01060060 CITY ILDING DPEuONxo PERMIT CONTRACTOR INFORMATION: .
BUILDING ADDRESS'. PERMIT NO.
10651 CARVER DR MOHIT DOSHI 01060060
OWNER'S NAME: APPLICATION SUB DATE
MOHIT DOSHI 10651 CARVER DR 06/11/2001
PHONE: SANITARY NO. CONTROL NO.
o O za ARCHITECT/ENGINEER: BUILDING PERMIT INFO
W C BLDG ELECT PLUMB MECH
H<i E -1 I-..1 I= L1_1
LICENSED CONTRACTOR'S DECLARATION
5„? Job Description
O Z_ ll hereby ed cff Net I am licensed under provisions of Chapter 9(commencing
rmt-w with Seri-n]WO)of Division3of the Business end Professions Code,and mylicrnse
6 m I
is in full force and effect.
X U Lacerate ease Cana REPLACE WATER HEATER.
3 W y Dam SDECLAContracto
[-u O a ARCHITECr'S DECLARATION
1 understand my plant shall be mud as public rtcoNs
wr
Wn a. Licensed Professional
OWNER-BUILDER DECLARATION
a y 1 hcrtb y affirm that 1 am exempt from the Contractor's License law for the
X 5?,
E T 0 following season.Isomer 9031.5.Bmioass end Pmfasioms Cale:Any cityor county /
which requires a permit to construct,alter,improve,demolish,or repair any swm
cm
ou 3 --hour en,ill illuarme.-I-reg Inc ppl enna for such fem t t file.s g ed wmemem.
thth 1'tn-Jpun mldthep ,izlnnsm the Comrucm. f 1 wlChapmr9 Sq.-FL- 1'1001-Area - 211:QUa[IOII
.1 atFais a -m saa� lgml f e bass n or s the Bus, . mpti
of Sect hers exempt tP y applicant
and the been for the alleged ezemant u,Any violation
--f Section 703.5 iv any hundred
am for o permit subjects the applicant m a civil penalty
-r rot thou man fine nanercd dmlwrs asool. 3759PA$I :y Type
°1,az owner-(the property,str my employees with wages os their sole compensation,
will do the work,and Pa.Im Line is not intended or offered(or sale(Sec.701t.
Business and Professions Coda:The Coronation's License Law does not apply to an 502 - FINAL PLRNi9T1Il4sj9NjDRGY '
owner of pr-perry Who builds or improves thereon,and who does such work himself
or through his own employees.provided that such improvements am not intended or 506
- GAS TEST.
oRered far sale.IC bdwever,the building of improvement Wield within one year of - - ----- - ---- -- "---
completion.the owner builder will have the burden of proving that he dm not build or 507 - FINAL PLUMBING
improve for puryosa of role.).
P owner of the property,um exclusivelycontractingwit hlicensedcontractorm -- - -
- _ zwn the project(Sec.
appl]to a Business and Professions Coda)The Co there-,
- License Lew does trot apply m an owner of property who builds p improves thereon,
. and-vectors License
(Law. .pr-lats.with.a rontmcmdx) licensed pursuant.m.d¢. ... _ .... .. .. ... .. _. _. _
^ ' : Commcmts License Law. - -_.._ ....__.__.._.__.... _ ...._ ......01
naxetmPp der Sec. � }B&P C forthis reason
Ownc Dam -
- WORKER'S COMPENSATION DECLARATION
_ I herebyaffirmmderpenaltyof perjury oneofthe.following declarations;
° l have and Will
maintain a Cenificam of Consent m mlf-insurc for Worker's
_ Compensation. as provided for by So,tion 3100 of the Labor Cale, for the
Performance of the work for which this permit is issued.
_
DI have and will maintain Worker's Compensation of t le work
Insurance,as required by Seaton
Muo of the labor Cole,for Bu peion once of the Po for which this permit is -
--_ ., - a corner arid Policy number dre:
us d My Workers Co pc i n Insu one
Camer ! a 1''lPolicy No.
e CERTIFICATION OF.EXEMPfION FROM WORKERS N-
'„_, COMPENSATION,INSURANCE
"Misecon Peod nm be c-ntplmul if the permit is for one hundred dollars 'I' 1
(s10010 Is.) 1 .
-.... i- ...... .. 1
1corr ify,thuun the p R al cq f tl to become
I N p thin Ger t
shelf not aempnon L any prison in any manner w sea m bcm subject m'the W�akere' 1
Compensation Laws of Cullfurnia.Dnie' '
cavi.
