02080009 C B t OERT
F GUDPvi
ON PERMIT CONTRACTOR INFORMATION:
rI-N
ADDRESS: PERMIT NO.
5 CARTABLANCA ST TIMELINE CONTRUCTION 02080009
NAME: APPLICATION SUB DATE
OS & NATALIE SCHULER 14589 S BASCOM AVE 08/05/2002
PHONE: SANTfARY NO. CONTROL NO.
(408) 356-1790
QO O ARCHITECDENGINEER: BUILDING PERMIT INFO
z W C BLDG ELECT PLUMB MECH
til - IJ C1 LJ L_7
5 y 2 LICENSED CONTRACTOR'S DECLARATION
y 1 hereby affirm that I am licensed under rCha ter 9(commenein Job Description
0 i_ Y a provisions o P B
t-_f W s itho,mn] )of Division 3of the Business ay�Pmfessions Code. it my nttns< BATHROOM REMODEL/ADD CLOSET
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Licer ll ro d LiC.N JV�9
s Ja
6 License C 1� �®
a�dSDECT n—OtlTNA NG ® E
in ARCHITECT'S DEC. ATION f'r'd Fiw
�-°5 1 unaers,ane my plain undo The used as punhc recons
far
c i a o Licensed Pmf°5,'°^ 0 C T 3 0 2002
6_i OWNER-BUILDER DECLARATION
1 Mrtby.ffirrin(Sect that 1 1. .Bump)f an the ConuamC s Littme Law fur the
C?a following (Sectio ]O3I 5 ct . ms and improve.
der of Code A t
ou O which permit[ wt Imr, mforsudemo)tio repair anymannert BUI�MICE'20000
i -peso m o issuance,almrt requires me applicant such a fleaaw(Cha ter-9 .. _. ._
q apP ttsigned
tha(M1S sI emtApuesrpanl Ty me pm .in fmContractors Ltt.eln (Chapter- Valuation
dam ncngSylhSectton]TNIand Tsi 3 rm BfineStal�JPPrss code) (:fbwi332. , b�l °x( ea,, , ' t
or that he Is exempYthercfmm and the basin for the allegetl exempnat.Any vmlat on 1
-of Section7031.5 by any applicant far a w miuubi ec,The applicant m is civil peva y
'..orno,more than five hundred dollars(s5oo). 101APN1� ATION Plait";117 17 1.11 Occupancy Type
❑1,a awrcr of me propcny.or my employees with wages as I sole compensation, _
-
-will do"thework:and'the Suaur
ve'is nor intended or'offered for sale'(Smr]Ot1; - ------- - - - - --------
�Biumesi and PTafeslioas Code:The CI mmcmrs Lieense hw d«n not apply to an 103 - UFER Required Inspections'rl"scH r,.v
own
r or property Who builds or improves thereon,and who does Such work himself I
or darmughn employees., dant himprovements 1intendedr 104 - REBAR
oBgeeio 1 "Jr.ne th Wilding p " entu' W 'tun one build
'r '.__.- .. _ .....___ .-... ..-.___ ._ �._.__.. ._._.._ ......._
amyl nonJhc owner builder will have the burden of proving that he did not build or 105 - ANCHOR BOLTS 1 "•'- � - r- � �'.'� � ��
�mpave far purpoustf sine.). 106 - SEWER & WATER -
- -- --- ----.._...--------------- --
_ d..ther orlhe pmpenyam Businessexclusivelysaid contracting with licensed Th contractorsommeo 202-.._ UNDERFLOOR-'PLUMBING- H.1'^T't;:Pena rr;:n ..
t Liccnwi Law
project(Sec.7044,ownroand city who
Code:)impact
Contractor's -
`` and
awdoes not apply manownernrproPnrwhawildorimpoa n an. 203 - UNDERFLOOR MECHANICAL" '
--- ------- -----
end_who-canuans.for_such.ProleCTs win.a.conuacmr(s).liceaed.pursuant.m.me. ...______. .-
(: Dl am ars { 204—= UNDERFLOOR-FRAME
Contract r Len
exempt under ,.�_ B&PCT ms,.,sP." 205 - UNDERFLOORf)lI'N'SUL'AT-ION
o . "I D"' 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB S OR SHOWER
Ihereby aIla„�under Feet,ofPepy:ypn ofThe following ee<iarroic :--- 303 - ROUGH MECHANICAL
-! ❑ 1 have`and'will'maiothin Certificateof'Conunno'LIf-insure for Worker's 304 - ROUGH ELECTRICAL
Compensation, a,mvidN�for-by-Section 3]00-of the Labor Code, for m<
-_ paHormanc<ofthe'work for which Ott .I,is issued.l:P 305 - FRAME
❑I h <a d"11 mllinl8 W ker s Compc ono InSurdrice a5 regbiied Ay Sxtion
306 - HOEDOWNS
3)00 f Thr Laboi'Cod< f th,perform c f the-work fo men this Itaor.'is
siid My work t c mpc r T.I m ce c b a rqp y nu be 307 INSULATION
5-rwr.6l�ya7D � . . a
'PohcyN DpDbbtb UNn 04k 3��, ;;t SHEETROCK-"._—__t....�.,n-._._.__...._,.....�,
tCERTIFlCgT10N OF IXEM NFROM'WORKERS t - f , a3'09 '-s�EXTER�IORi LATH"•`'
_,� " COMPENSATIO NSURANCE-5 5
na.» fIh cin nem not x'<ainplh�Ea nn<peTmil is lar aa<nunarte donors 3TO ,�p-'INT.:ERI OR liATH 1, a.; -.-_._, ...
