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CI BUILLDwc DPERTONNO PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO,
10490 PINEVILLE AV
BAY AREA
SUNROOMS
02030215
NAME:
APPLICATION SUB DATE
,PWNER'S
17 W 41ST AVE
03/28/2002
PHONE:
(650)341-6201
SANITARY NO. CONTROL NO.
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
u u I=
LICENSED CONTRACTOR'S DECLARATION
Job Description
i3
1 hereby affirm that 1 am licensed and¢¢ provisions of CmP ' 9 (commencing
with S«lion) ) of Division 3 ohne BusiaBasand Professions Codc,andmyhccnse
PATIO
ENCLOSURE (260 SQ. FT. )
.x mor ✓
Licepu Lic. b
1
Jpv'f Comms
k
ARCHITECT'S DEC A
1 unJenlvnJ my plum shall he used m public recccoMs
FA 9� B A n ILS
E VY /�4 l��wu
Licensed Professional
OWNER -exempt R m the Contractor's
I hereby .(firm that 1 taw for the
from the Conions
LiAny
I.S.eusini
Chi c
following uires a permit r iot 1031.Business end Professions Cove: Any city st roomy
winch q s o win h improve, demolish or repair any stricture
6 1 8 0 0 0
Y
JUL 2 200
- -----� - -
e.
.Ourhali, Isoreq th finmich
_
{ ppa t gqOrpp��,�r :•' ,sly
3 V3
Valuation
Ihio he 5{' ep.m pursue a 'tM1a P. o sof the Convacoors License law (Chapter 9
(comm thSalo 1000) fD on3oftheBusinessandfi fessionsCode)
g
or th0 the is esemyt oheicronniond the basis for the alle8ed caeinPtyo. Any violation
�' \' R ,3
of Section 1031.5 by any applicant for n pcmtit xubjttu the npplirnm m n civil prnnlry-
ofmmntnrethamOvabvmdudch.11. (m).
10lPNNYl9tVDATION
i"'3"' Occupancy Type
01, as owns, of the pro,it , lir my employees with wages ns their sole compenuoion.
will do the work; and the'onarmre is not intended or oR=red'far sale (Sec. )Oso,-
'Bumness'ao l Professions Code: Thc Conwnm'e License Law does not apply .an
-
103 -
UFER Required Inspections' -
owner of property Who builds or improves thereon, and who does such work himself
104 -
REBAR
or thmugM1 bis own employtts. provided that such improvements are not intended or
' compile for sale: If. hdwev=i, the .midi not year of
'completion,
_. _ .. _ 5 . _....___..
105 -
_ _____ —_.. _.. ....._—..—_•__ _._ _... .._.__
ANCHOR BOLTS
that
one owner -builder will have the bu,dcn of proving that he did not build or
the burdenof provinghe
improve for p.tp.,a of omit.).
106 -
SEWER & WATER
05;4,owiu,ofmrp:apenr.=me.cl-ivalr=onomcting witniic7n:,dcurd.cto ao
202-
UNDERFLOOR-PLUMBING_.L', ...-. ..._._.. _. .. _...
nswct the project (Sac. 7044, Business and Professions Cmc:) The Contranor's
License Low does not tippy m an owner of PropcnY woo milds nr improves thereon.
2 O 3 -
,I
UNDERFLOOR MECHANICAL"" , . .
.and wbo.c.mnctsf.esach projacu won a.com acuins) licensed pmmam w the
._. __ ... -2'O4- -'
UNDERFLOOR -'FRAME" '-"'--- -----"-
Comrumrs License Law.
0lnmeaamptmder SeS ;' .B&Perm thio reason
205 -
UNDERFLOOR"INSULATION
n' Data
301 -
ROUGH PLUMBING
_ WORKER'S COMPENSATION DECLARATION
302 -
TUB & OR SHOWER.
I thereby affirm under penalty of perjury one of the following declarations:
303 -
ROUGH MECHANICAL
0 1 have and 'w 11 maintain a Certificate of Consent to self -insure for worker's
304 -
ROUGH ELECTRICAL
Compensation, m provided for by Section 3700 of the Labor Code, for the
performance of'me work for which this Permit is issued.
305 -
FRAME
❑ l have end'wiil'mainiaioi Wedur', Compensaoitm len mance, m regvimd by Section
306 -
HOLDOWNS .
