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02080135zz OC u y�c �y3 oz. C1 Gp6( iply- H OC dW_ft l—,a xs_ a4 3' CIBUILDIING DPERTONNO CONTRACTOR INFORMATION: PERMIT BUILDING ADDRESS: PERMIT NO. 21821 MC CLELLAN RD 02080135 UB DATE APPLICA08/23/2002 k3yg�r'�S9"XUNG & PHILIP YEN PHONE: SANITARY NO. CONTROL NO. ARCHInC`DENGINEER: « BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LI U L_I L_I LICENSED CONTRACT'OR'S DECLARATION Job Desc ton loony klirmIhm1am (commencing DEMO 10e1VALE® m3li1B,mastProvisions,i esC.d9(commencing with Scaion9W(11 of Division J ofine Business and Pronasions Cuec, Brener is in full force and cffcn. License Class Lir. x Date EC SEP 1 0 ARCHITECT'S S DDECLALA RATION 2002 1 undemand my plans shall be axil . public rtcoNa Licensed Professional OWNER-BUILDERr.amp,DECLARATION BUILDING I hereby .(item Inm 11. exempt from Ins Contractor Lkrnx Taw for the o following reason. (Section 90]1.5, Business mpr Rvfasims Code: Any may or roomy $16000 whim requires a pilar, improve, demolish, or repair any uncture core. -- - da, for such pemuuolike poo t is suadlano eort9 - tae e, Mus, re ,,���. ae .l's•. ?3 YHi ,,Tr, VT3 s _•`.'f �'}, t } r„ .. „ !Is..I IA tn. isl; Valuation Law (Chapter that he is licensed ySectiot lithe ofprovisionson the Contractors License lawim, Casr9 f (cpm c g,with S¢ton]11001 ofDivision l of Ne eusirmsa and PcNessions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation -of Section 7031.5 by any applicant for a pemdFsubjects the applicant o a civil Penalty r of not mom than five hundred dollars(5500). NO AMNsNlov INSPECTONS" ' Occupancy Type ❑ [,;is owner of the property, or my employees with wages as their sole compensation. Required inspections will do the n k'and the structure is not intended or offered for sale (Scc-7046," Bds d Professions Cody The Contraan s License Law does not apply Io an owner of property Who builds or improves thereon. and who does such work himself or Through his own employers, provided tart such impro, nm intended or � .. .. ---_. _.. ._ ... ...... . . ....._ ... _ _. . . �-���- �� - is sol within ar 'IoRcicd for oak. If. hmwcv<r, the building`--� wtis sold within one year of Y lmproof r. t e will have the buNen of proving that he did not build or ownemh pro oprove for ander improve for p,rry:x,r arae.). pa t2rh asowner progeny, a usin vi sly contracting with licensede m ' haractx Character's consumer the project and Code:) The Contra no (gee. ]loan reach. an owner of Properly who builds or improves msmam, does owner o erry who naw d«s not apply Licensewho .mdwhorontmens for inch.Prul11.1.iNa.cmntrecsortst harped.pursmnt.Io.toe._ , Contractor's License law. Olam exemp under Sec. � �'�' .,. s�'r( 'BBsPCfonhism er ate , WO K COMP TION DECLARATION v ' 1 herchy affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a CenlEcete of Consent to .self -insure for Worker's Compensation, as provided for by Section 37110 -of the Labor Cole, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain Worker's Compcnr tion Insurance, as required by Section 37M of the Lahr Cole, Bir the performance of the work for which this permit is issued. My Worker'd Compensation Inzmanec carrier and Policy number me: t;g:. Policy No.: - ..] .7 s. ,. m'•a,bY 1' ,'r L;,,l..�. 1 l�'1' t'•'pl I.i y'• 1 : Y } :� i (7.11 1 •' . CERTIFICA'T'ION OF EXEMPTION FROM WORKERS{ :S r x'•.;S s . ' COMPENSATION INSURANCE" } ,- .. l" 'mrii union need nm h completed if the permit is for one hundred dollrrs (SIM)or less.) .•..'-i aeriey'inel in the peefonnimie or me w,ri m. wnkn iris permit .e i aged, I .'hall - . r .: ,i .. ' s , res. `` ,' r ' n t e PI y any pc a Y e be u bI t I Ih Workers' aa55 Csmpe s u La ofC I'f i D'! ✓ 02 Aliph ' f0 PLICA II f k g th C n Iia t t E gti y should bernme subject to Oe Workcri umpcnsm on pnvsons of lM1<Lanur CnJs, you moa ,Co Itrnhwith comply w'nM1 turn provisions or this amtit shall be deems] rtvokcd. CONSTRUCTION LENDING AGENCY I hereby affirm that there is u construction lending agency for the pe,fico a t<e r of the work for which This perorit is issued (See: 3097, C'w. C.) ..........__. __ ......_ .._ . .. _.. .. .... .._.._ _ .. .... .. ame— _. .: .._.. ...:. ...-. ........_ . .. ... .... ..Lender's Name- . ...... .. .. .. ... ..... .. Leader Lender's Address 1 an tom 1 have read this ion ane state information is ey all ciry irk county oNinonces and state laws miming m 1 city mad anc s a d So to soon. Wes. and h Wilding construction, and hertby ambodu posemativo of this city to enter upon risebuilding property for inspection purposes. u Ne ahWO irgiuncd (W'dxgme the against smsi rund keep hamay in way a cone.,.t liabilities, judgments, rose rad eapanxs which may in any way uccrve egainm said ts. costs scat v of the gmming of this permit.. City in CANT Ulcre APPLICANT UNUERSTAND54' WILL'COMPLY WITH ALLNON-POINT Issued by' Date G . ATI SOURCE REONS .63102 �• _ 102 y' Re -roofs i,rature pplicmmf" at HAZAR$ 5 MATERIALS DISCLOSURE ' Will thppLr I or future balding occupant since or handle hentardmis houracriad Type of Roof. .. ..._...`. •. .'• _ as E Tried by the Cu,acmno Municipal Ced Chapt 9.12, and the Health and Safety Code Section 25532(a) -i ,. '. f ,, ... i I I tr ° 3 7 Y' f •, ( ti a °Y' N 1 Y' I (` .. , All.roofs shalt be inspected prior.to.any- roofing .material being installed.. _ Will the ppl c t urfunum building I use,niprout ordevices which If a roof is installed without first obtaining an inspection,' I agree to remove rim, Winumm,rrco rano m rscWmcdby the B.yAm.Ai,Qmni1y Management 'Dislrla7�/ all new materials for inspection. Applicant understands and will comply with iter,• keN, - all�non-poinf source regulations., ,1 have mad the hanallous materials requirements under Chapter 6.95 of the Califomia Health k Safely Code. Sections 25505, 8533 and 25534. 1 understand that if the building does nm cumen0y have a Iewnt, thin it ix my respureibility to notify the - oecupam of the requirtmena whir ust be met prig m issuance of o Ceniftcme of Drr"panry !%,.. Signature of Applicant Date 1310.2.. All roof coverings to be Class "B" or betteriff' Owner mr thri<ed rgm ': DaI .. .. _ .. ..OFFICE r - • - rte_=