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S1956 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF C.UPFR•P,NO BUILDING-ELECTRICAL PLSIITNO. 1956 CAL BUILDING DIVISION APPLICATIONIPERMIP PLUM HING-MI?DENTIFIC l\J III]IhDING PROIF.CI'IDENIIh'IGl'110N BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMI'TIAL DATE v VI S- ON'N S NAME: ZP�,U �V Y CO"I ACTO :S NAN LIC NO. N/C n CONfROLa ITECT/PJJfN:1-:k: UCNO: ADDRInts' ❑ JT{ 9 tat+ L +11 CONTACT: ;' y\ BUILDING PERMITINFO Nit J r� ❑ Consultant Fees Paid by Applicant(Initial) ,D' ELECT PLUM13 MUCH (ipwu�l'V1�/C.i 2,54 (. LICFNSI )CONTRACIORS DECLARATION QTY - ELEC""TRIC PERMIT FEE 1 h by from t t 1 a I :dad p : n u,avter donne 'ng .1013 DESCRIPTION a2Z the t 7a0)rfD J fth Buu dP f::'ns Code,and mylce license RESIDENTIAL: WO, w, PF,RMITISSUANCH F W`= in ant force rod effect. /- ❑SIUWL ❑KI I CHENREMODCL apV hre se Cbn lick !/ APPLIANCES RESIDENTIAL El ADDITION C1 PLUMBING RE PIPE F Z W Dulc font for CIIITICCS DECLARATION PANELS ❑MULTI-UNIT ❑S'1 RUCI URAL Z O-"Z 1 understand my plans shall be used as public records '7 MOUIFICA710N OZ--C, ' UP TO 200 AMPS L Z© CINTERIOR [-I CHIMNEY REPAIR t 4LW Licensed Prot'...meal 2014H00AMPS IMPROVEMENT [ISWIMMING POOLS OWNER yK d'¢ 1 herchy affirm tM1 I am Raeo,DER DECLARATION t front he Contraar's License Lax far the OVER I000AMPS ❑BATH REMODEUREPNR [I DEMOLITION X..O y U fullawing mason.(SentimI]031 5,Business and Praiv,sinne Codc Any city or mu itY SIGNS IiLIiCTRICN, ❑QTIIER W 3lLy Rwhich m,im,a ,,all as coasnan,alter,improve,den udi,ah.to repair nay orvewre , ¢ priori t u I: 9 're.the1 such permit flsigned:,rone'n, SPECIAL CIRCUITRE!ISC. Ems} tharh 'dp .. .h p n fth C t , 1 1' (Chapter 9 CI Qtnuens ingw Ib Seen r,WOtlpgD"v's`on 3 of the Business and Pnlesi nn C la) r 'I EMP M IiTGR OR POLE'INS'R COMMERCIAL: d d e IY that he is exempt therm,,nt and the basis Tor Ihu idle,,)usanpdnn.Any violation of ❑NEW BLDG/ADDITION ❑DEMOLI'I ION k m W Section 7031.5 by any applicant for a permit mbjects the applicant 1.a civil penalty of POWER DEVICESNANT ❑1-001)SERVICE W to ern more than five hundred dollars P65W)- IMPROVEMENT 2d p I,us�wnernRhc propcny,nr my umployeue with wugesux theirrnlc nnnpn,xufinn, SWIMMING POOL IiLF. RI ❑OTHER F, will do the work.and Be insure is lintendcd or offered liar sale(See.7004,Buxincse aLf nd Profevi.ns Coda TTe Contractors License Law does not apply ht an owner.f UUTLISI:S-SWIT'CIi13-FI%TUR A.3^ propcny who builds p :Iforatim and w he does such work himself o [Enough Its y provided th t "h p t ,' 1 t rod ff d Lor NEW RESIDENTIAL ELECfR FT ' gorinpmvem one ysarra p SQ.1-I',FLUOR ARI?A $/S0.Ff sale.If.eilde,hduvc� et[have building enre slid ilia , icon Ie Tot the UGY cr"builder will here IM1c burden of pm ing,bm he diA not buildo,improve far Aur Ursc f: ), ( L: 1 I f theProperty, exclusively command g ith licensed t n :toOtto oroactII p J f(Say.7014 Imon,si andl f :Code:)'I -uniumiurs1i- nsetaudorsnotapplytoannwmrofpropWywhoboldsorimproves th o nd QTY. PLUMBING P17RNIIT FEE who eommcts for such projects with a conunetoos)licensed pursuant to the Comme ors Liccnsc Law. I PERMIT ISSUANCE 1 am exentp,under Sec. .B&V C for this reason ALTER-DRAIN&VENT-WATER iA) VALUATION Owner Data �►� WORKER rderPCDM PENSAT,QN DECLARATION BACK Ir1.OW PROI'I?CP.DEVICE 1 hand w affirm under pcmthy reperjury one of the bollowarlim,me for Worl r tions, Ibaee and willmainlandby Se Cion 3700 ofCom,ent lso uxli.farc/er