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01120068 CITY DrsDVSONO ILIiiNPERMIT CONTRACTOR INFORMATION: - .BUILDING ADDRESS: PERMIT NO. 10069 OAKLEAF PL 01120068 "ONLM6"THEN/CHUNG Y SHIH APPLICATION 2/18S/2001 DAM A� iONEE:N _ SANITARY NO. CONTROL NO. M'ac 2, ARCHITEC(ENGINEER: . . .. ... .. .. :. _... .. ....' : .. --.: .....: BUILDING PERMIT INFO ._...... ti le- BL EL' P UMB M I W, IL-.1 L 1 w:Gd N LICENSED CONTRACTOR'S DECLARATION IO Descriptio hereby Brian Ilan l am licensed under provisions of Chapter 9(commencing, w;thsectpinn)Puumroivnron3anneBasmeasanapn,m>amnsn,de.ammyhcense KITCHEN REMODEL n force and effecL. Lkenne Class Li,a a a O Dom Convaaor , ARCHITECT'S DECLARATION Lilo; ra ups�etFumA;my;Pl:m.v shall mused as public irmrdz le. C o L fen J R sf>�etbtal. IL ., .. ... ... _ ` . ' 'OUFCR❑UILDLR DCCLARAT16N " •- � � � ' uxs 1 hereby anion that 1 an exempt from the Contractor's License Low for the F Z hollowing reason.(Section)031.5.Business and Professions Cade:Any city w county $25000 - C,�❑ 'which mquires a permit nm em"me'.cher,improve,demolish,m hepar any awaure a3� ,pnu t L 'also 9 'rc m PPlic tf hpcnnu fl .'g al smmmenL .... ..-_ _._. ma he.Ice sedp uocmm"U airon rth C L noraL In, lClmme 9' - - (comme,c'nawtnsect n]000)arD.,i 3 of Bashes. dP rsnn.ende) l'•„L3$� 6�JI3S[.bQyq 1tr:"j: Valuation m mm be is exempt therefromand Lhe box is rot he allege(Client inh.Any violation - •uf5mivn)031 5 by any applicant for v permit subjects the appliCan,m a civil petarlry afoot mart limn five hundred dollars M(sh. 101�PN tfvlT1[1113JDATION " ” Occupancy Type T1as owner lir the property.or my employees with wages as their sole compensation, 102 PIERS do the Work,and the atmaorris nor intended or offered to,sale(see.)(w, 10 3 - UFER Required Inspections owner Buserss and Professw Propositions Code:The Contractor's License Law does not apply to an y p sew of property Who Builds or improves thereon,and who docs such work himself 104 - REBAR or through his own however t provided that such improvements me not intended year Or ._ offered!forI' Ir however meWilding p t la to held or - - 105 - ANCHOR BOLTS ' 'completion,then Idc 'll have thburden prayingfthat hdid Lbuild or nap rpm.: r l 1. 106 - SEWER & WATER , X "PLUi (Lhe prti meaew.vly untracting withlicensed contractors to - 202 - UNDERFLOOR MBING itinvet th project(Sec7u44 Business ondProfessions cad ITB Contractor 1 203 — UNDERFLOOR MECHANICAL License Low does a.t apply in as owner of P openY IsM10 Wilds or P <s thereon, aid ho contracts for such pmlaas.With a Coloss fa)licensed panoan to the - 2 04 -'— UNDERFLOOR- FRAME Contractors Liccnse Law 01Waexempt a Stt. 10 B&PC for his Ana 205 - UNDERFLOOR 'INSULATION ow�ar C �. Date 1 /2--/e-J/ 301 - ROUGH PLUMBING WORKER'S COMPENSATON DECLARATION ,302 - TUB & OR SHOWER I hereby afrounder pentary of fa Jary one of the fauawing deemmnoaa: 303 - ROUGH MECHANICAL a. c�f;no�y'anp;win;mamLain ;ce�m�aebr cn�(enrt�self-inane tar workers 3 04 _ ROUGH ELECTRICAL tape s i n, 'as.,provided for by-Secuon 3700.lir the Ial,or Code, tar the .. - .... .. .. . .. 'air arra.ser the work for Which this Permit is tsmed. 