02040010CITYERONNO
CIBUILDIING
DII
PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS :
PERMIT NO.
10675 CLUBHOUSE LA
TOM'S PLUMBING
02040010
OWNER'S NAME :
APPLICATION SUB DATE
RENO AND ANNA DEBONO
12246 SARATOGA SUNNYVAL
RD04/02/2002
ONE:
(408)867-6010
SANITARY NO. CONTROL NO.
zo ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
G
BLDG ELECT PLUMB MECH
L�
�' RATION
I hereby atlimthat lam CONTRACTOR'S under
nd rp Di ons of Chaffer 9(commencing
Job Description
to with Section 7000)°fDivisien3mfdeBmine�eyandProfessimoCore.anone,Ivense
in full fpry!
REPLACE WATER HEATER
rs arytcffc�L 7: 1
License t °l
CIXrs _� Lie. p
Cant t e
'1
.
f ARCHITECT'S OF R
I u demand my plans shall be used as Duh cords
OLicense) Profersional
OWNER DECLARATION
that a.BUILDER
Is 1 hereby °Bien that 11. exempt from the Contract.,', License Law for the
following reu°a (genion 9o3L5. Business and Profusions Code: p city or county
Co
D whicM1 require permit Ini onswet, aher, improve, demolish, or repair any mm�urc
trox
$550
n
Pnm. uss Isoryu Inonio ant for such wMen
Thai be meter ines. Lev, (Charter
— (comm sl--.Jp-.0 ngthe p 'a nfThe Commaofs Leenselnwrms Code
(nom ting mSecfon ]000)ofhe Di3 ofvision Businessand Professions Code)
a^
C,; %-nr !3'3,tl'(4'i i�, V -a, `lY 1+y,3
Valuation
or hotbeis escmpt mere(om'and the basis for the ciempnt Any violafon
e tS
subjects
-nf Senion 0031:5 by anyaPPlicam for n Permit subjnu the applicant to a civil Penahy-
rn the
ofnot more than rtaeneredreddanars(x500)
502" N�' Al PLUMBIN
ENERGPccupancy Type
01. as owner of the pmpce>', or my employees with wages as their sale compensation,
_ nap TpqT
will de'the 'work, -and the structure is not intended or offered for sale (Sec. 7044,
'trainees and Professions Code: The Cmslo is License Law Jas no, apply to an
507 - FINAL P WI(Wspections:'-''
owner of property Who builds or improves thereon. and who does such work himself
or Nmuggh his own employees. provided that such improvements art not intended or
,offs Jfor le if, how thehiWing P tem is Id th'n n Year of
completion. the . for-buildee will have the burden of proving the. he did not build or
improve f i pro.e if sale.),
®®
❑ {; e f the property, y con rate g licensee contractors m
am contracting
construct me project (Sec. lto and Professions Code J The Contractor s
Buser
t I R
License Law does not apply .o an owner o
a progeny who bunds or m Thereon,
improves
'. P"'.es
' " -:,r" rf ( r
th
Pr°Jeti a pursuant m me
.Co who contracts !or such u.wim a onwaor(s) OcenuJ
License
-2002 ----
El I am mfs Ww.
❑IemenanpSunderSec."' " "'I ',B'&PC for this reason
_.--
"
BUILDING
ENS
WORKER'S COMPENSATION DECLARATION
Ihereby affirm under penalty of perjury onepf.he fol lowing declarations:
❑ I have'and will maintain a Cer iream of Cie sem m self -insure for Worker's
Compensation, as, prm�ided-for by Section 37W of the Labor Code. for the
Pcrfofmanco of the work far which This Permit is issued. „
01 have and will 'Inair6dis Workers Coropi ,eltion humdnce. as required by Section
37W of the Libor'Code. for ma performance' of She work for which this poneit is
ssued NlWorker 'sC p t 'I ran tad Poli y he ...
�% ..•
�f
_ .-- .. .. — —:
W;'y uP°lic tiW% ll �Cn� OY
t�s 1t FEXE ON FROM WORKERS'
NPOco
_.
> e". t .: 1 + t.t Yi 4 t
yFl
SATION INSURANCE
.'l..��•
IThrs u t n ea
nesed rn leted if She
P permit is far one hundred dollars
�! .1--
..,,. 't
(8100) IcssJ
,;r .
. .it _..
- 1'<nfyyihmmeromin t of tn- nice m'spc
shall t employ any -
... ... ._ _ : _. _.:..._ -.
:: :t I
as
a n m arty im m az to hccbme subJcn to the Workers)
Compcnsmion Lows of Califnmiu: Detc�°� The
s. � t
:hApplicant.
zt
NOTICE TOAPPLICANT I' k gThis C nfm fL lepton you should
C Code, you must
becomeh objectocomply
Compcnmtion provisionsofthe Labordeemed
fonhwith'camply with such provisions or this Permit shall be Jcemcd revoked.
s "r CONSTRUCTION LENDING AGENCY
I h ny that th it co swn 'lending age ncy for me per(ontanee
hiiTh
of the work for wh tin th s permiS rs rssuad (Sec. 309], Civ. C.)
t ..
12nder's Add' ss'
rte';.,
- 1 certify mm I have ¢ad Nis application and Tom thou the above in is
-
emreild 1 acme to comply with all city and county ardiwnces and stale laws rcloting
to building conswciion: and hereby aumorire repasomatives of Nis city to enter upon
Ne above-mentioned Property for inspection purposes.,
.
(We) °gree to save, indemnify and keep hamdess the City of Cupanirm against
liabilities , judgments, rolls and expenses which may. in any way airtime against slid
City in consequence of the granting of this ramel- `" ".
'APPLICANT UNDERSTANDS
n
AND WILL COMPLY WITH ALI:l N
'RCE REG LATI NS.�'n
Issued by: v v
(_ ZI
Date
awreo ppLcaner-moracttoor.•.'•,r;;�/„�•.:,.�,:,.. .... DDDakre-
HAPARDOVS MATERIALS DISCLOSURE '- "
Re -roofs '
p; t store o handl hazed ' n nidal
"" W Il Y c a I pert
definedb c g w
Type of Roof
as the w Mm d IdCpd�u
Pa, . e Ch pier 9 12 u ti le Huhn d S are,,
.. ,
Coda Setif 2553 (a)+
DY 5t t�g`at n. ..
r
,y' p:"sr 4. . t
- ,rT
All roofs shall for to
I: Will the io f S bufin bya p tum.Aequipment devices-:.enn
emith ab a comnm meas defined occupant
cth Bayse Ai Quality evicwhichajimant
-be-inspected- any_roofing,material being installed .
If a roof is installed without first obtaining an inspection, Ilagree'to remove
g
°""" ,�
OYes
all new materials for inspection. Applicant understands and will Comply.,with
'II
all non -point source regulations -'"- - -
have d IWITTinrdo 'mat a Is req `menu under Chaps 695 of the
e
Cal fom a Healln& Safety Code Seabee 85058533 and 25534.1 nderstand that
tithe bmldrng does not euemnay have a —ou" mor is my rcsjionxibiliry to notify the
adpariS of the requirements xhich rnusl be mei p - time of
otica ..., . ,prmissuanee or�crnir
gunny: r.
... ..
" e• -
Signature cf Applicant
Date
All roof coverings to be Class "B" or'betfer
m "=ea.gennt _ a
wn
tar a 4—
OFFICE -' --