01050092 CITYBUILDING
UIV SIONNO CONTRACTOR INFORMATION:
` PERMIT
BUILDING ADDR659: GB GROUP PERMIT NO, 01050092
22017 MC CLELLAN RD
OWNER'S NAME: APPLICA'T'ION @+F1)^>49/2001
CAROL A EPPS TTEE EPPS 987 RE 8921 MURRAY AVE
PHONE: SANITARY NO CONTROL NO.
(800) 653-7172
O C Z ARC111'I fCr/FNGINC1iR: BUILDING PERMIT INFO
14 O O❑ BLDG 121.PCI' I'LUMit MEGA
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m- LICHNSEDCONTRd add,,paDowo,'If CION Job Description
p S= 1 herchy affirm thin 1 an licensed under provisions of Chapter 9(rd my I cert
g
wnnflltoneandefDis;,n,m3annena,me,,.narrtfe„irm,c anemrhan`e REROOF/SIDING AND TRIM
m < Is infull[lass vnJe
< plate Class
O O Dae CDITCLAr
w 3 a v ARCHITECT'S UIiCLAR,\TION
F O I understand my plans shall he used as public-cord,
c < licsn,cd l'mrmsiooil
Co
OWNER-BUIhUIiR DECLARATION
I bamhy alrimt that I ata exempt loon the Cnnvncmd License Law for rM
7S>' Iblluuing m r.(Section 7031 5,Re,mce mW 11 ic,aicn,Code:Any city or county
Y FC C soh 1 Two r u 't t atm ) I li p any structure
Lie
a, pr t t' al I het 'Ppf t f Ila uin f l y rd ,am nc r
t1,tl r f pursuantt the n tan 1n c t mi l Law ChcPar”) Sq. Ft. Floor Area Vahtnb(1294
(cotntnuneing with Section 70(Xq of Division 3 ol'Ihe Iin,ineve and I'mfewier,Cod"
or that Its is c,lana,the-ram mad the husie mf the alleged ever,r a,Any violation
of section lulls by anyapplinon lora ismait,tmjca,the npplicmn a,a civil penult) APNN 0. Occupancy Type
or ad... mothafive e handled dollar,($500).
01.m owner o the p r scri ,m n y e r,do,,ss with wage,os their sole compensation. 00
will do The work,and the stmctum is not itnenJcJ or necred for sale(Sec.7(W.
Itu,incss and Professions Code:Ale Contractor's License l.aw docs not apply to an 305 — F FMfjtgred Inspections
owner of property Who hold,or improves themon,and who does such work himself
or through his oxo employees.provided that such improvemetus am not intended or 307 — INSULATION
offered lot sale.If,have"'.the building or improvement is wld within ane Year of
ompletion.the owner-huildar will have the harden of proving than he did not build or 601 — ROOF TEAR OFF
improve fbr purpose of sale.).
602 — ROOF PLYWOOD NAIL❑I,usnwncro(Iheprupcny,;ao,xcItI clycnntmctingwlthlicensedcomrtcmrstn
tan-1 the pmjcct se.70004,Baa It profs$ w Cole:)The Contraemr', 603 — ROOF BATTENS
nt
unease lnwdoe„ .pply ' n,penywba hand,mr:nrpro,e, fon, ROOF
aI who eart-ana t a)e� aarttrtar(y pemnwe par„e t ia`ma 604 -- IN—PROGRESS
c--rima,Lied e
C len cmnt,n nd r Sc,. n w' ” .li k P his no
Owner__ me
O OMP.NSATION DFCIw\RAl'll _
1 mmby affirm under penalty or perjury one of tis following Jeda itions:
0 1 have anti will maintain a Cenilicac of Consent to sell-insure for w'orker's
Cnmpn.w,idn, as provided far by Sevin. 37W of the lasbar Code, for the
peali,mmmce al the nark fnr ,which this permit i,i...of
01 have and wit]maintain Worker',Cmnlwmation Insurance,as myuimd by Section FI NA L ED
37(X)of the Whor Code,for the performance of the work for which this permit is
Issmed.My Worker's Coy nvayon In-ince emnen7d/falls)nmnnor�' NOV O 8
Carrier CliltOsNNp(/\yP CXLMI'fION�OFI W( KERS' lyl V V ZOO
CUMLIiNSA'I'ION INSURANCE: R
CTIII,xrtion need not be eonincled if the permit is for one nnadmd dollars BUILDING
($HgN m lea,.)
I certify that in The pvi-hantance or the work list which this permit is issued.1
,hull not employ any person in any manner sir as to hcennm subject to the Workccc
Coarpenmrion laws of Celirnsom Dam
Applicant
NOTICIi"TO APPLICANT:IC after making this Cenif am of Bslandion.you should
became suhjca
to the Workers Compensalion provisions of the Lobar Code.you must
OIimhwhh comply with such pmvi,ions or peri[shall he deemed revoked.
F = CONSTRUCT ION LENDING AGENCY
a > i he-hy aRmr that there is a comwetion lending agency for the performance
W of the work Iia which this pcomit is iswM(See.3891,Civ,CJ
QLender',Nott
7 z Leader',Addy.:,
U O «airy tint l n n n.:rd thl* ppra:elo ,nd,cn, d0lealftran imonn tiaa 1,
R. t..t c..tact.I gm to comply x'tth al h incl rorty at nr and sate law,Icicle,
O V mhuWfngeonoruedn main thnr mpm, ttive,,vi III,city mcnmr u n
the move.mm'dione nape f u peel t parpns �� -
f'• 1 (Weiser, -w ,mJ n run cep her ;1 of Cape na iaa
rn liahilitics.judgn nix .,k: J pen any way aceme gain said
U Z City in con pec of,c ng s 't Mmi f� ' 1r^ Gem w�
APPLICAN! NDERS A ' VI 1.0 B'LYw'o AL.. ( Issued by:�T� �w�`��y�'�" e Date SOURCES. .GOT —
s ignsigmmum pplicanV. n tc r
i tC Re-roofs
IIA AR US MATBRL S DISCLOSURE
will the appueamor-tum ander p:m,smmmlmtdithasmdousmam.1 Type of Roof
as de8nel Thy the CuPeniru Mmnictp out.Ch:tpler 1),12.and the Health and Safety
Code.Section 3553:(.)'
❑Ye, No All roofs shall be insp ted prior to a r ofing material being installed.
WI11thcappli<ata ler rtnttre hr��Iding npmm ase e9ttiptaeta nraa,ia,wmelt If a roof is installed itho st 1 ' g an inspection, I agree to r move
011111asuninus an anmuminunts x,Ile It by the flay Area Atr Vun110'Mnnagcnem
1,;,„a;m,., all new materials r i ec 'o p 'an erstands and w' I c ply with
0 Ye, all non-point so cc r gal•
1 have mad the b' mast eyuit tams ander Cruder 6.95 or the
California Ifeahh K Sa y de s$5585, 533 and 255]4.1 der and that
it the building tires n cu ant.th it i,nt nobil ya tmifythe
occupant of the. r o o...n c of C if mor
«apammr. - - -tm Signator f Applic t at
Gwmeaoaat
,car a, All roof coverings to be Class"B”or better
OFFICE