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05516 (SFD)Building Address P.O. BOX 1504 N o . 78-105 AP -11'A U'40t8 r4�1m LA QUINTACCLLE ESTADO Abe 6, 'TM1= Gro s837i m ling vvau wroaa ave. :b..: City - Zip Tel. I Northridge 91324 818/349-5894 fi Jam C. Cashman Address 717-200 Himesots City Zip Tel.: I 7aft Desert 922.60 6194345--543 State Lic. City 8 Classif. B 195333 Lic, # 260 Arch., Engr.; Designer. Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION II herebytaffirm that I am licensed under provisions of Chapter 9 (commencing with 7000) of Division 3 of the Business and Professions Code, and my license is in full fo>r effect: .� o _.n... r _ . r�/s'• __ !r �.... _.. r .�� _- _ si�F.F" OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,s and Professions Code: Any -city or county which requires a Permit to construct, alter. Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to We a signed statement that he is licensed pursuant to the prov-sins of the Contractors License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, or that. he is exempt therefrom, and the basis for the, alleged exemption. Any vfQW= of Section 7031,5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (8500). ❑ I, as owner of the property, or my employees with wages as their sole compensation; will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or .through his own employees, .Provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within, one year of completion, the owner -builder will have the burden of proving that he did not build or 'improve for the purpose of sale.) ' ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec. 7044, business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) ficensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Ser B. & P.C. for this reason I Date Owner h I WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Poli No Company ,M -Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM I WORKERS' COMPENSATION INSURANCE (,his sermon need not be conpieted if the permit is for one hundred dollars ($ 100) valuation or less.) I I certify that in the performance of thg work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - t CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lenders Name Lenders Address 1 This is a building permit when ro � p petty filled'out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above. mentioned property for inspection purposes. Signature of applicant— Date Mailing Address City, State, Zip I F ALIFORNIA 92253 BUILDING: TYPE CONST. -' OCC: GRP. A.P. Number . " 617-640-063 Lot 63 Legal Description PIM. 5 Project Description 0.55.5 ZONE: BY: Minimum Setback Distances: Sq. Ft.�� Size No. No. Dw: Stories Units New O► Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Side Street Setback from Center Line Side Setback from. Property Line FINAL DATE INSPECTOR 3/14/89Permit Issued by: Date Estimated Valuation $103,145.00 PERMIT AMOUNT Plan Chk. Dep. Plan. Chk. Bal. -\ -'548.10 Const. 65.3..50 Mech. 66.5,,7 Electrical \'� 1-12.36 ' Plumbing 144,50 S.M.I. 7.Z8 Grading Driveway Enc. Infrastructure r ; TOTALC.k �,•{.. REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from.Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from. Property Line FINAL DATE INSPECTOR 3/14/89Permit Issued by: Date Validated by: ' Validation, CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE S ,� �P' 2ND FL SQ. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CARP. SQ. FT. ® TEMP. POLE WALL SO. FT. GROUT DRINKING FOUNTAIN. SO FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation =$ FLOOR DRAIN MECHANICAL FEES ROOFING VENTILATION FIRE ZONE ROOFING FIREP CLA E SPARK ARRESTOR GAR. FIREWALL LATHING tor(Al 10LI (p MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING / ELECTRICAL HEATING & AIR COND. SOLAR SETBACK - GROUND PLUMBING Q UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE S ,� �P' ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS r- - _ SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. S 3 ! GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING Cu. yd. $ plus- x$ =$ LUMBER GR. FINAL INSP.' FRAMING FINAL INSP. ROOFING VENTILATION FIRE ZONE ROOFING FIREP CLA E SPARK ARRESTOR GAR. FIREWALL LATHING tor(Al 10LI (p MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. REMARKS: INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL