02060012 !
CITYDNGnpESIOND
BUILDING SINPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
22239 HAMMOND WAY S .E .A. CONSTRUCTION 02060012
OWNER'S NAME: APPLICATION SUB DATE '
TONY & TERRI ZINGALE 655 SKYWAY RD 06/03/2002
HONE: (650) 802-9585 SANITARY NO, CONTROL NO.
rc0 p ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
H= LICENSED CONTRACTOR'S DECLARATION
z 5„ Job Description
O O 1 hereby affirm that 1 am licensed under pmvisions of Chapter 9(commencing
pH L- y wimfatfivr 0& efDivisi7yyianrmeBaxincyedPmfesxiomCode.endmyliccnx REMOVE BATH/ADD BASEMENT
7 fall de RCC ✓✓�'((R FI1\IALEp
u Lernx �' u g ADD STAIRWELL
3"•�+ ARCHITECTS D f AR ON
(:u O S I undernend my plans shall be u.ud es public rccoNs
NOV 2�7 2002
is.O O Lmensed Professional
a�•g, OWNER-BUILDER DECLARATION
1 hereby from Nat 1 am esempt Imre me Cmmacmr'x Lt..Law fa the
?� following reason.(Seciian7071.5.Business and Professions Code:Any city a county -- III�D'
SCC D
which construct.dim
quires a permit to construct. e improve,demolish,m repair any xqrnrt B
uVV
3$..Prior In its issua,tt.af.nottircame applicant focsuch permit m file.sigodmtemmi. _.. _
that bel>hctnea pahugnito the provisions of the contractors License Law Chapter9 _t ;Sq.Ft. FIODPArea S• -til Valuation
r
(comryelicingwish Section 7001)of Division J of the Busine5r dna r7TtPfgsionx Code) (,l�yh*1'1 y_",( 7.V)i'a T+N f is EZ:�(rx) 11.? s {
m mat he Is exeniot th�iafmm end the basis for the ellejel egemptl0h.Any violation
-of Satiem7031.5 by any.,i licans fora permit s.hj.,s the applicant toe civil penalty- r-
lofnatmore than fivahundxadollen(SSW). Number th'ol r'i0 Occupancy Type
❑1,as owner ofine property,or my employees with wages as their sole compensation, 1
will do mewoh,aoicons sde:The s-noflmended'in ense eredLaw wasor sale(See:70i1-
'Bhsineof frmpri y Who
Code:The Coeidtor s,dad w law does oat apply to an 102 - PIERS Required Inspections
owner of property Who builds or i provided
that
such improvements and who encs such work need or
or through his own employees.provided mat such ii-o.lare not intended or 103 - UFER '
Igotple'for sale:Tthowaild',he will Wildingorides finemn stop,he did one year of 104 - REBAR '•'"•„° '�' ':-'�''�+��: '•'�
complsion,the owner-builder will have the W Nen of proving that he did not Wild or {"
Improve for purpnxofsale.). 105 - ANCHOR BOLTS _
OI sowntt Doth p(Sm.7 m Business
ss and Pmcssime;Codc:)xdcommsmsm SOb SEWER & WATER - •1. I' I' t I-ISS' -
'Li w t the project Iappl to a owners dna Prty,%he s Code)The Contractor's 2 02 - UNDERFLOOR PLUMBING
Lrecme law doe not apply to an owner of property,who Wilds or tmPmvn thcsean,
i; _.ond_whv convacb.(orsuch.Prolass wire e.contssator(x),Iice,uea_pursuam.m.t�e -__..._—..2-03--=--UNI.DERFLi00R"'-ME CHAN I-CAL—"---'--------""'-'---'—"
C tractor License law
y - 0 aemryunde, so " r''` 1 " '+F "' isikf thistrzsun 204 - UNDERFLOOR°IFRAME!""'
Owner 'fiat 205 - UNDERFLOOR INSULATION
WORKER SCOMPENSATION DECLARATION _ 301 - ROUGH PLUMBING
Ihercby ofTvm under pewhy,of peijuij'&ii ofthe following declamtionsr— 302 - TUB & OR SHOWER
L 1 hiss and'will''mainiuin e'fcriificaie'orcnns2m io self unions for WoskttS 3 03 - ROUGH MECHANICAL
Compensation; as,pmeided-far by Section 37W-of the Lak, Cade, for the
pesfosmaree dome work•mr which mis,pemt�ijshsund.l.i`, 304 - ROUGH ELECTRICAL
❑1 ha s a d 11 m a ompens qo 1 rt e a'mqu red hySect n 3(]5 - FRAME
q e P tfie ark for which th a u 3 0 6 - HOLDOWNS
-, Is6 Wi M Wa,eorks C m ens n u n ecurt Ontl Pol¢ L bar r" '. -._.. -TY, .-L-YS`_�RT•,
a start q ars
3700 of th Wb r C' f she r(
lama~� sPPol ey O- a.O v 30T7� �
INSULATION ONe' 1
• f 2f,s I ICA 10 OF EXEM ION ROM WORKBR$�l' j.i.: W ►3°OB :g SHE ETROCK' ` {'-
COMPENSATION INSURANCES b �-q 1"-------3
__
dollars _ -•----V`
' 30'9 EXTERIOR'liATH �L✓,II'r (;ca: ru:, I`yrsr.
