02020061at
CITYILDING
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DrnsiONNO
PERMIT
-CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
02020061
OWNER'S NAME:
APPLICATION SUB DATE
EBERHARDT DAVID H AND LORETA
10570 S DEANZA BLVD
02/19/2002
PHONE:
SANITARY NO. CONTROL NO.
(408) 861-9545
ARCHI TECT/ENGINEER:
O
BUILDING PERMIT INFO
F
BLDG ELECT PLUMB MF.CH
u
LICENSED CONT0.d S DECLARATION
Job Description
1 hereby affirm that 1 am licenses under provisions of Chapter 9 (commencing
under
with Senforceando(pivision3of the Business endProfessions Cole.poem license
Isinfull r°reeana{R
REMOVE/REPLACE EXISTING FURNACE
License Class-_ L6
Can,is
Dat /'/' Commctar
CHITECT'S DECLARA ON
understunJ my plans shall be used as public recnNs
Professional
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt Pram the Commenia i License Law for the
lta ny city Y
hinquires a Permtion'contra t, alter,
whichreq requires Permit to a lirunprovedemBlt
prove, demolish,ore
or o anyswnure
stocco
$4156
—which
re&
tol'a Is qureth pplicnnl for such perosiun ltleastgned statement
t a sig
_ . _ _....
T is
s of
'fj
temorrea licensed twmn71t
5q FG Floor`6-t10 a*,. -
Valuation
)o 3 ftheBuaor.LmenselnwonsCo e)
Professions Code)
m iie th Scctn ]000)ofDivision ooRhe149ca
or
of tam he
{ ,
�,S-i*a,T iS36'932026[IO Qfx cl s,tt'i,Y�['1L:
chori vi
7 ex03 LS b thert(rom'and or .perm for the subjects th d eiffirr .n a m violation
,..of
aSW). ubj«tin the nppbeantm.clue penmtr..
notSectionoe thnganydred dollars
mfnOtmprctnannenanareaaanara(ssaon
APN Number
!w t,�':'e0 Occupancy Type
301 - ROUGH PLUMBI
G'
Cl 1 r property, ormy employees with wages their inion,
;
w work. loose (Siw:
oared Tor sale lSec.
"Bill do hetk- t d ihe structure is nor intended Or.1
"' -- -- '— - - -
m s and W ou Code The Contractor's License
tir s License Law Joss tut apply m un
to ad
hon$ '•
caner of hides or fl
thereon, and who encs such wink himself
304 - ROUGH E
_;.1his ow em sided is
othroughH own employees. pro den that himprovementstone
-eowner
__ ..GAGE__. 505-----F-I NAL --ELECTRICAL-------
cote cdfra its la year
tfiebhavet of
'" "—". ..—.,_-,.
, %, f 2"•' ._...
completion the owner-buJderxAl have the huNen of proving thin he aid not builder
burden ed build er
507 - FINAL PLUMBING'
Improvefor purpose of sided.
FINAL._MECHANICAL-
p 1 as owner of the Property, am exclusively contracting with licensed commetans to—
_
con d , ,h p .ject (Sec 7000 Bus nes ad Profe s Cadc,) The C ntraunr's
License Lew does not apply to an owner of property who builds or improves thereon,
" '1' 1+
.und who contractsfor.such projeen.witM1 a.commuctoosl licensed.putsuent to the.
..... _._.. — _ _. __..... ... ...-. '. ._... ._ ._......
Contractors License La
"f`t-',
_.__._.. __.. __.
�pp
❑Inmexempt undcrSc Bek PCfonhurtssan
r'-
WORKER'S COMPENSATION DECLARATION
F1Ul]
AUG sx 2002
I hcmby affirm underpemjiy of perjufy orie. of the following declarations:
❑ 1 have and'will'meinuin'a-Cenificaie'of Conxm msell-insure for Wmkeri
Compensation, as provided for by 'Section 3700 of the Labor Code --for the
BUILDING
performance of the work for which this permit is issued.
