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02070081O he X F w OFFICE- CITYBUILDING DIVISSIOrvNOPERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 10735 PINOLE CT DIJOSEPH'S PLUMBING 02070081 OWNER'S NAME: APPLICATION SUB DATE FRONSDAHL MELVIN E AND ANDJEL 205 WYANDOTTE DR 07/15/2002 PHONE: SANITARY NO. CONTROL NO. (408)365-2058 z ARCHITECT/ENGINEER: BUILDING PERMIT INFO C BLDG ELECT PLUMB MECH ai CJ I--1 CI LJ i LICENSED CONTRACTOR'S DECLARATION Job Description v=Ni z_o hertbyeR thin]amlicenxdunder provisions ofChapter 9(commencing REPIPE nC J with Sectio ]000)of Division]of the Btxi_xae sand Profcaslons Cedr. vnd my license in a eRe • I Y�6 License sis -nd L'£.p I f �r8 �, A0. E© Date Conmaaprm N, O 3 LL ` O a� a JUL 3 1 2002 ARCHIIECf'S-6@I.ARATIO nders lens d as blit se<oNs �i--y`�%p% r F ��' Licensed Profen tml Y p p OWNER -BUILDER DECLARATION +� - 1 hereby (Brat thin 11. exempt from the man's License Law for the i a R=A feso following reason. (Section 7031.5. Business and Professions Cade: Any city or county . BUILDING $ 6 2 (] (] which rcquirts o open improve, repair any swaur<. cores y�o i '-' hdemolish,permit he e. also re die file -poor wits issuanec also requires thoxismrofineapplicant for s«hpemdlm BleaaLw,(Chapter9 tipp pp rynp`e t Y Valuation i Ibatb'd iali«tatulpllhu`WI Ipt prvNuons of the Convector's License Law, Cods) the urinet8�s.arpi ftp�o. peyvi Code) (r don the ingysith Seai frmn�and to basis Sect he ii eaembi theiefmm and the basis for the demrn any or violation or altsg� t to - of not Section v any hundred applicant dollars ($50 mit subjects the applicant to a civil Penalty mannlnlot<manry<hnmredmnaa(s5a). NLWffi* PL MBING�''^ Occupancy Type ❑ 1, as owacr.f the progeny, or my employee with wages as their sole compensation, t -'-' -'- --- - - - - 502 - FINAL PL�BSj�t�BdC3n5 3Ii,�](Sg `" •'l^ -will 'desi an Pro, -an 'the 'ode no C not' Intended Liven aofferedLaw for sale apply to ij 'ownerofpim'Pr,Whonx apply an owner r of progeny Who builds m improvo thereon, and who docs such work himself l 507 FINAL PLUMBING his own emvloYa.aprovided that such improvements art not intended or '-LR--d'f- said.71C however: the Wtlan - tissuld' withtnnni 7" e. P Y Ito _. ._.._... - ..._.__.__ _.lice.__. lice_- .-.'--_ -lice ._--'- ,>ihel ` the o Ider will have the burden of proving that he did not build Or ove ecr o improve far pnrpoar ornate). far � ov1:ovinstr rnrthe pmpeny, am 7 l'..' --- Buiusivelycontractingwithlicensede Contwnl0 c4 theoesno(Sec.toa Business and Professions Code:)Thrves thrown. � i,il.i'I r'L[f .,i•.4 CLCs� License law does not apply roan owner of progeny who builds or improves thereon, Livens :i-r.C... ch proj«u.with.a contr«mr(s).Eccnsca.Pursuant to.the._______._._._..__. and whore lice -lice. _._.______..___._. _. _..._. _-_._.__..__,_ .lice__. 