311 - SCRATCH COAT
''�! Ittrt rrm lin me peK nn h«im kfr h¢Ath permi ' ua-1 -..:.. .3'13'°'`=''ROOF=NAIL ._—_--
`:non mempl y'any,perso yin 'n to bcdomc b)c too me�Work<rs' 501 - FINAL ELECTRICAli'`ENERGY"'•"
Cbmpc canon la ofC Tom Date -
APO' '"' 502-----FINAL-PLUMBING
-.ENERGY _
NOTICETOAPPLICANT If arm mak ,This Cen fc t fE mptlon y u ho Id '""--
z b2romesub3cil the'W krsCompe 'ton proaabriheLaMrCoeeyoh..el 503 - FINAL MECHANICAL"ENERGY
C h --comp, Ih such orth x anauxa ee < ked - __ 504...-.....FINAL.-..BUILDING.."ENERGY _ ",,.-,
° _ _
a,I' Irl tq.dmsraucrlorv.ENDmcnoelvcv "° 505 - FINAL ELECTRICAL _�" •"
ul ,
" I h by off Thin th c auun o ending agency f the parr mid crl a.. I MI"'i
w< dror n'nmspe t sspd(s 309]. c) - 506 - GAS TEST
0. Q - Urbi Named + 0 _a.. _____
'acts Addrc 507 - FINAL PLUMBING
v.0 508 - FINAL MECHANICAL f )`'
1Iaagrnee thin Iha application state That the above ofcmme,is
tobu hngcoe} comply thrall ",and o Ty rdnen.s and,late laws mining
^O;V mnuddingconawcimn,endhcmnyaahoiecrepreantativesbfihscityroen¢rupo509 - FINAL GRADE
`np''b ' dp x'rr ect 510 - FINAL PLANNING
(W) grc ia'. 've TNe (yand k phnxm0 rh Cry ofCpennciI 'nn v
m
liabilities.pollutants.costs e x Which may r w y a< g; a. is 514 - FINAL UB C WORKS
U Z City co mi ce of the Brant g r int'pc T .
AP ICA.'YTLYDERSTAVDSA\D WILL COMPLY KITH ALy Sr0y POIV'T"` I
'Rc. GSp�r , .pub �, �✓S/AY Issued by: Date
Signa Ap ', elf o t seta 1. /T p t
HAZARDOUS MATERIALS DIS OSURE Re-LOOTS
def l l c°' f'ore holding' 'occupant ro' or ha dl h nW ) material _
r „ wu1 m pType of Roof
1 91 and Health ad
Cod2 Sal Y 25 3uPan til M a I, t, f ; t s '
II p \) rs' y Y i 'S, y
_ DY 11 4J I No 1 4'#1 l 1i i 61 A ID �� ,
All roofs shall be inspected prior to any roofing.material being Installed., ____ _
wnme ppllcent int rLding by p t aAi T«a< Which If a roof Is msialled without first obtaining aniinspecnon, I agree toffremove
haraTd s a o ia'.I a d f ind by m B y Are q Q ry ev a germ l
f D SUTCI - F all new materials for inspection. Applicant understands and will comply with
int
_ ---."p. - -_ - -
1 all non-polo[source regulahons5t
I M1 ve dnhe h b s aural y vements'under Chapter 6.95 f the
Ca1Rom,a Health&Safety Cud Scnionr-550Y2S533 and 25534,1 understand that
if the¢nT d nmcancn bavcamnanl;matitismYresponsibili,y,mnofifY he -- -- -- - --------- ---------- . .
orcupam 7th cqu' 'm a nich'musibc,mcl poor to iasuapce of h Certificate of -
" ? Signature of_Applicant__ Date
.:i uo oat o All roof coverings to be Class"B"or better f
OFFICE _... -
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