01100029CITYBUILDING DI ESIONNOPERMIT
CONTRACTOR INFORMATION:
Bu'i'D1YtP31thMITE LOOP
PERMIT NO. 01100029
O"AppLAEE COMPUTER (AT&T SERVICES)
APJ_6A7Ibl Sr2ttTb1
PHONE:
SANITARY NO. CONTROL N0.
z ARCHITECT/ENGINEER:
O
BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
I herebyarrLICENSED
IamO end od Rprovuons DECLARATION
f Chin'tcr9 kommcncing
Section 10001 Divi 'n Jnone easiness Professions
Job Description
TI & ANTENNIA
with or aha Code. and my license
License
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v AHCHITECr'S UGCLARATI�IQ�
g 1 uWersmne my plans shall he uud a, public recoNs
MAR 2 9 2002
OLicensed Professional
BUILDERDECLARATION
by affirm that Iaexemptr tit Contractor T for
m<D
toll ag .leer 70315Besa dI f.i Code ,AryCity ommiry
BUILDING
witch requires p<mt to Cn EhrappotOC, derry0loh. Or p Y strocron,
610000
'1
statement
trio tolscensede .unto toalso res the ovisio sot for inch Commum s Licefile nse Law
— thmheiioicgwith ection700B, the ofpitns°ftheCeBusinesLiaenulawonalsC
Sq. Ft. Floor Area,•-
Valuation
d
kommencingwith Section ornan°�he bsisor the ,temp Professions Cod c)
or that he is exempt therefrom and the basis for the olleged exemption. Any violaion
)
31602 1 5 (]
'-of Section 7031.5 by my applicant fora permit subjects the applicant to a civil penalty
Of not more than five hundred dollars ($500).
APN Number
... Occupancy Type
D 1, as,Ofdo, pmm
py, or my employees with wage: ax their :ole compersohm.
101 — FOUNDATION
will do lar work, and the e0unme is not intended or offered for sale (sec. 704,
Business and Professions Code: The Contractor's License Law does not apply to an
1 J 2 —Required Inspections '
owner of property Who builds or improves thereon, and who does such work himself
10 3 - UFER
or through his own employee,. pmv,ded in., s p mems arc not or
.. -1'04-..-..REBAR ..... ._.... _...._ ....,. _.-. .... _. _
Offered for ,.le weer builder he bn'yvet prn,emeurx anal within.6.yearof...
' 6. year
ompvelfor,hc ownerfbuiieJ,r will haw the hvNcn of proving that he Did not build or
105 - ANCHOR BOLTS
improve purpose o
-
-with
._.._ ... 106 ---SEWER .&_.WATER ... - --..
to
D L as per of the p(Sec.mp�Y. am exclusBusiness andcontractingProfessions
lice:) The Contractor's
construct
t:
202 - UNDERFLOOR PLUMBING
hobendorTheContmemr'a
License Law toes nO, atply man owner of property who bones se'Impmves thereon.
r and wba.mommmrs rae.xumh pmjemu with., mummmtor(x) licensed pursuant e. the
-
_.. _ ..... 2 03..r.-. UNDERFLOOR. MECHANICAL .......... .... _ ..... _._ ......_...
Cnntmctor'x Llccnsc Low. '204
D l am exempt under Sec.' ,B&P C for his reason
- UNDERFLOOR FRAME,.:
1
- UNDERFLOOR INSULATION
owner" Dole205
WORKER'S COMPENSATION DECLARATION
301 — ROUGH PLUMBING
I hereby air,. ander nenully or ,jury on, of 'he following denmmdnns:
3 02 - TUB & OR SHOWER
D 1 have and will'malbmin a Certificate of Consent to sdl:inmre fm Worker's
303 ROUGH MECHANICAL t
Compensation, as provided for by Section 3700 of the Labor Code, for the
_
304 ROUGH ELECTRICAL
performance of the work far which this permit is issued.
