01030144CITY OF CUPRR'1'INO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
RUI;JANG ALL E'49599 EDWARD WY
PERMIT No.
01.030144
GWNER'S NAMM ICHAEL TEHRANIAN
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APPLICATION SUR DATE
03/27/2001.
ONE:
SANITARY NO. CONTROL NO.
ARCIIITEC MNGINFER: -
BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
LICHNS12D CONTRACT'OR'S DLCLARA'I']ON
I hcrchy affimr that 1 am heenwd under provisions of Chapter 9 (commencing
Job Description
with section 7(Rp).fDi,i,in.3onheBe,me,, and Profession, C le. county license
is in full tierce and Gucci.REMODEL
REMODEL
License Claes Lick
Doc ie.nr
�a
- • B�99C �,�L�,®
ARCHITECT'S DECLARATION
'
1 underNnnd it, plans shall ba reed n, public accord,
JUN 1.4 2002
Licensed Poda,,iond
OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt (rain the Comracor's License Law far thewhich
- a
I luwing reywnt. (Sectio, 70315. Brains, and P ..te„ions Code: Any city or county
BUILDING
requires a pcm,it to construct, alter, improve, demolish, or repair any structure
pins 1. it, issuance, Non, e'uit" IT, nppl icon onsuchpermit In Tile a sigmd sa enn.•nt
Sq. Ft. or
Ar
Valuation
Nat he is licensed forward To the provisions of the Carlini License Law (Chapter 9
(, racing whh Sell or Ax)Ol ofDid n 3 of the R., and Pmfe., ., Code)
nee
or that bais therefrom and the husk for alleged exemption. Any violation
�T�•�
$ 2rtJaUO -
31.5 b
nfamlFar ttha 9byv uapplicantfuropemrit,ohj.n, the npplieanl I.ndoll penalty
orn.t annre man live h.namn dollars ($503),
APN Number
Occupancy Type
. Las owner of he properry,or my employees .th wage, y, than sale compensation.
- 35619008.00
., .
will do the work, and the structure is not intended or offered for sale (Sec. 7BW,
liminess and Pious%ion, Cnde: 'rhe Coutracmrs License Law doer no, apply to an
Required Inspections
owner .1 .,ay Who buildsorimprovc,the...and who does such work him°C'f
101.
— F.OUNDATION
ar through nk own employe.,. pnoalcd that such Iarpooemcnls are not intended or
offered for sale. If, however, the building or improvement is sold within one year of
J02
—' PIERS
mnplcuml, the ow.er.huilder will ha.c the hmden rf proving Thal In did ran hadd or
_
. -
improve for purpose ofsale.).
103
— UFER ' .
ID ],;is owner or the privers. w,exclusively contracting with licensed contractors to
104-
— REBAR - '
tmunncl the proSec.ject ec. 7(1Ji. Business and Profession, Caa10 ne Contractor's
isane Law docs and apply n an ,..at of prapeny sells) byJd-, or improve, mcreon.
105
— ANCHOR BOLTS
and who connivers for ,ace projects with a contracmrLy licensed pursuant ,, me
Contractor, Li.en,c Lunn,
105
—
❑Iamexempt under Se.. .B&Pefar this reason
SEWER d• WATER
uw.a T. , . ,Q� Dale 3 / 2� 10 1
202
— UNDERFLOOR PLUMBING -
oRRISR'scoMPENSAT]ON DeCLARATION
203
— UNDERFLOOR MECHANICAL
I hereby M., trade, III of pe,a, low vfba.+Bowing deelansu ,
,
204,
— UNDERFLOOR 'FRAME~.
1 have and will maintain a Cen,ficate of Consent 1. ,eR-inmm for worker,
20`9
— UNDERFLOOR INSULATION
Compensation, as pnwidod for by Suction 37011 .1 the Labor Coda, for the
Ped ...,ur. m he work for which this peril is i...ad.
