01120047 CITY
upEsoNo
iNPERMIT CONTRACTOR INNPFORMATION:
BI1.9 flORNULKNAP DR INTERNATIONAL KITCHEN E M6E 01120047
•O`L!XftI,tbN RICHARD J AND JOANN 1175 E HOMESTEAD RD APf`f7TYyY6T61
! PHONE: (408) 296-3055 SANITARYNO. CONTROL NO.
WC O O ARCHITF.CT/ENGINEER; BUILDING PERMIT INFO
&m— BLDG ELECT PLUMB MECH
u u I_T L__I
p v Z LICENSED CONTRACTOR'S DECLARATION
i v 1lum by arum Than I am licensee ands,vroviki e,of Cbavmr 9commencing LAUNDRY RUN G,&Reffff TbR GAS RANGE. REMO
f lu with Section 7000)of Division 3 ofine Business and ProfeWinnn CN and my license
;yES biumnrera «� l�j' EXISTING KITCHEN
OU Limnse Class Lir.p
i 3 a Dam S DECLARATION
N F..O m 0 A L .E.
ANCHITECr'S DECLARATION G9Y
1 understand my plans shall Is,used as public records
:LLx
;;off Li<cnsedPrnfessinwl APR 042002
x,-,_ce OWNER-BUILDER DECLARATION
w— 1 hereby aRrm that 1 am exempt from the Contractor's License Law for me
v.
orollowin6 reason.(Section 70315.Rusinese and Dressier,Code:Any city or county
which requires a Perant to[rommut.alter,unpmve.demoli,n,or repair any structure
i3 so prior o- Iso 9 me applicant fur sash permit t n .'g e t, em _ _ 6_000_0---- -
mnam f -Thed . nt ,m P . nrmeTheBusines a L (Chapteroe) .IoorArea - Valuation
(con ' g Th Section om ad the irsi, or t meauene x aiProfession,code) q'. s { ( ,
.,,he,he i exempt herefrom and the ba,for the alleged exemption,Any violation ` 3 6 2 0 8 0'4 2'.'0 0
of Section 7031.5 by any appbcan,for a prom,sobject,the applicant to a civil penally APN NumbOccupancy Type
of not more Than live hundred dollars Draft. er
01.as owner ofthe propely.or my employers with wages as their sole compensation, 101 - FOUNDATION
will do the work.and the structure i,not intended or offered for axle(See.7044. Required Inspections'
"Business and Professions Code:The Contractor's License Law does not apply to an —
owner of propeny wno builds or improves thereon.and who does such work himself 103 - UFER
orr through his own however,t Provided thm such improvements are nm We
er
completion sale.If,however,the l have t eor burden
of
to atom within nor year or _ _..__ .10 4- - REBAR..". .. .._... .. .. ..
completion,for me owmrr-naiiaee watt Hatsa tali numen of proeing that he ilia not nulla or 105 - ANCHOR BOLTS
improve Pomose n
. 106- - SEWER-& -WATER -
O C.a owner of the _
prop.cny,_am udusivdy contracting with licensee contrunon to
emelow, he projeet(see.7044.Busmeaa and Professions cane:)The Centimeter., 202 — UNDERFLOOR PLUMBING
License Law does not apply,o an owner of property who builds or improves thereon,
and who contracts for-such pmjens with a.coneramort).hamea pursuant to the . 2.03 — UNDERFLOOR_MECHANICAL_
oia`,nexempt`�latersc. B&J`Crerthis rcaaoa 204 — UNDERFLOOR. FRAME . .
owner Date ' " " 205 — UNDERFLOOR INSULATION
• _ WORKER'SCOMPENSAIIUNDECLARAI'ION 301 — ROUGH PLUMBING
1 hereby affirm under penalty of 1',erjury one of the following declainumns 3 02 TUB & OR SHOWER
❑ 1 have Sed wiR mit mail a Certificate of Consent to self-insure for workers 3 03 — ROUGH MECHANICAL
Compensation, as-provided for by Section 37M of the falser Code, tar the 304 - ROUGH ELECTRICAL
'peau r n wnrk r n'nun a Per t '.. ea. ,
❑1 have ad 'lit-arramor,Worker',Cman,relvaumor halrommic.as required by Section 305 — FRAME
37M of The Labor Code,for he pe,forrenT6 of he v olk for which his Permit is 3 0 6 — HOEDOWNS
e W ero Pe ,n 1 ranc ' d Pu num be n "'
�" ' 3 07---- -INSULATION-... .
e Policy N r _ ..-.. `i- _ ip
...... .-...
