02070076 CUPE
CI•BUY
ILDI C DIIVIISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
21597 FLINTSHIRE ST TATOYA CONST CO 02070076
OWNER'S NAME: APPLICATION SUB DATE
PAM & JESSE MARINO 57 N SUNSET AVE 07/12/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 251-1234
00 ARCHITECT/ENGINEER: BUILDING PERMIT INFO
Q U BLDG ELECT PLUMB MECH
1• Z' LICENSED CONTRACfOR'S ECLARATION
J m i I hereby affirm that I am licensed under p inions of Chapter 9(commencing Job Description
F��C with Seaion9 )of DivisinnJol the Buslned"P°f nna Cw,and my scene KITCHEN REMODEL
<y E is with
u a rce �^e
ii:d�<U License Clan ` Ln". o FUNALE®
D e Con
C ITECf'I DE
d G 1 unders d my tans xha be used as public recmds AUG 2 3 2002
i S pe z Lreenscd Professional
ca u. OWNER-BUILDER DECLARATION
I hereby affnn that 1 am exempt from the Contractor's License Law for the
C:?< following beano.(Section]031.5.Business and Professions Code:Any city or county BUILDING
$21000
E F C which requires a permit to connmc,,.lits,improve.demolish,or repair any structure.
bi 3 m_poor m rss ruuance,also requ'ues the applicant for suN permit m fk a signed satemcot.
ktIbq,bLIicS.j.dpurstmntr ffr provisions of the Conmecmis License Law(Chapter9 j
a- 1\ 1 Valuation
(comm he igwnh Session.OWl fDivis;onJohhe Qqus1ne5s agdP frssions C°eel C,t.J�tl .,5_ '_Vov -U'�T/y YZI'j p�,I��,� • 1 r
or tha he I!fkempr rheicfmm'ma the basic for the allkg�d shni ub.Any,;dation
-of Section 7031:5 by any applicant for a permit mbj«ss the applicant to a civil pencity-
:of nmmre
inthan five hundred dollars($500). 101AEN fY ATION r>a r:o Occupancy Type
r'
❑I.as owner of the propeny,or my employees with wages as their sale compensation.
-
-wilt do th tk ad-thcstmemrt-a no,irumbed or offered for tab,(See ]?ta- -- ------ - -- -- - --- - - - -
Bu' d Profibiitons Cate The Contractor's License Law does not apply to as 103 - UFER Required Inspections tui .P n,.-'
owner of property Who builds or improves thereon,and who does such work himself
or through his ploy provided that such improvements are not intended or 104 - REBAR I
-iaff ar- 1-'lrh r min-la-garmpmvement is-sold- -thnoney ' o 105 - ANCHOR BOLTS
ompler nn.the owner budder will have the bun en of proving that be did not Wild or 1
improve far purpaae ar x.")' 106 - SEWER & WATER j
-
__L .andn:uiawMrnfthsc-p
c -a-m----sl---uac-r ---e-en-.w----^-to--rsm
--------202 02 ----UNDERFLOOR
Linstmci the (Sex.7a,Business and ProfesionsCCe:)Th,Cot
wndoesnot.pptoanowner nfpperwhobae.orimprove. ereon, 203 - UNDERFLOOR__.MPELUCMHBNINIGC.A-L._-'-acr—"
:rr
. cenn os
c [o .such pot cts.witne -.-_.__-_204._ - UNDEFLOOR.--FRAECoIat L e La " ` M _.__.
_.NI-------------
I
-.:_-=-__e
_
$ '';B&PCfmdbiabon.n r
...-._--..
