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� INORKE�R$ COA�IPE'��S"`A'�i'Td�'SE�CARATIdl� :$ �'::� .=• �'.�.» `..',�"`. "��. �� -:.... - ;.'"" `:. - 6A66)A /� ..� . � } _ i herebv ajfitm tha't��I have a eettef cate of conaetit to setf ce ev�(z-eo)��/�1������������ ��� �����_��!��������n� insure'Sf a tertif�cate ot Workers Coingensation Insurance,or � �- � V � � a Cert�fled coyy[hereof�Sec 3800 Lab C) � � � - - ---- � �- -.� ` ; -,` --' - - CQONTY OF'COS AICCGEL�3�"rW` _= BUI LDt�IG ICR�I`D SAPETV Pol cY No�� _ Com an � . �:: P1 - ..,...,...ti,.....,.,..Y....�..,«.......,-.......�.�.... .>_..»,.<....._,.y.,.�..,.�..- ��._....,,._...-..�.v.we..,� _ ..u--_ �..,..��s-.�_�.��.. � ❑ Cerdfied copy is herebv fumished , _. F�OR APPLICANT l`O F1LL 7N�(PRINT OR`{'VpE) ���� BUILDING -�� �� � � Cectified��copY is fi}ed v th the county builSimg]rispection � AD�RESS �-�L" ���� } NUNBER FlJfTURE'OR�ITEM� "- • FE . �SL� •{j-� department -� - ��- LOCALITY- �;^�"' � Date -�� Appticant _ - _ wATER CL65eT ` _'" L �-� �J[�'(`(\�}�jy �i2 -- . � � ' NEhREST . ,�: -: ,� . ._. ' . .-_ . :. .,.:.. ., . ,., ,, ,_, - _ - _ . , ` � - " '� BAtH7Ue� ' _� ,�`/ CROBSST ��'���"— '.= CER'CIFICA'I`E OI'4EX"E�tP�F"R"`O`�M-W'O��'K�� �- ._ , - � .--. ,.., �CObTPENSS3"CYbt7��,�°$�L�Vj"'CE� �,..._.��.. � ! SHOWER _. . .. -�J� OWNER � � _-_- 1 ti � -' ` ,.': _ . � i _.,. _ , . . . .. ;: . R . ��� ,: - -. .-.- �a,� _ - �yl � �- MA�I._ - (This section.need not be completed if the woxk €nvolved -,.�� �AvaroRv - �- � - . �- -- � by the • _ � ,.E.�ci- . - permct ns foc one hund�ed dotfazs ($lOQ)oc less:) - � - � .400ReSS ' � � �%}� i - � - � - �� .�. - -, S�NK � ; -.;� °d . - . . T ce t�t" that�n the `�" '-""�� . - � -�- CITV-� ��t� !1 Il TEL.-N6 ��r�",L�. J Y pe tormance of the or c�lm whuh this .. - ,J t•}pe_ �permit s�ssued I shal!not em la an �ISNW,4SHER - CONTRACTOR' �+ ^sv,,r P Y Y person n an manneY . _, ri� ^� so as to become sub7eci-eo the W s Compensat�on Laws. � �- �-, � � - �- `K� 'C' � U.,y�.V Q . -, '�� ��� �� CLOTHES YN%SSHER � ADDRE55"t'�� �� - Da[e pplicant a, i�{� G`y . . , - � .. .� -: - p T° �oi ...._ .� . "' -- SWIMMMG POt7L RECEPYOii '� ���� '' il � ��9 NO�TIC�'.'I'�`tP�Y.I�"A�"��'I�f':�,�a ter making thu C�ate'of�v CITV����'�'� - �9 Exemption, pou should-become..subject to the Workers� LAWNSPRINKLERSYSTEM TEL NO '(��G� Compensation-provfsAons nf the Labor Code,you musf ferth- -- -... �.�- - STATE- �- � - LIC.��� � �� w`ith comply with such,provisions-_or this_permi[ sha(1 be - WATER HEATEIi � � LICENSEN6. CLASS__�� deemed revoked . GA$SYSTEl41 -� OUTLETS I I—� -DISTRICT/�O �- PP(QCES5E[Tffi��"' . ,�_^°L`T�C'E.�IS'E��C°d���`T��E��A�2� ,.��,.� . '_ OUTLETS OVER I 7 t� [�ereby�affirm�tha£I am ljcensed'under pro�sions of Chapter_ �_ 5 PER SYS7Ef61�"'""""" � -- - -�� -- �J Q�=C..