02060179C
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OFFICE ". _.. .._
CITY
DIVISION� PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
1173 CANDLELIGHT WY
ATLAS HEATING
02060179
OWNER'S NAME:
APPLICATION SUB DATE
CHAN MARTHA
155 SAN LAZARO AVE
06/26/2002
PHONE:
(408)739-0516
SANITARY NO. CONTROL NO.
ARCHII'EC"DENGINEER:
BUILDING PERMIT INFO
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BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
Job
Job Description
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I hereby art,. that 1 am licenud under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Busfne:s and No ai�nd my rause
REPLACE FURNACE/ADD A/C
in fou force and of t_
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License I s Lic. a
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ARCHITECT'SS DECLARATION RATION
so ,g
I Lindemann my plans shall be used as public recount
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c c Licensed Professional
tats,
OWNER -BUILDER DECLARATION
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I hereby affi m that I am exempt fount the Contractor's License Law for the
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following reason. (Semina 7031.5. Business and Professions Codi Any city or county
which requires a permit to construct, Ther, improve, demolish, or repair any awesum,
$3500
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prior requires statement.
Pcnrds License
,mss ,,F] ply
�' A r„ -4' eef f' � Valuation
7. 3 C� Zt2Fj Uai��:UV Ii s
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licensedur
Puriprarnslicanl the Contractor
punumpotheP f Diionsof theehe Buitols LicenseLaws
aw(Chapter
thatheiscing with of Divisiun3of the Business and PrpfGssiuns Code)
is
that
or he comp,00rolin
n that he is exempi mcrcfmm and the basic far the allegeM ekemptina. Any violation
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of Section 7031.5 by any ap,hemss for a permit surbjb she applicant m a civil penalty
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of mot more than rive handleddonors(8500).
303APNti"k MECHANICAL l" " Occupancy Type
Dl, as owner of the propenyl or my employees with wages as their sale compensation.
304 _ ROUGH ELECTRT 'AT,
-will do the work: and the':wcture -Is not intended or offered for sale (See: )UM,
Business and Profession, Code: The contractor s License Law does not apply to an
505 - FINAL EIIRQS (1l7%Pctions .. ..
owner-
of prapeuy Who builds or improves thereon, and who Jas such work himself
or through his own employee.. provided that such improvements are not intended or
508 — FINAL MECHANICAL
-'blfaired (a, sok: IE however, the building or improvement is sold -within ono Year of
"' —"' -__..___ _ .___... -. _ _.. _ _ ..._ _., __.... _. _ __ __ ._ -------
iompletion. the owner -Wilder will have the burden of proving that he did not build or
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mprove for purynse of sate.).
...,_.__._ors to.
❑i. ad owns; or thy' property, am uc uvve y contmmimg with lice co s
-
construm she project (Sre. 70dol. Business and CW e:) The Contractor's
ompose 't
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License Ww docs not apply to an owner of proper who bulice or
eny who improves thereon.
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.,andcomrac¢ forsuch projects with .a commcmr(s).licenscd punuam. m.the
e
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Contract Licenselaw.
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❑IamesemplunderSec. ��� ',B&PCfor this rtuon
_
Own Date' -'
' WORKER'S COMPENSATION DECLARATION
I hereby afrum under Penalty of perjury one of the following declarations:
M
ED
01 have add 'will'maintuin n Cenificam of Can.sent to ul6 insure for Workers
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Compensation, as provided for by Section 3700 oftheLabor Code, for she
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performanof the work for which this permit
m is issued.
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D I have and will maintain VJorker:s Cmadi rtuian Insurance, as required by at
'
3700 f th Loo'
Cod f theaefarnt e f th walk for which this pe t issued,rke' 9x1 ata ecm n all �L
Corn i -. ERTIFICATION TENtrarlION FRON WORKERS'
_BUILDING_._,
S t. ,.l :.( r.,. s S, i, s)'Z sI ns...
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' COMPENSATION INSURANC&t` `s' }
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(This section nitid not be cmnplufcJ it the permit is for one hundred dollars
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fS 1001 or teles.)
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__ •• Icemify that n the performance of the xorl for winch th pe --l' \duce. l
shall not employ an) person in any manner so as to become subject to the Workers
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Compensation Lows of CAifontia: Date
._Applicant
NOTICE TO APPLICANT If h anasngth CertificateofEE pfo you should
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become subject to the Worker'sCompensation pm nes of the Lahr Cost, you in
forth, III conplyxth suchP It It is femai 1. hall bed ended revoked,
CONSTRUCTION LENDING AGENCY
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thereby adiona that there is5conswaion lending agency for the performance
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oen a work farme which this permit is issued (Sec. 3097, Cie C.1
Lender's .' .. -. .. .'-- - .. ...•
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Andre'.....
Lende'r's AAdrcss
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I certify that 1 hove read this on and sum that the atiom is
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cityand
m comply with all coy and county ordinaries and store lows relating
d side
correct. .ing
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biro send ., and herean,,vedi lie representatives of this city to enter upon
above -runs to poupeny rposes...
she aM(we)
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agree indify and
fWejagrcetos..i andv,erw keep Irulet'the Cxa,a`Cupersinu against
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IWbll'1 j 'h' in
tc, .... L li npof
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r t nnY Y ugain:t sail
ry old
City 'u of theg ing of fhnpmd,
thi
APP 4 INDERSTIN SA 'D 'I MPLY \`�pIT'�sU'�0 I?
Ssi Rey c1 '.
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Issued by: Date
gnaturent ApplmanUComrbco-'r'. Date.:.
RC -COOPS
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HADIRDOUS IATERIA S DISCLOSURE'
\YII the applicau or future i ing occu or store or, handle ham'rdous material
-itdel FIb the c
y pen M -' I.0 a Ch, t 9I and n Health and
_Type.ofRoof-_.
CoA S n 5532t�7 -
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All roofs shall.6e inspected pnor_to any roofing being Installed.
u m pP` t r r b Ise g e muse equip t a ' e sat et
e:n'l h a d ont t roars ,all neo by the B use a -uses Qnt l'ry M wBe ext
'D"rc'
-material
If a roof is installed without first obtaining an -inspection; I agree to remove
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all new materials for inspection.
DYet r.a.
Applicant understands and will comply with
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all non -point source regulations.
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Lhave rend she heed isnnmriak rtquircmea" under Chapter 695 of the
Califor- Hcahh SsaBty Cu ,Sections a" older
andert.similar
ifthc ddingdov,mmdi halt I antdoutt o"Ponsi Bryn" fY.the-
&c m of the requirements ich must be met Prior to i oraJef very' is f
O u Inc
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Signature of Applicant Date
Ow r or authorized agent D. e
All roof coverings to be Class "B" or better
OFFICE ". _.. .._