02040025CITY ut DING DIVISIONND
PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
22272 BAHL ST
02040025
OWNER'S NAME:
APPLICATION SUB DATE
TED & GINA CAVALLINI
04/05/2002
HONE:
I
SANITARY NO. CONTROL NO,
RCHITECDENGINEER:
BUILDING PERMIT INFO
'
BLDG ELECT PLUMB MECH
I L._J I ILIC"
TION
I hereby ufnrmEhmEDnfi cn�xd unndderr pmv s onn R S of Chap er 9 ommencing
lob Description
with Section 7")of0ivision,3 of the Business and Pmfessio s Cod an myh nx
KITCHEN REMODEL. .
i.mmn r�rce nna ere .r/i�' �
Lice x lace (C Lioo. p
Date
��
S ECLA
RCHITECTre an pub
i I understand my plans shall be used an publi cords
O�
i Licensed Professional
DECLARATION
Oat
1 hereby .(firm that I am
am exempt (man the Contractor's License law for the
( Ccs
Cuae: Any city or county
(.(lowing requires
a (Seaton ]031.5, Business and improve.
i which requires de io demolish. or ream any swemx
ure
permit re construct. alter, improve, dcmont
$25000
n
3 .prion.i¢issuance,also requires the t -
the suchpermittoGlcssignetstatement
provisions o
that commeniinfiltngwan udu thep -i of the the Brininess
Ia (ChCode)
(commencing th Section ! he intent 3 of the Bupmwp tl Professions Code)
, +G�1^sy^C- a, ValnatlOn
or ium an An
and the buts for the .tinged cxemant Any violation
or that he a exempt tart'
--of Smion 9031.5 by any apvlicam for a prnnit zubjccrs the applicant m a civil pcnil,y
application to l
of not more man rive hundred dollars (S500).
10 S PN UUNllAT I ON "'' I V, Occupancy Type
❑ I, as owner of the progeny, or my with wages their sole
notin
will Jo the work: and the'stmaurc is not intended or'ofkrtJ'for sale'(Sec. ]Oly-
a le (Sec.70,14,
'Busia&, and Professions Colc: The Contractor's License Law doe.. nor... 1, to .a
103 - UFER Required Inspections
owner of progeny Who builds or improves thereon, and who does such work himself
orthrough h'.employeesthe 'dcdm,. b', p_ t. t eyear or
oRercd for sale. lfhow 'tneb Id' 6 rtnprove next rs- IJ lh o-eY year of
..10.4 — REBAR--------
�-� ""-- -""—"" "--"-' --- -
completion, the owner-builder will have the burden ofprovngthathedidnotbuildor
,------
105 — ANCHOR BOLTS
improve for pmpnx .rsale).
— --.
106 — SEWER & WATER
_..
cont as, he bfhe progeny, vin nodus vdy contracting gwim licensed t a0rs to
conswet the pro3eet (Sec 701W, Bus Ness d P lie -ahs Code) The Commcmr's
----_ _ _
202 — UNDERFLOOR PLUMBING '" -'' f ' 1 :•
IJcenseLaw does nmappymanowner nra who n.udsnri thereon,
.,.- v u. •.�.,
203 — UNDERFLOOR MECHANICAL. ., ...
conn pumm
.Co vector's wctseL such N_wish.a contmcto ).loaned pursuanLto.me
Contractor's Lv:cnu La v %em Rs
.. ..... _..___ . ,-_-
204 — UNDERFLOOR FRAME'
'-
❑Iamenetnptnneersr ,B&peronnnsremp"
'
205 — UNDERFLOOR' INSULATION
owner "
CO'nate'' "'
WORKER'S COMPENSATION DECLARATION .