c
-''••r'(rhts acctlon need not be compiniNv (the permit is for one hundred \' { )• s
(sIW) 1 ) r
310 - INTERIOR LATH ; ,
. , y Pe pefm Ia Wiied'1 ill._.i fl• ')Cdlts.n)r Zt.' I:
6Fill n t rept v a y per on in ny roil erl m to tiecome s bJ's t m workers 313 - ROOF NAI�f"'t I '
co phsalio'awaorCmu ..oqe .501-------FINAL--ELECTRICAL--ENERGY__. __. _._
..Apphcdnt .. _ __ _
INOPICETj AdmdbCANTIf Crumpeakt gthsCisrurts. umptbn', hold ""' ] f'C••'^•B "t
Z bac nes bl Atom W k r Comps sat Pro -finelabor Combyou t 502 - FINAL PLUMBING ENERGY
O O rens m reply with h pro o th Permit shall be domed tra MECHAN I CAL...ENERGY
CONSTRUCTIONLENDINGAGENCY 504 - FINAL BUILDING ENERGY
by affirm lh nh sseconsWcticonstruction dt gagencY fm the performance
nim work for hichth prmlrasaid(s 3007;Civ C) �n' 505 - FINAL ELECTRICAL
-"506 - GAS TEST ! b — --_..__._..... _.: ...._...
L<nde sAddms I' f
U-Q 1 1.1.compertadths city an to emus...eaW ,.law.nonxx 507 - FINAL PLUMBING
0.,Qto
bidding
id 1 gra t comply With cb tut and count'ordinances aM stat I relining 508 - FINAL MECHANICAL
O.0 to Wdmngc trusion adfi rtnya thourize ripTaiinnifivis of this city mcomer upon
} fa7 theaWve esu d,propenylr pecrmnparppxa ,. 509 - FINAL GRADE
r" dI (W) gree ave dmnifyandtrichamilcst theCryofepent oagainst -
LL�� m
liabilities,judgments,_ oxo dna expense,which m y �y y me against raid 51 FINAL L ING
U'.7J. City m cons q nbe t hhe gran ing of th s pc it. - p
AIBP FN N STAY ANDW Lt017PLYWLTH'ALLNU4.P0{ "' .%14 F A WORKS
R A a q ,;Z Issued y: Date
a reofA 1 nim tb: :�� .;.. t: ,. ate '• Re-roofs '
IAYABDOUS MATERIALS DISCLOSURE- \ r sr i
,;,` Wll the applicant rf tore Wilding acuPon,itae or haMle hvanlous material
-.._Type of Roof. —
as delated by me C pen no Mum teal Code Ch pt 9 12 aM the H alth andSafety
Cotl S u p 3p51 1 1 r •c r r, rs 1, +)`t S l'r! F f JT r 1-'s :s M 6 - .-._ `. U tL .l -
., ❑Ys i aA1S '' I N( 1 ,
roofs shall be inspected prior.to.any.roofing.material
-being
,a^^, Wnith pph,urea fm budding acupa t se cq p t d es hick
cm th b elr comammen[sar Defined by th<Bay ArteA rQuahry Me'nagetnent If a roof is ins[alled'withbut firs[obtaining an ibspeehoti;'I'agreeao remove
ontnct b , t . x _ all new materials for inspection Apphcant understands and will Co_mpl_ywith
.';R ❑vu''t,f.,„�hUp� r ” ` ' ' `: .. i : _•1, - 'all non-point source regulanons.:oatr d f:) t.7�d1, r. n•' : .
1 ha a reed m haaallo s'm evils regwmmenti'u der Chapter fi.93.d the
Deco en{of me re vi ms wh¢h roust he met io Sand 353341 derstandmu _ ,,!- _. _
Celaom sHealtn k'Safety Cod genion 55033557
tf the bu ltlingd es not arrtndy ha set n t porn smy po stilily mnmay the' "�'--"-
L nl p ssmnce ofla[etti0c teM �' �I
p q ant 11 i pOL d Z Signature of pphcant at
ancy , ,i�'� ✓ -
wnrrq anm g All roof coverings to be Class,"B" of better al`
OFFICE---
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