W of,he Labor Coq for the perrorma c of the work far which this Permit is
307 -
INSULATION
W MyWorker's Com ensau nl sun.[ c dPotiry m=
-,'
_.. ,.
...._ 308:"-- SHEETROCK
. e .Rcy-LQ�
CERTIFICATION OF E%EM N FROM, 5
V ! 3'0'9• '
l ., s' S k`• (_
'EXTBRIOR L7ATHj ... , ., .
). e
1 COMPENSATION CE INSURAN;, ; a
he e .. •r
.f'
Illi (Thss ummn need not b ebmplem a of the permit for one hundredundred dollars
311 -
-t
-
SCRATCH COAT
(sloo).rle,aa , ,., •
�
,Icnrtymt-;(.Darr "rnnaw.rkr.rwrircilm t
ii siaJed;l
.'.313`-
ROOF NAI -L-----
shall t employ anyparaon in naynumberson,wboon bje,t db Warumv
501 -
FINAL ELECTRICAL'"ENERGY
Compensation Laws of Cal fomla'Dole '
Applicant
-" " --. 502 -
"F-INAL PLUMBING --ENERGY. ... .
NOTICE TO APPLICANT: If. after making this Certificate of Exemption. you should
become subject m Jia Workels Compensation Drovisians of the Labor Code, you must
503 -
FINAL MECHANICAL ENERGY
forthwith comply wimauch provisions or this perm it snail be decone revr
._. "._ 504. __._.FINAL
_BUILDING ENERGY. -
NERGY._CONSTRUCTIONLENDINGAGENCY
CONSTRUCTION LENDING AGENCY"'
505 -
FINAL ELECTRICAL
" I hereby aRrm that N t a on Icndmg agency f b continue
of die workf hich tlua!sh a t. issued(Sca 31397, Ctv.c) _'�';
506 -
GAS TEST
..Lenders Name ........ : .. .. .. .. .... ....:.....:.
_. .... ..
507 -
_ _—....._ .. ...__..._.... _ .. ...__..._ ..
FINAL PLUMBING.,,,
certify
508 -
FINAL MECHANICAL '
this application and suat bove information is
1 that I'have mead this Nthe a
.rest d agree to comply with 01 ,61y and county, ordinances and state laws missing
509 -
FINAL GRADE
w Wilding conslncoon, and hereby auJloh." RprtlenNllvea Of this cloy insider upon
thaab.ve-emmpedpropegyfarinspectionp.mmaa.
510 -
'
FINAL PLANNING
(We) agree t6save!indcmNfy and keep handles{the City of Calpimino-against
514 -
F INA PU IC WORKS e
liabilities, jndgmama, cast, and as,oves ,which may n Any way accrue .gaunt paid
Cit in conscqucntt of the granting of this pcimiL '• .. ' -
O ^b w
AP Lt UNDERS S' D WILE'COMPLY WITH ALC NON:POMT'�
I
]sued by:
Date
s .,lug_ NS. �
ran nvu r .' .' •, - Calif. , ;;
HAZARDOUUS MATERIALS 151SCLOSURE o
Re -roofs
Will Ina ppf m fmok bp'IdinB bcc Pant Wore -,handle haxvddv mmvitl
Type of Roof.
__ - .. -,.. _.
as def ed by thec aro M Pm Cm Cn Dt 9 12 doh x hh the Safety
Cods 5 no- 25*32O r y 1 .: 'I
❑Ye IF}I�
,
a 1 n ) .
t a
All roofs shall be Inspected poor to any roofing material being installed,
^
, . "....
W ll Ne ippllcant future building occupant use equipment or devices which
�i
If a roof Is installed without first obtaining an inspection'; I agree to remove
d sair conmmnan's u defirim by the Bay Arca Ai Quality Management
Dian, tt,Y' -
all new materials
,
for inspection.:Applicant understands and will comply with ,.
all non -point source
regulations.
[those read the'h ,ardour mmanals rouiramments under Chapter 695 dthe
&it oroia Health& Safety Code. Sections 25505; 25533 and 25536.1 understood that
if the building does notcurrently htenant. that itsmY respansibiloy to notify the
occli q,orc hick must W mat p or to oswance. of a Cenifcete of
1 _
j&,0
_ Signature of Applicant
Date
All roof coverings to be Class."B„ or better ..
)
._ ., . 1.