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�WORKERS"COMPENS�'fION f3EC�ARA71°�'f��it`+�e��a.i�:cfi's�vu�:,e''.:s4A�.e�.��.-3��a. �-+.�ar� , � ak �. �s -� wv�- � a,�Md' '�AA.z"3.,.��»'�"...:^........,_.-:...:,.._ .. • . w ' .,,�:�m .�� .�.. ' I�he eby at'f m thur I have a cerrifimte of cansent to self �py��q � �� " '���'������ ������•'•��� ��•`•�� . . (rtsure o�6"cerr�cote of Workers'Compengahon Insufance, CE 8i7(REV itl/Blj' " ��� .� ��� � � .« ...,...,_.. � e.,� " � o a e r'��e�ri�/opy thareof,{�5ey�3800,[�Lo6 C�. � /n COUNTY O}'"��S AN�a���$ � VBUILDING AND SAFET��,,,�� Pol cy N� L_�•��_'q--/�ompanY �J��t`aML . . . . .,,_.. . �.. , ;: .. � � . � rtified copy:s hereby furnished . �:� " .. ... '.'� . . � :.. �� .��� +� . �-. ._. . ...., .�, .. ,. . r .__. BUDCALITV «...,a � P py� Y 9 p � NUMBER �RAPiIXTUREiOR iEMNlPRIN70R1YPE � ` � A� r:= ' � .. .�,,...� �,s� � ;c»- ..., w�, . ,. . � - �� � � NEAREST� L` . _ C�ent�d�r��s f led with ihe co�n��ild n ins ec� � FEE� AD�RE55 ��� Date « APpi Spnt WATERClCSET' �... - -.�-- .. "���* '" CERYI�IC�sPE O�kE'"�`MP�''I�rv'F1��0�`�1 WO���$� � BA7NTU8 .. � .. q� CR0.SS57: - . .. . r . .� ,.. ..:., :. .. �.. ..,. ... �. _.. . . '` ^ CDMP�ET�VSAYON rN5Uf{�,�YV`L`E „ . � - ... — OWNER � - ,���'h�Psectfon need not be enmplePed if`fhe}ork Invo)ved by LAbWeR � �,� �. .. . A, , - , _ �.� SH � _, ' MAIL ',the armle is for one hundrad doll,ors S1U0 or`bss. VAT�RV � ADDRESS� � � � �� ..� , ,. .,, . . � .._.. � _ .w- �I ce�ify rhai m the performar�ce of the work for which this ��"' � -� ��� �.�. 'permH is issu.d,I shall no+employ cny persan ir�any Mpnnep �'-� SINK ,., CITY -- J . 1 , + ;3a'C�s'fo become sob�ec�to the Workers Compensatron Laws. Di5HWA5HER ' � � � �� . � a,. , , .. �-� , . . ,' Date � �Applicant �� ' ��` .. ;-„,�.�„' C�6�FIESWA6H@R''� �..�, �v ]p��-^�h/� �^ p � /� � � CONTRACTOR � ,. .. . .. ..,.. .. . .. ADDRE55. /V /{�I r.J J�'IV.��fR.-Y �rti hon, ou sho�id become �ki�g th s Cert�f�cate of ._. . ; �w`thl comOl��w ih�su h Iprovis ons ubjecl to 1he Workers' SWIMMMG POOL RECE1�TOk . _ � �� ..omperSsaflon provisions of the La6or Code yau must forPF- _ .,. CiiY ��� iE � � C � IANJN SPRINKLER SYSIEM � a, py or ihis permn sho�l 6e � - STATE � UC. �.deemed evoked � .w�, -��a .�._,u„_�, WAtER HEATER' ��� � �� � � �•:-+" LIGENSE NO �j�J d- � CLA55 � I�he'oeaffirm�'hr5em,�TRACT��S�DECIAR Tf�N �� � - � "� ' DSiRfCitJp;��� �� PR�CE55'Edg� ( 9 on 7000)ofdD v,sion 3�of ..� �' _ LI'C� ED�b y p ot Chopte�9 GAS SvSYEA6` � '�� OUTLETS "` � � � i� � ... . the Busir.ess � OVRETS OYER - '-- . ....:. . .. ...._.. � an'�Professio�ns Co,de,and my licen;e is in full forc9 and effeci. , 5 PER�SYSTEM - _�.� .. � FINAL� 2 ��yt� VALIDAT N .. y„ , �; . � , ��:3� � � � _ License Numt�e�-3���r.v�Lm.Class �. - ..:.. „ :..- DATE '�:�6 . . . �_.-.. . O . " --���� �� �. fINAL � U. ,Contracfor ' Date w � ��� � BY � - I " ' . � . . . _ . � " � I om exempt under Sec ....�,...M = � � - O; . ,..