305 - FRAME
D 1 have and will maintain Worker's Compensation Insurance, as required by Section
3700 of the Labor Code, It,, the P ,formanC. of the wofk,for which this ptnnit is
306 - HOLDOWNS
'C issuer My Worker's CO'CluallmiCal Insurance terrier and Policy number are
Came ll�TfS:-i:
307... -..INSULATION
h PohcyNn"37�
308 '-1 SHEETROCK
r CERTIFICATIONOF FROM WORKERS
'
COMPENSATION
. ON 1rysuRANCE
_.. _........ _ 3.0.9.... _. EXTERIOR__LATH ......__ _ _ ... ._
(This section neednnl he c,impletel if the permit is for one hundred dollar,
310" - 'INTERIOR LATH
,.--.. 1:311. _ .,SCRATCH.. COAT
I'scriff, that in the farfammorce Of the work for which this pemit Is issued 1
313 - ROOF NAIL:, • 1 ':'t
shall not employ any person in any manner so as a become subject to the mi
Work'
Comte t, n�m.afClif°mia,Date
501 - FINAL ELECTRICAL ENERGY
Applicant _ _
.NOTICE IOAjPueANrIf, foe makingh'.('nT t rL ,ti n. yousmam
.__ .. .. .. ... _... .._..
502 - FINAL PLUMBING ENERGY -
becturne sobjtact to the Worker Compensation p o isioms Of tit Labor Code, you Coast
forthwith Comply with such provisions or this arromil shall he deemed revoked.
5 03 - FINAL MECHANICAL ENERGY
-CONSTRUCTION LENDING AGENCY
504" - -FINAL BUILDING ENERGY.,: 7 --
" I hereby aRnn that Chert is a consaumim leading agency for the paro7ance
5 05 - FINAL ELECTRICAL '
f rit k for which thisn is issued (S 3097, Civ. C) "
ofNme ° �
p
.506 ---.. GAS -TEST- ..-.....
Leader Ald,ess
507 - FINAL PLUMBING .. '
1 minty that 1 have read this application end stat, Nat the above infemmian is
508 - FINAL MECHANICAL
contact. 1 agree to comply with all cry and county ordinances and state laws relating
o building Construction, and hereby authorize representatives of this city to Intel upon
509 - FINAL GRADE
9 the eb°vbmemi°ned property fm mspeclion Dartoses.
cto save' "Fee mniryand keep harmlmi;the City ofCnpeoiri°s'ain't
(J�EGUIF,�7
510 - FINAL PLANNING
I. liabilitieems, cn anJ ex noes hvh mny,in any way accrve against said
Ciry in nceo greni of0 pcimit.'
N WORKS
a-APPLICDF AV 'AND rILL CO\1PLt'N'ITHALI NO': -POINT
SOUR
Issued by: Date
6 I
sig. rmnrAppman"C°mrama ,, ., Dme;
Re -roofs
HAZARDO S MATERIALS DISCLOSURE ,
'; W II rite ppf<a t r f Wilding oecupam state m handl hmardous matenal
'as
._..
_ Type Of ROOF. .... --
d by the Cupen c pat Code Chapter 9 12, and the Health and Safety
,
: sce
Cdde,ScY,,, 5321e) t- _ r Y' ._.) ..
. ❑rex - -•t..''.•'..
,' ,
All roofs shall. be-inspected.prior, to roofing material.being.installed..
' Will m ppl , future building occupant- use equipment deices which
mit
-any __
If a roof is installed without first obtaining an inspection;'I agreedo remove
I I ) y e y nagement
Dist
`. a
nreC
all new materials for inspection. Applicant "
P PP. nt understands and will comply with
DY l�' °
v
all non pro souice regulations.
1 have lead the hez5rdous materials rcmentru air cna asMe
q M .95 or the
Califomua Health & Safety COde; tions 25505.25533 and 25534: 1 understand that
lY tl es rtm e h is my responsibility if to Corf he
Ifilrc,ll
y, o
nccup nt f t 'eq' ire h muni I'll., to ixx cc °r Ce team of
Fit c
V
orae n / -
///e
6te
Signature of Applicant Date
All roof coverings to be Class "B" or better '
nr authonxa agent
L
OFFICE -