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2102 (CANT TO FILL IN INFORMATION WI1'IIIN RED LI .- PER t js BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT 2L1O 2 rulNr. ;. F.,�_ - _t BUyLDING - ELECTRICAL-PLUMBING -MECHANICALOw a/J ;jnlFr ¢ ^Vr' 7PLAN CII CK VALIOA CITY ELECTRIC PERMIT'i 1? I yt J� FEEI17 I aiorvE ,a., f�LIrI i:nfp,a hi. ron' OUTLETS-SWITCHES-RECEP 5.00iY1,00 , MAR 29 1993 _LIGHTING FIXTURES 5.00/1.00 rnNmnaon's APPLIANCES-RESIDENTIAL 4.00 C(1Y Ur l:UYCrl l hive nDD FaS�Q y. "F 55 f(j}D� PANELS 5.00 DATE OF APPLICAT ION PLAN paECN FEE P.C.NO. -Anum uTaSIGNSOR 8.00 o�pD ENGINEER SIGNS TRANS. 3.00 LIC.NO. PERMIT VALIDATION A11%SS ENc. SPECIAL CIRCUIT 5.00 exons$$ zIP CMP.METER OR POLE INS. 15.01 �nX nrrucANr's MOTORS S FEE i /- nomas$ SERVICE CHANG 1 1 0 LICENSED CONTRACTORS DECLARA'f ION I hereby affirm that I am lie cnscd under pmvisio,ts or Chapter 9 [ ISSUANCE DnTE (cmmmmnCing with Section 7000)Of Division J or the Bu$iuess mol 6111A1 UG ELECT. PLG. ,MECH. I'wfcsslo s Co 1y.li9 c�sc it In full forpyl�I§��.7 __ 6111 Lica CI 11�'Ve-W- Lic.Number F'1 =!5(l./_Af/j�a` Datny-ContraclorJ, SV JUL p�8- BU LDING PERMIT �i }}..�a OWNER-BUILDER DECLARATION 1 Z REFh TO ORD (¢INFORMATIOMp:WIPWri I hereby affirm that I a.,exempt from IIIc Contractor's License MISC.- VALUATION $1FT, Law for IIIc following reason (Sec.7031.5,llusiuessand]'lures sinus PERMIT ISSUANC 6.00 ka, D00� Cade:Any city or county wbltb regniresa perlmh lOConE1rUCI,aIICL CLEC,CONTfI. 1(fQ/ improve,demolish,or repair any structure,prior In Its Issuance,also ELEC. �o requires tilt applicant for such permit to file a signed start...C311 like( //PERMIT TO Ile Is licensed pursuant to lilt provisions of the Contractor's License - f Law(Chatter 9(commencingwith Section Division of -: PLUMBING PERMIT4(+` i 4yG '�h FEE}' Business and Profession Code)or that he is exempt Il,eref eno and CITY. _ ,v I a �f 1 Itp 3V�' STORIES TYPE CONSTR. the basis for the alleged exemption.Any violation or Section 7071 5 by any applicant for a permit subjects the applicant to a civil Penally ALTER-DRAIN & VENT-WATER (EA.) 4.00 or not more than five hundred dollars(S500)J: ❑ 1,at owner of the properly,or my employees Willi wages as BACK FLOW PROTECT.DEVICE 2.00 OCC.GROUP I .UNITS Ihalf sole compensation,will do the work,and lIIe structure is not �}ry� intended or offered for sale (See. 7044, Business and Professions DRAINS-FLOOR, ROOF,AREA,CON D. 4.00 Code:The Contractors License Law does n01 apply Io an ower of properly who builds or improves thereon,and who dues such work FIXTURES-PER TRAP 4.00 SO.FT.FLOC TOTAL ACREAGE n himself or through his own employees,provided That such improve- I GAS.EA.SYSTEM-1 INC.4 OUTLETS 4.00 's are mol intended or offered for sale.If,however,Ihc building nrovmnenl is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4 (EA.) 1.00 BUILDING USE :r will have the burden of Proving that he did not build or im RES IND . CON PB Omer prove for purpose of sale.). y INDUSTRIAL WASTE INTER. 