01070006 CI ouDI
BUILDING
t DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT
01070006
21845 HYANNISPORT DR
o A U— TON SUB DATE
MEI 07703/2001
PHONE: SANITARY NO. CONTROL NO.
C-0a ARCHITEC(ENGINEER: BUILDING PERMIT INFO
s w F BLDG ELECT PLUMB MECH
,aa
y" LICENSED CONTRACTOR'S DECLARATION
z y z 1 hereby arum,that I am h«nsed under Job Description
O Z—❑ Y provisions of ns Code 9(commencing
with Section 7000)effect.Division Buttress and Pofcssihns Cole,and my license ADDITION 200 SQ. FT.
m y U
is full force nnJ effect.
z a License Class Lip,k
aF5 O a O Date S DECLARATION
/
5 LL O�n
ARCHITECT'S be tried
DECLARATION
N aj I understand my plans shall be used as public records
ta
wO Licensed Professional
n MOWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from me Contmctor's License Law rot the I
FS?< following reason.(Section 7031.5.Business and Professions Code:Any city or counsy G'2 0 0 0 0
3 2 D which requirea permit to construct,ahcq improve,demolish,or repair any structureY
requires theappliunt for such permit m Bka siplaxishommanott
that heferma iraing it pSection 7")
cpf Diimas ision me Con tactors rodPelswors Cord ry a Valuation
fc that he is exam Section om and t e basis
t ec Businessromp Professions Code) `•i�L'd_','3 5 i 0 �N.,�Q';T211. 'i'
or thathe7exempt ncertfiomanefiebasisformectshdommptioo 0Any
coil
'
of Section 7031.5 by any dre dollforapermit subjects the applicam r°acivil penalty
or nm mom can Ese hundred dollars S5010), 101AP-NAIF1I)N Occupancy Type
�7 as owner of the propeny,or my employees with wages as their sole compensation, `
- i'do the work,and the structure is not-intended or offered for sale(sec.7044,
Bus103 - UFER Required Inspections `
Dominant,and Professions Code:The C.Moremr's License Law does not apply man
owner of Motherly Who builds or improves thereon,and who does such work himself 104 — REBAR I _
or though his own employees.provided that such improvements am not intended or _
offered for sale If,however,the bu leng or impront
vemes sold withn one yea,of _ 10 5 - ANCHOR BOLTS -
ema,leion the owactbuilder will nas=mehumenmm
of 106 - SEWER & WATER
improve for puryose flat,,)
`X 1;b pmPeb,amesem5 elY -t rigwdnicensed1conta«6r,to 202.._.._ .UNDERFLOOR "PLUMBING . .. .
t t me project(see 7144 Bus e s e Professions
coda)The
Contractor's
2 03 — UNDERFLOOR MECHANICAL
License Law does not apply to an owner of property who builds or' port thereon
-and who commas for such pojems with a contractors) licensed pumunnt to me 2 04.- _ UNDERFLOOR FRAME- -
Characters License Law.
❑lam exempt Order sap" .B&P C for this reason 205 — UNDERFLOOR INSULATION
o' ae (—o} 301 ROUGH PLUMBING
A -:
WOR COMPENSATIONON
302 — TUB & OR SHOWER
_,• IhcrcbyaRrm derpenayhfpajury,opeonnprmhiwmgdename°"s: 303 — ROUGH MECHANICAL
0 I have and will maintain a Certificate Of Consent to self insure for Workers 3 04 — ROUGH ELECTRICAL
Compensation, as provided for by Section Slop of the labor-Calc, for the
performance Of the work for which this pemti,is issued. 3 05 — FRAME
01 have.ad will maintain workers Compensation Iasumncc.as required by Session 306 - HOLDOWNS
3700 of ma Indoor Code.for the performance of the work ter which his permit is
307issued.MYWalk cs ComenInsce arier - INSULATIONmc
.•__,
308 "—' SHEETROCK"' '
Cense r i CERTIFICATION OF EXEMPolicPTION FROM WORKERS IJ. : s •a S
COMPENSATION,INSURANCE'• 309 - ERTBRIOR LATH
--"310 -INTERIOR-LATH
(Thssecu°n need am be cnmplaed if the permit is for one hundred dollars 311 — SCRATCH COAT -
(SHO)or less 1
"313 '— ROOF NAIL'
• 1 can fY tl t n it p f an<e f the k f h h m tit � � �
asron=cn 501 — FINAL ELECTRICAL'SENERGY
sh II t cm, y'a y th m an,m j
qmPen inn Laws Icmrrgnr Dai tib Mm Renew kis' .. --. .502_ FINAL_PLUMBING ENERGY. .. - -
O no.
