02050190 ClBUILDINGDVSONO
IiiNPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
7451 FALLENLEAF LA PROGRESSIVE GENERAL CONS 02050190
OWNER'S NAME: APPLICATION SUB DATE
LEE ELAINE F AND GENE S 1691 PHANTOM AVE 05/30/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 371-8007
w O ARCHITECTIENGINEER: BUILDING PERMIT INFO
u❑ BLDG ELECT PLUMB MECH
yea I'-l L=
z N i LICENSED CONTRACTOR'S DECLARATION Job Description
O¢- I hereby alHrm the 1 am licensed under provisions of Chapter 9(commencing P
Fyrlu with Section 7000)of Division 3 of the Business and Professions Code.and my license WHOLE HOUSE FAN
�x FS is in fall farce. , M ff 1.ii: {3Sl
_m a a License class ILint.a T'2
O a O Dae_ Comrecmr
3 u. .I`i " '"' - ARCHITECT'S DECLAR
t:=O 4 I understand my plans shall be used as public records ��trA Q N. 7
Ewr- CV.N" L
w S p O Licensed Professional
c o OWNER-BUILDER DECLARATION MAY 2 9 2002
1 becebaffi
y from Nat 1 am exempt from the Con mown s License Law for the
LEa a following reason.(Section 7031.5.Business and Professions Code:Any city or county'
Y o which.,Moes a permit to conswn.oBer,improve,demolish,or repair any anctuo, $500
-'peso tots Wena ce,also req Rs the ppllcant for such permit 1,1<..igned stammcm.
Iha'hQ floensed Pub hn)to the Provisions of the Comractou License Law(Chapter 9 0�yw�'yl5sp�eµ,Rip-gg�g Valuation
(co cngwith Sel ]000) fDivision 3mRhe ltusm it andPofessions Codc) {,: -'\-t�35.D'GO'.VL"J" •r `` 5 �' ,-q;
or that he Is,sem t d mfmm and the basis for the.11c'bd eaem tine.An Z- 3
-
of Satins 7031.5 by any applimnj for o Dennis subjects the applicant to a civil penalty �y ,��
•of not mom than eve hundred dollars($500) 101 APN V8ftATION - Occupancy Type
O I,as owner of the -pen,or my employs with wages as their sole compens..inn,
will do the
o work.-and struclum n_ofimmndeTLa for sale
102 -LIERS
" madssionsCode:The Con Licenselaw does notapply to an 103 UFER Required Inspections'
come,o mad Professions
Ihereo tl h J h te himself
or through his own emDIOYee.provided Iht -`
'
n'improvements t' m- or _._ 104. .- .KEBAB
uQ re°forside:de If,h 1M1 building p I s-sold within- ,year of
inmpleioo theoveobuiderwllnuvetheburdenolprovingthathedidnotbuildor 105 - ANCHOR BOLTS i' "
mprove for purpose of srale)" 106 - SEWER & WATER
❑j s avne,of,lit, ow,n,um esclus ly con t 'i g with lice sed cowmet.ma to
- - construct the project(Sec 96W.Business and Professsons Cede)The Conuaaors 2 0 2 - UNDERFLOOR PLUMBING - -
andweLaw,contrsnot for,surtnanecanernfnicoatywnebuilds oricemo improves thereon.
the 203 - UNDERFLOOR MECHANICAL..
_and nm.coml.cts.fm.such.pivjca with..contmemr(s),IicenseJ.pursuant.to the. ,_
contmcror'.e Liansc L.w. . •" " - - - -2 04 -= UNDERFLOOR' FRAME--- ..-- - - -----------'---- '- .
❑lam exempt under Scc' ,B&PC,for his reason 205 - UNDERFLOOR'I'INSULATION
owner Otte ' 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
I hereby efforts under penalty of perjury on,of the following dMaratioos: 303 - ROUGH MECHANICAL
1 ❑ I have add will maintain a'c<nlEntate of con nr'ro mv-insure for workers 304 - ROUGH ELECTRICAL
Compcns.nu
on. nprovided fa00 r by Section 3] of the bra laCode, far she
_ performance of the work for which Ibis FCMHi is issued,. , 305 - FRAME
❑1 nave and will maintain Worker's Compensation ldsvmnce,as required by Section 306 - HOLDOWNS
_ 37M of the Labor Cade,for the mrfO331oaoce of the work for which this permit is
issued.My W.6me,Compena l mn Insurance loader and Policy thumb,,a.: ._ 3 07 - INSULATION
ca t ,ty . • ! f.
t -... 4l' PolicyN 3.08- '�" SHEETROCK�.:
nRKERSI - ` EXTERIOR'- LATH'.,
CERTIFIC I� 309 ,
COYPENSATION INSURANCE
._- .....- .- ._.-_ _ ...... - -._-_...
