0206000916
CI TINO
OF Pv SIONPERMIT
BUILDI
CONTRACTOR INFORMATION:
c D
BUILDING ADDRESS:
PERMIT NO,
802..CANDLEWOOD DR
RUDD STEPHEN S AND.BARBARA
0 02060009
OWNER'S NAME:
APPLICATION SUB DATE
RUDD STEPHEN S AND BARBARA 0
06/03/2002
PHONE:
SANITARY NO. CONTROL N0.
IS ARCHITECfENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
2 LICENSED CONTRACTOR'S DECLARATION
Job Description
hereby affirm than I am licensed under provisions of Chapter 9 (commencing
ill ,with Section]0X).fD,,i,ion3ofdm Business and P.fitllionsCdde,andon, license
REPLACE
rd I. Inl Bsreeand•ff r,k
.WATER .HEATER .. .. ;
rs. -i+'. t..,-
H :Dine?'-- ' Contractor :
ARCHITECT'S DECLARATION
g I understand my plans shall be used as public records
OLicensed Profnsional
u19- OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the
following reason. (Section 7031.5. Business and Professions Code: Any city or county'
o which requires o permit to consumer, alter, improve, demolish, or repair any structure
$500
_prior to its Issuance, also :equires dm applicant for such permit to flea m
signed soduent
- that he is.licensed personal 1. hprovisions of the Cmurachea License La (Chapter9
re -
art `.
Valuation
(conild s th Se to 700�)of D' icon 3 of the Business and j'uf` ns code)
or that he is eomipt th rshom and the basis for the alleged eennpuou Any violation
.CµI ,,aq��Qp ,
�,., ).' 5�':36T1 1'/"J-5'l�V ti:i J 5 `.
"
of Section 7031.5 by anyupplican( for o pcmnt subjects the applicant to a civil penalty
.of no more thmr hundred dollars (S501)).
i'�3i
Occupancy Type
_
502APN
{a PLUMBING
ENERGY
D 1, as owner of the property, or my employees wid, wages as their sole compensation,
-will'do'the wmk.mod the structure is no, or offered for sale (Sec: 76 :
rBmsim:aa and Procession, Cudm The Cormisto', License law does ant apply m an
-- - - - - - -GAS -TEST -. - - - - -- ----------- - -- -----
507 - FINAL pI{g�rp0jbspeetions
Winer of property who builds or improves thereon, and who docs such work himself
or through his own employees. provided that such improvements are not intended or
offissed e - If, however.year
t b Id ng p t Id within one Y
'impasse
._.. _ _ _ ........ _..__._....... .. .. ..__. -. __ _-. .- ._ ._
"A'• 1. - r
will have the burden of proving that he did ndt build or
fo
• " "
Pmpk a of z.cr
impasse for purpose of salt 7.
'
U•T er rthP pony e l . ly i t g with licensed t i to
ttM1 p 3't(S 70 .14 Bc dP fs ons Code) no C t r
_-- .. .._ .. _ _ - -.....
- - a
LicenseLa doe. of apply t owner of p pony M1 bu IJ o p ves tb o. red
'
am{ho c n
h ccs, for.such Projects witha conuacmtts)_uc nxd Imported to he
Dltr
Contract I c Low
pt sec. t B&e as(;'
P in
Pazi
_. _._ __ __ __. -_. _ .... .._
t, sro eta RKLR S COoN A�{U ppN DECLARA
l+fr is :41J y
airy. ii afla following decla,alion,
5 I hereby ff tl pe I pe t ry
s
D I b ve aad istil mainland a C n fc t of Comem.t self msurc for Worker's
Compcnsauon. as provided for by Section 37W of be, Libor Code, for the
_
peifom,ance df thio work for which chis per. it is issued;
_ -
❑ 1 h 'd II'mii u W d 's Compo m n'limmmnce as regwred by Section
77W'of='he Labor'Cede, for the performance of the and, for which this permit is
e' issded.'M Workers C,om..,..--.:...roc.--- •,
y num
-., _ pensacion Insurance artier and Polio berarc:,,,,
,_„}
- e '1..'(`.t• Tr Ir YI'•Ve PUIicy No.