20.00 0 0 0 ❑ ❑ 1,as owner of the properly,am exclusively conlracli"&with licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law docs not apply to an owner of properly who builds or improves thereon,and who LAWN SPR IN KLERS-OV ER 5 (EA.) 1.00 0 contractsfor such projects will,a contractor(s)licensed pursuant to SEWER-SA\1ITARY-STORM EA. 200f1/8.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ Iain attempt under Sec. ,B.&P.C.for this jjJ07WATER HEATER W/VENT 4.00 ra [)are - Owner WATER SYSTEM 4.00 ACC,DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 4.00 I hemby affirm Ihal I have a certificate of consent Io self-in sur., ZONIN� ENG.SITE NO. or a c,Uiritau,of Workers'Compemalion Insurance,or a certified copy it'.ry m �- Polic)'NS 4C6 P•FA•q�.4111/l.Pi?4--.�V� ❑ C. cds py libcrcby ufnhi ` .wapG-Lag4[IK ENERGYT]4 ❑ Cerl real Ile I n a vision MISC.- REFER TO ORD. Yvjv',�,(I rv� A TIP licanI 7 � ^' PERMIT ISSUANCE 6.00 FLOOD ZONE ?a- CERTIPICATEOF EXEMPTION FROM WORKERS uG-.�I COMPENSATION INSURANCE rALTER LIC NO PLG Pi Y 0 N (Phis section need not be completed If Ibe peen It is for one TOTAL hundred dollars(1100)or less) ,H( Xj i:^ } A ' G:$:."k Ra-• ^ y P pc a " '-FEESUMMARY a'pi0 tr;$: I certify that in the erfonnence or IIIc work for which this rECHANICAL PERMIT '' I +vof FEE ♦mil isissued,I shall molempioY any P«son In any manner so as to become subject to the WorkeriCompensation Laws of California. BUILDINGDine Applicam ADD TO MECH. 4.00 NOTICE TO APPLICANT: If,after making this Certificatef Ex- emplion, you should become subject to IIIc Workeri Compensalion 4.00 PLAN CHECK provisions of (he Labor Cade, you must forthwith comply will,$,tell provisions or Glis permit sliall be dttmcd invoked. NG UNIT(TO 10=C.F.M.) 3.00CONSTRUCTION LENDING AGENCYG UNIT(OVER 10=C.F.M.) 5.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 2.00 the perrornalce or the work for which this permit ]s issued(Sec. MICROFILM 3097.0,,.C.). - �Q HEATING UNIT LTO 100,000 B.T.U.) 400 Lender's Name- HEATI NG UN IT(OV ER 100,000 B.T.U.)7.50 ELECTRIC Lender's Address _ ' I certify that I have read This application and star Thal Gm above VENTILATION FAN (SINGLE) 3.00 7R.,c-olentioned rnation is correct. I agree to comply will, all city and county PLUMBING %Mees and stale laws relating la building construction, and BOILER-COMP(3 H.P.or 100,000 0.T.U.1 4.00 , ty auOlorian rcructentaliati of this city to enter upon Olt BOILER-COMP IOve,100p00BTU)SEE FEESCH. MECHANICAL ai properly for inspection purposes. eageesaveindemnify anA keep ha nn less the Cily of MISC. - REFER TO ORD. nin againbi li lies jlid glum a, COSI$ and en parses which CONST.TAX In lywayaIislsaidityIa conscqucncc ofIhcPERMIT ISSUANCE 3.00lin8 of Ii penal MECH.CONT. LIC.NO. MECH. '}4" ,�i*fd& ,I4O 7TOTAL � dc,�• �},,of APPlican llCP el or I7ar, •-.i>�; ^'�YiB.V^