9905-163 (PAT)LICENSED CONTRACTOR DECLARATION
|xerobyrm under penalty �p�u�m�|am|�o�e under provisions of
ro kmmmonoingwith Section 7000>ofDivision novthe Business and
Professionals Code, and myLicense iomfull force and effect.
4'�icooav# uo.o/aoa Exp. Date
' 699690 D03 D.5
^/b�o ighatvmo/
OVVNEm'BU|LDERoECLARAT|Ox� ~
| hereby affirm under penalty v,perjury that |amexempt from the Contractor's
License Law for the following reason:
( ) |, ooowner ovthe property, o,myemployees with wages ootheir sole
compensation, will dothe work, and the structure ionot intended o,offered for
sale (Sev.zo*^.Business mProfessionals Couo).
( ) |, as owner of the property, am oxo|uoi"o|y contracting with nuenaoU
contractors to construct the project (Soo 7044. Business a Pm/oaviono|o
Cuu*).
()|amexempt under Section .amPc.for this reason
_________
000 Signature of Owner
WORKER'S COMPENSATION DECLARATION
' hereby affirm under penalty of perjury one o/ the following declarations:
()1have and will maintain acertificate orconsent mself-insure for workers'
oaoon, as nmvivau for by Section 3700 of the Labor Code, for the
bono,man000f the work for which this permit ioissued.
(k) | have and will maintain workers' compensation insurance, aorequired by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is |oqvod. My wm,xom' compensation mvumnoo carrier & policy no. are:
Carrier Policy No. .
' ����� ' 3�|'��uV0����
(This section.need not be completedif the permit valuation isfor moO.0O or less).
PERMIT #
BUILDING PERMIT
DATE 05/42/199 VALUATION %259,26.00 LOT TRACT
JOB SITE
ADDRESS 79-135 KRISTEN COURT
AON
I
OWNER.
CONTRACTOR DESIGNER I ENGINEER
79135 KRIM'N Cr
16080C.'ALHQUN:Yl.'KKFr
(760)347-0_592 CRU 4-096
USE OF PERMIT
A 70
PORC-FITATIO 220-00 S111
EISTIALMD COW OF WINSTRUMON
2,926.00
PLAN CHECK F U, 101-000-4,Y.4-318 $35.10
009
106
USS PRE -RAID FEES
$0.00
RECEIPT
DATE
By,
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
`emp. Use of Power
5
Final
Utility Notice (Perm)
COMMENTS:
�oil
�
i
{ �
�
� �
{
�
';
+ ,Cum �
wo o`
j4-
-
-
-
--
--'
L
I--- -
i
NL
�I
�i►,
I
I
{
/
+
SU LAND
CR
o
EN�B�
WNI
G
0
6
_/---
_
_
�IUTIV
-
eA
r' 60) 34 •05.2
AX
76
CK
Up
...
�.-�:w..�.
^r{.,..��
...-.-i ..e.aa•....x.ex..onnta
I'art�az�Mw�..
.I I
.I
�,...ecrena
.
f _