3
ROUGH P01 — LUMB I NG
0 Lass, and will maintain worker's Compensation Insurance. a, required by Section
302
— TUB & OR SHOWER '
17", of the Labor Code. for The lerojorame of the work lin which this peril it
,rued MyWorker,Cnmpea,ati.ninsurancecarrierandPolicymaliceare:
303
— ROUGH MECHANICAL
comr; Policy No.: -
304
- ROUGH ELECTRICAL
CF:R'TIFIC. TEON 01; EXPMPTION FROM COMPENSA'1 IONIINSURANCIWORRFRti
303
— FRAME
(Tho ,cell.. need a.I he cnn,lea,d it It, permit is fnr one handrud dollars
306
— HOLDOWNS
($100)less.)
307
— INSULATION
I cwity that in the pem,m,ance of the work lar won s this pe,,air is i.... IT 1
,hall nn, employ any Evers.. in any manner so as,, became subject m the Workers
308
— SHEET ROCK
Affluent nsali.Ir Laws of Cauf""'ia'Da1e
npplic
309
310 —
— EXTERIOR LATH
INTERIOR LATH
NOTICE TO APPI.ICAN L If after making this Certificate of Exemption, you should
become svbjml to the workers C.mPe.,stion provi,ions of lee labor Cnde, you mus,
n,nbwith conply Isahsuch mookion, to Thi, p.uml %hall he dc.,am revoked.
311 —
SCRATCH COAT
CONST'RUCT'ION LENDING AGHNCY
313 —
ROOF NAIL
I hereby affirm there is a construction lending agency for the pedra
onee
amThal
of he work for whpera
which his rt is i...ed(Sec. 3097. Civ. C1
Lamr,Nmne
NAddress
S01 —'FINAL
ELECTRICAL ENERGY
Iwmaar',
502 —
FINAL PLUMBING ENERGY
I c.nify Nat 1 have read this application and stale that the afewc information is
Comply whhanray aariw mtrboolaance,and sciity laws mfupog
503- --FINAL MECHANICAL ENERGY
mboldbuilding contr
ingaontruetion.and berebyamhonzere,,.,c,ves of this any to enter
meal„,(War
504 —
FINAL BUILDING ENERGYC.^2"'`�
to Sava
agree pr,e. rtymention, and kepafemale.
and keep hm snst
(s. a
SOS —
FINAL ELECTRICAL
judgree
and expenses ay in an way rCaperton
Cuba against
CITYirie,, judgment,. f he and , orThi which may in any way accrue ngainsl ,aid
r,'IIY i..m,ugneac..f the gantmg Dani, peril.
506 —
GAS TEST
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
SOUR,`I
Issued by: SOi7 —
�rnlo� AL��- Date ✓(�
I
s yI
Signature ofApph<ualfC..tmnor Data
Re-roofs ..f08 — FINRL
�
MECHANICAL
HAZARDOUS MATERIALS DISCLOSURE,
Will the tmewart nrfair,. buddo,Oc.optrn,mm.a handle ha.a:dna, notarial
Type of Roof 509 —
FINAL GRADE
as defined by the Caperton Mmticipal Code. Chapter 9.12. and the Health nal Safety
Code. Scali.. 25532(v n
�No
510 —
FINIAL PLANNING
:2 yes
All roofs shal5l],e/nspecl 1NORr.. t(PI BLOPEnI.g4V"V being installed.
Will lhenppica,tram...abuudingoccupant use equipmeorordevices which
�laiartious air contaminants m defined by the Bay Arca Air Quality Management
If a roof is installed without
first obtaining an inspection, I agree to remove
.,,ICI �:No
all new materials for inspection.
Applicant understands and will comply with
ye,
all non-point source regulations.
I have mad the holadou, maanals requirements under Chapter fi 95 of the
-
Calio inH.alth&Safety Code, Scninns 25505, 25533 and 25534. 1 understand Ih:n
ifthe bmlding dans no cuncnlly have a tenant that it i, as, responsibility lin notit dor,
we.ant of the rcquiremcm, which nest be mat prior In i... are, of a Canificmc of
occrpancy.
(�
Signature of Applicant
All
Date
roof coverings to be Class "B" or better
Owner or authorized agent Doe
OFFICE _ -