01060172 CIBUILDING OF
D
PERTONO
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
21328 METEOR DR 01060172
OWNER'S NAM@, APPLICATION SUB DATE
BULENT BALOGLU 06/29/2001
PHONE! SANITARY NO. CONTROL NO,
t
w O z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Zw E :::�l L 71 1 LJ
LICENSED CONTRACTOR'S DECLARATION
Z z m' 1 hereby )firm thm I am licensed under s of Chat 9 honnor Job Description ,
°�{.M with Section 7W)of Division3ofmc Businesspand Professions Calc,arWm license FENCE.
a m Y is in full force and effect.IE y
IE0 Licerse Class Lic.Y
Dam Container
0 rn ARCHITECTS DECLARATION
I la: I understood my plans shall be uu0 as public records
�Y
i i p C, Licensed Proion
fessal
OWNER-BUILDER DECLARATION
n Q—'u, I hereby allimt but 1 in exempt from the Connunor's license Law for the
1-Z- following reason.(Section 7831.5,Business and!Professions Cale:Any city a county $6950
which«9nire'o permit mnu
ict on,alter,improve,demolish,or repairany Structure
�> Prormt c AIIU lectuicaiJ plue l nor such Pernitt tile soloed Sorenerni,,
� — tbath Ic :dprs,ntt theprofthe C totor'L L "I
YC1mr'9 F )f pea Valuation
Sam coy with section)u88)of llvi' 3 tbel n
Jlfcunns Gude) , ,324 O1'�f3.,Q
or that he is exempt therefrom and the basis for the alleged exemgmth.Any violation
of Section 7031.5 by any applicant for a permitsubjens the applicant to a civil penalty
of not marethan five hundred dallxm(SSW), 5 16A'LN �TRNL BUILDIN - Occupancy Type
❑1,as owner of the propcny,or my employees with wages as their sole compen'mion,
-will do the work,and the structure is not intended or offered for sale(Sec.710.1,
'Business and Professions Cade:The Contractor's License Law does not apply to an Required Inspections
owner of propcny Who builds or improves thereon,and who does such work himself
or through his own employees Provided that such improvements old
arc not:mended orcompletion
for sale.If,w howevere the lhave
Wilding e t Landon foto is rola within otic Wild of --
completion the owner Wilder will have the burden of proving that he did not build or
im�purPr,m of sale.).
. . , _.,__-,. _ .. ....t
Las ME
prate y,ore c. v, contracting with licensede Cmraca to
constructt fscc ]tWa, t and Professions Code:)The Connatmr s , � t„„ �t . I ,
Licenseot app to art s pmpeny who builds or:mantises themon.
nd whor Su h.pot c u cr contmcmgs)licensed pursuant m theContraLax'. ,'' S sF PCfor M1isrtason t �'OwnerDartOR M ENS I N DECLAR ION
affirm under Penalty of rjury one of the following declarations:
t] 1 have arM will mainain a Cenif ase of Cunsem m self-Insum for Worker's
Comp f pur,ded far by Solna. 37W of the f b Code. for the
ped.rairrince.flin,vandjer, h Or th' peon Ys J
I have and will maintain W d Corurpon,rairminsurance,as required by Section �QC
37W of the Labor Cade for the offormanne of the work for which this permit is
Issued sly W k Con,en,ni Se.I . A Policy be _
Carnet.' _.t r r '4lidwy No.:
"CERTIFICATION OI'EXEMPTION FROM WORKERS': - >• `s - '•` - ' '
COMPENSATION INSURANCE
. .. !'., ...l:i.. .
'Orris section need not be completed if the pnmit'¢for one hundred dollars -
(SIW)orkssJ _ ,
l'�eni g that in the arfomance none wmk'for which dds permit is isute.l
'hull not employ any person In any manner,So ly to become subject to the Workers' `
Compensation Lows of California,UVC
-Applicant . . _.. .. ._ _.
NOTICE TO APPLICAN T:It,afmrvnakiny this Cenilicmc nl Eumptian.you slwuld `
become mbjet to the Workers Camper satioo provisions of the Labor Cale,you must
O fanhw'uh comply with inch pruvi.sions or this permit.shall he deemed rooked.
Z _ _ .. _. .. .. _. .. .__. _.. . ..._..._..... _. ._.. _. .1..... ._.. -.:—.. _.
CONSTRUCTION LENDING AGENCY
1 he"y affirm that there is i construction lending agency for the performance
of the work for which this permit is issued(See.3097.Civ,C.)
Lender's e. -'Nam .. .
Lendeh Address n.:n
1 cartity that I have read this application J State that the aboveinformation is
tss F. cohect 1 ,me to comply with y and tY crolift.s and state law.refining /
Q f_) ah 'IJ te' tr II p rives rdii,ci,w,truer upon
the M P epigd nn p Ha*e. �
�a p. f\ )a.rcen ave!lA f kfir may in
he Clam Cupcnno agmsid
liabilii s td mens co d 'xhi may In any way acme xgaimt said
Cit in S t e t c-rant ng (e it. -
AI"I.IC. t STAND. I .Y WITH AI )� P IN ' Issued b Dale
r N Wil the, nNSt LOSUR y
-- :_ ignmun APPI' nUCo,'L hu Id'my a'cuPam Imre of hon Dm Re-rOOPS
I t
End $cl Onhe Cu9ZA SC L
as r m th cin r d1 1I dna tnatonal Type of Roof _-
PP
y pen n M11 'npaCM Ch pre >L.u d the H Ith and Sa&ty •, t _
2553 2(ar?
All roofsshali.be inspected prior to-any roofing material being instilled._.....
\VIII the applicant or restore building occupanl n.w Wuiproem or devices anh If a roof is installed without first obtaining an inspection, I agree'to remove
emit heiofdous air cunaromarrt as darned by the Bay Arca Air Quality Managemmtt
Dimrlt,I all new materials for inspection. Applicant understands and will comply with.,
❑Ye' �• '.❑No' all non-point source regulations.
I u .aJ he her ' n rc iretnents ruder Chapter 6,95 of the
Cal fo'
Tc,
Safet oe.S coot 558. ' 3 and 25534.1 mtdersand that
if the n in
u n doe ybe cat ni.tha ii espaneibilitym nmifythc - -
ocoupa t e r which mu net i c
/ enille mol
lJ Signature of Applicant Date
Occupant
_ d' D n ; mrd.en agent.,' Dm All roof coverings to be Class "B" or better
cc
OFFICE -
.. 3 "IL' s