3 05 FRAME .. ❑1 have and will maintain Worker's Compenmrion Insurance,as required by Section 3 06 - HOLDOWNS 3700 of the Labor Code,for the performance of the work for which this permit,is 307 - INSULATION issued.My Worker's Compensation Insurance carrier and Policy number arc: — 308 ::_ ' SHEETROCK.. DO Icy Caner ' sCl'RTIFICATIONOFF-%EMPTIONFROM,WORKERS' '- t ' r L 3O9�1f-''EXTERIOR -LATH t COMPENSATION INSURANCE • ' ° --3"10 ,-7 INTERIOR-LATH-- (Thisiectionneed;orbecompletedif[heper it is for one hundreddollan 311' - 'SCRATCH COAT If 100)or IessJ ` Benny ma.in he rmroirnee of he Work for Which this m,i i:pet is ismsJ:1 ROOF NAIL shall not employ any person in any manner so as w become subject to the Workers 501 - FINAL ELECTRICAL"ENERGY Compcnaanan laws or California.D01C Applicata 502 - FINAL PLUMBING ENERGY - ... - .NOTICE TO APPLICANT.If.afar making this Certificate of Exemption,you should 503 - FINAL MECHANICAL "ENERGY O pbecome subject to the Worker's Compensation provisions of the Labor Cade,you must forthwith comply with such provisions or this permit shall be deemed revoked, 504 - FINAL BUILDING ENERGY F-I,) ' CONSTRUCTION LENDING AGENCY 505' - FINAL -ELECTRICAL ' m > Iherebyannorthattheseisacomwctionlendingagencyforanepermedmance 506 - GAS TEST r of the work for which this permit is issued(Sec.3090.Civ.C.): ti q Under'sName' 507 - FINAL PLUMBING. o z Lenders Address r'.) O Iecnifymatlhave lend this applicationand statethrottleaboveinrrmaionix 508 - FINAL MECHANICAL IL'F.r •coarser.1 agree to comply with all city and county ordinances and stain Taws relating 509 - FINAL GRADE O p to buildingmmwciion:and hembytONCr6mrepresentatives Ofthis City to enter upon 510 - FINAL PLANNING t>a the above-mentioned property for inspection purposes. IS '(Wel agreetosave,indemnifyandkeephamuess'heCityofCupertinOagvinst - h liabilities,judgments,costs and expenses which may in eery way accrue against said 514 FINAL PUB IC WORKS U Z' City in conserpience'Of the gmnring Of tbispermn.., > SPPLicA oo FU RSSTANDSAND WILL'COMPLY WITH ALL NON NT' ]SSUed by: D3Ie /` ig afore lir APPlinnAate : Re-roofs HAZARDOUS MATERIALS DIS OSURE Wilt the pp.fa to futbrcbu(ding L L ser handle Health and Safety ..Type Of ROOF. . . _ - .. - --- - - -. - 'as dc:S.by me cuMnm Mu pal C' pL 9 1 i,and theHealth and Safety Cod Sm n 25537(e) °Yoh " No All roofs shall be inspected poor to,any roofing material being installed. Will the applicant or forms Wilda cupant use equipment or devices Which If a roof is installed without first obtaining an inspection,? agree to remove .mit hazardomus air Co o nsois as def by rhe(day Area Air Goal,Management ka,ricn all new materials for inspection. Applicant understands and will comply with °Ycx "a- - all non-point source regulations: 1 have read me noted.,marcid,requirements under Chante,6.95 of the California Health&Safety Cada Sections 25505.25533 and 75534.1 understand that if be building does not contently have v moat,mat it is try rcspnnsihiliny era notify the xcupanL of the requirements which must h<met prior to issutntt or a Cenifiote of Signature of Applicant - Date _ nerpr•authorized agcut - - - Date All roof coverings to be Class "B" or better - - OFFICE -