02050151OFFICE. _ ._.
UPERUNO
CITYBOF
GN
IPERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:PERMIT
CHEROKEE CONTRACTING CO.
NO.
02050151
1076a oYQYfco G
OWNER'S NAME:
1220 COLEMAN AVE
AUgC/kn j'` l)IU2
PHONE:
(408)727-9850
SANITARY NO. CONTROL NO,
Z
O
ARCHITCCVENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
C� O C,J I_:1
2
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that lam licensed under provisions of Chapter 9(commencing
REPLACE SEWER Job Description
`int Sectio 0001 of Division? of the Busine and Professions Cade. and mylian.
int rwI arta ''r.
rte
a
Licenses' tp`-3 (rte L
N
m x b l 0 1 cont n
ARCHITECT'S DE TION
1 undnaaml my plws amp he i,eda, puhhc recurdt
OLicensed Pmfersional
LL
OWNER -BUILDER DECLARATION
to
I hereby affiun thin I um exempt from the Commaor's License Law for me
a
following reason. (Section 7031.5, Business and Profewums Code: Any city or county
$6800
Q
sitrequires a permit m consuvn..lon, improve, demolish, m repair any stricture
F,
Prion. its ismance.aRore,mos theapplicam fm such permit to file. signed smomem
.. .. .._. _. ._.___. __... ... .... ... .
Sq.�Ft.,FloorArez(., ,•,- •"r
Valuation
— he itslicensed pur'suamt the previsionsoftheContractor.L< seLaw(Chapter9
-Pldtl)t
cert JI Ovule)
1 "ir'
ex.ninael,
x
of that he it exempt m heb.sisotheaBged exemption.An,
Any violation
li and me aeras for the cts cplicant
"
yap the to
of Seniors 7031.5 by any hundred doll fora permit subjects me applicant m a civil penalty
'or not more man R,e nanarm eonara ($s(n).
5APN NERUW WATE X
Occupancy Type
202 — UNDERFLOOR PLUMBING
°I. as owner of the property out)
will do the work, and the structure is not intended or offered for sale (Sec. 7044.
301 — RUIDGH PF
Business and Professions Cale: The Contractor's License Law docs not apply to an
ections
N
owner of property Who builds or improves thereon. and who docs such work himself
302 — TUB & O
or his awn er pm,ldin that such Lnprovemert art nm mem .. nr
�gfferta"tor -- - -.
.... __ . __. _. ....._. . . . .. ... ....— -- -
5 02 F I -NAL' PLUMB I NG -ENERGY
erect for waver, t t i! seta aimin ant.. �
year
male. u. nnweve[ mr bauain yearo
Wildingorof
�t
pro
�completion, mcosena�iWi1ed'rwillhavemcWrdcnofprovingmancedid notWild or
506 — GAS TEST
mprove purpnsea
-- 507. ----...FINAL. PLUMBING _ ...-__...__._.. .... _........ ..._..
°1.asowner pians p(Sol.7 am withlicensedc
Businivrlyrontiufe,xi
Business and Professions Cade:) Thc traam i
onswn rhe oes n (Sec. C ....
.
improves
License Law docs not apply w an owner of property who builds and
to a menthe
.
purstrs
Contract for such protects with a.cumruaor(s) licensed purmmnt. to the
_.. ._._ _..... .. _ ..._.. _
.. ..,..__.._ ._.. _ . ... _ _. _.... .. _ ...
Licens
ContractorsLaw.
❑lam cacmpr underSu. - �.B&PC for this reason
01 am axe pt under
b'
-
—
Owner .'. .• EDate
NS . T
WORKCR'$ COMPENSATION DECLARATION
'
s
un u rte of me following
I hereby aRnn der Tend, of pert ryn .. gdeclarations:
_;t
30�
I have and will m >eLaborm for Norkrr's
n Cby Secti of'37M
O
C
provided o
C provided for by Section J]sued. me Labor Code, for me
Compensation.
yt\
performnncc of the work for which this permit is issued.
he
0
° 1 have and', ill nuontain Worked, Compmtmimi Insurance, o, mquirml by Section
3700 of the Labor Code, fur the performance of the work for which this permit is
'
I, tied w kces Compensation Inamenc camber and Policy number are
/t.'T (Na
m. !1
CER'1'IIICATION FX'- PT ION FROM WORKERS"
• L__',' _. COMPENSATION INSURANCE-
NSURANCEe(This
(Thissection need not be completed if the permit is for one hundred dollars
(E100)o1 less.) ,
I cenify Thal iu the l;J%ocoenee'uf the work ror which Ihta permit o rsmea, I
,halon, employ any person m any manner so as m become subject m the Workers'
Compcnmtion Laws iff Calimmin. Dau
ApplicanP-„ .. .,,. . ,. ..
'NOTICETO APPLICANT: IL ager making anis Ccnificau'of Exemption. you should
bedomc subject io rhe Worker's Compensation prdvrsiorethe WWr Code,you must
fnnhwitli comply with such provisions or Ihis pemtit .shallll be Jecmed revoked.
'
0
'. CONSTRUCTION LENDING AGENCY r
''
'I hereby afrrm that the,, n a cnn,tmetion lending agency for the pinitumlarte
..
dthe wail, f ,'which Ih Permit"hriie. :'wed (Sec 3097, Cn.
.C.)
Under',M.- .
Isnd !Ad c.
.. __ .. __ .. ... ..-.. . .. _. __._ ... ...-. _... .. ._
?
j
I xi fy that l h 1 thisApplic t d t that theW f mons
torrent (agree t comply II c ly and county d dstateI
upon
V�..
�/
enter
w building onsmieuon. and hereby aumonu rtposics. ivesblthis c ty to enter upon
he
s
r7
me above propend for inspection purposes.
y
agree tooned
fyandkeep h may sixin the of nst
Wo) w. arve.cost and a said
O
against
may in any way accrue against said
and expenses which ,,raa
liabilities, nojudgments, of the of this
City in consequence ntingDmi� "'
sis
perh
grantingpermit:'
AP PI NT UNDER, pYD$A\D LCONELY WITH pLLN YPOI T'
RAA,g
0
Issued by: ! Date
02
signatureof Applicant/ onuactor' t Uam
Re—roofs /
HAZARDOUS MA DISCLOSURE
.
mil , the Ippicarto Dome Wildingocc.,.of ross, we lbdl handindear, insommil
.. Type of Roof
asJl ed b"h Capers Municipal cod Chapter912and the x Int ands Safety
Codc. lion 25532tu)
i ''' .f) ' ' !
s �/I� - ♦ s
°Yes '' D�Nn'.,
'a:
.. t e
_ All roofs shallbe.inspected prior to any roofing_ material being installed. -.._
Will m ppiir t futurebb ilding occupant q.p on, or d mcn
'emir
If a roof is in without first obtaining an inspection; -I agree to remove
emth d i'"sdfined b,mo Bay Area A Quality Management
Distrtn
°Ye
all new materials for inspection. Applicant understands and will comply With
all non -point source regulations:
I have read the'bavrdous manrials requirementunder Chapur f.95 of the
1
if the Wilding does not ety Condy have i mnvn5 that itis and
California Health Sk gdoesntcur Cod>oAc a tnant.t:t5s yrespo34:1ity10 notify the
nresponsibility tu noJ(y me
occupan of the' requiumcnts, which must be met prior to issuance of a Cenificme of
°cp"
nature of Applicant cf, ate
All, roof coverings to be Class B" or better
OFFICE. _ ._.