NOTICE
OT
NOTICETO APPLICANT.the Workers
If.Compcier k loth Centcamnf Labor odc.y yon
becomesubjectcurie ly the Worker's Cunipe or his plumn nsll Pe d eunor Cade,yeti must
Q Q fo th -2 ply with h p siona n Ih p rmit ahnll he J neJ revoked
F•>
"."CONSTRUCTION
,CONSC... ..NLEND' ING AGENCY
Q1 hereby which the'themap i nlending y
y
for the
.peffonumtt
of kr rwhich thpermit nissued IS )097 Crv.Cl
Lcutureii Name
Under
._ .-.... .. .._._... .. ... ........ _ 1. _,a...,
V ,I certify that 1 have read this application and state that the above information Is
ce t I grc tq comply,with all city d my ordinances d state Tawe relating
mbu lelWfir, n:t a dthereby niauthorize p Illy lyo city to ewerupon�.Ik] th bo a me i ncd p party much p rp
(W) g meas indemnify and keep hick les.the C ry f C p Wino agama
rp liabl jutlg ors costs d sparse which may' :my ),accrue aguinn saideel
APPLICANT UNDERSTANDS AND WILLCOMPLY WITH ALL NON PUINT
S RCFREGULATIONS'
Issued,by: ��f,.�_ - Data
Igwmregf,Pph[amBCohmcmr. ;. ' ., " DamRe-roofs
HAZARDOUS;MATERIALS DISCLOSURE,,.'
Will die applicant or future building occupant store or handle nai,dous mmedal Type of Roof
ase Bred by the Copenn Mu ,,;Cod Chapter 912, d the Healthend Safety
Cod See on 15532fit . ' ( d;,•._I : -.t'i t %'iL�)ii.^' ', "s ,
°N '[3
l'a .All.roofs.shall be inspected.prior to any roofing material.being.installed. _.
- ,Will'he "c amt nanturebulthmdbytheoccupant useequipmentore naswhmh If a roof is installed Without first obtaining an ins ecti6n'I;i ree'toFemove
emu harnNous air contaminants as defined by the Bay Arca Air Quality Management g P g
District” all new materials,for inspection.,Appkicant_understands and-will comply with
❑Yee...;.. . . - .:°No' , . t _ .. .. _
. . '` all non-point source regulations.
I have read the hauedous materials nequirements under Chapter 6.95 of the -
Califomia Health&Safety Code.Seniors 25505:25533 and 25534.1'unde amid that'
-if the building does not currently en
have a tenant.that it is my responsibility to notify the.
oceua t pof to requ -monis which must be met poor to ism [ pf a Car ihcam of
po '
Ob ny
N•� Signature of Applicant -- _ Date _
r-r at-thonzeq.,out Data All roof coverings to be Class "B"or better
OFFICE .. .. . . -- -.... " - --
CITY ILDING DPEuONxo PERMIT CONTRACTOR INFORMATION: .
BUILDING ADDRESS'. PERMIT NO.
10651 CARVER DR MOHIT DOSHI 01060060
OWNER'S NAME: APPLICATION SUB DATE
MOHIT DOSHI 10651 CARVER DR 06/11/2001
PHONE: SANITARY NO. CONTROL NO.
o O za ARCHITECT/ENGINEER: BUILDING PERMIT INFO
W C BLDG ELECT PLUMB MECH
H<i E -1 I-..1 I= L1_1
LICENSED CONTRACTOR'S DECLARATION
5„? Job Description
O Z_ ll hereby ed cff Net I am licensed under provisions of Chapter 9(commencing
rmt-w with Seri-n]WO)of Division3of the Business end Professions Code,and mylicrnse
6 m I
is in full force and effect.
X U Lacerate ease Cana REPLACE WATER HEATER.
3 W y Dam SDECLAContracto
[-u O a ARCHITECr'S DECLARATION
1 understand my plant shall be mud as public rtcoNs
wr
Wn a. Licensed Professional
OWNER-BUILDER DECLARATION
a y 1 hcrtb y affirm that 1 am exempt from the Contractor's License law for the
X 5?,
E T 0 following season.Isomer 9031.5.Bmioass end Pmfasioms Cale:Any cityor county /
which requires a permit to construct,alter,improve,demolish,or repair any swm
cm
ou 3 --hour en,ill illuarme.-I-reg Inc ppl enna for such fem t t file.s g ed wmemem.
thth 1'tn-Jpun mldthep ,izlnnsm the Comrucm. f 1 wlChapmr9 Sq.-FL- 1'1001-Area - 211:QUa[IOII
.1 atFais a -m saa� lgml f e bass n or s the Bus, . mpti
of Sect hers exempt tP y applicant
and the been for the alleged ezemant u,Any violation
--f Section 703.5 iv any hundred
am for o permit subjects the applicant m a civil penalty
-r rot thou man fine nanercd dmlwrs asool. 3759PA$I :y Type
°1,az owner-(the property,str my employees with wages os their sole compensation,
will do the work,and Pa.Im Line is not intended or offered(or sale(Sec.701t.