� . . , , ,: ._�,;., W B&�C.�for th s reason ., ,"""'""'"` p�an Ch2Ck fL'2 . � a '- „ " �,,Date--�.�.�,�..,,RW. : PIUMBWG P�RM7�IS�$U1�1(3��E'�$'nr�w,� � ����1'.J�O f� Z Signarure _ � . .. � TOTAL�FEE- - � � � � �, � . . .. . 'r°,1.o 0 0�s j ��.. ! �. Plnn'checkaPplicant . �� . .• SINGLE FAMILY � . . � I �e I C5�Jr O � w,,� w , � . ... -.�. .�. . __..�,.... . .-.,HpME OWNER BU�LDER DECLARATf(}N Name v - _:.. � e�� �z ,e�_ . . . ..... .W . _ 'feby affirm thar I am exempt from the CoMroc�or's License Address � -� �7�� � � ,i�for the Sollowing reason(Setlion 703T.5,6usiness ond � � . . Q 9 ,� �.,.8,7 c - Professions Code): - � �ity� �� �Tel No � , � � I,os owner of ihe_prtlperry,�will do?he wark and Phe � �- �` �- � � ' "��" ' � . .- � � � � st uctore s nol nfended or offered for sale (Sechon .: �� �� � � ' 7Q4d,Bus ness ond Profess ons Codej � . -. .� �- � . •� ` CSNSTRLICTION CEND'IN� . ' ,,, ,.,;: " "."' „' „°' s.. pm� „- o _ _ . . . a . , . C � G'AGEF(CY _. .. , , . ..-.:;.. . .�... . � .. -.. ��hereby offirm tho7 there�s o-canstruction landing agency fo� .. � �-���� - �_-� ' _ - � '�'.�the performance of�he wprk,for which this�peimit s�ssued � - �. �� � � (Sec 3047,Ci C� � �� .. ` , ,�.. - . . . . ,� _. . . . . � � - . _ _.. � x � .."�� I . . . +I, , I ' . 7. > .4. � . ' :� � �� z . . � Le der's f'vome , ,. , .v . �, _ . . , � � - �� � , , �. � , ,��. � � °, .�-: . .'-6.. '•,,,,�.�., .>, .:e , ; .:,,.�',�. ... � , .,., ,,. . ^; ,. ... . .. �,��-ram�e�as.}�em'w��aa:.�.��r�"'=.n=.",��' ,� o, v lende�'s Address -�,;�y,.�awau�z , , �- - . �I cerf fy thpt I ho�e�ead ihFs applicot on and state�hpt fhe , , , , , . - � . .. � � above mformanen s correct I ogree ta comply•,vilh 411 CouSity � ��` �'` � � � � t oid nonces�and 5(aJe laws regulating PI�m6ing;'bnd hereby � . . . . . � � - �- � � ' � � � � � oLtho e rep ,'sen�otive of ihis Co�nty ro enrer upon +he � ��� � �:. .�. �..- -. - � � � � abo a_ Nio d propeil o� pe<i on p�rpoze5' .. .. . _ . . _ . . .�. ..�r r . � ..,.o.,.._ ,..._,� .,.. .u�-..w .. .....<.. .... ,..-. _ . " � SEE REVERSE�bR�XPLhNA'fOR�f'�i�C1;�lA-'�'s`k _ � ,,,, Slg ure b Permittee . 6d� . � 'r;': .,_ ,..,, ..-w,: , , ,,..,.; :� � . � -�r.�'`�a .,;w�s*w?e.�. v,��� ��� s.��Y°',.� �.�..`K�`..��u''.�".�"�'....`''�.....j�a.�`��c,�'�. :,a',�. v . . � � � . �.n.» ... . M S�, .,k,. � .,,�'<' $� �,`� 5 "x _ . , ,.; . . .., . . . :. . . _ . . .. . �,.�.,. ;', „ - ,,.. ,., ; .,. .- �.� . _ � � � �iN��cfb`k�s�o'�Es...��,,. �, �._ . �� . � a�¢����R�_,Faaz��yo�v : _ � . x,.,;..wP`N51�.,_.R,S'�57GNATUke . ,.' , ' _., . . _ . -- . '..i " a 9 s: . � .. '.� 0U4� ROUGH P UR�O�ALS �� � DA�E '- -' �� � m n C� 1 1� � � , ��� hereby ff rm sh t I m .�a pf f a WORK �� ' -. � .. se L� for }he foll rg e on (S 70 1 'h . ��� , . ...:� ,��� ��� µt:. -' dus Ye s a d�p o�es o Ccd A y clfy o c � Y... M61NG,& '� �- �p,+a.•y �r --�,j�� - .. �� - � ' � � - GASPiPiNG����� � p�e� '� - ^�- ^� e q.+resa emi�t �sfr f alter mpr e d_mol�s.