02030153 OF
CI BUILDING DIIVC'ISSIIONvOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
.7509 'DUMAS DR JUST WATER HEATERS INC 02030153
OWNER'S NAME: APPLICATION SUB DATE
TOPRANI UMESH K AND PALLAVI 1764 NATIONAL AVE 03/26/2002
HONE: -. SANITARY NO, CONTROL NO.
(510) 293-9901
O O ARCHITECrIENGINCER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
L-1 1=1
LICENSED CONTRACTOR'S DECLARATION lob Description
i z=O I hereby aFirm that 1 am licensed under provisions of Chapter 9(commn¢ing p
yr; with Section 7WO)o'Division3aftheBusiness and Professions Code,and any license REPLACE WATER HEATER.
in full force and affect.
iasw' 6 uaeasClae ua.« (40 GALLON GAS)
I, Dole ' Conmacmr
ARCHITECT'S DECLARATION
ml� 1 undersand my plans shall be used as public records
Ii d o O Licensed Professional
a I that I a exemptBUILDER DECLARATION
I hereby.Rete that 1 am exempt from the Contractor's a Any c Law for the
L:3 0 following reason. comil to
703 IS,Business auove.de ore Code Any city or county
o which requires pcmmo .t ct R mfar sudemolish or repair my structure
t 6 $ -pdo to is an Iso q N applicant far enc,pemJno ElaesLaw suamem _-
S L,FloorArea,,• Valuation
- Rulh Ltt seiy rsaanu'Nap s sof Ne CommcmrxUttnsc law(Chager9 q p
(commenting withSectionminanofD'Division oofthe alleg,Business and �y"�`e?'C'j,( Pkyfv g_ia.` , Yf 1.2 f(; '
of that he n exempt ohe¢from and Ne basis for the alleged exempt ri'Any vtont on x-,_
15q�)417)4c; 00
o;
Seedon-7031.5 by any applanat for a P,mit subjects the applicant to a civil penalty,
iof evil metre than five M1uumd donors O500). APN Number j,a,.vi Rr Occupancy Type
❑1,as owner of the propcny,or my employees with wages as their sale compensation, PLUlsi
-win'do'the wmli,'Tnd'the xwemre-isnot imcndm-or offared'fo. ...e .a.. -
Basrtess and Pim fessions Code:The Contractor's license Law does not apply to an 506 - GAS TE SI$equired Insp'ectiohs-
owner of pmpcny Who builds or improves be..and who does such work himself
ter through his own employees,provided that such improvements am act intended or 507 - FINAL PLUMBING _ _ _ _ _
.(fired for salt IL Wawa er the b Idmg p t' sold withina year of -"" _.__ ---- _.___.._. _, _ _.___-___,_ _ __ _ _ ---_- -
completion.the miner W Iderwdl have the burden of that he did not build or " " . '
p proving
improve for pugoa oLsaleJ. '
------- _........ ..._...__..__..-.-._._.__..._.-...._._...
of1he
t7l;auct da, nojec propeny,am excBmina,;,and mm,mionsCacensedcontractors m• - - - --
icew,awproject(SOT.appl](40,Business and Professions Cotler)The ves the
mr's
License Law does not apply to an owr,w of property who) lids ea improves thereon, - '-' L. -
- o'=. ,_and.who. kens.Lesuch,pmjeas with.a.cmntrator(s)Beensed.parsuanrm the .___.... ._... I
� Contractor'sLc sc Le _.�.._....,._. ..__.... _.__._ .. _ ...
❑Iamexempt Onder Sec r '�B&PCfor this recon �1bta���® :P
Ownc " i.r Datc _ yV
WORKER'S COMPENSATION DECLARATION APR
r Ihereby afrrm under penaltyof perjury one ofthe following declarations:- APR C. [J �oo"
�O 1 have And'will maim6in Campsite'ofConsem m calf-insum for Worker's
Compensation, as-mrovided-for by Secbnn'3700 of the Labor Code. forme,
WILDING
2a 'i L®INC r
perfomuncc of ohc work for which this Mrmitii issue.: V L
.�t �;' ❑1 have onA will meim6in Worker's Compcnmdun'lmuomxa,as required by Smion
_ - 3700 of the Labor Cade:fair the pcifotinanbe of the work for which this pmm is
•
issued.My Worke7s Compensation Insuancn carrier Policy number carry
.., ., .r.. ... .. (
Caul! {
'CERTIFICATION OF EKEMPTION FROM WORKERS t •A, f v,5x. •; •. .^ ••.•. . I .... . .... .... .
COMPENSATION INSURANCE-2 -
a need not Is,completed d the ')•r
15100)o less) ,,, P Permit is far one huured dollars - I t' ) .; l C•
1 ttnt'l that n er paint corm work f r rich this pet isteen d 1 - - - -"
shell no, mpl y a Y pe any mann rr rm so as in become subject m the wormis,
jl
Compenxoaon Levisof C m:1 f Date' "
Applicanb ..n.
., .___. . ..
NO NT MaharCertificate
of - .....-i
bsubs s,iiWoke s C "mou las mofNeLabs Co ... . . . ._.._..
- - '— -
you rotitt
Z0 forthwith such comply withh p '.'ons or N Pc t hall bad ed ked.
f~ ! ' th .1 CONSTRUCTION LENDMG AGENCY _- - -
he by a(R a that 1there is a consumscurin lending agency for oha perf' once
of Ne ,a,whch this pe t ud(S 3097 Co,C)- .hi's' .. ....._... .,-u ._�. ._. -.....__.. .. __.._......_.....__.. ..� _._..._. ...._.�. .... .. ..
,s Neme .. t ._ .. .-_. ...
y 1 have mW This application and sum That the above information is '
kat' eorten.hagree m comply with all city and county ordinances end stem laws aiming ��
Wilding conswcdomaridheati city and
county
ordinances
and
loenarupon ✓`
the above-memioned primary fonmpe,ion proposes.
rL. (W)'egrte'to save;indemnify and keep harmless the City ofCopenina 6gunst
.y liabilities,ju lmomas,costs and expenses which may in any way accrue against said
.U ^ City in consequence of die gaming of Nis permit.
APPLICANT UNDERSTANDS AND WMLCOMPLY'KI TH ALL NON�POINT'�` 1
s0URCEREGULATION5:': ":. Issued by: Date
SJ
lipaboot mfnppecanvice w terv'' q t ;,'t: Re-roofs
HAZARDOUSRI
MATEALS DISCLOSURE '
Wll Nrippicna,or prime r Id ng occupant nae a houl baaaMou oro evil .Type Of ROOF_
ITT deOnW by NeC pen M cp lCd Chapter912 dN He IN dSafry !' t - - �` .. -- •- -
Code Oxon 2557.(l A !
Cl No
? -
' All roofs shall be inspected.pnor to11, any roofing_ma[enal being metalled.
Wnl Nepppllcant f madere Idng oc the ti,som
uAmAiment t Maar wpcn If a roof is installed without first obtaining an'ins action,I agree to remove
nut h urdous conn t.az d f u by N B y Ams se ip O al ty Management g p
°i-a"'oY n l N _ _ all new materials for inspection. Applicant understands and will tom I with
T all non'pomt`source'regulations p y'
a'+✓'Llwna,
rt d Ne hazarmalei% .]Ui&Saf,yCue,Secmons25505,25573end25536,IpundernndNet
does nowurten0y hev<amnantNt it imdhc rcquiremcn¢whish must W-met p' issuanceof dCmificete of
pris
Signature of ApplicantDale aee_age t All roof coverings to be Class "B" or better
r.. � OFFICE ,. .. . . ... .. ... . .