02020014 amt otyouPFRTINo"„ " CONTRACTOR INFORMATION ,
ITY OFC
mvtstoN a;°I ;. t, pPERMIT';'. -
BUILDINGADDRESS -
'
- ', _._. __ .. '_..... PERM .... .. ..
f r41s N0.
^ OWNERSNAME:J` ,• — ! - - - -. .., i = •'s=- -- _ '. .. _. APPLICATION SUB DATE
s Y, . . .. .. _ _ _ _ .._ _ - .. . .._
A.
,TAYLOR- WOODROW 'HOMES' r`i'7 '62/05/2o62
HONE - ._.. ,. .....
F� SANRARY NO, CONTROL NO.
411 '7
'�`OZ ARCHITECT/EIJGINECR: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
¢O.yi LICENSED CONTRACTOR'S DECLARATION - Job DeSCn non
i,_ +1 hertby amim that 1 am licensee under provisions of Chapter 9(commencing
_yt—:8 wdb SEximi7 0)af Division3 ofihe liglmessiod Proof cssiom Code.antl my license P'
is to fallf«e and elect ,i; DEMO.
.zre 6 Lce CI VLc p 3 S'IC r-(�
i LL LL Dai 1 1.�/�--•'Commit., A. BLDG. 4 CANNERY WAREHOUSE
I
ARCHITECT'S DECLARATION
0,
� 1 L rsmanil my plan shall'he ated as public recoNs
�r
Lensed Prof e.siwal I .ILD ,, - t r t I s u. ri' '.
e ' "a,"am
DECLARATION' - � ,
t 1 herehy aH t thvPl.tm'exetnpt
'a
t.. .e,Contractors License Low In Ne
fNl g ' t'(Secit t""I,'Blnum"",P "e'"o Code Any cry or coumy - ,. .+ ..
wh h requ e o Perm�o c stor"
Phe p d L h or repo r ony suuct
i3 p��rm Iat suance(ul «Rircuhe appit
c ngf csuch pennn tiff g ed trot n t t _ _
NitJ a�I an2d pujsuanl iqthe prd Nio s of the C I mr Lactim
Law
a (Chaps 9 - tSq, F[ Floor Area y - - ahon - -
(co en8wnh•Secnn j7000)of Di'is
n3 Tine Basin selu,i tons Con")
_t.Ll...s
or th s he 13 a its t6ercf did.a on bat"If",
for Ne ulIEgcd Net poo Any violet n „ .
6f5 a n11315 by.1
applies
mforape t h3 t the nppltcam toac vl penalty
..."
of
tn,n« 'I..d en Wambold
nartasw) ' . ... b - ,,:- „_'• 'Occupancy TyPe. ....
l ..,. ... . . .11. l _
,n �� ❑I a net-rill
pmpeny yemployce wtti wagesn n i Ie compensdiio¢
',will dd Jk work:and".'s
ti xtfuemrt i3 dot nttndee or'oHcrte fur sale(Sec']044,` - -- -- -I lOn$ ,t'a'6?S'b -
i
am. a tl`Profas s Cale:.The.Com«nm's Licens LaW does no1'apply to an --- - •
owoer of propeny,Whn builds or improves thereon,and who does such work himself - -
or ill o gh h own employees prow Jed That such p arem t art n s intended r- ear
,q((e d, - IiTCnowever the Wilding or tmprovcmenu -Id iN'money- -'f' -._......_._ _._.. ..._. _. _ _...._ _..____ _.._ _..- _"_ _,.
?
completion,theowner- alder x ill have the bract of that he did no bu ld or '�
imProvef."roseofseleJ.l Proving
-". ext.usiv.:..
.e R �Bi;unwnenaf the propelpropelant udelYcom«ring with licensed contmcmrs to - ----�-- ::!.
mwx the pros o(Sec.704,1,Business and Professions Cade:)The Conthe
License d not apply to an water f progeny who Wilds pravu therrocon,
n,
.an0 who c va u.for inch
projects with a comrucmrls)licensed pursuant to Ne
Connect I License Law B&PC
❑lam pi rider Sec r for Nrs rcnson -
1 . s`
own r as xr /. .
