02040045 CI BUOF SI �O
BUILDING DIIVIISIONPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7802 FESTIVAL DR AMERICAN BRANDS CONSTRUC ION 02040045
OWNER'S NAME: APPLICATION SUB DATE
7AI EDMUND W AND KAM-HAR Y 1145 HAWKS HILL ROAD 04/09/2002
j' HONE: SANITARY NO. CONTROL NO.
qqqq.- (408) 210-4945
00 ARCHIT6CTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
P,Z LICENSED CONTRACTOR'S DECLARATION
Z IS- 1 hereby affirm that 1 nm licensed under provisions. Ia.Rs{om Li - Job Description
t=� with Section]OW)of Division usia"sgF (esil'pns viild'y ien L�A O NCLOSURE (435 SQ. FT. )
is in full fort andrff n. 1✓J`
:0 U Lir�eg5e C ` ` Lic.
Dail Commct��.,��//y'
t to
ARC IT >tt1A
r
g 1 underomnd my plana shall Y pante r .�
3 E c IIA 0 o Linnxd Professional
OWNER-BUI TIO
I hereby affirm Ihm I am axe m e olvrican's License Law(or the
1-Z< following reason.(Section]OJLS.Business antl Professions Cade:Any city or coumy $38500
O 9 P P L, file
repair any stricture _ __.....
ua Nat bd ialim requires) PP Permitoicense signed mem
which requires a masa to ronswcl,alter.improve,demolish,
(commennnuwith Sac�on47"pf Division 3 of the Businescond Pr lowons Code) - - -
its the applicant for nllLll
a�thmaatonaann[canractor Valuation
aandpro.Anyvicme) 3�� rj,� C _',`• ', _'; j;.}'°,
or Nal he is exempt theie(rom'erb the basis for the alleged dem'puon.Any violation-
-of Section 7031:5 by any Applirvnm for o perent subjects the vpplirnm m e civil Aman, p y Typ
jai not more in..five hundred ounnn(E5oo). 10 _FOUN
. PNDATION '''"x" '" OCCn ane a -..\
❑h as owner of the pmIparty,or my employees with wages as their sole compensation,
-wilt 16 the work,,and the sticture is not intended or offered for sale(Sec.76 ,-
'Business and Profession Code:The Contractor's License Law does not appy to an 103 — UFER Required Inspections: - L
owner of property Who builds or improves thereon,and who does such work himself
or dramatic his own employees.provided that such improvements are not intended or 104.,,.--.REBAR_
'�ofiered r7 sale.If,howinveiibe building ar impinmenticift is sold within one year of •p! - �� .;,� -'
'compleu n,nxownerbuilderwillhavetheburdenfprovingthathedidnmbuildor 105 - ANCHOR BOLTS
improve for purpose of sole.). 106 - SEWER & WATER
_-.._.- -- pert -- --_ _ _ -- - --- - —
OLasownermjmt(,peny,em Business andPrefeuins oanudLommamf1O 202 - UNDERFLOOR PLUMBING i1L • '
License
the does
a (Sm.)to A Business and Profusions Code:)The CA.bA mi s
and who
l.mmoresnatappy to ro ownerth.. enywhobuilm oeimpm..A[1.on. 2O3 - UNDERFLOOR MECHANICAL
- ontmclmc Urcts.for such Projects wish.a.comacmgx).licensed.porsuent m Ne. _.. .. - _.-_
and echos
c ucumdm i 204 _ UNDERFLOOR FRAME—-
01
_ Planda see egPc.far do,nausea 205 — UNDERFLOOR' INSUliATION
Ownei' Dam'- ":'• 301 — ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
Ihercbyafftrmunderpenalmyofperjuryoneofthe following decimations; 3O2 - TUB & OR SHOWER
• 303 _ ROUGH MECHANICAL
❑ 1 have and will maintain a Certificate of Consent to selGinsure for Worker's 3 04 ROUGH ELECTRICAL
Compensation, ms_pavided for by Section 3700 of the Libor Cade, for the
- 'parfamsaa«of di work far,which this permit is issued.