Business and Professions Coda:The Coronation's License Law does not apply to an 502 - FINAL PLRNi9T1Il4sj9NjDRGY '
owner of pr-perry Who builds or improves thereon,and who does such work himself
or through his own employees.provided that such improvements am not intended or 506
- GAS TEST.
oRered far sale.IC bdwever,the building of improvement Wield within one year of - - ----- - ---- -- "---
completion.the owner builder will have the burden of proving that he dm not build or 507 - FINAL PLUMBING
improve for puryosa of role.).
P owner of the property,um exclusivelycontractingwit hlicensedcontractorm -- - -
- _ zwn the project(Sec.
appl]to a Business and Professions Coda)The Co there-,
- License Lew does trot apply m an owner of property who builds p improves thereon,
. and-vectors License
(Law. .pr-lats.with.a rontmcmdx) licensed pursuant.m.d¢. ... _ .... .. .. ... .. _. _. _
^ ' : Commcmts License Law. - -_.._ ....__.__.._.__.... _ ...._ ......01
naxetmPp der Sec. � }B&P C forthis reason
Ownc Dam -
- WORKER'S COMPENSATION DECLARATION
_ I herebyaffirmmderpenaltyof perjury oneofthe.following declarations;
° l have and Will
maintain a Cenificam of Consent m mlf-insurc for Worker's
_ Compensation. as provided for by So,tion 3100 of the Labor Cale, for the
Performance of the work for which this permit is issued.
_
DI have and will maintain Worker's Compensation of t le work
Insurance,as required by Seaton
Muo of the labor Cole,for Bu peion once of the Po for which this permit is -
--_ ., - a corner arid Policy number dre:
us d My Workers Co pc i n Insu one
Camer ! a 1''lPolicy No.
e CERTIFICATION OF.EXEMPfION FROM WORKERS N-
'„_, COMPENSATION,INSURANCE
"Misecon Peod nm be c-ntplmul if the permit is for one hundred dollars 'I' 1
(s10010 Is.) 1 .
-.... i- ...... .. 1
1corr ify,thuun the p R al cq f tl to become
I N p thin Ger t
shelf not aempnon L any prison in any manner w sea m bcm subject m'the W�akere' 1
Compensation Laws of Cullfurnia.Dnie' '
cavi.
NOTICE
OT
NOTICETO APPLICANT.the Workers
If.Compcier k loth Centcamnf Labor odc.y yon
becomesubjectcurie ly the Worker's Cunipe or his plumn nsll Pe d eunor Cade,yeti must
Q Q fo th -2 ply with h p siona n Ih p rmit ahnll he J neJ revoked
F•>
"."CONSTRUCTION
,CONSC... ..NLEND' ING AGENCY
Q1 hereby which the'themap i nlending y
y
for the
.peffonumtt
of kr rwhich thpermit nissued IS )097 Crv.Cl
Lcutureii Name
Under
._ .-.... .. .._._... .. ... ........ _ 1. _,a...,
V ,I certify that 1 have read this application and state that the above information Is
ce t I grc tq comply,with all city d my ordinances d state Tawe relating
mbu lelWfir, n:t a dthereby niauthorize p Illy lyo city to ewerupon�.Ik] th bo a me i ncd p party much p rp
(W) g meas indemnify and keep hick les.the C ry f C p Wino agama
rp liabl jutlg ors costs d sparse which may' :my ),accrue aguinn saideel
APPLICANT UNDERSTANDS AND WILLCOMPLY WITH ALL NON PUINT
S RCFREGULATIONS'
Issued,by: ��f,.�_ - Data
Igwmregf,Pph[amBCohmcmr. ;. ' ., " DamRe-roofs
HAZARDOUS;MATERIALS DISCLOSURE,,.'
Will die applicant or future building occupant store or handle nai,dous mmedal Type of Roof
ase Bred by the Copenn Mu ,,;Cod Chapter 912, d the Healthend Safety
Cod See on 15532fit . ' ( d;,•._I : -.t'i t %'iL�)ii.^' ', "s ,
°N '[3
l'a .All.roofs.shall be inspected.prior to any roofing material.being.installed. _.
- ,Will'he "c amt nanturebulthmdbytheoccupant useequipmentore naswhmh If a roof is installed Without first obtaining an ins ecti6n'I;i ree'toFemove
emu harnNous air contaminants as defined by the Bay Arca Air Quality Management g P g
District” all new materials,for inspection.,Appkicant_understands and-will comply with
❑Yee...;.. . . - .:°No' , . t _ .. .. _
. . '` all non-point source regulations.
I have read the hauedous materials nequirements under Chapter 6.95 of the -
Califomia Health&Safety Code.Seniors 25505:25533 and 25534.1'unde amid that'
-if the building does not currently en
have a tenant.that it is my responsibility to notify the.
oceua t pof to requ -monis which must be met poor to ism [ pf a Car ihcam of
po '
Ob ny
N•� Signature of Applicant -- _ Date _
r-r at-thonzeq.,out Data All roof coverings to be Class "B"or better
OFFICE .. .. . . -- -.... " - --