02010098 I BUILDING DIVISION PERMIT ,,CONTRACTOR INFORMATION:;')
1
BUILDING ADDRESS PERMIT NO
10744 ALDERBROOK LA 02010098
OWNER'S NAME APPLICATION SUB DATE
ROBERT MC GUIRE 01/24/2002
�•� PHONE SANITARY NO. CONTROL NO,
•ARCHITEC iENGINEER BUILDING PERMIT INFO
m BLDG ELECT PLUMB MECH
I I U L _1 L-A
8�. LICENSED CONTRACTOR'S DECLARATION
{,w- Ihembyaffirm that l am heenedunder pro.ammof CTapter9 lrommenang Job Description
u,, 0 with section1000)ofD,vmmn3 f1he 9u 1masanndPmfe,amnaeade.and.1homm NEW SEWER LINE
y 2 is in full force v e n
:O i U License Class Lic.O s r
Date Commemr
!LL O G. ARCHITECT'S DECLAR T{0
I urdessiond my Plans shall bit toad as Publa records
i oe p O Limaun!Profese5onal
OWNER-BUILDER DECLARATION
u 1 hereby affirm that i am exempt from the C°ntraeror's License Law far she -
t-Z following moon.(Soaa.1031 5.Buaress and Professions Code:My a y a ewnty $7600
—Sy.I o which rt painv a permit m ciaman:el.ahu,improve,demolish,w mposm any urseturt
w primmusissuma also tires the Bunt forsuch ton file*signed statement
a. rrt app penm g� .. ..
(cmaOSlianidpumoant t7Wy Provisions Law noanarslaxnssi�w(Cs Codk9 Valuation
or he is themfunn a the bronor the alleged aMion Anyvi Code) '3T5�J Y�lY4��:tlVr + ,
or mot he is 31.5 bt Ney appli and the Dana for the alleged exemption .m1phtion
of Senion)031.5 by any apphcvm for a parent subltts th apphnnt to a cinlprnal. -
ofmtmom than five hundred do0us(s50(n 106PNN9 R & WATE Occupancy Type
°I,as owner of the Property,or my employm with wanes as their We compensation, 7
wdl d°the work,-and the strvctum is w(intended or,offered for We(Sit:1000, -
Seemisa and Pmfenarmrs Cede:The Contmnora Littnic Law does nit apply to an 3 01 - ROUGH PRAN&B>}Ii9pections
owner of property Who builds or improves therein,and who does such work himself 302 — TUB & OR SHOWER
ve mmugh hot own employaes._Provided that such Smprovernems as not inknol or
offered for sale.IL howsm7r,-he WildmgxImytovemim is sow within oieyI.of ... -_ ,. _ _ ._. ._ _._. _._ .._...__._ ... ... - .. .
eomplarmt0eawner.bmldawmhave the bmdenof pmvi.etho hedidnotwddor 502 - FINAL PLUMBING ENERGY
prow fa purpose f aii 506 - GAS TEST
as o"ruf ihe with Jim avoid comerie ass to . . 5 0 7- — FINAli PLUMB ING- - -- — - - -- -
comtruct the project(Sec ]010.Business and Pmf esua s Cade:)The Commaor's
License Law cook not apply to an owner of property who budds or improve thereon, '
.asd wed....fm.sach protect with a constituents)Bocmnl ..,.t to the_... _
pus
0..on airs pt trig Law. '
' °lam aemP[t�tuf�MviSc � r/r�fi O!�B�dJ/PC(a Ws reason r ���••• ���
ma WORK<�COMPENSATION�ECIANAT10 .9 j
/// reby athrm under penally of perjury one of the following dalaraoom:
ry : I love and will maintain a CemDcue of foment m Wf-mk rc for Worker's
M.` Compmsatson, as PmvrdeA for by Sution 31M of the Lbar Code, for rbe
pedomunce a!the work for adult dos perms is issued.
°I ham and will maintain Worker's Cmou omatiori lowness,as required by Seedon
3700 d the Labor Cade.for the pedormana d Nc work fm which this perms)is
I ssued MyW s Comp Lion Insurmee camenrN MICE ass:
Lamer' PoicY i.
EMPTION WORKERS'
.
CERTIFICATION COMPEYSATION MSURANCE _
(This mcl i oced not be complcrtd if the permit is for one hundred dollars
($100)or less) „1
1 empty that in the n I.mynce d the wank for which m:i permit a issued,l
shall not employ any Pcmn in any manner w u m bemmc sublea m doe Wades'
Compnsauon Lars of California Data
Applinot
NOTICE TO APPLICANT.IL Compenktng this CemOCam of Exemption, .you should
st you beuma n camp to me Workspr Compensation'arrim shmill the aimed myokyou must
t7 O foMwM comply wish such pmvtstoass or this pmnit Mall be dearticd rooked.
z _ .. .._ . .- - ._ '.- - - ......
CONSTRUCTION LENDING AGENCY ..
a Infer vfhI,h that there nit mn5wcuon lemmngagency for th<peRoisnvsec
W
of the work for wM1ah this permit n sued(Sec.3091,Gv C)
f•L C lender's Name. .yam,. . .. .. :. ._ . .
L) Z ltndcr's Address
C)
0 I cemf5 that I have mad ms applicaum and stare Nn Ne above inform neon is
fait F comics 1-,me m eomply wed.ii ary and ttamy o dmarmen ord sure laws mining
Q to building communion.and hereby oumaruapresomoveaofmri osy to corer upon
7a W lheabove-mentioned property for inspeevon purpous
rF+ G4 (W,)agree rn.ca,1VI an comfy and which habe,n me Gty of mom is o agamv
UJ Imbilni s,juJym<ms,casts and expenus wh¢h ray m any way f CuP m. I said
V .9 City in consequence of the gmming of this perm:, ///� •�
APPLICANT DERSTANF&I SDII'ILLCOMPLYWITHALLN N- ♦ ,r / / U
soup^E WL-ATTIONS. r Issued by:%� r_ i/ _x,,...
rgn a olApphcandconI.cre, — — �Do. Re-roofs r
Nev 'stmt or futurebutwm aACS DISCLOSURE
by the Cupm o Mop l Cod,cupapt r 9.12.handle Ho.1th an macnd Type of Roof
W,li vv g
as defined .Chaperon 9.12.aria me Heave one sdery -
Code.Sccu'on 23532U)^. ./ yr ... _, r:. - : r• .
.0 a, All roofs shall be inspected prior to any.roofing.materia]being,installed..
Rtllthe striboantorfumrt Building oumpamuuegmpmentordenas whieh If a roof is insialled without first obtaining an'ins ectiori,'Iagree'to remove
man hanarel ah corm m nts u d, by the Bay Area Air Qual 1,Management la' P
DivhmO all new materials for inspection. Applicant understands and will comply with
` °ion all non-point source regulations. .
I hive mad the Inwdous m Lions 2 eg.25533,trader Chaps 6.95'of the _
aldomia Nddr @ Safely Code,Sections 25505.25573 arM 25530.I mdersrard Nat
of eo bwldmg data not a mmiy have a n be ath,t it h to aeponaiMhty to nobly me - "' - -
cupabt of the rcgwrtmens who's must be rdlt poor m msuarc !a�e�d�:f�ieyagm of
�mp0 /
Signature of Applicant Date
ownerorautharmdagem Date All roof coverings to be Class "B"or better
.- .. - OFFICE _