. ..__..
310-;-_,.; INTERIOR ..LATH .a.
ITh¢section need not be completed if the permit is for one hunched dollars -
fsloo)grleaa.i, 311 - SCRATCH COAT
ILnfytnii 'heperfurmhngbfch iCarZ�h'lh'us"moous",.,dl1 -. .'313' -ROOF- NAIL-__ t __ .. ._ . . _
sM1 ll n t ply y person'n any I Isce. hen m the Workers .....
'
Comp iid1},gwsofClfrdili.Dine n °=�° o-yr� 501 - FINAL ELECTRICAL ENERGY
AprCE - 502 - 'FINAL PLUMBING ENERGY- -
,NOTICETOAPPLI ANT Iter akmg the ri feats IE Pi you should -
z b& abjctciliaWorker' emrmost p sofa Ld Code.'..QmQ 503 - FINAL MECHANICAL ENERGY
O fdnh' ih -ply wish,suchProvisions o d pxmit shall be deemed eked.
z ► - - - 504 FINAL,.BUILDING- ENERGY-
�"'-vi •l•'+t" ^'` ""' - ----- -
CONSTRUCTION LENDING AGENCY"""'
-� SOS - FINAL ELECTR
I hi I1 rm Nat the onewcro Ina ng agency far In,pcif...be I CAL '.,
yo 'Lcte N'fe which thisd(S 309] Civ.C) 506
-.-_GAS .TEST. ..-- ..
oz `d Ad 507 - FINAL PLUMBING
I certify t I have madm ppm i and state
' thalthabove information 508 FINAL MECHANICALco t I e8 ,rIQcoply In II city and ordinances state laws misting
. O V
tobuildingcov dheeby mohomm mpoeo6nutlivesofhisctymemerupon 509 - FINAL GRADE
p„
the bravenenionedproperty for inspection purpoms._ 510 - FINAL PLANNING
rFi 6i (W)limm7Q,v d nify andpenses hickep yon any a fc nagainstsaidaso
514 - FINAL UB C WORKS
Z liabilities,itjudgments.tom,Ict d expenses which may on any a gains
i City <UNDER thegranting f this permit! r` \l
APPNTUNDERSTANDS AND WILL COMPLY WITH ALL NON POINT Date
SOURCE REGULATIONS. I Issued by: -9 1
Signedure of ADPncanoContmaor ,Dae
as firedlby theC HAZARDOUS MATERIALS DISCLOSUHL '' Re-roofs
pplicat in,. ildingoecupamt or handle Widows mtmm ,._Type..of Roof
codSen he Cu ,) Ii c Mea p/al Coe Chapter 9,12.and theHealth and Safety , "i`
❑re t7flq (rir,'_ tf 1 , . t , -Pt 4i . .-:Y_Y:.
All roofs stroll be inspected prior to.any..roofing,material being-installed.-
cmthOWill tin,jarplicam,or future azildJding tech,'heoccupant use equipment devises which If a roof is insialled without first obtaining an inspection, Pagree:to remove
Distrix^ j Iryhfanagemem
Lnsavcomamman¢�as/N fnedb 'he Ana n all new materials for inspection..-Applicant understands and will comply_with
> Y Q
o o
all non-point source regulations.._ - - -
I h se o,"d:the h i-ardmus materials requirements under Chapter 695 of th.c
C.htomi.Heelth&Safety Code,Sections 25505,35533 and 15534.1 understand that
if the building does nos currently have a tenant,that it is my responsibility to notify the "- '-" - -'- " -"_ - --- -- -- ---- __ ... .-
occupant of the requirements which must he me prior,to istmance of a Cerificac'of
Oc ancy.'. .
.Signature of Applicant Date
owner en, Dae All roof coverings to be Class"B"or'better "
- LL ,
OFFICE