02030157 OF
CI BUILD NO DIVISION O PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10480 OAKVILLE AV 02030157
WNER'S NAME: APPLICATION SU DATE
VICARI ANTONE E AND NICOLETT 03/2612002
PHONE: SANITARY NO, CONTROL NO.
s _ �
GOO ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
U I_' L= L7
LICENSED CONTRACTOR'S DECLARATION
5�z I therm rfirm that turn licensed ander Job Descriptio
i z—o y u provtaons or ns Code 9 and
(commencing
;_t, wnnsecaan7000)aroi,hsmm3armeeusme anaProressmnseaae.amamyheemse KITCHEN REMODEL.
in rwl r 5fral. 2 F OQ2
:
',it Licenu yes e / Li.x �yiZ3l/
•O i U t Z Comraclo �^
l 3 a ARCHITECT'S DECL±Jq�ATION x-t �, V
O I undersand my plans shall be used as public records DI
i p o Licensed Professional tA1�a
Q.R E., OWNER BUILDER DECLARATION
—w I hereby mmrm that 1 am exempt from the Conlranum's License law for the v
t? following mason.(Scotian 7031.5.Business and Professions Cade:Any city or county $10000
D which requires a permit it)construct.alter,improve,demolish,or repair any Structure
e,3$ -pnormits issuance.also myuimvhenpplicanr focsucM1 permiuo fileesignW stemmem -_ .. _.
— Inatrye_itrr�rweapaau.mmm5prbssmnsarmecantraetorsucenttlaw(Chaper9 - s , y
__
momrmnVWqt)WValuation
or Thor he is exempt therefrom and the basis for the allegW exemgibo.Any violation
-of Section 7031.5 by any applicant for a permit subjects the applicant m a civil penalty-
1 OAIPH NPk!ftDAT I ON i Occupancy Type
01,as ownerof Ne property,at my employees with wages as their sole compensmion. '
wIII do the work,and the suuaum'is not intended'or-offered for sale(Sec.7bW,-
Busincin and Professions Cade:no,Contractors License Law does not apply to an 103 — UFER Required Inspections-, '
caner of property Who builds or Improves thereon,and who docs such work himself
or
improvements not 104 REBAR
through)its own employees provided mv Jed lh 1 such'
sale If,however t will
buddingo a tics Ia 'ih rte Wild
_ _""- - -'-" ...._._..-
105 - ANCHOR BOLTS
me owner budder wIII have the burden of proving total he did not build or '
completion,mprove far purpose of sale.). 106 — SEWER & WATER
❑ilia.,owner of he pmm pmy,eexclusively sumac Gg with licensed<aoGum
ors to202 - UNDERFLOOR PLUMBING
construct the project(Sec.7064.Business and Professions Code:)The Contractor s 2 0 3 — UNDERFLOOR MECHANICAL!
License Law dues not apply to an owner of propsny who builds or improves thereon,
and who containers for sum.pmjecic with a contmmarkdAicemea pursuanttothe_ _ _ ----- 204 UNDERFLOOR' FRAME
Contractors License Law.
0 lam gemm
pt uor Sec: `.B,&PCta mUNDE
isrc..i 205 - RFLOORS INSULATION
Owner "' DSa' " " ' 301 - ROUGH PLUMBING
I' WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER
Ihenby ammt Linde,Penalty of perjury one of following declarations: 303 - ROUGH MECHANICAL,
00 1 have and will tiolammin a Ceniftctim of Consent In self-imam far Workers 304 - ROUGH ELECTRICAL
Compensation, as provided for by Section 37W of the Labor Cade, for the
Performance of the work for which this permit is issued. , , 305 — FRAME
01 have and will meiineln Worker's Compensation Insurance,as required by,Section 306 - HOLDOWNS
ren a
ia�ea Myw k 's ca pe :tont rc ° 307 - INSULATION
3700 trot.{ERT Fl miens, OF FXEM e Labor Code.for he peof.mus.ce 1,N FROM WO KERS this'� ^
ren d Policy b
lb'1d fCdlau4x'C�pn p'n. u3:08'.';.'; SI�EETROCK_;' _ _ - t
l`'`' 3 t 30911 ' EXTERIIORt LATH.
