00110101 CITY OF CUPE RTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PIiRMI lNo.
192-01 PHIL. LANE SUNBORO CONSTRUCTION CIRP001. 1.01.01
OWNER'S NAME APPLICATION SUB DATE
SUNPORO 1.307 S MARY AVE #2-0 11/20/2000
lei PHONE: SANITARY NO. CON'ri 1,NO.
(408) 810—E122
PacZ ARCHn'ECIMNGINE[R: BUILDING PERMIT INFO
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111.1 I11,14cr PLUMB MECH
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LICENSEDCONnsed under provisions DECLARATION Job Descrl pt� I1
I hcrcby alliin,ma I um IiccnxeJ under of Chapacr 9(commencing
F v,Fu! warn timeam0)nf Divrxinn3n(tne❑usiner and Pmfe%sinn.,Cde.and mylicena
_ee mmBrmrctanatrr 7 75£ DEMO
enxt Cl... Lit.a
a 3 9_-9�
nae /.11. Contractor
ARCM"'""s DECLARATION
n roll be ua uNic record.,wve
gLicensed romieanal i.OWN .HIIIL)EH UECLARAr10N
� 1 hereby arlinn tbw I u carona Imnh me Contractor',License Law for the
following reason.(Section 7031.5,Businn%and Prnfessioro Cole:Any city or county
$x❑ which retluire%a permit to conw uct,alter,improve,demolish,or mpuir any structure
i3m
prior to t also yutt theapplicantI suchpc itt tsignedstatemcm
thathe is Inemedp %aa h the prioisonis ol theContaxon',Liccnw I (Chapter9 Sy. Ft. Floor Area Valuation
month g with Sect 71PP0 l n' n 3 I m u est a r. ' n,Code) $10000
or mut he is exempt therefrom and the nad.v for the allegcd exemption Any violation
of Seaton 7031.5 by any applicant loin remit subjects the applicant to a civil penalty
of not more than live hanJmd dolle,(550 ). APN Number Occupancy Type
0 1,asowner of the proNny,or my employees with wage%as their.sole comtpensation. 37540044. 00
will do t k I hh (,act l,i,on, mended uttered r (See 7094.
Basi d I t :: C d 'll C t I I' 1 I'1ply Io un Required Inspections
owner olproperty Who builds or hpnx:Ihenon Id h dw suchkhim.mf NO ASSIGNED INSPECTIONS
,r,,d for
his a ow ever.I ......idcnxthut atmh horn cuts a un....e y ar
son c
oln+d for sole.II:low ever.the I have,lifin,l m inden el o,in null within ane ycrt of
mhpl c ben,the pawnor-bullJm will hove the hnrticn of Plrning th,n he did bol bnIIJ lir
mrrmxt ror ramose orxalo.x "
01,u of the pnga:,Iy.0 xclnnivcly cantrocling with lhcnwd conmmm..m
mI...I he ,rojeo(See 7044.liusincs,nn l liar ..on,Civil,: Cmm�mnrr n
ucen,e Low alms ma apply m an,.wmer of property who noun,or dnrmve%thereon.
and who eooma,l,ror ouch pctoco, ,,It n u..ami licenced nunoo.,to One
Cmemetor'x Llcanw law.
01 ad cxt npt anile,Svc. .If&PC ler mix reason
ownervile
owe :
WOHKIiR'S CUMPION DECLARA'OUN
I heathy alErnh under penally of Iwim,one of the hollowing declarellnn
O 1 have and will at ;,in o Cenilicwe of Consent ,,mlf-insure for Worker's
I Gnnpcnshtion, is provided for by Stenon PIX) of the IaM,r Cade, for the
performance of the work for which this ptnr in i...eJ,
01 have and will maintain Worker:Gnnpennorimn Insurance,as required by Smion
3710 or the lalw,r Code,for the perfonrunve of the work lin which this peredi is
sued Illy Workers Compensation Insurance carrier and Policy minter are:
�T.dns F+� outyNo, 1S1337$•
CERTIFICAnON QF EXrh119 ON FROM WORKERS'
COMPENSATION INSURANCE
fonds section need not be completed if the pcnait is for one hundred dollar
($1 Oho,los.)
1 cert ily than in the performance of the work for which this partner is issued.1
shall not emptily any reran in any manner xo as to become subject a,lie workers'
ComiN malion Uws of Culifomia Date
Applicant
NOTICE TO APPLICA NI':If otter making this Cent theme of 1:le rption,you should
become sidjccl to the Wnrkar's Cumpen,ution provision,of the Lulxn Calc,you most
C fnnnwith comply w'nh such prov iambs or the,armil%hull Is,dean ed revoked,
z i CONSTRUCI ION LEN DI NG AGENCY
a > I nemhy affirm Bmm . inion bd t h ..... lending agcacy IM1r the pxdomem,c
at he work ler which thin rennet i,issued(Sea 1007.Civ.C.)
L Q 1,cai Name
z, z Icndrr's AJdmsx
U 1 canary,ha,1 have Icml Ilan appllemlou t I sun e,hal the have inl'unnwlmn is
W [r a rrea.I agree hi enmply with all filly and c,army nnfinunxcv:md state Iuw,Nesting,
0 U (, uholding 'r ly' I l ft' : I llhi,,ilyl I I nt
r� 11eab f d"I'llInyI '.t I
Fy 6x (We) 8 nl II ly andkeep lI Ili ('try it( 'em .g. ill
Vi luhill I I6 I. t I I %sex.11111h olLy an any In,'tc uv ganno '!iid
�' APP( AN ND WII I COMI'hY WITH Al 1.NO 'DINT Issued by: Date
p�eanuc„Ito — n rpt Re-roofs
IIA! )UOS) I?RIALS DISCLUSl1Nli '
will
Gds Swrinn 25.532(a)
ln) of nlharc nhlBJimg a<apmhl.tom onhadne na amoas lna'x'd:11 Type of Roof.
an amimd try me carenim,nwhdmp:n ode.cl,alncr 9.I z,acts me Hamm and s lcty
ar 25.5321255 '!
0i'e, ON. All roofs shall be inspected prior to any rooting material being installed.
Will the afflicted or lmurc hi line,weldnan use OpoipineDl or devices x'hieh If a roof is installed without first obtaining an inspection, I agree to remove
emit hazardous air comatninaets as deined by the It Area Air Quality Manage nem
Omdcrr all new materials for inspection. Applicant understands and will comply with
0 yes 0N all non-point source regulations.
I hw,c read rhe hwardou dal%rcyuf ems trader chapter 6.95 of the
Califomia Itcat R S.cry Code,
2550 .5533 and 25534.1 malsooand chat
if the building docs nor currently have a tenant.that it ix ny respmsibility to notify the
nr ter rhe rc nircmemet pdd o ixxn:ben/ of.0 late
Signature of Applicant Date
tP”,gxDateAll roof coverings to be Class"B"or better
OFFICE