W'K,,.Q,,f the 2 DRAINS-PL(]Ok.ROOF.AREA.COW. S'IDKIIS '1'YI'G CONS'1'RUCTION smi.n,as provided far by Section 3](0 of he Lahr Calc,far the perfommnce nl @e work for which this pcnnit is invoal. FIXTURES-PI?R TRAP (]I have and will amimia Worker's Compeneminn lnmranee,as required by Scedon 3700ofthe WberCodc,forderfa I nf,be work far which this pcnnit is issued. GAS-EA.SVSTE 10U'I'LEI:S OCU.GROUP MIN Nay War m�t yjy s �c and Palicyie+, � �� A Garner /✓✓ iad11 Nn: Lrjrh GAS-f:A.SYSI'lihl-OVER (. C CP,R9'll*KATE(1Y IiXI?MP'IIUN GROMW(1t lijtS' COMPENSATION INSURANCE GRF,ASIVINDUS'I'RI.WAVE IN ]I OR III LDI l 6—FISlIKENS (Thissmtion need n„,MnnnplaMif the permit is forone hundreJ dnllan(51(01 GREASE'I'RAP or buss.) PLANCIIECK PIi. /� I eenify that in the peffor anccnflhc work tiro which to,annfit i x Lvwcd.I shin) SEWER-SANITARY-STORM EA.2 •I'. not employ any Pawn in any manner so as it)become subject,,,the N'nrkcrv'Compcm F.NIiNGVI'Iili Z sa iso La.,ufcalifnmin Dae WATER HEATER WNENCELEC R zC) Applicunt GRADING FTai NOTICE'I0 APPLICANT:If,adcr ,nmking this Cimidea c of Excnfpnnn,yon should WRIER SYS'I'ENAT BEATING > hecnmesobject,.the Worker,C. rsmoria,pmvlsionsof the Labor Code.yem aust SOILS FEE W forthwith comply with such provisions orthfslsrmu shall he deemedmvoked WATER SERVICE p” CONSI'k11C'I'ION LENDING A01iNCY NEW It1i51DENTIAI,PLMI1. SV.17, PAID UOthereby affina that them isa callfbanion lending agency for'Ile performafre If 6 kc«iptN F the work for which this pcnnit is issued(Sec.3107,Civ.C.) O U Lender's Name TOTAL: r L1.1 Lender's Address .I 1 vicinity ilia[I have read this application and state Lha the above init anima is BUIL )IN PI? Fon comet.)ogee t.comply whM1 all city and enumy ordinances and sac laws rcWting,. QTY MECIIANICAI.PERMIT FEE `h V z building construction.and hereby authorize fcprcscnmfives ofthis city m enter urymthc S 11C F.i �YiJ aMrvcnmminncd properly I'onnzpcwion pnqutsu" PERMIT ISSUANCE (We)agree to save indenmify end kucp harmless,he City of Cum tine ugnins, CS/ ELIiC IC PlCli Iiabiddies.Judgmems.errsts and expenses which may in any wayaceme against'did City ALTER OR ADD TO MECIL PI-151MBING PEE consequence of the granting of this permit. APPLICANTUNUF,SrIAND. AND WILL COMPLY WITH N,L NON-POINT AIR HANDLING USE'r(TO 10.000 CFM) Mli IANICAI.FEL .SOUR EGULA'Il0'S. AIR HANDLING UNGr(OVIiR 10.0MICPM) GQNS UC'1'ION TAX wrcnf App, tlC mraeter ate EXHAUST 11001)0W/DUCIl HOUSING NITIGATIUN Ili1S HA.ARDOUS MATERIALS DISCLOSURE Will thell,licant or future building'ecupuntsrorca handle hamrdoavnded.1 HEATING UNIT IID 100,10013'1U) as defined by the Capcnin.Municipal Calc,Chapter 9.12,and the Health and Safety Code,Section 25932(a)? HEATING UNI"r(OVER I W.nts)BTU) ❑Yea 0N VENTILATION FAN(SING IA RFsI Of PAID Date Receipt a Will the applicant or future building otmixort use equipment or devices which BOILER-COMP(3HP OR 100,00'3 BTU) mit hmnrdous mf enn,aminmes as defined by,he Bay Arca Air Quality Managcmmdt " 1 A Disnicf? BOILER-COMHOVER 100.00ORTU) ❑Yes El No Ihave read fbe hazanlma ntafenals wroblennnr under Chapter 695 of the Cup- AIR CONDITIONER ISSUANCE DATE foria HcdO&Safely Code,Scafmns 25505,25533 anJ 25531.1 andcrsnnd that if The NEW RUS1DEN'IIAI.MECIL SQ.FT. building dost do¢umndy hove v omni that a iuny orspnmil iliq to nobly m,oc,r,dd of am n,march rob which most he tern prier rot ext encs of a Cenificam of Occupancy. Owner or authorized agent Dat AL ISSUCD BY: OFFICE