01110048 OF
=, CI BUILDING DIVISION
PI ERONNo PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7451 FALLENLEAF LA PROGRESSIVE GENERAL CONSF 01110048
OWNER'S NAME: APPLICATION SUR DATE
Ask LEE ELAINE F AND GENE S 1691 PHANTOM AVE 11/07/2001
In PHONE: (408) 371-8007 SANITARY NO. CONTROL NO.
n O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
e U BLDG ELECT PLUMB MECH
h« o o u v
m- 1 hereby affirm that LICENSED mONTudd under previsions DECLARATION
9(commemm�g Job Description
iy=p with Section 7000)ouivision 3 afthe Business and Profess ionsC rte REROOF.
x E U IS In full force en
:o ., Lica._Claaa t C Li<,. 2 INSTALL ASPHALT SHINGLES .
O c U Dam Contractor'
ARCHITECT'S DECLAR\ ON
v O< I understand my plans shall ba used.public recur&,
i¢c ce Lic >ed Pmfal
siona
'Ka en
c s OWNER-BUILDER DECI-ARATION
'•"I 1 hereby abrin that I am exempt from the Connectors License Law for the
E i< following reason.(Section 703 1.5,Business and Profesame Code:Any city or county _
f s O which raquiras a parmit to conswn,alter,improve,demolish,or repair any structure
63_ ._pn«roirx iasm«e.atm requires Ore applicamfor suchpcmutm Rleasig«d patemem.,- - ---------------_-
(,,mon iunim;WitpSe.drbldti1)pifDivisinf theContractor'sBoluasLi«nselswon,Chapter 9
Cod) !( .ri s .t-Floor-Ae i t
(comr««in8 with SCcuom7000)ofDivision3of the Btyureu arrT�de Professions Code) 1��,�'`'��c4lil9t.)a ..t E`sea�Ltilh4�S1 •: Valuation
or ibn(he li exempt momfrom and Ne basis for the alliged can. Any violation I
-of Section 7031.5 by any applicant for a Permit subjects the applicant to 0 civil Penalty-.,
.til..,banfivehundreddollars(a5o ). _ _ _ . .-_. APN Number Occupancy Type
01,as..an,or 0e >employee, S compensation, �••",.,•i ."
progeny,rum em 10 cinende -o es Brad fsolecore tion, ff1
,will Bothe work"atims ode: re i5 Contractor's
is Licen eLaw for sale(Sec:7000,-
'Baainea�ana�naresaiana case:rhe cantmrtora uaa0a Law does net apply is°n 307 - INSULATRQ]rLired Inspections("'''•'' '
owne
r of progeny Who builds or improves thereon,and who does such work himself 6 01 — ROOF TEAR OFF
or throes M1 his own employees.provWed that such improvements art intended or r
...- _ -_.-_-_.. __.. _
. .grr easale:-H,lu the wading or improvement is la don one y of - —- 6 0 2 - ROOF PLYWOOD NA'PL' - •7 r, <o _..
iompl t theowner-builder will have the burden of proving[bat he did not build or
mpowafmforpnsaofsale.). _ 603 - ROOF BATTENS
__.sowverve-sive --- ---" -.
L7 Lasgwnerof thercjec property, Business
an Professions
Cods:)
Contractor's 604 - ROOF IN=PROGRESS
- _
construct theLaw
does n(Sec.7000,Business ane property
who
Cade:)The Contin thereon, - ( fl'. ,'r .. •,s,
:{ License Law d«s not apply man owner of property won wilds m improves thereon, - -
..and who.cumrsetssuch prajec¢.with a.contracmr(s)BcensW.pursunmao Ihe.
_...
Com acro s License Low.;L -'-
❑lame pt 'darSet " B&PIC for'his reason
WORKER S COMPENSATION DECLARATION
1 h by K der Pe Ily of pe 1 ry f the in declarations:- �+
❑ 1 have and will rn imam'.Cemficam of Consent to self-nrsom for Worker's
_I,— Compensation:as,pmvidcd-for-by-Section 37W of the-Labor Code, for the
Perfomronce of the work fu which this permit is issued.„
111 hive'md'will nuoi iln Worker's Compensationinsumnce,1s required by Section
3700 of the Labor Code,for the performance of the work'for which this permit is
'_ ,,sued:MY�«kcr's•Compensation Insumna canier,nnd Policy number art: "" __..... _
[timer. e blf.'F , 4 a'1`<'POI cY Na :.,•... r.r_ . � . . .!!. _ T�=.
