01120056 CIuoOF
DI FSIONND
BUILDING CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10706 PARTHREE DRIVE TIM HEYBOER LISA CASKEY 01120056
OWNER'S NAME: APPLICATION SUB DATE
SANITARY NO. CONTROL NO.
1
E-,. ARCTECf/ENGINEER: BUILDING PERMIT INTO
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BLDG ELECT PLUMB MECH
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dad
Z N i LICENSED CONTRACTOR'S DECLARATION Job Descri 'hoBI�A
LfttU
O z_ 1 M1ereby a)of that 1 am licensee Diacid provisions of nsChapter Code.
(commencing
FNtw with Section]OIXry of Division 3odthc Business and ProfcssionaCWe.and my license CONVERT PATIO TO DEN
x In raB darts and edf t. p CT p 4 2002
ti ttCoo
< License Class Lm N
Dare Convector
LLLLO I-n ARCHITECT'S DECLARATION n7
oIl
a ]understand my plans sM1'll be uxJ as puhlic recordsBU' eIL1BiiG V Ip,g,/
r
w iEp O Licensed Professional
OWNER-BUILDER DECLARATION
1 hereby affirm mint 1 am cacmpt from the Commaor's License Law for,he
$10000
•
r Z a following reason.(Section 7031,5.Business and Professlooa Code:Any city or county•
91 O O O O
E 2 o which requires a permit w canzwn,alter,improve,aemplifi,or mpvir any swnurt
-prior to its iteamence,also requiresthe applicant for such Permit to file a signsai auumentbar he islcengJ partisan;10 the Positions of the Contractors License Law(Chapter 9F pp ACEs Valuation
(ea mi,inStt p,7000d,atDivisaa3mmeBeemes d Pp.fi .,ma,Code) i,1).'° i 35b'0•zJ.44`.aa;U '..a12i1.1;.".7��f��'i:
or that he is exempt therefrom and the basis ha the alleged exemption.Any violation '
of Sccdna]03lsbyany.p,limpforaPermitsubjectstheaWficanrtoacivilPenalty APN��yy mt,eT Occupancy Type
of not mom than five hundred lrr.(ss0o). 101 — V8ftATION p y yp
❑1,d nwnaofk. property,ru myemployeeswithwageseedforale(Se.jinn,
veal ne be work.and Professions Code ure
C not uctora Lie offered for anotappl.mar; 10 3 — UFER Required Inspections'
Business and'Pr y Who
Code The Conwaor'a,nod av Lew cons no,apply m an
owner of property Who builds or improves thereon,ane who does such wank himself
or through his own employe=d.provides mm such improvements are not intended or _„ 10 4.._ -REBAR _ _ ------
o02red frit alcf If,howast,the minding or mprovemem o fold within bne'ye5;of ---- _ --�'- - - _- '-' - -
comple,ion,a p
<ownerbuilder will have the burden of raving that he did no,build or 105 — ANCHOR BOLTS
improve for purpose of side). 106 — SEWER & WATER
pl.ns owaernf the prnpeny.pm esdusivelycommaingwi,hlicenseJconnactors,o 202 — UNDERFLOOR PLUMBING
construct,he project(Sec.]OBJ.Business and Professions Cedeq The Commcmrk f
License Law does not apply to an owner of pm,my who buima or improves merton, 203 — UNDERFLOOR MECHANICAL
_and who contracts for such prokas wide.a.commcmot licensed pursuant.m.,he _ _... _—._
C'era<tnral.icense Law. 204 — UNDERFLOOR FRAME—
_ Ptaadersr;"'I "' 1&Pcrnr,ms esp" 205 — UNDERFLOOR ' INSULATION
Jr 30�oZ 301 — ROUGH PLUMBING
_ - WORK'R'S COM1 gg�TION DECLA ATION
I
hereb rrrm ander n==a �" 302 — TUB & OR SHOWER
hereby a per)nrY,;n�nfmgfnunwingaeemmanna: 303 — ROUGH MECHANICAL
01 have mal will'maintain a Certificate of Consent ,a salt-insure far workers 304 — ROUGH ELECTRICAL
Compensation. as provided for by Section 3700 of ,he Eaton Code, for the
.-' performance of work for which this permit is issued. 305 — FRAME
01 have and will maintain Worker's Compensation Insurance,as required by Settlon 306 — HOLDOWNS
37M of the Either Code,foe the performance of me work for which this Permit is -
Id:sect.Mywankeracamp<nda6anmaumnee<ameranaPareynamb=r art: 307 — INSULATION
car„ t . 1 +'Policy N . 308—'` SHEE,TROCK_.,,._. ..
