01010047 CITYBIo;N Virxi NNo PERMIT CONTRACTOR INFORMATION:
RU I I.DING A DHRIiSS: VERNEI NO.
21719 HEAVEN DR EXTERIOR SOLUTIONS 01010047
OWNER S NAME- APPLICRI'ION SUI3 DXIE
HAWKINS SAMUEL R AND JOANN I., 1771 SMITH AVE 01/11/2001
-�
PHONE: SANITARY NO, CONN Rol,NO.
(408) 358-1.233
�0 V5 ARCHITECT/F.NOINFER: BUILDING PERMIT INFO
LI ELECT PLUMB MUCH
.I L
TOM
y" LICUNSUDCON'FRACTOR'S DECLARATION
o o nerehy rima„Drat101,1 lar—,ddimfid r....ills.of Chaplin 9r�n.aCa,irg Job Dcscripl on
dmf; will,Suainn700),lf Division 301 hu Ruxinc,x i IPad awl,Ced, dr,lkrnac
"m is ir1 inn Feld and,)rest � 1o33_S SHAKE TO SHAKE
W I,lcmnc CI � Q�
O L els_/ L Cnnlrumnr
AItCa l l he'I"S UECLARA I(V II
c.LL LL G
� I mdcrnvual Illy plum,n11oll he n,nl as public lvconln r�
z y 2
lit O 5 iwncu Prtdcasian,1
L X Pill I LW OUdall,h is I,,Cow;
u1 u. hme11y uthnn Ilett l um exempt honi me Conlraam'x Lisnse Law f r the
toll ,(Sem 7u31sR ,iac dl I .: rvCI Any -ryurrrn,ly
SSO wl, l y ''. .•Fent 1 ') aIle f IWid p.'..ny abacu
pn. L h 'pili tr I"lineollo f1 E I:wm ua
ho']is I n - n p 1 t ill,Conlial License I.Cor Icll,hro S Ft Floor Area
do a ,ill Seu n,70001dD„a,3(11 tire Euv,vee:md Prole,,Ions Codd) q' Valuation
or 111,11 loo is a,e1„P1 ieercl oa,and me n.l,i,for the anegnl axwnplik Anv viol i $10000
of Scawn 7031,5 by i y,1ppliumlh,rufeealtsabjcah the nppllaml10:1 cirri Pea,1Ity
ma iaam than Eve Illlad2a aahnm(x500). APN Number Occupancy Type
oLa,awaarar lhelm,Pe08 or my 011rl,ma whh ere ge.,1s 0iva,ala eompea,ahoa, 2647057. 00
will I [lie ralf, t-1111CITaled CI olfe le(See.7044,
litoraell soll1 Cod, nre ChdaI License Lry,,dusProo ,PPI,to ail Required Inspections
(,I pnperly Who be Id,or pr oven iheraon,and who dol„aeh work h'ar—If
o1r�hrvugll la,own eoledym,.pmvlded mal sono iny,rare�oenla are do'imeaded ar 305 — FRAME
offiard rorsale.Ir,however,hoe hooding er iloproverneal L,sold ealoo aae yearar 307 — INSULATION
na,le.10ill,e ownarbubu
ildcr will have the rden o1'pri ving)hal he did not haild or
alpmw far porpose of sale 1 601 — ROOF TEAR OFF
❑Lasaelanllapr 1, arIe,ew,l reaniaielmgw,,I,deea,eaIarri..ar„” 60.' — RUOF PLYWOOD NRIL
Linw'ICI w[he pmjeel(Sec 70,44,Euc rid PIofen s Code,) I'lie Coawmorx
es el�wdoe ann.splay to as wirer of�prnperty C,K) (Ir Ilnlar eadleer0r. 603 — ROOF BATTENS
,ria hall eallvaas or saes Prai 1,will:,Caalihe[ad,) heen,ed pnrsmav 1u roe
I'd I,aeo-ai Law. 604 — ROOF IN—PROGRESS
❑Iain uen,pi nndclSm, ,Hk PClur Odx rcaw
Owner Uwe
WORKER'S S COM o NSAI ION II[CI AItAI ION
In -ly a - I 'I Ity fn ) y r❑ nl
❑ 1 1 ' C I I -i I c f I Cell f W 6Lra
J Gn 1a, t p- ho, by S 1900 of 1 1 - Code, ka, me
per) of 1h klor which11 Peollit I.