NDTICFTa,APPLICANT it atmrmak gmsc rtu fExempu r.ynushbad 503 - FINAL MECHANICAL -ENERGY
became
e a m e. bjcct m the W ke C pen ti n p has of the Lm Cwle,you amt
Q z 'fo th m uply with h p ns o th' Permit
shall be d J voked.
4,2 .. _ ... . . .. . . . . . . _ ._ . .. .. -._. ... 504- FINAL . BUILDING -ENERGY..
CONSTRUCINON LENDING AGENCY SOS — FINAL ELECTRICAL
I hertpy atprm that them is dcobfwaion latding agency for the perfommnce
'Of me walk far worn this penhit is issuod(See.3097,Civ,c,) , _ 506 - GAS TEST +
Lenders m
Nae - 507 — FINAL PLUMBING.
-L 'LcnddsAddn:xs
v O 1 m;ary that 1 have rand inns apprcadoa and sate tear me abeve ins°rmoaon is 508 — FINAL MECHANICAL
ii tr cones.1 agree to comply with all city and county ordinances and state laws miming 509 — FINAL GRADE
" :0 (> to building cunswceon.end hereby authorize represematives of this city to cmer.,M
�..W Ins bo _ } neJ p.,hyf .,.,,i nth rpo:s. 510 — FINAL PLANNING
F a s =lin. aindemnifyaekepea ks.tn City ofeycnhinagairan 514 — FINAL PUBLIC WORKS
Vi liabilities.injudgments, l:and pens h ch vin anY )archon,ago nit saes
LV y Cry consequence fStheTAgat AND
ih part. ,.`
SOURCE EGULTIIONSNDSANOWILLCOMPLYWITHALLNONPOINT Issued by: Date~ (J
Sig atf Applicint/Comr ao' Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will b ppl'cnat rrtom huild,g occonerat Oorenh Jl hmNus m,ni ,.'rypC Of=ROOf - o... .. ... -. _. . .
a.defined by the Glprt OM cpJlC de Ch pt 9.12 and the lleehanf Safety ,. i
Code Scuut25511 1 ':i 'D No �'1 ( J I' i I'.n,, ; "Y +>la of 4p�.1 1,�,''q ..... .
0r . . r I 1 _-All roofs.shall bedrispected pnor_to•any roofing.material being installed._
Will the appu«arr future building httupent use equipment ord Hn which If a roof is installed without first obtaining an inspection,Iagree to remove
'e, rhazardous hir cntammams as define by the Bay Area Air Quality Management
D r st' -,.. all new materials for inspection., Applicant,under_stands and will comply with
oY"' `' - qN° " - all non-point source regulations., ,, ,
I have mad the huealloas mmmials requirements under Chapter 6.95 OLthe "
California Health&Safety Code.Sections 25505,25533 and 25534.1 understand that
ifthe building dins not cundntly have a tenant that it is my rtsponsibiliiym nmify the - -
m -
cupant of he requirements which must be met prior 10 issuance of z Certificate of
cuWncY,
Signature of Applicant _ ._ _ , - _ - ., _ Date_
cpvnrrm
_._ .
aumndzed 'Date All roof coverings to be Class sB"or better
,' .. . .... .._ OFFICE .