02050129 CITY
DPEsONO
iNPERMIT CONTRACTOR INFORMATION:
B ALpIN('s(sT'T!NDA VISTA DR WATER HEATERS ONLY PERMIT NO. \02050129
O`TP9,"}"IROYUKI AND HITOSHI 970 E . MAIN ST, SUITE 20n`11 FV sjnT62
Am
PHONE: (415) 566-2209 SANITARY NO. CONTROL NO.
O O ARCHITECT/ENGINHER: - - BUILDING PERMIT INFO
5 wF - BLDG ELECT PLUMB MECH
y a h 1 --1 O C-J L,
��_y=. -LICENSED CONTRACTOR'S DECLARATION
:�' I hereby affirm that l am licensed underprovielons of Chapter9(commencing REPLACE WATER F �1�' RnPhon
-,�C with Section of Division 3 of the B usiness and Professions Code,and my license (40 GALLON GAS)
..in;n ran mise n f t 3 5 7
o 6 License , ` Lit.a
LL LL Daft 3,2
Commewr
ARCHIT[e DECLARA ON
1 understand my plans shall bused used as public records
Y
!V60 Lianxd Professional OWNER-BUILDERex,romDECLARATION
omment
=�w 1 Mass.(Sera,lint 11. exempt o an the Cottons C s License Lata Forms,
?G
following uiresa(Section]O3L5,Has inessand Professions Core.Any city or county 7O0
which requires a permit me.also requirestconstruct,alter,improve,for such
demolish, file
repair any structure
63$ prionoits iumol pursuant to
oithe theapplicantitiocatn far ns of Me Commarmiuofilea,Law(Cmemern - - - -
(commencing
with Sivannto00)of ivisin3ofteBusines ad li law fare Cod) t 1 S- Ft.%Floor , ai Valuation
(commhe i1 tooem Section]0001 othe basis
dw.BgCd ec and PrafAny vi Code? ( 'i j 1,t 6 - � 5 "^'' y
or that is31.5b thyapplianJ the basisfor,bectsthtl dempioo Anyviolation -' 356670 9 . [] '-
-'of Section7031.5vnnyapplicnmforapermit subjects the applicant toarnil Penalty
errant more n,an me htinarm aonnra(sson). APN Number �' 1- ' -' Occupancy Type
❑1,ns the
ortheprogeny, my employeetwithwagesfe,heirsolele See,mtinn,
502 - FINAL PLUMSIN ENERGY
will Business
the work:andthe ode:Tstructure is not intended d of se Lawred'for sale(Sec, to an _
Business end Professions Code:The Contractor's License Lew dos nes apply tom peetions "
through
of pmpeny Who builds or imprnvice of such,mpr who eats such work need at
507 — FINAL P 17V1i
or through his own employees.provided that such improvements within
not intended or
offarab for sale. v hu-b.ild the building or impn mfpm h sold within one year or
p..cion,the owner-builder will hove the burden of proving,lira he did not hWild or "
impfave rat pnHmat nr\ale.).
❑1 as owner of the propene am exclusively contracting with licensed contractors to -FINALE D
Consmct the project(Sec 7014,Business and Professions Code.)The Comm ute's
License Low docs not apply to an owner of property who builds or improves thereon,
.?:. ...and.who comm us,for such.projects.with s).licensed pursuant to We. .. __.- __.__.__.__ .. _ _ _ .. _-.- -.. ---
0
...
antmmaK JUN 1 0 2002
01 m tors d audit Law.
❑lent exempt unser Sec,` � - � ,B�&PCfonhis reason � � ., ' t':f`11
ow r ENS . BUILDING
WORKER'S COMPENSATION DECLARATION
1 hereby off m under petmlty or perjury ane of the following declarations:
° 1 hive acid will maintain a Ceitifcam of Consent to self-insure for Worker's
y Compensation, as,provided for by Section 3700 of the Labor Code, for the
- performance of Nc woA for which this pem,it is issued. '
have and will maintain WorkWs Coint nation Insurance,as required by Section
37W of the Lahor Code,for the performance of the work for which this permit is
ssu d My Workers Compo'motion Insurance atner and Policy number ere
Comer ' hey No:
' Po
CERTII9 ATIONOF H%EM1`11UNFROM,WORKERS r, �._t. •-'. I I. ee: , ';'. }~•4. tr,t t
COMPENSATION INSURANCE_
f (This sevuah need not heCompleted if the permit is for one hundred dollars - .If.,.
(EloO)or less.) . -
d c n fy that in the nPerformance ma d the work for which this Permit issued.I 1 ,
511 nes anon Laws
person m any manner m m to become subject to the WorkcK
Compensation Isws of California.Doe
. Applicant
•NOTICETOAITIenGoof Exemption,yyyheuLl
x,
z hecomesubjotheWok Compensation np provisions of the Lab Code,you must
00 forthwithc mply With hor . .
chirpermit shull bedeemed re ktl.
r - _ _GA _ _. ._ ._ ._ _.. _. .. ..._. ... _.. _ . ...._ .. .... . . I .. _ _... _
`�., " CONSTRUCTION LENDING AGENCY ""
a'� 1 herchy affirms that driers:is a mnsmetian laremending agency for theperformance ,
W:ti of Ne work for whidh this permit is issued(Sec.3(19],Clv.CJ '
Add PY y Hopi
Py a _ ... _. _ . .. -_. _. _._ __. _..__... ... ...''-.. .__... _. .
Lend Ne
5 z laude Address
1 grey.that I have need Ili s city
and on and state thin the above information is
W E., tomo I g to cora with all it and rat ordinances nee and cite laws rel ting
to building micudpropedhtrcb euthbmere rescnmi vas ofN sntym enter upon
the abo_(We)a tie,to properly for inspection purposes., -
�.W eWc)dgmetosant,indemnifyse,add kaphain-,inthewaytrCcro, ong said
y Cit hues Judgments, ts and opo(th which yin any way ac egeinn said
@.1 � City consequence df the g ming of th n
APPLICANT UNDERSTANDS' 111. OMPL 'ITH ALL" N� IN
v SOURCERFOULAT16 (q Issued by: Date
i
Signmurt of Appl,canAZARDOU ' Dme. ';c Re-SOOT$
HAZARDOUS MATERIALS notation
DISCLOS URE" ra
defied by
iture Municipal
ode.Chamnorto.andth hvadwtsmnfety Type of Roofas d.Sec by the 32ho M c pal Cad Chert 9.12.and the Hea1N antl Safety -
Cod Sat 25A2(o) n,y :r , ,a-:'_ tti f\•
°Y i All.roofs,.shall be utspected.prior to_any roofing.mater al being installed. ._
Cam witm' rCommandants applicant
future b ,I, Occupant use . p t devices emnt If a roof is installed without first obtainingan inspection', I agree'to-remove
emith a eacram ra t buil by the museBay aAtmentoryhick P
District? : all new materials for inspection. Applicant,understands and will comply with
19yes; 1,. N� •. '; t,:, ;1J all non-point source regulations.
1 have read the harallous ,are
Hats requirements iInder:Cbripair 6.95 of lie
California Health&Safety Code;Sections 25505;25533 end 25530,1 understand that
the
have a tenant. -y responsibility to notify the
q p issuance of Cen(cal'of '
Signature of AppLcant Date
f
occupant '(Ire ' g entE wh ch use h< t w G _ __ .. ...
buildings not c rant ✓
Owner or ouch zeds e Y 1 'Da All roof coverings to be Class B"or better "
OFFICE ,_
CITY
DPEsONO
iNPERMIT CONTRACTOR INFORMATION:
B ALpIN('s(sT'T!NDA VISTA DR WATER HEATERS ONLY PERMIT NO. \02050129
O`TP9,"}"IROYUKI AND HITOSHI 970 E . MAIN ST, SUITE 20n`11 FV sjnT62
Am
PHONE: (415) 566-2209 SANITARY NO. CONTROL NO.
O O ARCHITECT/ENGINHER: - - BUILDING PERMIT INFO
5 wF - BLDG ELECT PLUMB MECH
y a h 1 --1 O C-J L,
��_y=. -LICENSED CONTRACTOR'S DECLARATION
:�' I hereby affirm that l am licensed underprovielons of Chapter9(commencing REPLACE WATER F �1�' RnPhon
-,�C with Section of Division 3 of the B usiness and Professions Code,and my license (40 GALLON GAS)
..in;n ran mise n f t 3 5 7
o 6 License , ` Lit.a
LL LL Daft 3,2
Commewr
ARCHIT[e DECLARA ON
1 understand my plans shall bused used as public records
Y
!V60 Lianxd Professional OWNER-BUILDERex,romDECLARATION
omment
=�w 1 Mass.(Sera,lint 11. exempt o an the Cottons C s License Lata Forms,
?G
following uiresa(Section]O3L5,Has inessand Professions Core.Any city or county 7O0
which requires a permit me.also requirestconstruct,alter,improve,for such
demolish, file
repair any structure
63$ prionoits iumol pursuant to
oithe theapplicantitiocatn far ns of Me Commarmiuofilea,Law(Cmemern - - - -
(commencing
with Sivannto00)of ivisin3ofteBusines ad li law fare Cod) t 1 S- Ft.%Floor , ai Valuation
(commhe i1 tooem Section]0001 othe basis
dw.BgCd ec and PrafAny vi Code? ( 'i j 1,t 6 - � 5 "^'' y
or that is31.5b thyapplianJ the basisfor,bectsthtl dempioo Anyviolation -' 356670 9 . [] '-
-'of Section7031.5vnnyapplicnmforapermit subjects the applicant toarnil Penalty
errant more n,an me htinarm aonnra(sson). APN Number �' 1- ' -' Occupancy Type
❑1,ns the
ortheprogeny, my employeetwithwagesfe,heirsolele See,mtinn,
502 - FINAL PLUMSIN ENERGY
will Business
the work:andthe ode:Tstructure is not intended d of se Lawred'for sale(Sec, to an _
Business end Professions Code:The Contractor's License Lew dos nes apply tom peetions "
through
of pmpeny Who builds or imprnvice of such,mpr who eats such work need at
507 — FINAL P 17V1i
or through his own employees.provided that such improvements within
not intended or
offarab for sale. v hu-b.ild the building or impn mfpm h sold within one year or
p..cion,the owner-builder will hove the burden of proving,lira he did not hWild or "
impfave rat pnHmat nr\ale.).