1 [ ti 'CERTIFICATION.OF EXEMPTION FROM WORKERS [
F,7 a ,.:', _ I i' ... t'f;e-,� ,1st._ .+'� �,' _1 t.•,
"COMPENSATION INSURANC
_ ... Wim ., ._ .. .a
sit'! 5 jlfi'. sttu6n need riot be enmpleted If 'he permit is for one hundred dollars
...-----------._......... ..... - _--__..__ ..-- .. _.
•` ” _: , r, r s.
fEI00) I ss.l
- '
I eeni in the peramminceof tM1'okf which the pe is issudI
-- --_ - --- _ - - -- - -- -'-' -
-that
am
�h311 d y plany' pe .on 'n nY man to become bj et co the Workers
t r
coIn laws ofClifo :Date..'
..'Applicant. . '.
....-._
ICETOA CANT: 1f, afteCmr m his of Eabor o you should
_._..... _. _......_... __ .. _.__....__... ____._.._..___. _
)
16 t ion
n,alio os III. , o d
the tabor Code, you must
becom2submpywit WbiksuchprCoions
or
fonhwitn'complY'with such prorisidns or this permit shall h deemed invoked.
Permit shall
LENDING dAGENCY
-
"CONSTRUCTION
f h the, iss cbn leading agency farcA performance
p L
for which
of the k for which chis perm c is rssv<J (Sec
i...edu '3097 Civ: C)-
:
mry tlr c 1 ha c ad th pplicar o ❑ t ¢ th nh bd of tion
,1 rs
turrets 1 g e t tcolnplyy ch all city and o iY ordinances tlstatei rtlaring
b Id gconamno Akd hereby dutfimz p
.[nuc ves ofch' rym, enrcrupon
9 ;�hc b muld parlitt, f -msperl purposes' -
-
I W } reg cd'. d 'fy and k p hamile, of C perimo nimnst
heeCity
liabilities.judgments. tp c t J xpenxx Inch r r r against said
City seqq uence of dreg ni gof ihi pe n -
r
APP1,iC QNDERSTIND$'.NrytV LCO\(P WfpH ALL Nb %OIyTf
ROURr ., 1dn f�A r„ • C "9Y
�/ v
[SSlledb y '' Date
g, tum -of, pplicanUcommctBr }':'. .'-,.:• ....: '... :' Date .''.
- . I.
Re-rOOfs /
•, , HAZARDOUS
., MATERIALS DISCLOSURE ' ''
Will to ppl r t f t re amIdmg'a,�imjpaAf.stor n dr named minimal
-Ca
,Type of Roof_.._
as'defndbyth p
Crtn Municipal Chapter912 and theH ITh ad Safety
-'- -..... -- ^-
Code.siich.23532(a)?
DY - t �../� ` f
t (F"' l., ft
.:
All roofs shall be inspected pnor_to. any roofing. material, being Installed.
wnm it a t f u build' gx p �us�equp ettdraevLec n n
�mic h do cora ant as d fined by ih 'Bay Are. Quality Management
If a roof is insialled'without first obtaining an'inspection;'I agree''to'remove
-
°i-- 0 -
-
all new materials for inspection.: Applicant understands and'wlll comply with
`all -non `- -
r . „
-point source regulations._ . , _-'-
1 h c: J'thc hazardous material requirements and Chapter 6.95 of the
C. f6 alieiltib& Safety Codes Sections 25505 35533 and 255341understand that
ifihe dsildingdoesadccurtemly have atemanr, that it is my responsibility tonotify the
occupy t of ch o amenrems which muse be t p or co iso nue of a,cenifiene of
-
Signature of Applicant Date
All roof coverings to be Class "B" or better'
wner.rcielihad nt, ;tat .
t