02010077CI ser OF C nIPERTINO.
PERMIT
' CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
6541 CLIFFORD DR
02010077
OWNER'S NAME:
RONALD WAIBEL
APPLICATION SUB DATE
01/18/2002
'iONE:
SANITARY NO. CONTROL NO.
c ARCHITECTIENGINEER:
BllILDING PERMIT INFO
��ELECT
1. PLUMB MECH
Q LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that l am licensed under provisions of Chapter 9(commencing
Job D Cl t10n
[3
- witnseedofDivision lofthe BusinessanJPmlesxiomCnJe.andmyliaen¢
REPLACE
7 WIND
7 is n full force and effect.
����E®
a License Class Lic. x
Due COmmcmr
ARCHITECT'S DECLARATION
1 user+land my plan..+.+hau be... d a, pablic memo,
FEB 13 2002
Littnud Prorasinnal
z OWNER-BUILDER DECLARATION
I hereby affirm that I :ma exempt (turn the C nkma mr', license Law for the
following reason, (Section 703 1.3. Business and Professions Coda. Any city or county'
/�
BUILDING
which requires a Permit to consumer, alter, improve, demolish, or repair any structure
$ 4 O O O
E Is r 1''. also req the applicant for such Permit( fl a: gned IaxmNl
,at
- thole o.ci aper uammrh p sof the he Contractor d La Khaplar9
(commencing \h Sem fDivision ort the Business Prof Code)
_
v't 1�'j;y3'i3ti �t6VV 3:�VV ti=,,• i•
Valuation
or that oum an inainli
s exempt therttrom and or basis for the alleged exempnt to Any violationmaty
io
of genion 7R31,5 by any applicant for a permit subjects Ne applicant m a civil penalty '
.ofao,momthanfivehundreddolbn,(s500),
101
PNNDATION Occupancy Type
O 1, as owner of rhe property. or my employees with wages as Meir sole compensation.
102
-
-will the work. and the',umcture is nor intended or coffered sale (St Toa,
' Buoresi and Professions Code: The Conwaor's License Law does not apply to an
103
- UFER Required Inspections",
owner of property who builds or improve, thereon. and who does such work ormelr
or through his own employees, provided that such Improvements arc not inor
1 O 4
- RE BAR
comple for, the If, however: the building or urden of pros n sold within ane year of
completion, me owner-hufia<rwm have me nare<n rr Proving that he did not baud or
- - - -- -"-
105
- -" "-" N - -"-"- - -- -- -- '• _ _ ___. -.. _
- ANCHOR BOLTS .....
improver«pmpr,eofame.).
106
- SEWER & WATER '
Dome propcny, am eaduzivdy contracting with licrnxd conoaaors m
L auct
'2 0.2
-.-'"UNDERFLOOR PLUMBING- --- - '--- - -.--" --- --- ...--
the Contractor
me project (Sec. to a, Bavowner o and Professions ills or The improves
License
n
ua,l Law does nmrsuc apply manrummerofpreperywho nulla,nr
203
•' ' `• -
- UNDERFLOOR MECHANICAL'
,parw«thereon.
.Co vectors ices for such projc« wish o. cono-u<mgz),IiccnaJ.pursuanr m.ah<.
> crnrra<ror'sLi«nxlaw..,, ,1,
-- 204'-'-'UNDERFLOOR-FRAME
-' - - `- - ---"-- -
❑lameaemptander_S2c. B'&PC far this. .,on
�1.
205
- UNDERFLOOR'INSULATION
• .t l8 02'
301
- ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
302
- TUB & OR SHOWER
I hereby affimr under perahy ofpe;i6;y one ohne ronrwing declaration.:
303
- ROUGH MECHANICAL
'
1 1 have and wdl"mabtam'a Certificate of Camara an self-imure for Workers
bmpenaation,
304
- ROUGH ELECTRICAL
as provided for by Section-3700 of the Labor Code. for me
m
perforance of me work far which this lc7ua, is board..
305
- FRAME
❑ 1 have and will maimain worker, crmpemaeon lasumnee, as required by Section
306
- HOLDOWNS
0]00 of me Labor Cade. for me perfomuncc of the work for which mis' permit is
ssucd. My Workers Compcnsali_on Insuran« carrier and Policy number are:
307
- INSULATION
Cam'. .' ..s �XoEMP`TI "
3 0 8 .;.
