoked. FiCONSTRucDoN[.ENDING AGENCY , � > Ihereby:dBnn,h:n mem is a cnnnvucnon lca0ng agency]or lhe ,f de oI the work far which his pennd i.,issued(Sec.307,Civ.C.) Q Lcodcr's Name 5 Z Leaders Addrea.. U cenity slim I ha.c read Ihi,upplinoio land.case seen the above Information its correct.1 agree to malply with all city and county ordinances and ore laws rdaing Q U m building cnn.auction,and neteby authorize representatives offlu,city it)enter anal the aGwotnendoned property rot Inspection pulpswca. Hy (We)agmem save,indemnify and kcep haramess,he Cnyof C,erhinma,ma IA Ilnhhlhicn,jad"otil,,a 1,;ud Ii'",whim may in any way;mems against,aid U Z City in consequence of the gaming of,his peri,. APPLICANT UNDO STAND.$$$,,,AND WILL COMPLY WITH ALL Issued by: Dale �2- _ JC9 soURC' U Slgitalu u,. nppli�und non, + - Dmt Re-roofs tARI)OUS MATERIA[S DISCLOSURE WJl the npplic;un,it future building amupnot doctor handle hanabus macdul Type of Roof as dcdined by the Cu,mru h1uni,pal Code.Cbaprcr 9.12,mtJ,he WaW rad Saliry Cale,Sion 25532(0)' E3 Ycs KNn All roofs shall be inspected prior to any roofing material being installed. win menpptieantortnamebuildings,upantusee0uipmentordeviceswhich If a roof is installed without first obtaining an inspection, I agree to remove nil huzallou,air camum guns 0s delincd by,hl,Bay Arca All Vualily Management .racer all new materials for inspection. Applicant understands and will Comply with oY" No all non-point source regulations. - I have read the huznrdaun i ateriulk maptirentents under Chapter 6.95 of the Culifonlia I lcallh N Safety Calc.Sections 25505.25533 and 2553-1.Iundcon nd that nthebuilding dre.not cnrrendh v have a tenant.that it is my re, ihl el, tonotKylhe ram of ha mm gt lrnxnl,w wh n;n,ha c,mi... ,,in.nnnce of CeoIB ne or Oct °`y Signature of Applicant Date - ,,,art a an k All roof coverings to be Class"13" or better - 0 / a � § } � � ( 9 E ) f © - ; \ } m 46V � g Go } a ® � : : ! LLJ -dWw \ / \ � \ 2 ) } \ ) ) ) ( 2 - , \ ) Z. _ t / ƒ \ % f if. r�1 ° r fi ">�`� '•a "' fir n,'my�"R'���' , °:d rt err • 2 H t ir'��� },� 5.^ i.�;p�L',�} t'�"C rl �Jx �3iv�W ��tltl.. }}yy �,e 4 1 4t er j�n2y�tt. �l� N;^ � • 4 t 'I:♦ t Tei} �r3�II ', \ t + p pj4y v �i �yR r . r•