01030113ct•ryoFCU I eH rNNo
CONTRACTOR INFORMATION:
BUILDING
PERMIT
BUILDING ADDR1iSS:
10109 OAKLEAF PL
JUST WATER HEATERS
Pt{AjLND 01030113
OWNER'S NAME:
JEW THOMAS S AND ALIPRA
D JOAN 1764 NATIONAL AVE
APPLICATION SUtl DArn
03/21/2001
PHONE:
SANI'T'ARY NO. CON 'I'Rol, NO.
(510)293-9901
Z ARCHI'ITCIENGINER:
BUILDING, PERMITINFO
C
BLIR'. I.LECI' PLUMB MECH
E
CI ff 1=1
0
1, In thanIlCONTRAC.OR'SDEeme.of [ONbin
lob DDSCPIpIIOII
that]umlicensed under pm]Naft mouse
7yaflirm
i section the Holmes, li v, Cmdr9mleyI
LnSeeinttlandufniv nn7nnnen,t.me..xndProre..en,nscele:mdnayli"n`e
40 GALLON GAS WATER HEATER.
I Ln lull lbrc and cticcLi`
REPLACE
It imenscClass— Lic a
O Mato Contractor
ome
y ARCHITECT'S DECLARATION
1 unJcrstnnd ntY PehullIl be
ns .hM sada, pnhlic rcvarJ.
'
O Liermed Professional
LL OWNIiR-BUILDER DECLARATION
I herchy $Nino tem I at entpt fool dm Contra,lor'v I icenm Law birdie
r
sn
< following,exn. ISemion 7131.5 �Rucinexs and Profession. Coe: Any city n, county
p which requirm a pem,il to ennstmcl. Am, improve, demolish, nr repair any amaum
prat , is belimucc. also4 the applicautfor such pe lu file a signed s,a¢mcnt
m
Sq. Ft. Floor Area
ValuaCon
thsl let 111 ilemed1 ma It th, p nr of theContrachoo, Lechol I staplers
',esand
Isom g thSect70I(1 itDi si 30 he BI 1 ms Code)
1326
or that he is exempt iherrhom and the Iasis for the alleged exemption. Any violation
'
of Section 7031.5 by any arpI want for a .it .hjecls the applicam m u civil penalty
APN Number
Occupancy Type
nn,l cthan oil handbill dollars ($5010).
32618045. 00
01. to nwnef lobe prop rtr, nr ter mnp]oyees with wager as loch tole eompensndon.
Required Inspections
will do the work, and the structure I. nn, intended or offered for sale (See 7(M4,
I1mci r d tholloi ms Code:'n,c Clounnnnr's 1.1—le Lew docs hill apply to a,
treat' troproperty
Who huilsB or improver memm6 and who does such work ldnnelr
204 — UNDERFLOOR FRAME
or through his awn anployecs. presided ,hat such improvements am all intended or
offered Tor sale. IL however. the building or improvement is sold within one year Of
301 — ROUGH PLUMBING
ndclion, the owncr-nuildar will have tee hnNen of pro ins mut he did n u hu11d nr
in,
..cfor pm,r,wofwle).
303 — ROUGH MECHANICAL
01.x.s owner of theproperty, am exclusively contracting with licensed councilors to
304 — ROUGH ELECTRICAL
Lin.umth the P,,,j,ll (See 7044, Businew and Proressinl,n Cn le)'Use Cumm�ctnr's
Law does ranapply n,an ho'ddxortl p,ruatillth.
505 — FINAL ELECTRICAL
rmawnw'th acomywen
and who a,mmem for such projects with a eommnor(tl liansel pursuant m the
and who
Law.
507 — FINAL PLUMBING
Cnntmend hmense
01x0 a.rempl under Sec. .H k PC lot his reason
508 — FINAL MECHANICAL
Owner Oath
WORKER'S COMI'I,NSATION DECLARATION
- l hereby morn undef penally of pcfjury ane of [tic following declarations:
514 — FINAL PUBLIC WOR
0 1 have and will maintain a Cenificme of Consent an self unsure for WorkcG
X / �✓ /
Conmcnmlion_rs provided for by Section 7700 of the Lubar Cute, fur the
Ieflornamec of the work lin which this permit its Issued.
G7
01 have and will maintain Work,, s Cmnpensi ion Insurance, as minimal by section
3700 of the Labor Code, for the pennnmmm of the work for which this permit is
,
.sued, My Worker's CompnIserion h,xraen(e can and Policy mmnber are:
Cartier. Police Na:
Clift I'1171CAlION OF I CIiMVnON FROM WORKERS'
CONIVENSAIIDN INNURANCH
I'IMs section need not be completed if the permit is for one hundred dollars
IS l lull or lilt.)
I lobby, that in the Ikhourn:orae of the wad for which this Permit is i... ed. I
shall not employ any per.nn in any manner su as In hecaam subject a, Tho Weeden
Compensation Law-r of Cullbania. ITim
Applicant
NUI ICE; 'r0 APPLICANT: If, ober making this Ccnlficxm of L'acmption, you should
become subject o the Workers Comrensuion provisions of the Labta Core. you must
forthwith comply with .such pros isinn.r, or this permit shall be deemed revoked.
A CONSI'RUM ION LENDING AGENCY
1 hereby affirm that there is a construction lending .,in, far the performanm
of,he work 11n which this paohn is issued (Sec. AM, Civ. C.)
'j Leonc,'t Name
7 Lender's Addy...
1 cloth, thin I have read this application unC stem that the u1n,we inramutinn is
rcat. I ngrae b, comply with all city and couvy ordinnnees and cram laws hchumg
to building antstoction. and hereby au,hnmc representatives of this city In enter upon
y the aMmcmemiond progeny for inspection puHs,scs.
y (We)agree to save. i ndcmni l y and keep harmless the City of Cupeninn uguina
,
n I abilllios. judgnrcnts, cult. trod cnpcnscl wh;ch may Ill soy way Lent( against said
-
Z City in cnntequnme of the granting N this perntl.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONLPOINT
Issued by: Date
y'
SOURCE REGULATIONS.
Re-roofs
Signature of Applic.bUC4 truclor Ilam
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or luwm milding occupant stem or handle hurandous marina]
Type of Roof
as dcfined by the Capertlnn Mnniclpal Code, Chaptcr 942, and the health anal sally
Ux]o section 255)20)1
❑ No
All roofs shall be inspected prior to any roofing material being installed.
Will the al,tic:ant Of etlme building oecupam use equ'ipmmn or devices which
If a roof is installed without first obtaining an inspection, 1 agree to remove
eon hxmrdous air couch moul, to defined by the Bay Area Air Quality Management
all new materials for inspection. Applicant understands and will comply with
Dis,neo res El No
all non-point source regulations.
I have rend the hma alms tnumnal,, requirements under Chapter 695 of the
Califomiu Health h Safety Code. S etlont 25505. M513 and 255}1. 1 undcntand that
if,he building does no currently hall a mount, then it is by resrmtlhlRty to maify,he
u.i it of the requirements which oust be Incl prlof to issuer(" of a Ccnilicum of
-
O'.aury' -
Signature of Applicant Date
All roof coverings to be Class "B" or better
I
Owne.,,, hate
unit ell agent
OFFICE