02060145r CI
Bu°F G DIIVISSIION�O
BUILDING
CONTRACTOR INFORMATION:
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.BUILDING ADDRESS:
PERMIT NO,
19315 CALLE DE BARCELONA
ADVANCED ROOFING TECHN
02 0145
.. OWNER'S NAME:.. •,
".':.
APPLICATION SUB DATE
"
1179 MYRTLE DR ."... ..
4/2002
06/2 /
PHONE'
SANITARY NO. CONTROL NO.
(408)249-4937
ARCHITECDENGLNEER: --
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
y . LICENSED CONTRACTOR'S DECLARATION
hereby l licensed
Job Description
sl affirm ih t d ...... sof Chapter 9 (comme g
with Station 7000) ofD 3 orth im al Postzsio Cri andm Ian.
WWW] .umtu for, cHa
INSTALL 40 YEAR COMPOSITION
U Lia _ t •-Lt
C mote
.. ....-. -
- u V .. AR HITE 'S DEC ...
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- I undersand my plans shall be used as pu m mcordz
OLicensed Prefessino d
' ,' 'OWNER -BUILDER DECLARATION
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I�'-fhemby affirm that 1 am exempt from the Contractor's License Law for the
Qfollowing reuoo. (Section ]OJ L-: Business and Professions Code: Any city or county
a -which requires a permit to construct, alter mw improve, demolish, or term, any omater
5 0 0 0
_. prior to its issuance, also requires the applicant for such pemdt to rbc a signed saament
- shathCi liccndedformedBsCl�epresBionsoftheContractorsLicens, aw(Chapter 9
(commendrig with Section.] ) of Division J the Bu}loess
S EI Ploor.Alrea,� .s -„meq
i' Flo rcAr
Valuation
of and Professions Code)
or that he is exempt therefrom and the basis for the a1legN eiemptlon. Any violation
.'( s3,;�.5M1,
' - �'•�%�i--a\J•\'
'
-f ion403L5 by eny applicant fora permit zuM1jects the epPlicam io a civil pewliy-
i
p.rnoma,i.mdrethanBvehanareaaoilars(ss00). �
APN Number
Occupancy Type
305 - FRAME
C3 ' fN p rery y pIY 1M1 "g.' tn' I penaon
will Jo the work: and the i t e"ni inmudeaVot offered fsale (See: 7(1s9,'
'-- - - --_--.- -- --- _..-
-TE qpi,,-,] Inspections)
'Bis' ss cand Proifics,icaus Code' The Cmumela, s License Law crisis not apply to Ba
owner of propcny Who builds or mprov ll m, and who d ch work himself
601 - ROOF A
or through his own employee, prodded Nat such improremanta are not intended or
--- 6 02 --
offered fofi5ln IChowtsec the building be impruvcmcnt is fold within one is. of
.. _. .. .ROOF- .PLYWOOD. _NAIL _ . _.. ”' --' -- -- - ---- -- --- - -
ortipletion, the owner -Wilder will have the burden of proving thathedidnothuildor
, S ..
603 — ROOF BATTENS '
improve for pan,eme of. 1 ).
ROOF IN PROGRESS
.(J 1'az fth p prty I ly t nI 'th licensedcontractorsio
_. _604.= __ _.
constrict thproject (.See 7a,&4Businessand Professions Cod')ThContractor',
LicenseLa J i pply t net f property h hums p there
and ho i i (r such p of ts.w N e emanations) I eased pursuant. t th
Contractor , License Law.
-
' JUN
Dw e Dat
WORKERS COMPENSATION
2 7 200?
'Wy y i o - c DECLARATION t
Y
he ,y R7 "de pc. 11y fperlmy fun fnllo.' 8d lar,.g•
.
I
'I
❑ 1 ha tl II m nt C n fc i I Consent to If f Workers
/A�vG
Compensation, . Provided I by Section 3700 of the Labor Code, far the
performance of the work for which this ',.it is use ed.
,f 1/have and will thainain Worker's Compensation Insurance, as required by Section
Y/00 of f' theperfoon�c f Ne
j obo `Cal work for which this permit is
i ed i tend Pol mv number arc
Tu
-
Cern • ' OleEX yNu /S x0997 -C2.
,- CERTIFlCATION OF EX FI'ION FROMWORKERS'..'
_... ... _. ... _.. _.: .. _..e ..-.-�_. .. .. _-..-....... �..........
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S�f-,.1'}:vl: m -✓.i i bili
`COMPENSATION INSURANCE
'(Th t m need tot be enmpletee if the fern us f one hundaJ dollars
7 ^ '_s - '. ,
(31BD)or less]
'
1 n 6 tb i in a Perfcm ice of a rk for which th peon i s smeJ I
nn s
shall of employ any rich z to become. subject to the Workers
-•
compensim Ww, f Califoma. Date(LL
..
APPlicam.''
NOTICE TO AP ,G ,a ter-ngthis Cisions f h Latim onyou should
6c bjeci, the W' Compensation provisions oRhe C u mutt
thwithmic
en Pr ha
Bothwith ply inti nchp '.ions or permit shall bed metl revokcri.
� erred wild
I
"CONSTRUCTION LENDING AGENCY "'
(
I h ny affiimr that here is' ciasomerian Icnd'ng i f crla
the prmancc
s of the work for which ih z penin it wined (Sec. J09]. Civ. C. - • "
C I
-
LedeName •c.'_...._. ....._ ._ _.... ... ..:_
LeadC,Arldne
f3 that, lha duh idem N -ted bo' of... is
it
coric(eon
ct 1 agreeto comply with all city d countyordinances d state la relating
p b Id int on ter
a J hereby ucbr ze rep t i vcs f N air, to t r yon
,
a d
1 ,77 bo m o cd sa renya' pe ti n
I',. (ue) pcemsn 4nd nn'fy and keephunt le iNc City of Cupen nn against
Iv/J[/`-I`
-
I'ab Inc l d J s h ch y n anY Y e g insI said
"
City n y fil g fihILL t
/w�r� �
80JAPPI IC R.FC, RST\ AND WILL COMPLYNxTT ALL ONP01\T'
e)�gF�
V V
Issued by:
Date
g ter of Alp candC ,actor .. Dam ,
Re -roofs
HAZARDOUS MATERIALS UISCEOSURE
J Wi11 the applicant or fawn buildio
PP g t.mrt handle hacvd material
'c
Type of Roof
y p
ha
Col f Section byline 255 Rruh1 Pal Cod CM1 pt 9 12 d'h H lth d S f ty
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QY t. a Y
C
4 i"e P � Av Cb 1� i. t 1 4 t... 1.
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-. All roofs shall be inspected prior to any roofing,ma[erial being installed.
Will he r<at Itrenu min tn,e.�
pP g otpan qa pn ' d item which
i h l and commitments defined by the Bay A� r Quality Management
._.. ... -
If a roof is insInwithout first obtaining an inspection; 3=agr(ie'to remove
' '
tt`rn`(7 Yer. - _ No - -
�ha:'e
all inspection. Applicant understands and will comply with
-allnt
regulations.
read Ne btan dour materials requirements under Chapter 695 of theCm"can
H mien e. sectons 25505.2551] and 25531. 1 un4nunJ ihaifthe
2neaterialr
but ng does t nc tlyhavc a tenant. Nat it is my esponsibility to notify the-
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me
occup: bf the req s which must be met print to issuance of a Ceni Term of
'� �d
Odc' arty.,,,, .
.- _ Cc_
S) nature of Applicant Date
All roof coverings to be Class "B" or better
bar atch.naed agent Date
-OFFICE - ..