01 have end will maimud Work,ex Compensationlnsmtinci, as «gtlimd ey Section
W of the Mbar Code for the performance of the wrirl, fee which this permit is
s�d My rke n'Co p n alt n, 1 ru c me Policy number urc
sand
Pidic
t
�I 5
C�TIPI ATO OFbxcnrr IO FROMWOR SKER { "'
Q_-,, I &t.tt:: i t! eti9 \F Y " If i� Is
"' OM
CPENSATIONINSURANCL' r
..
unio`n'n2ed naalbeeompleleE if the permit is for one hundred dollars
....
a•f.`. :`U.^:i'.'1' 's_"'•.M1 %+Ct^I(t;:: ;.; -tr
'
(Sl Oel or less.).
, hi ! 1 pthat p rf emu < f The- work To which d petro t issued,'l
.. - ..
v
person
shill no(employ cerLies person m a . are as to .eco; % subject to he Workers
U once; so e
Lnws of Coli ate,""'" ''
,, 11 f . jy, i. t .::
-
Applicant .,a'
should
NOTICETOalatheANTifafmrmakinion Lesions ofExemption,Labor
restore the Workers CompsnuuOn Provisions fine r Coes, you mus
ode,y d"t
forthwith comply with such provisions or this permit shall be deemW mvokW.
comply rma
_.._-.._._CT
'CONSTRUCTIONLENDINGAGENCY' "'nn "
:, I•.
' I h rice alh,,m that th t 's csnsuua - lending agenty far t.e perfoni:ence'
t� , . .,
e
of ih o k for hick th pe tin -ed (Se'? 3097 Civ. C )
.. Leader's N me - •. ,,.._ .,.... _:.u,.. -.:...._a 1 ..
_.__. ... -, ._. GAGE _. _. -.. _. ..
Lepd Aedrei ,
1 certify Nat I have mad this application and state that the above information is
c`oiieci: 1 agme to comply with dl city did,counry, ordinances end sum laws relating
to building conswction, and hereby emhorize rcpresemetives of thii city to enter upon
the eb a me t nee property fo pection p rp
(wej -pica til save'tnd molly and keep hurmlca3 the C ly of CLpenmo egatmt
liab,bues �g ms, cost and expenses wh¢h meyi any ay azcme against said
City c Bence bf Neg m fNii permit
'�
yAND$ WYLL COMPLY'R7TH IOt O.
$dCEN
Issued by: D
fUNDErt
e
Sign tun o App cwVCommcto -' - Dat �'
z74
Re -roofs
HAZARDO S I IA 1 S D SCLOSU
A.ac
t 11 eeppl'c morfututhy ldinp oc tort or. odic hazard material
Type.of Roof -
?S d Safer
Cfaefi ed y th C pen no M et Coe ChaPmr 9 12 nJ th H hh an
e 5 m on 255321a) a jF 4'
❑Ye t ry ; 1 t j..' I' ]
-
T ant l Ib'ix 111 1 il)
be
f P'
• will thee i.,ft {rre_ ld' 5•W •.
'•, P �cn^ g egmpmemo d ce mm�
hazallous
_All_inof� shall inspected poor to any., roof ng material being installed.
_ -—.....__._.
If a roof is installed without first obtainingan ins ection; Fagree to remove
P g
emit it he
air notnnmmws defined by the Bay Aria Av Qualify Management
Dismet ..
all new materials for inspection.. Applicant understands and will comply with
- ..
Y in N° ': f ' I
r
. - _. . _ . _._. ..,. -�-
all non -point source'Yegulahons.'
d'ihe, hazardod erials q iremetns onder.Chapter 693 of the
I .t „
Culi(orma Health & Sefny Codr; Sia ons 2550525533 end 255.14.I understand that
-
ifihcb.ildi does not currently have atenant that it is my responsibility to notify the
-bi'cupam
t gdiremenu h e hs M t pct r u c f a C mfcne of
Oaupanc ..
N,
Signature of Applicant Date
All roof coverings to be Class ' B or better
vvperlo t ozed ag ntD,;e,
I ,
FFICE-'-