02050140 CIBUILDING DICSNO
VIONPERMIT CONTRACTOR INFORMATION:
B1TT4T`l CT JAMES & SHIYI MACHALE PERMIT NO. 02050140
Ad "ff1 °S"E & SHIYI MACHALE APW§pI'1AN3s1nTS2
I PHONE: SANITARY NO./ L V 1/CONTROL NO.
O O ARCHITECGENGINEER: BUILDING PERMIT INFO
z F BLDG ELECT PLUMB MECH
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N i LICENSED CONTRACTOR'S DECLARATION
gi_o 1thereby affirm that Iamlicensedunder provisions ofChapter 9(commencing REPLACE COUNTERIO'tbe¢crfo"kITCHEN/BATHRM
m t-w with Senimn70001of Division3ofthe Business and Professions Code.andmylicense
: x
in ran force atm efiea.
i < is
cross U,O
O c O Dam Contmaor
1 3 .ri ARCIIITECT'S DECLARATION
.u O 4 1 understand my plans shall bo used as public mounds
ore Licensed Profesannm OCT 1 3 2002
co-o,a. 2 OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
F' a ti;llowing reason.(Section 2031.5,Business and Pmfesssions Coee:Any city or county BUILDING^ $3000
ExD wh hrequrc aPe Permit t t Iter ' p demolish.onrepairanystructum BUIL® NG
ad pro tea ce,alsorequiresm<applicantf ch permit to file asgned statementas. 6 /�.a �q.<L O �1 f __ ----
commanding
_
coo Ii dp .wan,ol they f[tic tContractors' Lcen¢WwonsCer9 ,4(0,, Viball �, P Valuation
or that
g 'nth Sat efrom1(fiand t e J f the Business and Professions Code) S, (i A f,I:," ; r).r`. .. I:
that he s 'xe pt thcrtfrnm end the basis for the allegegex<mpuon Any violation
of Section 2031;5 by any applicant for a permit subjects the applicant o a civil penalty
a
mfrs.,mrc tn..fio<nundred dollars S50ldh PN Occupancy Type
Ol.as owner of he prop<ny,or my employee:with wages as their sole compensation. 102 — PIERS
will do the work..and the suucturc is not intended or oBated for sale(Sec.20,34,-
'Business and Pmfessions Code:The Contractors License Lew does not apply to an Required Inspections
owner of propeny Whob m p tore d m a such khim,elf 104 — REBAR
or thrown his own employees.pm ded that himprovementsam not intended or
urrer<efgmr.mevnd th 'M1ulamg __ t .sctld h'none "r .. .. -105..- -ANCHOR..BOLTS -
completion. ----- - - ---.the owner builder dl have the burden of year
Proving that 106 - SEWER & WATER •, . ' .
improve for purpose of sale.).
.---UNDERFLOOR--PLUMBING
0 P -rte of thep pony xd IY t R g with licensed i vacmrs to -
<on w t the p ct him.7040 Business and Pninessions Coaea The C ntmnors 203 - UNDERFLOOR MECHANICAL,
License Law does not apply to an owner of property who builes or improves thereon. - !'
r and who eumracis.f°r such project with a cnntmctur(s)licensed pumuant.vo the . _.__. .. 2.0.4 - -_.UNDERFLOOR -FRAME
- — .. ....
Contractor's License Laweo. 205 - UNDERFLOOR, INSULATION
❑1
in exempt ynd<cgec.' ,0&P C for this reason
301 - ROUGH PLUMBINGat `
,I MORKER' COMPE.ATIONDECLARATION 302 - TUB & OR SHOWER
\ Ihereby affirm under Penalty ofrerjuryone othe following declaationx: 303 - ROUGH MECHANICAL
❑ 1 ha°e'and will mammim a Conificiie of consent to self-insure f°r workers 3 04 - ROUGH ELECTRICAL
.. ! Compensation,-as provided for by Section 37W of the Labor Code. for the 305 - FRAME
pedorn..nce of the work for which his Iwrun is Issued.