305 - FRAME
❑1 he 'and will mointnin Workar'i Compensation Insurance,as required by Seblion 306 - HOEDOWNS
Code to,the perfmmonce f thee�wqork f r wh ch this pemir lx
xs�d ia/ywan�[`rxc npc au,n I�nec'pl ! •Policy nu M m i4 307 INSULATION _
nA,. ` cyN /o uxT (v fp - 130.8,.7jSHEETROCK
-,CERCOF '309' EXTERIOR -LATH:THP -
COMPENSATION INSURANCE ; __ _ ___ _
.""fThissccuonneednot W abmpinmd if the permit is for one hundred dollars 31O -- -INTERIOR LATH `' „ '• ' -'
L.
311 - SCRATCH COAT
lttn fy'NsPin the performance'of ilia work(or wht hthis permiis iwued,l' "313"- ROOF NAIL „"�'.� -,:
shall not employ any person In any maxim so as tb become subject to the Warkers' 5 01 - FINAL ELECTRICAL ENERGY
Compensation Laws of California.Date"'
Applicant -- '- . 502- FINAL--PLUMBING' ENERGY-
Z
If after maki ijthis Cenificare of Exemption.yaushould . 't
z become minicar t the WmumsCmpensat nprovvionaofth Labs Code.yonmost 503 - FINAL MECHANICAL ENERGY
C forthwith comply with such pro 1 tons or Ili Permit shall be deemed re oked.
ZR - -. .._- _ __ . . _ _. _ ._. . .504. - FINAL BUILDING--ENERGY ---
F" "� . -
CONSTRUCTION LENDING AGENCY `
�n hheforwhihthatNereiisnsartiunio.3W79Cis.C.cyforlheperformonce 505 - FINAL ELECTRICAL.
Lnaar'kNaorwnmhmiaprineisiaa d(sea:3097;Civ.c.j 506 — GAS_TEST
5'a of the ark me -_...... ..... ..
Pio d Aad :al 507 _ FINAL PLUMBING
I certify Ihm 1 have read this application and state Nat the above information is 508 FINAL MECHANICAL
' 0W p:I corren:I agree to comply with all city And counly.ordinances and state laws reining 509 - FINAL GRADE
:U m building conatiuctidn.and hereby authorizertprescnlntives of this city to enter upon
gy theebove-mendonedproperlyforinsppnionpumox[s. 510 - FINAL PLANNING
I W)age to'sa a indemnify and keep hars4ss the Cly of C penin,Against -
-V]
liabilities.judg ms,costs and expenses h ch may in any ay me against sold 514 F INA P C WORKS
U. City nonose "ttafthe em t ilefN spermil
APPLIC jJDERSTA $AND- ILL GOMPi.YNITHAL0NON-POINT' Issued by: Date
A'O UTATI NS. CiA
_
tmmre o(APPlicanl/Conwnor '."'/ 7 "" " Date ' Re-roofs
r HAZARDOUS MATERIALS DISCLOSURE '
Wllthu applimiumfinarm Wilding occupant stoic or handle harerdmh matenAl .-Type of Roof -
m defined by the Cupenmo Municipal Code Chapter 9.12,and the Health and Safety
Code Seer,n 255320)
°Yos _ A" +, _All roofs shall be inspected prior[o any roofing,material.being installed.
�' Will the applicant or firm ie Wilding occupant e equipment devices which
PP. e aIf a roof is installed without first obtaining an inspection, I agree'to remove
em theaardous ev contammenu as define by the Bay Ana Qual iy Management
all new materials for inspection._Applicant understands and will comply with
(� °v` " all non-point source regulations
a> '
'I havelread Ne h,y CW,s materials rcqu;25533..d 235 Chapter 693 of the
CWi(amia He,t h&'Safely Cade:Senions 25505;25533 end 25534.1 understand that
if the Wiling doe-not currently has,.arta that ls myrcpoptbdiry to nalify the
occupant of auirem Is wht h'mdm W mol pito to its ante of a Certificate of
°p'` / rV Signature of Applicant Date
w roramhonxedagenf �' Data All roof coverings to be Class"B"or better
OFFICE