COMPENSATION INSURANCE ` ";•,;`4•.�_ --- ,_
10 _INTERIOR--LATH— -; . . - -
('rhssetbn readmit 1e completedf the permit is for one hundred dollars '
shall t 1
(SIDD)orlesi
311 - SCRATCH COAT
1 itfy that in the,pie romance of the for which thispermit- s issued,l
,313- ROOF NAIL _...
p y any person in any manner so as to becomes 63eot t the Workers S01 - FINAL ELECTRI CAli'°ENERGY
camps 1mnLaws arcTr ia.-- - .-,--,.,.. -502 - FINAL. PLUMBING ENERGY. __. _. . ----
NOTICE _
Applicant' - - to o..._ _. d _ _ _ _
omeTO APPLICANT.If.C6maften nkingmla visincofo ExemptCWc,,n. you
multi - 1
Z forthwithcocnoththsuchprCempcnm6anpermtsnnormeemedrede.yaamu 503 - FINAL MECHANICAL ENERGY
Z0 forthwith comply with such provisions or this permit shag h deemed invoked. _504 .— FINAL BUILDING 'ENERGX_ _ _
VJ :' CONSTAUCr1ONLENDING AGENCY 505 — FINAL ELECTRICAL
1 hereby affirm that then is m construction ding agency f me p rfur nonce t t i
W.,. of the work for whim this permit sissued(Sec_3D97,Civ.C.)_ 506 — GAS TEST
Lenders Name,... ., ... . . _ _.
Z Le, anaa 507 — FINAL PLUMBING..
U'O1 certify that 1 have mail this upplicaoon and state that the above information is 5 0 8 - FINAL MECHANICAL i
W."i. col"d.,me 1.comply-with all city and coumy ordinances and state laws relating 509 - FINAL GRADE
0^u to building construction,and hereby huNoriu reposemaiNes of this city to enter upon
>.'W the arove-mentioned_propcny for inspection purposes.,.. - 510 — FINAL PLANNING
row (We)ngne to rove,indemnify and keep hurmlcai me City of Cupcnloo against —
m liabilities,judgments,costs and expenses which may any way dame against said 514 FINA PUBLIC WORKS
V"tiCityy ibconsequcnceofthagmnr 8ohhis permit.
AP ' .TURD STAND NOW LCOMPLY WITH ALL NON POINT"'
_ REGUL IGN. Issued by: Dale
S'nature-of ppllc d t occur, - -" - ':"' " ' `Dam Re-roofs
HAZ ROODS MATERIALS DISCLOSURE'
me l emit o,,future building okisti,cut store or handle harnrd us rancrail ,'Type Of.Roof
as def m bytie camirtins,M [Code,Chapter 9.12 and th flarildii and Safety r -
Cod.Secuo2S5JIQ^ t - -y. , > i '• s '`m . \ .'1 !.�.
°Ye' /4"° i d' All roofs shall be Inspected prior to any roofing,material.being installed.
0JsWill me applicant or future Building occupant use equipment or devices him If a roof is installed without first obtaining an inspection',
I'agree to remove
ithazardous asdefined by theBay Areae, Quality Management
trc all new materials for inspection Applicant understands and will comply with
all non-point source regulations.',.-,,,, -
3' I have"ad me himallous mumdals requirements'under Chapter 6.95 of the
California Health&Safety Code,Sections 15505:25533 and 25530:1 understand that
ifihe nadding docs not currently nav a¢nanr.that it is my respossibility io notify the "" - ' " """ '
occuprmi of aintimmus whit us met prior to issuance of a Cenificate of
°"d Signature_of Applicant Date _
roreamarm Doc �a All roof coverings to be Class"B" or better
t.
m ,,t
OFFICE .. . . .. _ .. _. .. _...