02060027 TINO
CITYI OF
G DIVISION CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS: PERMIT NO,
10335 FARALLONE DR SUPERIOR ROOFING CO. 02060027
OWNER'S NAME: APPLICATION SUB DATE
^
RUMM CHARLES F AND CLARE T 421 BURGOYNE ST ,. 06/0,5/2002
IPHONE: - - SANITARY NO. CONTROL NO.
(650) 969-3103
'O O 0 ARCHITECT/ENGINEER:1. BUILDING PERMIT INFO
g F BLDG ELECT PLUMB MECH
a u. I_3 LJ L._J 1'-'.I
TION
c ZZy I hereby afntotha LIClicensed ENSED CONTRACTOR pp DEVns ofCaaper 9(commencing Job Description
h
sic t-� with Semioneand effect, nJofm<Business and Professions Code,and my license
YE� is in full force and cRect. Y SKYLIGHT ADDITION r�S p r�
p&u License Class' Lic.p R
Date Contractor
3 In ARCHITECTS DECLARATION
to
2002
caz�rlltuWnRemrple hllb sm vbl n a v ; IYVY 1 < 2�02
OWNER'"BUILDER DECLARATION f
X
- 1 hereby affirm tom I am exempt tram the Common,x License Law for the t�
F Z 6 following reason.(Section 7031.5.Business and Professions Code Any city m coBull �J lunty" ,
Ece C which requires a permit to construct,alter,improve,demolish,or repair any structure $'700
so
3 "'prior to its issuance,also requires the applicant for such permit to file a signed statement.
dagilwis limtuee pursuant to the provisions of the Contrast License law clager9 �Cyw,,ap,I 1 r�A+[Ba Valuation
Isom rating with Seaion.700b)of Division 3 of the Business Prof no'Codel _+-},T "'30,73i1�'14".iV'U 1de,.:;?;fy+.'f•,)�s.,,
or that be is ns2mpt IheierioM'and the basis for the alleged ckembtion.Any violation
of Section]031.5 by any aWliennl for a permit subjecti Inc applicant to a civil renahy- y mm1,e�r�
:vrnm.mnrc man eve nunerea amuse,(s50o,. 10 1"—' �SUNDATIONT til' Occupancy Type
❑I,as owner of the propcny.Lir my employees with wages as their sole compensation,
-will do the kand the structure is not intended or offered for sale(See:701 _'_'-- --"-" -'--'- ---- - - - --- - --- - - -- - ---.----.-
:Bn sea nd Professions cede The contractors License Law does not apply to an 103 - UFER Required Inspections " <'•''
owner of property Who W ids or Improves thcruon,and who dots such work himself
or through his employemployou,i.provided that suchimprovements are not intended or 1Q_4__—_ REBAR
t -improvementdp is-wild w thm one year of
improveI flux parfin r oleerwillhavetheWNenofprovingmatheddhatWJdor 105 — ANCHOR BOLTS -
mpraseB,rpnpa,=nr.ule.) 106 — SEWER & WATER _
1y of potheproperty.amBusin ly tractionsCWeauAcommaorsto 202 — UNDERFLOOR PLUMBING ' ' r
tit t the p es a(See ]041 Business I Pr f., s Cede)The Contractors Lr,-r.
,
co I t
License Law a«x hat apply m an owner mf property who W Ids or mprove,thereon. 203 — UNDERFLOOR MECHAN I CAL
-an c.contracts for such pro,ecl w mWcoi .a co t clods,licensed pursuant to me
W
KERSCOMPENS
DECLARATION - � --204' -'UNDERFLOOR- FRAME.`-
e
er Sec. s&Pcfnrt .recon 205 — UNDERFLOOR' INSULATION
o Dato 301 — ROUGH PLUMBING
Ih br I. nae v hy, fps, rr rine followingdeclarat roma: 302 - TUB & OR SHOWER .
303 — ROUGH MECHANICAL
I -OI I h ic ands ill°'run nia o Ccntficmo r C n nr iba If'nsnre for Worker's 1
a- { Com act s+pro WN-ror b Seg-on 3]W'abtbe_LaborCode. for the 304 ROUGH ELECTRICAL -
.,. . 'ptr rrta-dc=ofmn'yndtforw=hichthi kridti.instu`.it 305 — FRAME,
❑1 h d will ontimeho'ketkints Con pe -lnsuionec.ate required by Section 306 - HOEDOWNS
37W of the Eaton,Code:for'lbe performance or me work for which this permit is
i,iued'MyW lialiCs Com,neducation linumincut 6crierand Poly number are: 307 INSULATION
C.vnD CER . TOF-EXEM"I 308 _.- SHEETROCI ..