❑IIale ,W will n.',II Woo kers CC)[11 pe I'a I Cal lx ell"red by Scaanu
37W of me Luhnr Cndn fnr the peHnnmdce of me work for whiell lhe, rail i,
Ixsucd.My Wnrl cr Coinpcpgei0glpav_nmttcnr76IrldZ Policy 111111111111 1111
/a'KOT6C:1!75'
!7 q�p.�
Curticc < C n Policy Nn: B.2
C:If1'IFICATION OI'EXF%IP1"[ON FROM WORKI,I:'
CONIPHNSA'I'ION INSURANCE
('I Irk,ccllan need sol bcon,pleled it the pe,,ah is fataaa hundred dolwr,
1$100)d,lass)
I emfl'y lhn(in me pclmmanro of me work for which Ili,permil i,lesacd.I
shall not employ any pmol Ia'Illy m'Immr so as di hu,0mc mh'Imt Io iha Waked,
Cempca.,mim1 I_nv.a of Califnmia.Dale
A,,I Cial
NOTICE'I0 APPLICANT:II,re,making[his CarllfiCnle of ECellaioo,yes n1100a
Z heeaala sahJeclm me Worker,Colo,a,aran pm rix ul'the l.abr Code,ye, nw
a
f Iovilh comply wish such pa ', ,r III is pari I Is I b Iccnmd rcvakcd.
F14 CONSTRUCI ION LENIPINO AGENCY
I hereby aRmn)hal mole is a cmi,aaehan lendiog.genet If hoe laa fornwnen
W of the work lar w11i11,'hi,pcle it is.,sued(Sc,.91197,Cl,.C)
11 Q Lerida',Nw1
1J z Loader',Add,,,,
U O I lorlit,Ill,I hao,re,oaln' 'I. 'I ISI CallI ! i,
W
U en< .Ig t II, 'air ill ry p 'I 1F rel, le
Q W Iiht di,ge,pmel aq: dl aahyspoidi re y,,seri) ',,,an,l,eily la ei,ler nraa
W me aboveiCh al,oned loodsale,.a for l,,I d ke puIls-11a
f� OV)'g t .'u I -Pe dk IhcC1 fCLI l 1.1g: „t
t+ V] Iell,il t n [' r t I
U ! tilt f11 b Ph onyx y' 11,411111:'lid
APP C UN n W f LY >N Pr NT
S R An 14 issued by: Dale
h,a IAppfe.nhC '1a /Mata Re-roots
I IAZARDOU,S MAI ERIALS IIISCL0.SURF
wio the iipplieaal er rmare hmiding aceapant rare or Ill le ha,,wdona means Type of Roof
a,dJlned I,y OIe CaPetllnn Mun'mipal Cade,Chalaci 9.I2,nod Iho Iladlh and Safely
Cade.Seen 1 255320;1
°ve F2 No
All roofs shall be inspected prior to any roofing material being installed.
Will is,nPpheaalarhonrammdmgaaapill,t,lacatnnploawofdariee,ehieh If a roof s •Ile I without first obtaining an inspection, I agree to remove
malt hmaalon,ell canmmioanm:e,defmcd by do,Fey Arm Ah earh'y Manugemonl p
Di°ries" all ne�w,materi Is for inspccton , cant understands and will comply with
❑vel oNo all OIl-poillow'cereg'a"h Lia nmmriak Felli1 dolemc udder Chopier 6.95 0f 1he
nfciy53J.1 nn0owlaud ihm
;'d' aae.al01�
ani a he required, e pr'� 1n h re nl,1 Cott frac of /
O�tq
,.nature of Applicant Dat
eraraii[hariary agm,i D � All roof coverings to be Class"B"or better
OFFICE