-- � 9 (commencing-wrth SecLon 7090)of�Drvision 3 qf ilie Busi- � - � FINAL � . �Wm-�V_ _ "` 'ness and Profess�ans Code;and my i�cense is in'full force and� " � eATE�� �� ��- VALIDATION � --- � _ ,_ -_ ... ._.,.__ . effect. - , � - ... _. - .: . . . ,. . . �_ . LicenselYumber a� Lic.-Class ��� ��� � � FINA - .� :f t-�� - ` _._. BY , �"S�� ��_ , �.? (�,+, . ._.. on� ' "�jate (�'�FJ^�b 1..� .. .. . . ��'I am exempt frQm the Lcensing'�equirements as Ia�n a' P�aRCheck.#ee " ' - - I�censed architect ora registered professiona] engineer- -pWMBINGPERTvYYTT�$U1t5GFE�E� `- �(�. � . ... . __ .. . , ";.� �-acting m-my professional capadtY (Section-7651;Dus-- - _.mess and Profess ons Code) - . .� 7oTaL FeE� y�` �j�� - ,. Lic.or Reg.No.=: � , .'� - � ..::�Date �� � Ptan check.aPPticant -.�... . ... ...�. `..'.'.. t�drt�oa�v�lz-��s5�'"�Ec�x'�"�` Name �0 5 9,5 A : hereby af�rm that I am exempT �from the Coniractor's� Adtlress � � . � - � �g q e�-�:o v� _,e.,, -..__ . .v_ _. ... .. . _�... License Law foi the fpllo�ving reason_(Section 7Q31.5, Busi-- C�Ty. - Tei:No: � ness�nd Professions Code): �- _._ :�:� .. , � .-- � ' � 0 2-���. � �I as o ner.of the p ope ty am exclusively conVacting� � �-� � - � - - -�- - �-� � -- �w�th t censed conSractors ro tonst4uct , the project � � - � - -•-6 •2 L�.Jr Q c=.� (Section7944 �us`iness-and5�rofessionsCode).- - � - �� -- -� " - - �����- :: "_, : � _ . _. ` � I � ���T Co'�STI£O�TItS�'Y:ENDTI3�;`��f;"e�FYc4".'-....�<.'�....«�.A,- -�� �,..,.�.-b.... y�.�,_.... �... n .,�....�. _.,�... �..,_ ..,��m�.._ ..»,.,v,6..,..,�J,.,.� I liereby afCrm�that [here'�s a construction]ending agency-- -" ' - ' ° � • ' '�` -`' ' - `� '- - � �� - � 'for-the performance of the work-for which this permit-�is� �`��- - . � issueci(Sec.305�7.�Civ.C.j.�� �' ��- ��� -� -- � �- - � � - �-- - - - � � - � Lender's Name- - . . �. �� . .- . . . _ . . . . . . . . . Lender s Address � � -� � I cert�fy that I hn e read th s application and state that the� - - a - � abave mfo[mation is cotrec[.I agree to.complY uith,all County : �'� -- - .. .�:- .:`�.-_p.���.:���,�},.�...��.�_ _�u,.�._,..._, ��.-�.�� _...._... oxdinances and State laws iegulating Plumbiug, and herebv� ` SEE RE V ERSE�F'aR-��SfT'Y;%4�4-1'C)7Z�-��� �.____ a ep•Seiltatives qf this Covnty to enYer upon the � � � � bove menri qe: roperty forinspecti6n purposes:�� : � :' " ` '- � ��-'� -�--- -�- �-: -� � - -- -< `°-- ��'�,,�-�� � �{—1�-�! �.�_ ___. ._..�...,� ..u�.__�.__._.�.��____.�.. __..�._.,_� _,_._�..�.s..__�,.,...v���_r___.m-_r.._...�_ _�_,__.�._�__�__�... , .�amreofYermittee Date � �- � - _ - - - . � - - ' t:-zs�.: �_ _ _ _ - .. . _.-�^� �_.�-�:=� `' = ivs�E�rc�''�'[�F�Tes - , G�WMEI�S3UILi3�4�3?EC�,�R11Tid3iv aPasiova�s ` __ 'oaTE`in��c�''�"3�``fT"Tk`r'G�� -- ,- �.