❑1 as owner of the propene am exclusively contracting with licensed contractors to -FINALE D
Consmct the project(Sec 7014,Business and Professions Code.)The Comm ute's
License Low docs not apply to an owner of property who builds or improves thereon,
.?:. ...and.who comm us,for such.projects.with s).licensed pursuant to We. .. __.- __.__.__.__ .. _ _ _ .. _-.- -.. ---
0
...
antmmaK JUN 1 0 2002
01 m tors d audit Law.
❑lent exempt unser Sec,` � - � ,B�&PCfonhis reason � � ., ' t':f`11
ow r ENS . BUILDING
WORKER'S COMPENSATION DECLARATION
1 hereby off m under petmlty or perjury ane of the following declarations:
° 1 hive acid will maintain a Ceitifcam of Consent to self-insure for Worker's
y Compensation, as,provided for by Section 3700 of the Labor Code, for the
- performance of Nc woA for which this pem,it is issued. '
have and will maintain WorkWs Coint nation Insurance,as required by Section
37W of the Lahor Code,for the performance of the work for which this permit is
ssu d My Workers Compo'motion Insurance atner and Policy number ere
Comer ' hey No:
' Po
CERTII9 ATIONOF H%EM1`11UNFROM,WORKERS r, �._t. •-'. I I. ee: , ';'. }~•4. tr,t t
COMPENSATION INSURANCE_
f (This sevuah need not heCompleted if the permit is for one hundred dollars - .If.,.
(EloO)or less.) . -
d c n fy that in the nPerformance ma d the work for which this Permit issued.I 1 ,
511 nes anon Laws
person m any manner m m to become subject to the WorkcK
Compensation Isws of California.Doe
. Applicant
•NOTICETOAITIenGoof Exemption,yyyheuLl
x,
z hecomesubjotheWok Compensation np provisions of the Lab Code,you must
00 forthwithc mply With hor . .
chirpermit shull bedeemed re ktl.
r - _ _GA _ _. ._ ._ ._ _.. _. .. ..._. ... _.. _ . ...._ .. .... . . I .. _ _... _
`�., " CONSTRUCTION LENDING AGENCY ""
a'� 1 herchy affirms that driers:is a mnsmetian laremending agency for theperformance ,
W:ti of Ne work for whidh this permit is issued(Sec.3(19],Clv.CJ '
Add PY y Hopi
Py a _ ... _. _ . .. -_. _. _._ __. _..__... ... ...''-.. .__... _. .
Lend Ne
5 z laude Address
1 grey.that I have need Ili s city
and on and state thin the above information is
W E., tomo 1 g to cora with all it and rat ordinances nee and cite laws rel ting
to building micudpropedhtrcb euthbmere rescnmi vas ofN sntym enter upon
the abo_(We)a tie,to properly for inspection purposes., -
�.W eWc)dgmetosant,indemnifyse,add kaphain-,inthewaytrCcro, ong said
y Cit hues Judgments, ts and opo(th which yin any way ac egeinn said
@.1 � City consequence df the g ming of th n
APPLICANT UNDERSTANDS' 111. OMPL 'ITH ALL" N� IN
v SOURCERFOULAT16 (q Issued by: Date
i
Signmurt of Appl,canAZARDOU ' Dme. ';c Re-SOOT$
HAZARDOUS MATERIALS notation
DISCLOS URE" ra
defied by
iture Municipal
ode.Chamnorto.andth hvadwtsmnfety Type of Roofas d.Sec by the 32ho M c pal Cad Chert 9.12.and the Hea1N antl Safety -
Cod Sat 25A2(o) n,y :r , ,a-:'_ tti f\•
°Y i All.roofs,.shall be utspected.prior to_any roofing.mater al being installed. ._
Cam witm' rCommandants applicant
future b ,I, Occupant use . p t devices emnt If a roof is installed without first obtainingan inspection', I agree'to-remove
emith a eacram ra t buil by the museBay aAtmentoryhick P
District? : all new materials for inspection. Applicant,understands and will comply with
19yes; 1,. N� •. '; t,:, ;1J all non-point source regulations.
1 have read the harallous ,are
Hats requirements iInder:Cbripair 6.95 of lie
California Health&Safety Code;Sections 25505;25533 end 25530,1 understand that
the
have a tenant. -y responsibility to notify the
q p issuance of Cen(cal'of '
Signature of AppLcant Date
f
occupant '(Ire ' g entE wh ch use h< t w G _ __ .. ...
buildings not c rant ✓
Owner or ouch zeds e Y 1 'Da All roof coverings to be Class B"or better "
OFFICE ,_