-
,iSHEETROCK -
7CERTIFlCATIONOFE%EMPTIONFROM WORKERS'
''1 •1 -"309
`-%EX'TERIOR 7LJTH '
COMPENSATION INSURANCE',;
'
31'0;
_ I' ---
- ,,IN,TERIOR' -LATH """ �
I
(iT . •[lion ncednat be <omPlneJ d rhe peon t s for ane hundred dollars
a!op) leas.)
311
i. I ) •
- SCRATCH COAT '
. I
'-ha ..Te�mfymi nm pro «oro remr wnchm pa 'ai issued,I
313-
= "ROOF-NA-I-L._.., _ ... _ •., .__, .. ._'-... -..-•.
a! all Ply y 1Ci v ann< �o bc<rme subject r me workers'
Compcnsempl LawnoferR .Dae
5 01
-
- FINAL ELECTRI CPZ' ENERGY
Applicant..
NOTICETOAPPLICANT: Ifm
,aOerakingI 1Cenirrmeof Eacmpnon, you should'
--502-
-_.F.INAL --PLUMBING- ENERGY.- - -"-
be<ome,ubjecttnme Workers Compen,adonprovisions othe Labor Code .you must
503
- FINAL MECHANICAL ENERGY "
rokh-uh, comply vitn.uchpookion,Or'his perrir,bmlbadttmearevrkea.
•,'
50.4_
r FINAL BUILDING .ENERG,Y.
t -CONSTRUCfIONLENDINGAGENCY
I hereby affirmi thin there is u construction lending agency for the pe t' mance
505
_ ..
r
- FINAL ELECTRICAL
of he workfor which this pe ,Dea(s 1097 Cis. e)_
506
- GAS TEST -
Lender, Na
di
507
- FINAL PLUMBING„
.Icmifymm lhavc react this application und'uam manhe above informmirn is
508
- FINAL MECHANICAL'
cools$. I agree to comply,wim all city and coumY ordinances and slate laws relating
to building comnmction, aid hereby uumoiiie icprexmaives of this city to enter upon
509
- FINAL GRADE
;me above-mentioned propeny for hr+pttnon purposes
IW) g eto save tlemmfy and keep hated ss the Cily of Cupcn ho against
510
- FINAL PLANNIN-
liabilit es 7 agmen¢, con and pcnxs wn ch y' an y way e g nu said
514
- FINA PU C WO
City i consequent
q enrector, hN t n8 f ihii pe n
APPLICANT UNDDSAND WILLCOMPLY KITH ALLhON POINT'
err REGUOyfi 'j0
I
Issued by:
k ( 1 o Z
/Due
Date
Stgnamm of APPI¢HAZARDOUS MATERIAL ...
' ,'. _ '• ./ ' ,—
"'
S DISCLOSURE
Re-roofs
,
ppl o t ora b "Id'ng'rc' p m sort r,nandlo haralt .mace(
' edby
- Type of-Roof
YP
eni
t
by rh C peri Mu npaLCodc Ch pl 912 ❑ Ne He Int and Safety
-
--
..
Code:
CedwSection23532W1? i
ore+ r 1 s
1 ti+,'
iv, ,I
. All roofs,shall
be.inspec[ed prior_to any roofing.material.being.installed.
. wn me applicant future b lung« p i equipment e < -mon
nd num nanumdefined by the Bay Area Air Quebty Management
If a roof is installed without first obtaining an'inspectlon, 1 agree'to remove
wrist,
""""st,
DY_
hN'
all new•materials
for inspection., Applicant understands and will comply with
'; 71
1 h e d me hoamdo s tete 'ms q rem ¢ �uhder Chapte 695 of the
all rion-poinf§ource
regulations ., -
Califomta Hcahh & Safety Code Sections 25505, 25533 and 25534.1 understand aha
if the building docs not currently have a mrunr; that it i.uny responsibility ronolify the
.11
Oec pam of the requirements which most be min prior m issuance of a Certificate of
itvSignature
r/Ia'
of Applicant
Date
All roof coverings to be Class "B" or better
ownerpr pumrn=ed agent •. ,-�-D ,—
.. ... ., - OFFICE ... _