02010119 CI BUILDIING DONPERTPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10990 MARIA ROSA WY A PERFECT CLIMATE 02010119
OWNER'S NAME: APPLICe TION SUB DATE
REED ARTHUR M AND JEANNE K TRJ 10570 S DEANZA BLVD 01/ 29/2002
•PHONE: (408) 861-9545 SANITARY NO. CONTROL NO.
w O O ARCHITEC(ENGINEER: BUILDING PERMIT INFO
8 W BLDG ELECT PLUMB MECH
H= LICENSED CONTRACTOR'S DECLARATION
czgG 1hereby affirm that Iamlicensed under provisionsofChapter 9(commencin& Job Description
F:Cw witM1SeaiunJXgofDivision3ofilioBusncssandPrnfcssiamCode,andmylicense REPLACE FURNACE.
Y f; ter in f III Dome F ,C)
a z oc a LicetssJC _Lh.x )
C),U me Cotryt1 s�9cmr
W c.oc 0 ECT'S OP.6LA ON
E u O S 1 understand my plans shall be,used as public Hoards
�Y
W
n O O Licensed Professional
�t 6� OWNER-BUILDER DECLARATION
1 hereby infirm that I am exempt from the C.n,..r's License Law for the
t:Z a following mason.(Section 7031.5,Business and Professions Cork:Any city or coumy, $5765
Y F o which motormanperm t tomtsmucLidw,improve,demob M1.core,ndrio,sbuaum
u° m prior to itsissuance,al mildness theapplicant for such peoutt flsignedstatement
c3°° _. . _ ._ .. _.
Ikn nhiespurs Ont. the provisionsol the Contractor L la onsupmr9 r y a „S y Valuation
Imm he Ii ex th5ecjonbin an fDivmonor of the ndPPf Anions Castle) t_l\Iy,.j; •5 0 3o.yl�IF I� t s is;Vii•.
or ilia he Is eaempi Mciefrom"rid the basis for the all<gctl dtimpsiod.Any violation -
-of Section 7031.5 by any applicant for a pemsit subjects the applicant o a civil Penalty 1 _
'ofnor mnrcthan fivehundred douars($500). 301APNf`sUtn PLUMBIN (r, - '• Occupancy Type
Dl,as owner of.he property.or my employees with wages as their sole compensation.
-will do the work,and the structure is not'intended or offered for sale(Sec 1061. -- _ -- '- - - -- - - - "'--
304 - ROUGH ELl$�gfl RcT VA*Ctions t';°I r '"
'Basinesv and Professions Code The Contractor's License Low does not apply m an '
owner of properiy Who builds or improves thereon,and who does such work himself 505 - FINAL ELECTRICAL
-offered through his own employees.pmvided that such improveme is arc not intended or
c "for sale.IC however,the building - -- -t is nolJ'svithioone - of '- '_.__._ -"---- ---
«imen of pro rear 507—=— FINAL—PLUMBING— +�'—'i+ •. ..,
provei for the use of alder will have the burden of proving that he did not build or
impmverorPurWaenrsak.l. 508 - FINAL MECHANICAL
.."""I;m ownernfihc roto,am exclusively
tor..._
— ----------________._.___...._.__..__.. ___._ _..__
Q P Pc y,am Business a d Profiting with licensed c C.ourars m __.-
G _
construct the does
no(See.706,Business and Professions ills co Thc improves
the...
License Law
co d«s nos apply to an owner of property who builds m i 'Aho n Ihercon, FI -"-
....Y. and.who.commds fur such Prolens.with.a.commemr(s),IicenuJ pursuanLm.ne --------- !G .._.....___..