301 — ROUGH PLUMBING
Ihereb rfmn.naer n r
yet Penalty Nrjaiyoneofthefollowingdeclarations:'
302 — TUB & OR SHOWER
O bave'nnd will maintain a'Cenoficute of Cdaem to self-insure for Worker's
303 — ROUGH MECHANICAL
compensation: as provides for by Section 37M of the Labor code, for the
304 - ROUGH ELECTRICAL
performance of the work far which this permit Is issued.. ,
3 05 — FRAME
❑ I have and will maintain Workers Comped.adoem.iurance, hos required by, Section
306 — HOEDOWNS
3]00 of the Labor CW,: for me ocifirmance .f he "ll, for which his Permit is
!ranM. My W orkcracompensaJdnIn,urancelimmrandPolicyyumber,am
... -
307 — INSULATION
cont,:t9.•.IP.o1cyyN: .,
---... 308 ;:-.-SHEE'TROCK
' CERTIFICATION OF EKEMPTION FROM WORKERS.t�
COMPENSAnoNINSURANCE'-EXTBRIORprLATH','
+ '"
" fThsccdWneed not xcompleted ofinepermitisfor one hundreddollars
310'—.:INTERIOR--LATH ,,,,_..---
s1001or1aai')
311 — SCRATCH COAT
' I en fy,h , ,he ped,mta c of th k f h ah h pc t
3'13"="ROOFNATL
C r t ply ypb y ..r m become bje t to he Workers
Cmmnlawsofclfma'Date,°`• .'
�
501 — FINAL EliECTRICAL ENERGY
App( nt
. NOTICE TO APPLICANT If ft making thinCnfcrm of Exempt on. you should-
------502 — FINAL--PLUMBING' ENERGY'
Kceomes.bice,lomeworm,scam,rmrnonprovision, of helarorewe,yoomow
503 - FINAL MECHANICAL ENERGY
fonhwlth comply with such provisions or this Permit shall be demand mvaked.
4 ---.FINAL.-BUILDING-BNERGY—.!L....
" CONSTRUCTION LENDING AGENCY
' I hereby firth his h construction Trading gena for the ped nn ace'
,
505 — FINAL ELECTRICAL,t_
ELECTRICAL,.
onhm akr ntnhis permu-: els vn]e c)
Lender _. --. ••.,.a
r. :.
Name.: .. ..._ _ ..._ .: _.
Leader: A.m.,507
— FINAL PLUMBING
I certify that I have read this oPplu atim, and some that he above information is
508 — FINAL ME CRANI CAL
coves. I agree to comply with all city and county ordinances and state laws relating
to building construction: and hereby dudiono, representatives of this city m enter upon
509 — FINAL GRADE
me.bpWal. hagga,gropenyfog.fy andknpmpoxs.,_
I W<) agre ed save, Intl for re action p hposes. s the City of Ctipcniino against
510 — FINAL PLANNING
liabilities, jna u, c st and gnpeme, which may in any way accom against said
Cory incoj in co. me�$.I f his mail "' ." `this permit." "' .. . '
514 - F INA P C WORKS
APPLIC�P��N AND WILL COMPLY W]TH�ALL NON-POINT''` AND WILL COMPLY WRH�ALL NON-POINT'"
OUR ON -
�/
Issued by: Date
PP bAI! tin tot D . D te:; ,- •
• . •' HAZARDOUS MATERIALS DISCLOSURE 'a
the v.m or future Id g t t c r dont
Re-roofs r- T�
as def edWitlb hI e Cuperino Municipal e. p mSmn.l
Chapter 9.12
..Type of Roof. ,.- .. ... ._,
y RCode ddh.menet:
and he H alh end Safety
Code. Oion Ye. j553 11^ ❑'No t' u , IT I;, 4
- - I i
.. .. ...
V `'.,4 . .,.,, -1w., a ). t ,•
All roofs, shall be inspected.prior to any roofingmatenal being installed.
r deviceswmet
wf h ppf t future building p t. aAirQuality
mth zvd r mm is as defined 63 the Bay Area AV IN InyM gement
If a roof is insialled without first obtaining an inspection;'I agree to�rremove
°""' ❑Y ]N
new
all _new materials for inspection. A licant understands and will cont 1 with
P Y,.,
t
1 h read the fi do �1., manna, '
all source regulations .PP' ,.
'
mc,r nts under Chapter ti.95 of he
a Health A, Safety Cod S Nom 25505 25533 and 25534 1 understand that
Plotbuilding
P,tie bdild ng d n t e rr tly ha a tenann,hat n in my responsibility to notify the
'occupant of tin s x' " ..it be m'ci pfonm issu.nce of. Cenifi<h¢ of
P,
:.... ...
.-�
Signature of Applicant_ _ _ Date
a.genf a D t
All roof coverings to be Class "B" or better
-" OFFICE - - - -