"t CERTIPICATI NNOFEXEMFr10NF 0M.WQRKERS't "�", 1 30'9• ''"'ksEXTERIOR``'NTH`'
COMPENSATION INSURANCE s_', _
—' 370 INTERIOR—LATH r .
scniorineednot be completed it tM1c permit is for one hundred dollars -
(snw�mIt'anedfa - 311 — SCRATCH COAT
I n ry matin'he e r m ae of k r hi h thisp<- 't . ssuea l 313- -ROOF NAIL -
ahn ' ,e ply,�rype otk pm _z a n et m workers 501 — FINAL ELECTRICAL - ENERGY
Co p t oytE)�'N' al f
..APpglert(7 s
p, you should
z n hl«erosive k acmpnat p Bann Larcode,yaanmm 503 — FINAL MECHANICAL ENERGY
Nino is plrwhh'enp noisome p t.balb a J skis. 504 FINAL BUILDING-.ENERGY
CO.N.S,TARU..CT_IO.N._L.E.N.D_IN�.G.AGENCY
51.
I by (firm that pe - o construction lending agency f,.,h p_c.r.for.m.antt
505 FINAL ELECTRICAL
,he ark for which,h permt is issued( c 101,Cis C).,,
�.
506- GAS. TEST . -- __ - — — "
tlndgra naarea 507 — FINAL PLUMBING;
UO I«Wiry that 1 have rete Chia application and sum aauhc about information is 508 — FINAL MECHANICAL
El. F, and
F, rn 6aRnaedme ' etocnmpwonmlciydnaenumrordinances, natelaws relating
509 — FINAL GRADEO U m0nguadan.dna nembr'umad;e rdrve,ortmvea of this aryiwenter upon
>,-W, t mmentionedproperty f inspection p pad . pno against 510 — FINAL PLANNING
L (We) g w ae and keep hathe City of n
lien r es dg m and ,,snes wh hmaymany y acmeagmnn
seta 514 — FINAL PUB C WORKS
u
APPLIC 14 ERS
z Cry c equcn of the granting of tti.p n
1TA9DSANDWILLCOMPLYW'ITHALLNON Or Issuedb Date
I n 'TI n. JC �� y'
.anV are
Re-roofs
HAZ ofuture MATER g occupant
Dsome of an
cl worn eCte t rmurebuilei ca e p t.r rarsnardl Nae Health
and material Type of Roof ... ... .. .. . _..
as dcfneJ mi Cup=' M Iia I Cad Chapter 9.12.end the Hulm and Safety _ r _ .,„ ` +
Cod Sea on 255720 : i g•l) 's; ' fly i1 . SA ••
ores rat '.; I ( All roofs shall be.inspected prior to any roofing.material being installed.,.. _
Wn me apple r or future building partum cipr inurentmde cs vouch If a roof is installed without first obtaining an inspection, I agree to remove
-mthazardous ur contaminants as def of by the Bay Area A Quality M agmem
all new materials for inspection. Applicant understands and will comply with
oy s ' _ - all-tion-point source regulations; .. :.•,,L•.,
,I Iiava,"ad,he hvvdous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505.25533 and 25534,1 understand that
if the Wilding dues nmcumendy haverneram.,hat it ismy responsibility roe parity the -
a<pa o he regGircmem.,which mail he met prior m I...an"of a Cenifica,o of
_ Sign_ature of Applicant Date
: D to All roof coverings to be Class"B"or better
.OFFICE -