03020032 CI null DI(DIxVISSIIONNO CONTR�`?iCTOR NFORMATION��,',
PERMIT
BUILDING ADDRESS: WATER QUALITY PLUMBING PERMrr No.
948 FT BAKER DR 03020032
NER'S NAME: 1860 ALMADEN RD APPLICATION SUB DATE
OW
VIENKAT BONNAKANTI 02/10/2003
ONE: (408) 267-9330 SANITARY NO. CON9'ROL NO,
ARCHITECLENGINEER: BUILDING PERMIT INPO
BLDG ELECF PLUMB M9211
0 0 0 0
00 Lm that IDCON'IRd TOR under
DECLAR of
a u I hereby affirm that I am licenced under pdip 15 ns of C IS;I* v[commencing Job Description
tai withllfore d,fof UivisionJof the Businusr
dip and mylicene is
:(moan oder( , OPPER REPIPE
zo,y,b Lieena p.. :�, Lic. --,Sc SD @�� /� MAIN LINE
o NFo I Comm,. ���I��I�®
in ti ARCIIITECTS DEC A O 'P,_ N
I undcrsmnd my pfins.,hall W use
as m�lic teartd. 1
nt LL Licensed Professional FEB 1 9 2003
l iLL0� R OWNEBUILDER DECLARATION
a 1 mrchy affirm that 1 am exempt from the Contraclnr's License Law fur the
m_00 following reason.(Section 7831.5,Business and Professions Cale:Any city or county BUILDING
a le m which requires a pMa
permit to construct,alter,improve,Manifest.(It repair any structure
'o—'^ priorto its Issuance.alsunyuires the applicant for such Permit o file a signed statement
. E- [bathe pursuant provisions S Ft. Floor Area
fro p of
p 9 $41p[p®lion
eft- that he
exemit thereirmedand She
basis for
ohneegeBusiness antl Profcsy vi Oslc)of
ii Inst he is exempt Zany applicant
li and Ne nazis fur ube alleged exemption.nto Any violation of
Section than by any applicant far a permit Subjects me applicant m a civil penally of
not more man Rae hundred dollars($5ro). ar Occupancy Type
0 1,as owner of the properly,or my employees with wages as their sole compensation.
will do me work,and tlm swcture is not intended or offered for Sale(Sm.7W.Business 202 —
and Professions Code:The Courteous License Law docs not appy m an owner of 3 01 - ROUGH RSg IODS
property who builds or improves thereon,and who does such work himself or through his LV
own employees,provided that such improvements am,not intended or offered for Sale.If. 502 — FINAL PLUMBING ENERGY
however.the building or improvement is Sold within one year of completion,the owner.
builder will have the burden of proving that he did not Wild or improve for purpose of 507 - FINAL PLUMBING
sale.).
0 1,as owner of the progeny,am exclusively contracting with licensed Contractors to
mswa the project(Sec.7(3,4,Business and Professions Cade)The Contractor's Li-
wrom law does not apply to an owner of progeny who Wilds or improves memo,and
who contracts for such Pmjcca with a mourset (s)licensed pursuant to the Contract
License Law.
0 1 am exempt under Sec. B&P C for this reason
13700
wner Dale
WORKER'S COMPENSATION DECLARATION
I hemhy affirm under penally of perjury one of the following declarations:
I base and will maintain a Certificate of Continuo self-insure far Workers Compcm
ill,as provided for by Sectio 371g1 of he"be,Code.for t c performance of the
rk far which this permit is issued,
1 have and will maintain Workers Compensation Insurance,as reyvired by Section
of me Labor Codefar the performance of the work for which this permit is issued,
y Worker's Compensation Insurance carrier and Policy n rotation
(��(��. \ Policy No.: �in 3
her: CLRI'IFICOFFPFION FR OR ERS'
COMPENSATION INSURANCE
(This action need not W completed if the permit is for one hundred dollarx ol(o)
II
1 certify that in the performance of me work for which this Permit IS issued,1 shall nn[
employ any person in any manner.a)as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making his Cnndmism of Escm prion,you should
become subject m the Worker's Compensation provisions of the IaWr Calc.you must
OO[-+ forthwith comply with such provisions or this pami I shall he deemed revoked.
Zh CONSTRUCTION LENDING AGENCY
Thereby affirm tha[mere is amnrvction lending agency torlW performance of \/
GY. the work for which this permit is issued see,RN7,Civ.C.)
�W 0 Lender's Name
U 2 Lender's Address
U 0 1 certify that 1 have read this application and Sam then the above infrnmmion is
if, F correct.I agree to comply with all city and County oNlnarmes and sant laws refining 1.
0U Wilding construction,and benhy mullion nPnsenanives of this city to enter upon the
above
ct.judncdproperly for inspection prowhich ms.
F C (We)agree to save,indemnify and keep harmless the City of Cupeninu against
rp in
of the costs granting of this permit. may in anyway sector against Said City
U z in rnnayucncc of granting of this permit.
APPLICANT UNDERSTANDS AND WILL MPLY WITH ALL NON-POINT Issued b
OURCE REGULATIONS. y' Da \
.���� Re-roofs
get[ c fApp c ✓ on tnr 1 Dam
DAZARIIOUS MATERIALS ISCLOSURB, Type Of Roof
Will the applicant or future nuilding,xcup.moam or handle m ardess Soso inul
as defined by the Cupeninn Municipal Code.Chapter 9.12,and the Health and Safety
Crale.Section 25532(.)7
❑yea Na All roofs shall be inspected prior to any roofing material being installed.
Will the upplicamorfuture buildings'cupantuseequipmentordeviceswhicb If a roof is installed without first obtaining an inspection, I agree to remove
it hmallous air conmminana as defined by the Bay Area Air Quality Management all new materials for inspection.
District')
E]Yes \t]No
1 have mad the haefolou```s materials myuimmcna under Chapterfi,95 of the C,I1dm-
For Ileulm&Selcly C,sle.Sectinra 2515.25533 s,1255 .l understand mat Bill Wilding
does as currently bars a retain, s my respmai ity It nom xcupanr of me
quire ems which mustbe me pdu r fa rtificane pC1 t
Signature of Applicant Date
i Owncrnr.amari.edagent 17 D„e All roof coverings to be Class "B”or better