�. "�� � ' � ' ' � ' � � �- � � � �-� � aq siYU�ure orrnr to ts:-issua�ce; also re' ., � _�_ .., _:. , - . ._ . . .or repair y� � , . . � GAS�ENT� � '�� � _ `- quires the.cpplicani for svch permil4o file e�r�ned�s�nte- -..,,.:,,r , _. _. .. . .. , . . ._: . ,�..-":'��.,- .: .�._.'. , ;<..,v .�........,-.—........-a. -,-_.. . .»; .., � . HOT WATER"HEAiER � "-' . . ��k ° � ��-�Y ..uonf to th� rovis'cns or�hz PIJMBING�"rIX7JRf5 � ' �- � � � � � , " . . - - mo Piacto hs LScanseSLa P.-Chao+Pr 9(com .nciny ^-�'�h� . .,. . .�...�.. . — . . , '.�� " "'.` '. "���.'.`. "" ��' ."'�`"'"� '"� � � Seciio�n Z000}�"of'D sron 3 cf the Business ond Prores GAS TEST - �A! aF� .: � '_' - . . �. . .., -. UTILI Y CO�h07 FIE� ��. � • � � , � �. . �� Ifeged ex�hpt on��n.ty�v ala o��oi��Se on � � .a„� _,:�,y� �by any opplsani for o perm t�s d as' sions � for hh .. fl 703i.5 ubjech rhe appli- �-9 �7 f r'� cqnt to a cYi1��enalPy of not more inon ffve hundred . �' FI�AL � �~ � �� (ar nn 3 " . . —. . . � ,�.�k„„,,,, dollars(55�0).: � . ..�; ;�.. �` .,.,��.r : �,�' ."..'"� �"��"�.� . .�I,as owr,e.�c`'he Prouen wll'.da tf e york,�nd . ,..�G. ... , _ � . INUUSTRIA��_ �' �", �` �"• � "� - `--�� --����� ihe�sfructure is not nl=rided'.o�offered for ale. -� �. �.. . ... ..., .," �n�A57E AFaRCVAC � -- `'`�''. � �. �'- - � � � (Sec.7044.Business and Profosslons Code The Co '� „..,t. ..:.,..t �r•,^- . . h,�.� ., .�p..*,, �...�.. . ---... : . ..:.._ . ., '....,' � for'sLiCenseLaW�doesnotapply'oan�owneroFprop��ty� � t "�`. r � i � - (� � w6o bui7ds or improves th'er�on ond who does sucb _ ' ' ., �.... - �.�� . ^ -. ,„� : "`,.: �..; . .�� .. nteCded oifoffQ ed for sote.lf�howev�r,fhe 6mld"ng or - � . . ,r� _� _�-r,,.��„�K�.,� )mp7'ove'rrient i4`sold witRin one year'of completroR, ihe .� � - - " - "qwner-builder wili have,Phe b�rden of proving thai�tie did : ...�.�. f ..T ...., . � �. . ... ,. .�.. ., �.�. . „.�,�_.,„,„�.,,.�.. ..„,..._...-.,�.,.- �, .,,m..s nof b�ild or improve for ihe purpose of safe 1 . . . . � � - ... .. .. � , - .� , ' . . .� . .._ . .. _�. ` .- . .::. ... .; . ,., .„.-: ..� .�....a�.: _' �' . z �am exemp?under Sec. ... � ,,. , .,... � .. < . �, � _. ,_.__ ... _ _ ' . . . . . . >.. ' -.. .>: „ . .` ,�. .::� . ��,�>4"': ..,.. � . ..,r--.. . .F. .. ..., .r . � . .:�_. .�... _ . ��. .�- .� . ..- � . . B&P C for this rsason�.,.. .... ...... . ..... � . . . _..__ _ ... _ ... . . . . . ..,, � . . ... . : . ._.. . . : . . . . . . . � . ., �: �:,. . .. . . . � . y, ...� -�, .. Date �_.,..:.. .. . _ . �: , <.m.. Owner �„�„_ . , � � � � , .,,.. � ... .r . �,:. . ;., _..:,, ._,. ..,. .>,,.�'�.., e liJSPECTOR`S NOTE5 . , _ -»_„ � - �� � s.�.- � __�.. _�._ m; __.. 4 _ _ �w� . , _... ...,. .._ . . . ,. ,.,,rw., .:'.. . � . .. - . . . . ... , _ " , ..., 3.:, .Y .'s ' . � . .. �. . � .»:... .., �. ' . , . . ."_ e u if5ma:'«7,.,,...6�M3Y3k;�M.A1^tJ:Y+*�' :t'w-Fa-Y&e� xb�"�/;' . .. . . . - . , E,-:t.. , r . :.. .. 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