3____ ......lice._._________._. r _ . - ;*; LicenseLaw. Cl I a. oh License 1So o s ,. p «'-. • c' •,•".I '-'9,&PCfar this mason ❑lam poem funder g�. aGG _JCYL rte%ti Pi- Owner 4 r a k *� Daie `' ''''r " WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of pc jury one. of the following dttlarations: - ❑ 1 hrive chd will'idmmn b'Cr6,,me of Cement io self neon for Worker's C, pc sal -asprovided-for by Section 37W of the Labor Code: for the 'perfonrunce'of the work for which this permit is issued. , ❑ 1 ha eantl'will maintain W ke'y's Compensation inithanci,-as required by Section - - 3]W' of the' Labor Cade, for the pxaformancr of Ihr work for' which' this permit Is inIueJ Myker1C t Imo' e' " .' cNit!Pnl°29lJILkI'Go 3? it WORKERS; g_ t, :4 4., 1. vw 't.l ki it V .1 �,CERTIFICATIONOFEXEi PnION MM _ - - COMPENSATION INSURANCE L .� t\: ...- -I ,l5. -Y_ f .. _ IV +(Thta section need not be completed if the perm use for one hundred dollars I '. I`f • 1 Ys ^ , t \ 'L (8100) or le..) 1 n - - tti-- 1 c oh fY tit t pcR e f th k f h h t suedrs �C e s u ct all not employ any perwn in nm n as Yo'hcconm subject to the Workers .. ' C pe .,,tion Laws / California . Date Application- OPICE •' NOTICETOAPPLICANT If Tier mak 8th Cnf at ft mgt you h Id NOTICETO Q Oh mils 63em to the Worker C p '. nsll lee Latin Cale you nun fonh his fah- be deemed m, revoked t- plywith-- . provision,n pe _ VI �f s y CONSTRUCTION LENDING AGENCY 1 h by Rrm ih t the < is con tinct 1 d' e8 ncy f th ve i g pcH of th rk Nme hl h th p<mmi s ss d (Sec' JU9] Ct- C ) Le d m Sez Londe Ada U I certify thin 1 have read this applapuo t and state thin the adore mfarmauon I, roiien. I vgrte to comply with all city and county ordinances and state lawn relating Oo building construction; and hereby autharite'rtpeegenmtives'of this city to enter upon derisive monameadporcry fortir,colma part - I W) b ee iu d fy and k ep h n.nl . dm Cit, f C penmo ago nsl tq V_Z liabilities. judgments. cot and expenses which y n any y p.i. t. id imemisequenermt the g r� \/ APIUCANT UNDFRSTAN S4Dt\VILE COMPLYWIYH AUL NOVPOI.W - by: Date sov tRer Inr1oN /' + T �O Issued 5 a ApPliw VContmdmgt to j Re -roofs -� tIAZARDOUS'MA'IERIALS DISCI URE I1 the apOlicaa[ fuw bmlldl8« p t torch bendle paved u xt<nal .Type Of Roof. -.. •• , l - - •. ..•• •• -••. .a••._• . as derned by sfi Cupen M pal Code Chapmr 9.12. routine Health d Site, '' 1 . s_ tit; d*S r 5,:..'a4'iiY Code st 2ssJ_11 4..;^:. All roofs shall be inspected prior to.anyjoofing material_bemg,Installed. , , - _ WIl the applicant or future hu la gp t_ x cq p t devices itch cant h a contaminants as act d by the B y Arra Air Ou ty Management air District? Dyes°. l If a roof is installed without first obtaining am inspection d' agree to remove all new materials for inspection. Applicant understands and will comply with all non -'point source'regulations. .. ' ` 1i ' 1 havdrcaa the hbra timr, that'ritih regmtcam. tinder' Chapt r 6.95 of the California Health & Safety Code: Sections 25505, 25533 had 35534. l understand that ly a sn Be' lope bvilof does hot r my ssuanceior -.. ..._.. ......_.._. _ _ _.lice _ .. _- _ _. ._._. _.. . , s whithave the requiremg ents s, be et tri a ifird Oxch t y. Ne - mem which mu t be met prior m r,a Cenifca¢ of, ort cr /1 \ /s,` Signature of Applicant Date `B" -pmorar gent t;�Datr All roof coverings to be Class or better , OFFICE-