CC CPRTInCAnONOF,EX nIONFROMWOR RS I. Y)�s')J\. x4L'�.I� LJ}3t'Srf�w}S �^ sive ""
COMPTNSATIONINSURANCE"
�-.t
(TKs sen o need net be compiled d the pcmi'is for one huiidmd dollars \ -"j],
v,:_ .L'. vC I.•i!Hi r`r. - -_-_---
•)n^ I-emf Ih nn lh<perfo ' .. . ......------.._.-..._...�-_�__._..__-..-____._.-_. _....»_.
once (the ork f.,Which[h perm 1 issued 1 - M-'- -' '"� "•..
shall t p10 any peiso y m n w t become uplsct to th Worked It;
.Y{'i Lt•�:' ^. .• r
Compcnsau sof ifomia D- //- 7-OI
-APPlicant.: :'l ice.7 _ =r-
,NOTICE APP Ah pyiag fat of Exc
P Y e 1Qe perms shall be demand on.You should
Z tiecomc su comply
whp askabonpennout s11 orelaver Code.you must s ...l.
0 O ----in core 1 -Ji uch ro store or Bits bo revoked. - t
., , N UCTION!ENDING AGENCY ` -
Pi
I hemlo' III That them is i couioiuciion lendia'agency for Nc
ya"7 8..8 Y performs«e'
of.d work for which this permit is issued(Sec:3097,Gv.CJ
la�Q -Lma""Nemo""�':-u_..-cuu._.i,..:___..__..,- n.�..._.:_ias.u: ' ..... _ i..__._._.____.___.__ ._ ____
=;Z IcnLer's Ad mss
`.r^-.. . .. ..._...
I certify the[1 have read his appliaoion arta sate Na the above infmmaion is "
comae:l agree no comply with W city add county ordinance and stake laws ralning
t:) .to wilding constitution:and hereby authorize iepreeenutives of obis city to enter upon
W the above-memionW Pmpeny for inspection purposes.,,.• .
Fs.C. (We)agree to save,indemnify and keep hatNess die Ciiy of Copertino'against
-A liabilities,judgments,costs aM expenseswhich may in any way accrue again said -
U ti Ci Begat of Ndgraro gof Nis permit ' " '•
SAI ICE U I, NDSAND WILLCOMPLY WITH ALL'NOY�POINT"' - - - sive-.. ._.__ ..
ti cel ` uL na('s.. •'• -��_ D/ — Issued by: Dale
igna o PP anUCon taut . . +. Re-roofs
i HAZARDOUS MATERIALS DISCLOSURE U t 5�4 - /1 -
1 Ne a pl ant r fare b Ids g p.t [ hagla nawdo t w Type of Roof-._ _ f/
as def by Ne Cupen a Mun Cp 1 Cod Ch pm 9 13 end rM1 H hM1 and Softy '- sive- ^sive-
od Sect on 32(el y F 5 a - Y 4 .y t' a 7 !a$ tg'; ie it f 114 i7
.. OYs - ❑N IIJ 1 '�s si it F .I
All.roofs,shall be inspected prior.-to.any-roofing,material being installed.__.._
r. I W II Ne app(canto eno rc w ld' g«c p ruse equip <nt o a :bonen If a roof is installed without fust obtaining aminspecti6';I'dgre I it move
i[M1nmrd a cont t as d f d b Ih B Arna A 'age t
D stn'+ Y Y Q al I M .
1 new materials for inspection Applicant understands and will comply with _
-V ❑Yesa Y " ''it ,�Ni ...... .-_... _""- `- --...._r.
al on-point stare regulations :,.. r
�� f''' 1 h ve rcadthe"h xardnus mamnah regovemcros finder Chaper'695'�of and
Califm Hahh&Safay Codes uo s2550525533 rid 255301und tandtha
'f Ne bt ld ag cuts not cu d have on tlhat yksp nloy' oufy the -" '-
r -cupmt f the equ'ra [s h F mull be m'pmt to ssmnce of a Can finite of `
p Si Hato of /
g plLcant.
// 7 G •: _ Dae _
rte M10 tea agent i Daq , All roof coverings to be Class "B"orbetter
OFFICE
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