CERTIFlCATIOM1 OF EXEM11P INS FROM WORKERS' ' ' .. ( (�• j;' � H'` J
"' COMPENSAT1oNINsuRArvcE h I• '- - 309 _EXTERIOR LATH ,_
el.: _rTh int need 6nl W amnplet=e lane cemnt i,ror litre nnmdrea amuars -.3.1.0. "� I'NTERI OR._LATH. .
aiw,mpie,a., • 311 '— SCRATCH COAT
I n,tyin Incpcd -c 1 h kf hihth pe I s ea - 313- _` ROOF MALL
to
Is
NO"�all `TOpAPPllcn a opo k bm,c nn^_,t Or NeEaWPtc�yYnuh�n�a502 FINAL- PLUMBRICAL ENERGY
tr 501 FINAL EliECT
A n` �� IMG ENERGY" — „
m w kiCompensation p 503 FINAL MECHANICAL ENERGY
b asubjectt 1h
p from me ply m suchp this permit shall bc ddrevnked _504 _-_-._FINAL _BUILDING—-ENERGY.- --
to Ihereby rrrinCON'here
is ociroloaction
NENDIM1Gdi gage agency forthe performance'
6nhawnrkrn,wnmth 505 — FINAL ELECTRICAL ,,, "
"~ .eider's Name" p` ' .ucd(S e 309] C'.C)
y,q - .. .. -__. 50.6._.-_GAS TEST ..,—
:z
EST— '..Z leper Adda 507 - FINAL PLUMBING-
�' Ic rift lA tlh v1N
application..it lone mad the.1noe obvionromin is 508 - FINAL MECHANICAL
tat^.F cdiica 1 agree to Comply With all cit)and county ordinurces and.state laws rearing
O.v
16 buildingannnndfo annh=rehyanhmn,e ropre,won,vea nn:citytlenter npnn 509 - FINAL GRADE
t}„ a the '(W)ve ere idP x of 'or ry ak on ph�ml imcCtl fe-p �8�in,t 510 - FINAL PLANNING
_h liablte ,dgm t,c L d. xpnnses h hm, 'ntmy y. .ag n,tsaia . 514 - FINAL - .0 C WORKS,
V Z Cityt ria egbcnce RS7ANT t gut thi "`."
prtv ^
;hPPCie 1tII,Vy�fRSTtNi)S iN l' LCD\Ip Y,r VITH AL2.`NONPO1NT'`r Ij
SOURCE 1 ATIOM1s Issued by: Date
pelican omN=mr .'...:.'�:' ." 'ria=; Re-roofs
..ir, HAZARDOUS'MATERIALS DISCLOSURE D
wit Ik pp1 cant r tore Wilding'occupint store or bandm ba;nari t at Type of Roof..
as'd<Bond by th Ca pen o Mu I CW Chapter 9.1 d theHealth d Safety .• _.- .. ••
C detOoYum st75511a)S ur)e Yost'si SP sate tsl lir
All,roofs shall,be inspected prior to any roofing material being,installed. _
" dither, I,am f ..
Pp u IAing Pant qu p Ip d ,wo=n If
a roof is installed without first obtaining an ins ection I agree to remove
Dist h zartlo it cont rants by th Bay Area A Qual Quality M Management t g p
°""" yet, _ all new materials for-inspection Applicant understands and will comply with
all non-point sou ce regulaDons .
ha t dmc hazm do. m t "q mento and r Ch pt 655 of the
C$IIf rota Health&gutryCWa Sections 25505,25533' HEJ I understand that
- if the Miflding does net curtemly haves mnanr,mat it is my responsibility mnotifymr - '-'---' - - ----- - --
:naso lit of the rc ssuance of;1 Ceriifcare of
p quire s which must rte ru t prior m
' Occopan Y / / . .. '
CC (.(/\ - (� 1 04/-�7 Signature of Applicant _ Date _
-
own von ee,ag t All roof coverings to be Class "B"or better
OFFICE.