`'. Law..,_
01 amexempt
License _
_ °lnemp sunder Sec. ° '. � �;B&Pefor this reason APR 0 2 '-'
Owner Date 2002
- WORKER'S COMPENSATION DECLARATION
I hereby affirm under Penalty of perjurypne.ofthe fallowing dmlomtions: BUILDING
j;;• O 1 have and'%HII maint$in a Cer ifi[ate of
Consenttoself-insure for Worker's lJ 6J 8\VI
Compensation, as provided for by Section 37W of the Labor Code, for the
- - pcdhimi.h ce of trio wok for which this permit is issued.,.1
D 1 have and will maintain Worker's Compensation h000range,as required by Section
,l�eoro1 Latin,tC `Vrwork for in .it is
issue PFer
u
CFRTIgGAQOE%EIMPTION FR0 ORKERS
.. -.•\_. .._F ., t t
_......I .._..a.. +.e.•,.--e:.-_. ..,.._.,_.._.._..
f. 1 11Z 1i .1`s..-1/Rol 7 i .ss )i1 TR}1)QIC .•Attie
COMPENSATION INSURANCE, ' ,�1- tete._-_ __,
.+« _ _........._._---------tens. to tens"
.I(Thrcsenon need not bccomplaed Lhe permit is lorone hundred dollars Is S'1
SJOBor less.)
'I certify.that n the performance f the work for which this permit.s issued,l � -- �_ _ _ i„ �, s,. . •� ,}t� I e,
ihaWorkers'
ll hdt employ any person to any manner sb'a:s m become subject to the Workers '
Compensation Laws of Califomia.Dae
_Applicant
NOTICBTOAPPLICANT.If,
Z - kingthis i ' of .
should
bcc m mbleai hKCompett rip visosofty Labor Cd.you
ma
Q forth uh comply with such p cions o this Permit.hall bed ed revoked.
Z _ _ _
I s ''•CONSTRUCTION LENDINGAGE,NCY
a-' 1 forts,aRrm that there is v conswamn lending , -ncy for the perform ee
-r which this permit' issued(S 3091 Civ C1 .............. .. .. . .._._ . ......_------
0
. .. ._.. tens. .
Leder AJdrcx . .._. -�.:• ,..... � _. Y. _cense _ cense. .__cense - .-.
of
the k fo
d.Q Lender'sN do
,
Uz
V- A ecnilY that 1 nave read this vPPlica.ion vnd,taro tM the aMve information is
": BT+=[r <oren:I a8rtc m comply withal)city arid county,ordiwn<n vnd nam laws relating
: Q..V so builJing cnnsvuctinn;and hereby au.horiec reprcscmmives of thiel ci.ymancr upon
y sh b N P P nY f 'ns t o Pu po -
C.. 1 8 ie. Je n fY arid Aeep harmlc.s ih<Csy of Cupeninoag nu
(n liab l j cm t. rid pensc h h m y n a y y,c gat .t sold
4,) Z Cty e c th R t'gohh perms r
APPLI A� WDE SI'ANDBAN WILL COMP - 4'ITHAL N IN- L Issued by: Date
Re-roofs
HAZA OUS MATER LS DISCLOSURE
_ 'll p c t r re W Id b c pa..wrc or handl h zvdoushoderiod TypC,Of ROOF
n defin b th Cu M tpsl,C put 9 I'_ rid the He Illi
not Safety
'
CM 5 n25531C h,I 1 ars -t �i` -�• : . il3 s.i(tlril�a I J.1
❑Y a M'i No _All roofs,sball be.mspected,prior to any_roofing material.bemg installed._,
Wn me ppl cant orf t build g p . e eq pm tJ t«.which If a roof is installed without first obtaining an inspection I agree to remove
emit hazardous air contaminants as refined by the BayAr I is I'Iy Mit gement
.
Nixon,.? y,• all new materials for inspection. -Applicant understands_ a_n_d will comply with
�R all nonu
n-point source regulations,
., .. . , ,
,...', 1 It - ad the haiardousmatcnals requirements under 4.1cra fi95 d that
Califomi fall &Sofa- e,
Sections count.
that
t it
y responsibility
1,undemmnd thin
it the but dine) snort curly ha moan,thin it is my responsibili.yeti notify the -"' -_ tens._ ..
-occupam of the r quircm ata oust be met prior toIssuance pfp Cenificau of
Signature of Applicant Date
neror orrad,g n All roof coverings to be Class B" or,better
:.. .'n -OFFICE
L.
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