06040008 Permit _ ------
t i r+1•CIF CL URTINO �CONTR LGI'UR I'�Oq�MATIC'NCH,ILDING DIVISION PERMIT �
AmIZESS: PATRICK KWOK PaRMrr ND'06 Q 4 0008
i. `l}i�.�-.,CJ �`lFi� i1�� -- •—• •'� nWrTLSS&IBDA'11t
PATRICK K_ WOK _ 2
SANITARY NO. CONTROL so.
.F
SUILE1INOPERMrr1NFo
tk ttFT?40INESR: BL00 BL.Et'T PLUMB MRCH
I,;r,ENSPD COrMAC CA'S DECLARATION job Description
I Mrco f,�flirm au l am Iicetved rttsJcr profWons of C4pttt 9 fcaemencinB
n'i c u n'Ot1U)of Ctnttou 3 ofeg Owiaasa Aad Prorigaile t Coo,trod my)kegs:Is
r;r:•:ae �ae:fea DINING ROOM ADDITION & NEW ENTRY PORCH 194 '
_ ARCNIT£Cr'3 bECS,A t+FIbN
K I a^.dcnland my Pana atoll he reed as put&records
os;I I'.:dc1L3ioMl r
0WI,taR-61,;ILUER DECLARATION
I ar:ehy a0iirm Yat i am aaampt from the Contractees Ucetua Lw for the
I'.--1 acwn.(Secrkn 7031.7.Bssineu and Iamfcaiont Coda Any city r county �4 x C,8 7
n cy,tros a Poon:to etrras.rwc alter,imprme.demc,lish,"repsir any structures
It tAuaneo.alw ts:gwrea L%C tpplicint f01110 permitmfik is almni twementValuation
t h.5'ransed poisutnt to the Inmisiona of the Contessctori Limme LAw iCha(ter 9 Sq,ft.Floor/area
I = nn,enongwithSafon7000}c0tvisionSof$a8ualnesssodfaofrcul"a Code)ur
at be,i exempt trtamfmw wad the Wfa far iha atlated ewtpd as Any vidAtlora r$
,e uon 7031.3 by airy WIW. %(or a perrsals aub)eea the tappdc R to a civil peeaky of "''3 v Occupancy Type
n„n h:nfive islodraddollars(UM
,�i:r 1.m avoir of the property,ea my emproyoes wkh walla u You note tampeaSaUon, _ "'�""��""
.,udodework and9aawtweorotiatrawdcdaoRsrcdfmtufa(sac 7tks,RudSnt Required Inspectiatir
u.a P.c;ess:ons Codx The Cotrrncwej 1.1t:ero Law does lot Apply Us ser a+ur of
'pr-�Ixny whs,build%ce improves')rroui and who does such wrort hirt,aelf or'knw�it hu
rw n emplayms,prtedded than sun h lmprovnaenu ua na imaaQad or offered for sate.If.
i,c.we.er,me buildlnl er impte,vaamu it sold wither one you arcompleuoa,dtc owner'
+aa,ider.-it have Jae lumen of prayaC that he did art build or inp-!r v(of Purpose of
Ktc}
as o,ner of the property,am exclativelycatncrinj whhikenatd cortranors W
ii.:�nutucr:he projM(Sec.1034.Butinms end Prcltuiom Code:)The Coautowes Lt^ { .
Vv deco not apply ry an own"of ptupmy who bsiWt or improvts thereoe,and
no conusc is fa SWA p,ojeabs with a cnatusetwo)w4ruied pwmnt to the Ca urac/or'x
c w aeLaw. a F P C fat 014 in—
�'--j !tanmpt undo - ,-.
j W COM Le
DEWP"r,ON
t 1 Imeby 1Mm antler pemty or perj%y7 ore of the fellowsnt deciuwats:
•'l 1 h:.e and will tnsintaia as Cstnitkata Of Coestat'o self-toxon for Wotan Contpan•
'Sasso^,u penvided fur by S.tucm 17M of the labor Coda,far M pertamurte al die
�, •.•rt!.r rNich this permit is isitlyd.
