00090182 cf BUILD' G DPERONrIo RMIT CONTRACTOR INFORMATION: -
PE
BUILIBNGADDRESS: ' " PERMIT NO.
INTER ROOFING INC 000907.82
OWNER'S NAME: - - APPLICATION SUB DATG
151 WYANDOTTE DR' 09/29/2000
NE: SANITARY NO. 'CONTROL.NO4W 40A 363RO 52 .
u
MOO ARCH)FECTIE.NGINHER: - BUILDING PERMIT INTO
' a — BLDG 'ELECT PLUMB MECH
L=1 CI I� UJ
S H3 LICENSED CONTRACTOR'S DECLARATION lob Description
0 1h fiy flans Ili II ran licereadmado,owmar,int'CI ,h 9 boarmuncring
E, CrywilmSection7000)HIfivisame l AftheBadcssaddlmf ssia Cd dory liansc
a 'sinfilf deffet -
a!u I:IrnsaasSeal Leu_.�_,1d`G9�' WOOD SHAKES- TO SHINGLEC$y`,
3 i Dmc &/_I+ . ad a,PuAuer - I
ARCHITECT'S DECLARATION
1 uWemmnd my plans shrill by used ds blic recnnh
Y
' c4�00 Licensed P1.. 1 /1
OWNER BUILDER DECLARATIONM to
I batch,v( II ala iness nl11 Cntot 1' ctyo come 4/ y�`QIWYp—
�>jQ toll g nr5oer 901158 ." 11 Possums 1.A) n county
SSC
Much rc9 P also 10 pp D demolish,tP i Ystructure
a. aria I t e n I pr ki If nPermitI ic g astatement
main licensed I tt 0 p o. nn Commuters License L ICI ode) ,Sq. FL Floor AreacommVal ion
or
he
'th Sectsn700()n to basinoofihelege exendionhes'one Cnde)
or That he is exempt Therefrom and the naris for the vllegcd'exentptinn.Aby vlolmion
of Sedicn 9031 5 by any applicvm for a ponnit suhjnp the vPPllcum m u ovit Penalty _
ant m r h d rid n .Isvro) APN Number — Occupancy Type
-ol ,: ftl p I tY Y employee,wYh wagesasthat, emopematinh 2 O
will J thek and-the I I I Iintended r ,Re eJ (Sec.7044 - -
Bus and Professions coda.The Contractor's cense L J t apply to an Required Inspections
- r of property Who heilJs or improves thereon,and who does such work himself ,
or through lh+owe employees.provided that such improvements are not intended or 303 — FRAME
offered fur.vale.If,however the building or impro,chane is sold within be year of -
rumple don.the nwm-bmlder willImordw burden ofaroving that hedid nrnhand"r 307 — INSULATION -
mprtwefor purpoveor,aleJ. 601 — ROOF TEAR OFF
❑1,as owner of the property,am exclusively contracting w',In licenwd contmemrs m
construe,the project flee.7044,Badness and Profooim a Coded The Contractor', 602 .— ROOF PLYWOOD NAI L
License Law doei not apply m,an owner ofproperty who build,or improves thereon, '
and who anmraat, for,nen praja.,wild a comrnm(s)licensed parmart to me 603 — ROOF BATTENS '
lrxpuordsco ameento .' ,B&PCfnr this reason 6fih4- — ROOF IN—PROGRESS
Owner Data
WORKER'S COMPENSATION DECLARATION' - -
1 hereby affirm under penalty of parjury one of the following Jeclarabotts:
i I have and will maintain e Cenifmm of Consent to self-insure for Worker's
Connption . , as provided for by Section 3700 of the ]..he, Cale, for the '-
performance of the work for which this permit is issued. ,
r/�,I rod and will maintain Wmkcds Compensation Insurance,as required by Section
700 of the Labor Cade,for the performance of the work for which this permit is
Issued My Workers Compensation Insurance carrier and Policy number are: '
Carzier:_SPolicy No.: 14Y
r PI A ( EXEMPTION pi( I WORKERS' -
COMPENSATION INSURANCE
(This section need no,he completed it We pm'mit is for one hundred dollms
ISI W)or lees.)
1 artily that in the performance of the work fur which this pixmit is Issued,I ,
,hull col employ any person in any manner so as to herons,,abject ,,the Workers' -
Compomudon Laws of C9lifnmin.Data `
A ffiicunt a _
NOTICE TO APPLICANT It,after making this Certificate of Exemption,you amaN
become subject to he Worker,Compensation precisions of the Lubar Code,you must -
Q fonnwild comply with seen Pori ur this permit shall be deemed revoked
F 71 ''• CONSTRUCHON L[NIDING AGENCY -
1 touchy affrm that there is a amemamimi leading agency far the performance
of the .,it for which this permit is issued(Sec.3097,Cie.CJ - - -
a A Lender',Name _ _ -
.� Lender's Address
V 0 I coni fy that l have read lhi sapplicair.and ebue shat the above mf heard is
correct.1 agree to eons with affeit d eonm eminences and state laws nation
g ding n curably wi al an y n g
f,) tto he absee-mentioned
properyhereby far
represcnwtives of this city mercer span
the ah a to g ed p p ty f I .acct p p es.
�.a t4 We) gee los "ndem ly u keep horny in the va of ,bac e,ri against - •t
Ft rn Cab Il ) dg net.,coa d pen s h h y In a wry ccrue ago nest said
Clry'n t q cal thman,io thi pro
• -
SOPI ANRTTO D 5 DSA OMPLYWITHALLNON INT Issued by: _ Date• ^Ori
St at r f ppllc' C a a, Re-roofs
A RDOUS IONI'ERIALS DISCLE URE
Will the applicant or fund building occupant side or handle hc,indoux material Type of Roof
)Sea,
ea by the Cupenino'Municipvl Cnde,Chapter 9.12,and aha Ifeahh and Safety ' ,
C e,SaGnn 255R(a)7 - .
Dues • � All roofs shall be inspected prior to any roofing material being installed.
WilrmeappnaanIorheard builiflew,pualuse b,efpmemoraevice,whien If a roof is installed without first obtaining an inspection, I agree to remove
rani,hawed..,air conmne
mmaate u,deflJ by the Bay Area Ali m
Quality Management
>I,tHetores. - - ;, - all new materials for fnspectio r. Applicant understands and will comply with
(I all non- dint source re ulaf
n
I have read We hcm.Hhm, mteriuh reyulretnentx antler Chap¢r 695 firms, - t
Callfamia Hwllh&Safety Code,Se ions 25505,25533 and 25534.1 understand(hut
IRhehui Wingdoes not currently lin alenanl,that it is my responsibility mnatifythe
cepa i of he regeiremems wh ext bet prior m tethered of a Ceniliam it
Oar ncy. '
Si a e o Applica Date'
antro e a �' All roof coverings to be Class "B" or better '
OFFICE