� .. .,. _ ,.�_ �� ._G.� u,__ -- -. UND�ER SLA6 WORK ; --f + - �" � � � � - " � - :neceb, aft"arfi:�L'�zt I am--ezem�t xorn 23ae c.on.xaceoc's RouGH i'�unne�NG.� - - .- � � . . � ..` ". ""'.","".' .."`"•' ..."�'.•_" ..'�`.`.'-�;ieense Law ioa��t e �.,ow:'q, ea�on�fSecrlon. 7'J33..; .. >... . .,.-_ -F -,.a.., � .+ .:, . �,�..�:...w., , -� - - � �.. �-� a3v.sfnes.3 ,:nd-1'rot s �rts. Cgtfe�. A.rey:,city ar cour.fy�-:-. � GASPIPING - - .. . .-.._� ..-�_.,. ... : . . . . � . -w.:.__ . .. . .._�:Y_ .,. ,._._._. ,,.,��,>..���_�,. .�__.,._-.x ._a_<_.::,,: ,whicFi�-requr.^s a,��en:i: to-�consFrucr;�..a're�, �n:prore; _._.... ;:- �....: _ .-. _ ..� c,e5'ven1T. . �.. ..` � . .��' :�: . . .. ... .. .... . . .. ... . �deniolLsh,or=ep5tranysiructure,pnar-tcatsesauarec�,. . �.. .,-._�_� _... .., . _ �------ - - . Horwa'rER HEaTE� - �_ , ..._. ."" .,_�-. � ..;._...� -..- �� � ._.-� � --�« also rec7uY2a f.he,aPF�f cor:t.far sucn jier rir to �ile-�a: � PLUMsiuG-FIXTURES:�� �� ..., : . ... � S zad.-: icremef?"._ nt he is: icensea ursuanr tq�.th,e _ . - � . .... ...... . .. ... . ....:.: . _..,.,� �r'ci�is`;'oru oT tfie.-Cwrrrtcior's Lecense L¢ic l�hdpter 9 � _. _ . � GAS7esT � ,. , � ._ ..�..'. - - /,.atnmenc:r.g wilh Serxi�n-�70POj oj�Diursion 3`oj.the... -uTI�ITY Co.NOTI;IE�:-:.. _ . "'..�-.•,_• �_ .."• " ��a=z•_„`�"""'8usenCss QF�d�Prl�fe3siors��COdeJ �:'r�6i Sle is._exerllpt. .,-.-= nerefram a��a1:2 bYs �`ar trz a'e ed exem rion._,ar:y �'az�t �oa.�y .�� -- _,;.�.....,...... �,.;. , _ ,.. . .:....��..�.,�,.,;.. .,.�, .::���-,a-,"-� --��.-•-`��.�f�i�`ano"��ec`:on ii331.SbY¢�s�appiie�n 57raPer�m_ir F'NAL p��. . -.........A_ 4��.:,���_.���.._ .- - _..-,.. . � � . .. : sunlecrs the n�P�'7e�rr ru u civzi Aena!y of nct mo:e ti+ar+ . . . ,: ._. ... .:.-:-_-_ �+_w�,:_�__...-.,-d..-K...=-.�...e.k.�.-�-<= .«- ...a., '�ive6tund2ddcllars(5500)_:; ; , -. . . -. .- . , . . : _' . - �._,� ._..-�r..,.�s . . � . � lt�t�USTRiAL -�. . . .. -. �_ 25�a�ner.of�e"Pra� ty �till&o tne x'ocx;and as're aaaRo�a� -- . . . ...._..,,, __.,„..�.=<.�d,..,ss,>, -� �r. a�,, _� ... �..4.�,.,._m,^:'.4i�`sir'u`c`="aia es not mtended"oz ofterd ici;sate. � .. _< . . _ .., - - --,.._-,.e --- �_::m.,.r ,b. . ......� !Sec:,��gfi44.�&rz:'vress�cna Pr�.iessiflns�Code: The-Coti- " ._�. _ _ ..- h F� v.:�� _,�: ..a.. .� . _ . ,, ._ ._.. -- ' �.<,F.--...�...�.b.,,... �.<xa.N��,...,..���. ,.»...c..�.-�.:1_ �.x..�.,, .- __..._ . _ , . .. - - . }'.eetor,s CrcensE-Law,doea not c�aty�to an owne;of � :�. . . -- -. . ' �-r _ � --. _�_ .�_ .., . �.' �ire�perl3 x>Ir ba,idds o iriepr�ves�thereon arad x�ho ztdea-. _.. .:.. _ . .. ' '� ._. _�_,..._,._.=Ao.,.-.�»,w��.�...�a�.�-_�. �-,.��..,,�....�, , .v . .. ,� ._ . . .. , :. .. .,.. _,....... . . �. sFi_h"worR 1?emcefj provzuPd titat 3uch ,mpreverne;�ts� . ; ; ` _ are-:�ot�nterdea or,oifsred�or sa%e,`7�, hau•e.