iam
WORKBR S COMPENSATIONIDECLARATION
'i�rl hertby eHrm neer pe ally nftx)ary ate o�the folio ngd 1 tions:' _
❑ 1 Iono,and will arculmin e Cen team of C nsens-to sof—mare far Worker's t
.Compcnsmon 'iTlhe Pmoi ledifo, by,Section 1700 of,t1m L b ,Code;'for the
,pert rmon wIII for, ithih spennt s s d
.;t
h ;
❑1 ha an w II m ntn Worlar.C, p satmn Insara ce r q ed by Section , , y l _
s 00 of the Lih ,C m f tl pe donne of the rk t ht h lh s p rmr is
ins dMpy*W'kerb^rope st nlnmuntt y nu
ea dPlcmherae 15 i
'mHit:g oa.c HIl A.nYf At4rdi6 No J'`1=M U,(
C 6U .-(ZJG
s) yltq TRTIFICATYON OF,EXEMPTION FROM,WORKERS t �. s J' s c iy i� I Il Iia Q i �tl_Ai.l IJ `�
COMPENSATION INSURANCE
I .rftill o I(71us secs tin d n t be c'oI.gles d tf the pc t isf r ate hundtnd dollar i - r' th x�. •r e•' t` „r 11' Y
"h t ($1(10)orte s)
4I C mfy ihef in the Performance bf the work for which sh s a t is istudit 1
shell not employ any person in any manner so as to become subject to the Workers - `JY-`<.+ a.....
Comite it n Laws of Cal fn Data -
IAPpI cant ,: .,. . . __,. . t .
cHOTICBTOAPPLICANr;If.rs dompenter i gthprvisiono of Labor Code:you
t:- '. . :• •' - . '
;Q Qbecome aibjeny the Workers Compensation provisions of the Libor Ce lied.0 must' t
forJiwitti'cotnply with such provisions or this permit shell be deemed rtvoked. '
CONSTRUCTION LENDING AGENCY ° .. •• rl,,.: (__ ... ___ ...__ ._ .
t[FP'-GL�t .
1 hereby Rine that lin a cudswetion lending age cy for the
ae Ner'i Name" this linit issued(Sec.309],Civ:CJ.,;
..l<ndere Niitiea _.y..�._—,•r ...-.,..._.tv. .., t_:.:� _ _• _ _
Z):Z Under'.Adds
1 oirt has I here resid,hi,application and state that the above information I,
W-Ea
cc=1.1 agree to comply with all city and county okinences and state laws relating
U to buildingenst tion and hereby uthonz
representatives Les of Nrs ry(enter upon
;4 pNG bo em n d pat perry f ii peat n pulp..I-
In.
se _ 1
Oa IWe)agrc msave demmfy ane keep harmissineCryofcupenot against
Vi liabilities,judg ms cost and Sxp uses hie may in any y c against d
(� y n c cquence of the g«m g f this peon t
°AP IICANT'UNDflR$TANDS ANIy WILL CDMPLY'WITHIALL NOt� OINT •i t
REGUTiATYO S Is$aed by: r V Date a;•l�f• ft"
Sign t rc fApplmunt/Comhcto ( * ' """ ( ac' 'Re$OOfS • -
n ( a IiAZARDOUS MATERIALS DISCLOSURE{ ars '
y Will Ne appl'cmt future btEbing&cupam store or handle It us,mt 1 Type Of Roofut
-., ..
as d fined by the C4Pcn1 Mun<p I Codc Chapte 9 12 and the H.]N a d 5 f ty'
Codd.SectiEly 235{J2(.)r hl'�tt ` Iji: ��aT(,1i4,}t ! P' 4 I'' t s
L„7„ Al] roofs shall.be inpected poor to any roofing matenalzliem installed.
wnm epplicnot future buldin occupant seequpmentoree «sw!nm - If a roof is installed without first obtainin an'ins eetton„I;a tee td remove
mat hezallous en coin twins m defined by the Bay Area'A Qui(ty Manage I g -P .g ,
, _all new materials for-inspection Apphcan[understands-a ill comply with
(.r .+.m all non-point Source fegui attOflS'
rI havc'rtuli Ne haaardnusfinetedels rcgmrtismnta'tindei Chapter 6.95 of the -
Qmtfom a HeelN&Safety CMe Sextons 25505 25533 and 25534 I dersl tial that:'
if
bulof_t a resnolcusrendyhevcaimans Natant my«sponsbity to notify the' Ys/I// _ - O -' ® -" '- '-'�/r/e`� -- - --
-o&upam of ilial regairtmc Is h ch moat be met poor to issued c of”CeniRcale of "� ( "�"krI esu'ei
r Oe rpmeY e
Signature of Applicant Dat
owe r tr lthout agent to All roof coverings to be Class "B"or better '
A'' .n. r..
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'OFFICE--
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