01 have anLwill'maintain Worker's Compensation Insumuce,as required by Section 306 - HOLDOWNS
3700 of he Labor Curtis,for the pedarmance of he work for which this permit is 3 07 - INSULATION
issued My Workers Compensation Insurance comer and Pol cy ber arc:
308 SHEETROCK.._..
..30,91 : EX'T;_ERI(DR- LATH .. __. - .._.
1 EMPTION FROM WORKERS -,��. E .t ''
IThsscn on ncca'rot b<enmph'orvlrvsursAncg . 3.10.__.._....INTERIOR--LATH
CERT IFICATION OF EK
' COMPENSAT
twithepetmttsr°renenunar<aamnars 311' " SCRATCH COAT 7'
fsl0ol 1 ) 313 .._. ..ROOF_NAIL . .
_-_
I employ any. rpeK < inn rkr nnm xrml suaI 501 - FINAL ELECTRICAL_ENERGY=
shall i , n y 1 - p mer ��s,hc opT s'�je bx,W k
AA,,. ,tp 1� ' °'c9'�r ",� Ai .� 1� d'� ___ _ 502 - FINAL PLUMBING ENERGY
_YY` Ary art 'k'n71n cnrcm rEe pt Top sit Id - -503 "- FINAL MECHANICAli.ENERGY- -
_ n WoIkcr C pcnsvt pro ns of th Wbo Cal you t
z0 0) form meomply Insuch p ons or this Permit sballb,deema okod. 504 FINAL BUILDING ENERGY
--505 FINAL-ELECTRICAL h.,
bean bleat the
,F. ,r .CONSTRUCTION LENDING AGENCY - - '-
�._ 1 nerttiy aRim tom them is a conswnion lending agency for the pcdonnanca 506 - GAS TEST IJ:
,.., of the work for wh ch tntsp l : soca(Sec 3092;Civ.C) "'
91. ZIsade SNa - -507- ._... FINAL -PLUMBING--- -- - _-.
Wna Aad ss 508 - FINAL MECHANICAL'
4. O , 1enfyhtiha athis apprnm andminceboenntis 509 - FINAL GRADE
O [-s wirers I greet comply N ell Cry and my dinances d stain I awsa minting
V thbuilding consuuctpotpenytoyiyuutfiainfamlrcacnmtivesbMiscitymenrerupon 510 - FINAL PLANNING
. r- the eMWe)agree
to saw,ny for inspection puryoses.,
p., a eW<)agmets.save;indemnify and keep harmlessth<CityofCupeninoagainst 514 - FINAL PUBLIC WORKS
W liabilities,judgments,cost dna expenses which may in any way acme against said
V, Z City in consequence of the griming of this permit.
'APPLICANT UNDERSTANDS ANDWILL'COMPLY WITH' .0 TON-POINT�'d
s ulec :cuLAnorvs.
r.—a Issued by: r Date
3
{gnmq. r,i 1'eHAv RDOU ...-.- -Date- Re-roofs j.
s,HAZARDOUS ilshou ALS DISCLOSURE
\vn the pplicas, future ni la' s e«want sooner l9.12.and t Hvmw tet;I Type of Roof
Leri W by h CLpen Mu p I CN Channel 9 12 and the Health tl Safety
Code Section 25532ta) `L .. 1 I mx s t ' Y i vl. .r
oY N t All roofs sfall_be inspected pnor'to any roofing material being installed. __
wu to applicant future builds , t usc'Squip t devicesyhich If a roof is installed without first obtaining an ins ection'Tagil remove
c o n arao tam neat ed by theBay A A Q fay Management g p
snic all new materials for inspection.. Applicant understands and will comply with
ov all non=point source regulations: � -
1 have e d the h ra dos m¢rials rtgmrcmonts unecr Chapter 695 of the '
California Health&SafetyCco,$ eons 2550525533 and 255341 understand that
if the bailding does nix curcntly have a nno mr has n is my responsibility to notify the -- -- --
occupant of I e,rtquire a I wb ch'must ne'mn,Priono i.. anee'of a Ccnificule of
"' Signature of Applicant Date \_
—�
n aahon ea agent . '.: , Date All roof coverings to be Class "B"or better,
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OFFICE- - - -