•er; t:re ,.;; ;. . .,.. , .. , _; . ._.._��_ .,,....��-.. . . .'- . . '�":.=" -:"-.'��'". btc�ding or :m�rcuemeiit'is soJa�w:t:3in one--year e,`� ._:- _-_. . - . .- .- . . � . . .� .. _. � ._ �._. .�;�- " � .:. _ _� c+r;Fe uln t�e.:own r buiider wilt hyie rhs=burden' _ . .. . . ..._:,, ..,_�M .,_,.,..v..�,:.. «--�w�.,.-.w��-w3.N..-�.,.0, ..�w-_,�.��.v,..�. �:,,... { .:-s a _ _ . � o� CroiingY`�hqt'.tv did no"t$u:ki ar-ittrprore fa;. tke ._. . _. . .. _. . ... .. : _ ._ =..` . ' �.. purgose o)ca1e.� . ..: . - _ � -: � ,�.ev.,w.m..�.�.�.��-.�� ,,...�.,..w�•:���.-�.�r� �'. �aa-��u. � ,,,. .-�- _ � _,:, _ I arn_xempf`s.nsi_r� , ' .,,.,�_�.,.�._.:� w,,�.,<.;n.��,,:�..,�._ _Hxa..�:.<� Ht,x., ; >.�. ._.�... �__..:: . � �,-. _ _ , v � � _ 738,��;.*3r.t,'�ssrea`so� � --�- . . : . - . � �-;� � .�.-..-�: . � ;,_-:. _-<,...��,;.�_.�_�..,-�...:_,_......-,.�.....�-3;.- ��::;.:,. -..�..,*.,,,a,�-�...�.- ��;,;. -�.�._�...�€�s.z.,x».,� ssw :-��.�;+-s„-�v . .. . -- - _�...� �-.....�,.�.,.�... �.�.,-���e-�»:a.»-.�-;�..n..f.,�..Y-�-,..:.- . __.:.::_,.._--'"=`.� ...�-,�,,.-....,:�.,,.......��.-..�..:_.�.:.�.;:.: � . .. - � - .. „ ,A - .ce,-z r�c,. ,ra`� ���$t. . . _.. . . . - . . . , :��. , .;... �. . .- �::.,.. �WriEY �„ . . - � .��_ .., '__ a-�_' a'^� . .-., _. .' ��.�..�.� ,.-.h.� �w. _ � . .. . . . .. v.:..:.._.._�...�-�,. .: .._::., _... �,-r�'�._.:<. .,_-,�_-, ..�:.. _' _ . :._-.... �.,�:_ ;..--........-.,�«.�„�..,a.,�.�.:.�.._��e=A.:s..�.� �h-.... :>s,-.wers�-M*hv-....v:z� =wr-__:1.,. `,.�:. . 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'.- , _ -.--�'- � - ,_.. �....� .>.�„3.����.,...-,,.,.,.��„v.�,«..�,�=zr�-:t�.w.�*,� az'f�s�+w�a'._.... ,�xs�.��^�h;.��-c����'��.��„���'�'.��- . ._ . �._� � . a a o--o---=. . - -`- - � :-:. � - _ ,.... � _ -.:; � ---..,_ .. .-.:� ' ;�,.. .. . :... . ..:.. �- ' ._�, _.�:��,,.......,,.,..»�.-.�...�-;.�-,.�.:�,.--���a�;�`...._ _.:-.. --. - ��. . �,, . �._ - - � - .-. . ..,_>., __ -- . . -..:.,.�...,,-...�...:�:�:- ,>e:.>�,.,� �� ......� .. . _�__ . � F .�. � . ._.., � � . . �:..-�,.��-����.,�a. � -- ' ... � � . � . . - �.�.:...---�,.�...�,.<,,,._�.-�--..�+�:-�.:::�.,�.......,;..�.,..��v .. . -..... , ..-...._ _�. ,.,e . ......_...,. . .. �:..�_. ,.:. , „__ _ _ :�-'- -- ..-._ . .<...v.....�,.��.�.,.-.,� >::_� _......->->,:-.v.�»-�.�. ��.- .-�.:. �- �r- _ ' ' ` �. . . .. - -. _...._,__ _�._......a.:-_...._»V..-_..�..«->.. _ . :__.. . <._:.'��,.,,.��,._.�,- . . �_��..:-....s.,..,, '., _ � '� � . . . . . . . . - - ......- . . _ ,...:_.. :..,.. _.._: ._ .. _!._, . .�.�:..:..-.:���.����� ..�.�,.,xm�w���. . .-. ..� _ ,., _.. . .. . � -� ._ _-_.�.5-,�_,...�.:.��.3 -`- F a .�.:�.�,.a.,��-:�m�� -- - _ — . . . - - - . . . .. . �,.==�' _