,CSRTFCATION OPEXEM1 ION P1 MWORKERS' 3O8 — 11SHEETROCK "
oMPE.NsnnoN"INSURANCE .''' :'. . .;.'._. _309 —EXTERIOR -LATH
(Tnia'aecdonneed abet(... leandirtneomitisforonehundreddollars 310'1 - 'INTERIOR LATH .• . '..t'p:r,.., ,
(sloowneaa.) 'ss�ed l _ 311- - SCRATCH
A lnet n ..no to become subject To the worked .50.1 —. .FINAL ELECTRICAL
1 certify fleet tM1 P rf f'he
k f wh ch his fin,
,hill en,rmvmr any f 313 ROOF NAIL.::
Compensation faw,orCalifornia.Date - CTR I CAL ENERGY _
NOT ICE TO APPLICANT:It ft kinin CofofExemption,you,should
502 — FINAL PLUMBING ENERGY
becomesubject to the N A Compensation previsions of the Lebo Code,you mum'
e
O z forthwith complywithsuch oe's .,,his Primal, hall be da re,oked 503 — FINAL MECHANICAL ENERGY
O
,F lin •" "' -
CONSTRUCTION LENDING AGENCY 504 — FINAL BUILDING ENERGY.
I hereby alarm that there is a construction lending igency for the performance 505 — FINAL ELECTRICAL
r of me work for which this permit Is issued(Sec.3097.Civ.C.)0 -Linda',Name'.. 506 GAS TEST —
O.y Learr,Aaaye,. 507 — FINAL PLUMBING '
;a,; Icenifymaihavemadthisapplicationandslamtnanheabovemoromem.is 508 - FINAL MECHANICAL
F.t correct.I agree,o comply with all city and county ordinances and state laws relating
O.(� m timlding conumnion.and hereby authorize represemen,r,of this dryto enmrupon
'psi m ,he aisoe-mentioned progeny rot im,N,rom purym,s. 509 - FINAL GRADE
p.. o. (W) B to,e d ffy andper,c,keepn 1 _i an,way fc cet, u`r,,id 510 - FINAL PLANNING wA
W 1 ane,' j a6 a s,cot d penses h y', any w y [ gains,said G J
V Z City ge 'g,of me rd'I ofth Pc t
nPL�urr DSA.' tit. me
"in nT ",, 514 �s- NA WORKS / �^/2-0/
.e TIT Gla � c1` z�Zt�- Issued by: Date
SIS am,
Ppcam"CommetVMATERIALS Date' Re-roofs /
..
HAZARD. DISCLOSURE
Will the applicant or Laurie Wilding eccu,mor store or handle l x w m,runt nal Type of Roof
as f d bi m C pert M 'p 1 Cade Chapter 9.1 Safety yP
C "Section 25532(a). -
�` t
em oY " All roofs shall,be inspected_prior to any roofing-material being installed.
nae
Will the applicanto future,Wilding p t - - _- ....._..
h 1 - o a t defined by h Bay AreaAi Quality aM mem If a roof is installed-without first obtaining an inspection,-I'agree'to remove
T Di,tri t❑Yes - -- Nar all new materials for inspection Applicant understands and will comply with
�!s all-non-point source regulations ;
1 hv,ciera'uwhrer.adcam,mamdals „q iremin .'raderChii1te,695'bf me
Cillaftleallarldrie SafelyCede,$[el oma 25505 25533 mal 1 d milard that ,a\/J1P'a�z\7-7zIy-/X-�I�/w11n`�
if the bu ld gate spm curzently ha •ammo ,h tit': yrespo 'b ley, nleaY.the rl t (+ I V
Accu mm f The u, ed a- 4hch use ne q p' t Tell of a Cenifi[am of
Signature of Applica f Date
U.rwr aliflummiedegent': , , .Date - Al] roof coverings to be Class "B" or better
. .. ... .. .. . .. . OFFICE