00100090 CITYNIVN
C DSIONO
BUILPERMIT CONTRACTOR INFORMATION:
BIJUJ INGAnmu 4D525 MILLER AVE r1!Rhu'rNo. 00100090
OWNER'ti NAME.L OH APPLICATION SIJ.4prill 1.2/2000
PHON@ SANITARY No. CONTROL NO.
M s`Y ARCHITECT/IiNUNIeER: - RUIMANG ITRh11 lINFO
c`00
OO `, LU if
I.ECT PLUMB MIiCH
U Uk I_ 1_J
L� W QN
LICENSED COM'Hd arde.ti DECLARATION Job I DCSCI'I On
O Ieemhyarrruran,mamhaa,ednndcrprn,i,lan,nrchaplm9anmma°Cl°g HOUSE MOVING
°_C° with SclM1oncfeful effect. on3 of the Bu,inccs unJ Pnrlcsians Code.and mylkcnnc
I,,.lath forceful entre.
s cc < Lircmc Class Lic.p
O"u nam commrmr
ax+a tc f<n AR ,c, DECLARATION
C=O J I nnJcr,u,nJ nay PlShuiullll hoaut used a,pnhllc rccnrJa /O/
w��$
ce OWNER-BUILDER DECLARATION
i WF� m 1 hereby arllrm Chat am emmpd from the Commence,License Ww far the
f-K 6 rounwing,cmon.(Scc,ion 9031.5,Iluunns,and Pmlt,sinm Code:Any city nr mu n1, V O
F G x'hiell u,uju,a,,unnif to tontlm,I.oiler,inprnvn,dC nolik ,al repair tiny almemre
me
s, to its issuance,conn requires the applicant for inch permit to lith a nigncd%utmmm
a. mat he is licensed pursuant to the pmvocas of the Contractors License Use(Chapter 9 Sq. Ft. Floor Area Valuatfkiii000
(commencing with Section WW)of Division 3 of the Coolness and Professions QWe)
or that he is ecempt Iherefmn,tori he basic till the alleged exemption.Any vi.Imem
of$estion eons by any:apidCino fee ltcrn,t.Uni«t.n,c applicant n acivil penalty rj F�'704F.,. 00 Occupancy YP
d I„t mare man hve heUdred dolhn,,i$5tp” APN N Occu ane Type
01,as owner of the PmpcnY.or my employees with wages as their sale compensation.
will do the mock,and the swmure is not intended e e I-ew for sale(See. to a. NO ASS I l W_9cdI F�@T�I ONS
dismiss and Proe,ty Who build,Gden al,ile Com doere Liceme u d J,Is,nota mI an
r o1'pmpuny Whu s or i provided
that
sueln,and wen .........wink hlnuell"or broerect fo hissal own howeverct budded Out suer Impmvmnsl i arc oat into e y ad of
completion,
for sale.11;however twilling a impmvcmr v n nnla within one year of
oprove for the own of sale.).will have me MtNcn of proving that Ile Did not build or
improve for purpose n[sulc.).
0 L;is owner or the propcny.not osel uslvely contracting with Iweltved contractors m.
metmel the project(See.91114,poisons,and Pmfessmns Cudl,) file Contractor's
License law does not apply to an owner of preperty wno build,or improves thereon,
and who contracts for such pmjmts with a conductions)licensed pursuant to the
Contractors;License In,
❑I:nn emtnpt under Sec. n ffi P C for this reason
Owner Ilam
WORKER'S COMPENSA'nON DECLARATION
I hereby affirm under penalty of peritery one of the following declaration,
Cl I btme and will ncamon a Ccollleen of Coocenl to sclr.iosnre fnr worker,
Comprnsmion. as pmLusd for by Section 7900 of the Labor Code, tar the
perli,m,anec cf the work for which this permit is issued.
01 have and will maintain Walker',Compare:lion Insurance,as,equired by Satin.
Slap of the Labor Calc,for Ile performance of ON
the work far which this pcnnit is
wuJ'My �o er'n Cu'AT11 lobi) lyn :R are:
IIPI'ATI \ PIiKIih H iHS'
COA1PIiN5ATIONNCE
If his section need not be c....nowd if the pcnnit is lot'nue hundred Jolluru
($1001 or less)
I rani!,that in the peffom,ance of the sunk fur which this pcnnit is iswit I
shall not employ any person in any manner m as In become subject to the Workers'
Compcnsutlon laws of California.Date
Appllcron
NOtICH 10APPLICAN"r:It,after looking this Ccnifcmc Of Exemption, no should
he,much.thecun the Woisioof Lm
rker's Compen,minn provns the hor Code,you ust
Q O forthwith comply with such provisions or this permit shall he Jailed revoked.
z
F' i
0.' - CUNSon'LENDING AGENCY
S 1 herchy ollinn that'here
,nn e conSen landing agency I'nr the per .....unen
w
I the work for which This pem,it n issued(Sec.3dM)9,Civ.C.)
6. ❑
lncrName
Q 7 UIsndvder's Address
U Q I renify that I euvu read chi,a,,uiamion and sone that the shove information le
W. F Correct.l b it, Iry do all 'ry,la ty Il as d.t I P nl t b /
Q U mAuld g .I i JI by' th p I i s Ib city to enter qct
} k1 the eM t nW s pent f Accu pu,1a
F y (ed) g t . indemnity dkeep h I ..th Cty fCpen 6'aid -
Z Eric j,lg I. I d p l h hmY )' Y cc cagy na.laid
U "L City gUNDERm g.m Igor tli plot
APII ANT UNUERSTANDg AND WILL C' ,Y T ALI NONPO]NI Issued buy: Datc lVJ
5 C. .0 WTI NS. _ --
-tga to Pplivino .tractor Doc Rgr
e-roofs
IIAZARUOUS MATERI .ti UISCLOSUR
wan rite amplir:aa nr rmUm budding a rparm store lu nada c na.adou,unusual 'type of Ro
a,Icf neJ by he Co,en;no Municipal Cede,Cbupte,9.12.and Health nal Sufcay
Code.Section 25532(0)'1
0Yes 0 N All roots shall be inspected prior to any roofing material being installed.
Will menppicamor I bidding ne,upant use equipmemur dm ice,whldt If a roof is installed without first obtaining an inspection, 1 agree to remove
in nit Iueunluus oil omtaininans ors defa,c]by the Rny Area An Vuahly Monagenont
District! all new materials for inspection. Applicant understands and will comply with
over CI No all non-point source regulations.
I have read the inanition,nmmrinls mgducauevn under Chapter 695 of the
t Cal domia Hcdth A Sandy Cold,Section,25505,25533ard 25534.1 under,onithat
if Inc building does nal rut Notly In,c a mount,than it i,my reslxrnsibi li ty to anti ly the
occupant of the rcqulrcmonty"Inch most be mel prior moi none, a rotioan,of
o Pup° 7 Signature of Applicant Date
o" m aatfill.lar,"vid 1-*w — aI� All roof coverings to be Class `B"or better
OFFICE