205 - UNDERFLOOR)!%INSU 'L'ATION
D 301 - ROUGH PLUMBING
WORKER'SCOMPENSATION DECLARATION 302 - TUB & OR SHOWER
-I nebeby affirm under p n ,y of p rjury one of the to lowing declarations - 303 - ROUGH MECHANICAL
�.. ❑ 1 have. d in'na t ccrifiii f con tasel more for Workers 304 - ROUGH ELECTRICAL
Co pc ion-as-pro provided f by Section-3700 of-the Labor Code for the
perform305 - FRAME
...�_ - ahce of th<wark Tor which this pcnnit is issued;,,.`
❑1 have drul will i '°inI arse °'be 1:umpe�am I mote req red by Sect 306 - HOLDOWNS
3700 f th Lab. than of thek f which to perm t"
m arnerand be 307 - INSULATION
f m � 3 308 = SHEETROCK_-_....,.-- _._...__--
f�pe? (
jCERTfFICATION OF,EXEMPTION FROM WORKERS - ♦3 S.r3 Q.9, 1 . :EXT-ER16R-'LArI`,Hy ' '(1
- 'COMPENSATION INSURANCE't -'• '
r,:frkxi'saecd4cdjnotbecom lead if the .''_-,•" . __._.310'; =i`INTERIOR--liATH-_._ _ ,..-._-__.,_ _.. ._. -..._
fsmB), ir,.a1 311 - SCRATCH COAT
D permit is for one hundred dollars
313==--ROOF---NAIL
r .. nth . r is. a I
I sere( int the performance f M work f h
tau pIy'arM me M1latth=wahers 501 - FINAL ELECTRICAiP4lENERGY1,
Compo t L f C l f D Y - - -
^pPici t -- . .502 .-_. FINAL_PLUMBING ENERGY.-
.N
-- ..
OTICETO APPLICANT If.alms .lir gmsc nr<me'afE repro yushould
Oribb7ttothw or
EERGZ bee keercoorpeYout liNY( m th omly lODpprovisionsn °stn r ie '
p<nnt nanbeaec ea aka' _ _ .504
' ,__,FINAL_BUILD.ING.,ENERGY .....
�.' ��t, „t�[CDNsraurnoly LENDING AGENCY 505 - FINAL ELECTRICAL "
the by Tf'rmthat th a -odst u 1 ting jgenc5 forJh peri ituince'
V,6itthe orkfrwhichth permit :ued(s 30970 e) 506 - GAS TEST i
W
5.Z
Lenditr I Addit,sd 507 - FINAli PliUMBING .-- -
`- --- -
r VSO I beth( thm I have read thrs a licaaoo and st.t lmo th.'vbove Wmmation is 508 - FINAL MECHANI CAL
vc 509 - FINAL GRADE
u W_p 'emrectr I,agree to comply with all city and county ordinances and stale laws relaxing
O-.(� oWltl gc .t tion dh by th- rep nmf cs fth'city enter}} m the ha t -.aproperty r ^e p p - 510 - FINAL PLANNING
[r 6i (Wrl i io's.e ndetimly x1.mhannlcsS the way accrue
nb eg said
m liibrlmesmasmeenss.c gIfhiwngnmay,in.anyway_ace eag,; team 514 r- FINAL UB C WORKS
U Z
AP Cisr Ir A T iron ERS C ming
YDr tWILL`COMPLY\tTTH yYC'j6 i 1 +
F So 1Rf .j ID Issued by: Date
at npr_c nuc - rD r;i, ,;( Re-roofshcar
lir AZ S' RIALSDISCIQSURE
derrrc n the c t r bag cepa t rrV<, nanalenaaarao t I Type of Roof ..
Y pen t o al Cod Ch pt 9 1 d th H hh and Safety —
Cod S t o 2577 Sx3
❑Y [ t 41.�N n tf f\ .'�
t - All.roofs shall be inspected poor to any roofing material being installed.
emit.: Will their&applicant future building b.ytheB BayArea
p t rdb.ree:wnmh If a roof is ihstalleiIwithout first obtaining an'rtns ect3on;I,a ree'to remove
b d <M n( dfnedbYtheByAeA QaliyMangem t g p g
Dir"oY y tt� all new materials for inspection Applicant understands and will comply with
'` x "all'non point source ie'gulahons ...... jr
'� 1 ha circ a the
hancardous matetials requ rtircna and Ch Dt 6.95 of tfic r - - -
Califa
omu Herth&Saboy Code Sections 25505.255]3 mrd 2553..I undersand that
-if Ne bmlding dire t currently have s reunion.Nat it is my responsibility to notify the
a-uu pm ft' qu i nos h be hmst tprior to I�'faC nificme of •` IA - - -
n /
_ l _ Signature of Applicant Date
o.m or autha tea n All roof coverings to be Class "B" or better 0 -
i�..
-OFFICE - .. . ---_... .. .--- '- - - --- - ---.----------