-i ;'stT and wit maintain Workars Contpevswiss.s lnsurara,tc required by S'ccdo+s
t'lbm Cade.for use pcdafnacrce of the work rut•Ca;b shag pemn is iKued.
1 V,u:t:ra Con•kxruauon 4mtn cecamervidPolicynumG'+arc:
Pclky No. __ ----
CERTIFICAMOP EXEMPnON FROM WORXM'
CCN,IPf1rSAT1QN INSURANCII
f^,s sct'nu kiwi aaxbecmtpleacd Jibe permit is faaahundsedddlan(SIOM
r less;
i hat to:he pulorm":"r Lha wort fu whkh this prrtnit is i"ad-I shall trot
pir):n,peraon in any awanoer so u t to Ue WurkcK Campe::P r
C-ons a:Caltfarna.batt-.��-�...• _U
r4OCI1'LTC)APPLICANT:It.s+kr114ji.,njYtts ilinvatearEsernpkics,you siwvW
$:b�cet to the Worker's Cuepenaatioo proti:ions of the rah of Cok.you mus
'!. t„ra;..d,carnpty whh such lar.v ems or tho Mmit shall be decmed rewiked. .
t
CM.,4t9 CTt0N LENDING A%)ISKY
v:et;i,ysr(imtbs.Iharsiratumaisuctt+alending gcayfor UsePMOIR Med
. err w, `!,r wh,ch This�annil 4 Weed(Sac,3M.Civ.C)
jrole•—arna_�... - •--�•
Address
- 1
• �^, i rrtlfy that[have trod U4 sp;Iieatlan and state'hu rhC above information li
i- I agree w comply wtth aF city and cowry arJinatcts astd ataN iwa rolatIAB td
e" .r.r..oncLnKti-)A.and herabYsuthmireRpreaeniatfvr1Nshiacity tis gag"uf""MC
n.r.,rrsmd"ft),to,insfMicil ponoses
4 1..,. iW^,Agmv to love.ino�mnily and keep hareniew the City of Cup+vurso a;Nia:,
,an.;1,rs.+t,titmtnu.coutvsdcxpcnactirM:ha+eyinany wtyaa'c:rvaa$"said c1ly .. r.•0
s 1. ,,r rxyuerx-of the lrantln�of Chir penult.
nMICANT UNDERSTANDS A i t:OMPLY wrm ALL NON^POINT Issued by: Datta
Sail �i('-'E REGULATiONS. -7-
Dote
� «...
:,{-,-,�=c o'AppnawlCastt Date
{
HAZARDOUS MATBRIALSCSSCLOSURBt 1Ir `'f �}
w l l aha spill ysttt or fu urc bullJinl muputt store at Mndlc hnerdoca material
u k 9nod by the Coptnatao Ms a rlpat C ryter 911.and alta tkdth arra Sdety
as kIned an he CopYp y� -' All roofs shall be inspected Frier to any roofing material being instalit:d.
Z)Yes
r i t«drttes whiel Ia roof is installed without first obtaining an inspection, I agree to remove
Will ahc err oant or fewtr buildinloc:upant vw NAr4rtcn
elrardtsus at contamin"lt sA dafined by the Bay Am Air(Nei ity Mu ahrmeat all new materials for inspection
4 (7 Yea
IhavcrcadYattarssdays, hags r^menuunderChaptor6.4SAQwcCthfo[•
�•atktlthh5afttyG,dt. `':L 15 IS.: 37wW 25 5'004VA17d Nsdfse hu`hhnl - ._..
•'•vs.,,;t t,gtt Miy hast a teni it ss a a Cc'ry rsoury the t.nt tht ...— --••..,•
.. snan4i which roust 6c mafpiw ttf .r ru,asc a{,- s s . r.7/ Sigrtaturc of Applicant Date
_ All rcl(f caN-crings to be Class "S"or better