00100007 CITY of cul'ESION CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS; _ PHIIMI'I No.
OWNER'5 NAME: APPLICATION SUR HATE
1,9091 PRUNERIDGE146 TOENISKOETTF_R 8 BRE ,DING INC@01.0@O07
PHONE: SANFI'ARY NO, CON'I'PIE.NO.
1960 THE. ALAMEDA 10/02/2000
M W Z ARCIII'IECIIE' BUILDINOPERNIS I INFO
woo
IILDG IiLF:CT PLUMB MECtI
(408)246-3691.
SH LICENSEDCONTRAMOR'S DECLARATION Job Description
I hcmhy ath,m,het I at.licen.ixl th ...works of chapter 91Ymnmencing
with Section 70gxl or Dlvi.vinn 3ofthe Business and Pmfmsions G,de,and my license
t4 i ,s at lull forceon rent.
Llncnm�'J((��/I,� I.
m'%w S DrCLARCHITECT" DIeC1.AHA'1lON
tet=°4 Iunde,wand my plans shall he used ds public records 5t!
LY/30—DRY P MIT
rf
i a p o Licen.wW Profcnsinndl
UW NEmckcrlI!oanthe RA'll()N
u1 w I hurts,efurn that I ren cxcnnpl tram the Cnnunrorr'.hiccnne Law I'or the
C=< following radon.(section 7011.5,Buvindss find Prvfessionn Crelc Airy city nr loamy
E s C which requires a permit m construct,doer,improve demolish.or repair mr,svuwu ,
5eI prior In its i5suancn eho myuirts,hc applicant for rete pcmnino filcasigrmA smmrrrcm
thm he I,licensed pardea ,,the pro,k m,or the cm,nachl License Lev(Chapter a Sq. Ft. Floor Area Valuation
(connuuncing wird Section 71X)0)of Div lion t of the Bosinesa and prall"In I,Coat)
II teal he is ctema tbatolmm and to bel,fir filo ale 1ged ev......n.Ally violmian
of Section 70315 by any applienal for a Immdl objects the applicant a,a civil Pearly
of am more man five hundred dollars(551x). A PN Number Occupancy Type
❑I,as owner of me pmpcny,or mY employees with wase.d.th<ir sole compensation, $200
will do the work,and the snuctum i,an intended or offered for sale(Sec.7f,o,
Rusincss and Pmfes_siam code:Tire Cumreetera Lia„R La,does all apply m u I Required Inspections
I'll,or P,,,,,IyWill, n
huilds or imp..cs ,unou.and who Joss aoch wo,'k himself 31 F 07@43. @0
or nvWill,aaxh hie own call pro,tried out such impincludedvcmcol,me ren inled nr r
of coal for sale.IL howevea the building or impmvemem is sold within one year of
impletion.the ox nerbuilder will have the burden of proving that he did not build or
improve n,rpuros
pleofsalek 1.01 — FOUNDATION
0l,ds owner of the pa,peny.un,cxeluxively connacling with licensed amuamora m, I
1 a2 — PIERS
comduct the pmjca(Sec.7044.Rvurres and Pirofesvum.Calc)"rhe Contractor'v
License Law does ern apply m an owner of palpi who build,or improses thereon.
and who contacts for such projems with a crucial licensed par.uant to the 103 — UFER
Cranial Liceme Law.
01mr,.cd,aunder See. .B&PClot'hisrem,,, 104 — REBAR
owder Liam 105 — ANCHOR BOLTS
WORKERS COMPENSATION DI:CI,ARATION 1.06 — SEWER 8 WATER .
Ihembyaffirm under Penalty of elrjuryone othe following dedamtions: 202 — UNDERFLOOR PLUMBING
❑ 1 Igoe and wh1 Id,inmin a ccrhnnme if closer, ,, sell-insure far workers 203 - UNDERFLOOR MECHANICAL
Compensudon, Ins provided In by Swoon 3700 of the l dhor Code, lar me
pedendaaceIfheoak lin hirl, his panutI,I...ed, 204 — UNDERFLOOR FRAME
❑l have and rill maintain Worker's Compso,samn Insurance.as merited by Second 205 — UNDERFLOOR INSULATION
3700 of the Labor Cade,for the performance of the wad for which this permit is
issued.My Water's CodnpnsdanIsurancecamm':�mfdVoheyymm`ilg,cr�are': �7 301 — ROUGH PLUMBING
der IC(o.�
PolicyNoU oJa�N _/'7r 3012 — TUB 8 OR SHOWER
CERTIIIC, ION Op EXEMPTION FROM WORKERS'
COMPENsAnONINSURANCE 303 — ROUGH' MECHANICAL
(This onion need not be crandcmJ if the permit I,for ane hundred dollars 304. — ' ROUGH ELECTRICAL
(M0(barless.) 305 — FRAME
I cemry that in the se,fonnance of the work for such his pe.It(is issued.I 306 — HOEDOWNS
shall not employ any person in any mmnner so as to become subject in,he Workers'
Compensation laws of Califomin.Dam
Applicant 307 — INSULATION
NOTICE ro APPLiCANr:If.ane,loading his Ccookam of Escmption,you should 3 — SHEETROCK
beck me.11 kk mu W-1....Campend Iprovision,or he Labor code.Yau latest 309
— EXTERIOR LATH
p mrhx;tows..lywim.,Inikprookiansdrthistillluallbedcemedawaked
, 3@9
O
?” y CONSTRUCTION LENDING AGENCY 31,01 — INTERIOR LATH
1 hmeby vffird Nat them is a emvswction lending ugmmy fonhe performance
w fbewarkro,which this permitislssued(See.3097.CimC.) 311. — SCRATCH COAT
Pr Q LcnJcr'u Nen
Linde, Adda,,, 313 — ROOF NAIL
Vo 1 certify that I base u,ul this application and state that the morne information is 501 — FINAL ELECTRICAL ENERGY
E:,
Ii cool I agree m comply with all city and county ordinances and stale laws mining
O u mharline,coa rocdad,aadhereby mnhomice pm>enmdve.ofthiscity mm
care,-111 502 — FINAL PLUMBING ENERGY
r ta7 ,he nhavemcmim¢d popery ser in"ction pmpove"
F, y
(We)I,,,,"' live, kentoody..all kes,ac a...to,,like Cit,III Capella"'illike" 503 -- FINAL MECHANICAL' ENERGY
Ln liabilities,jor Cineol,enu.v and espenvea which may is any way accrue npain>I suit
v z cayhe seyunmeonnc mndnngannis renin. 504 — FINAL BLIT.I_DING..7��ENERGY 2 ��
^ APP A IN S WILL COMPLY WRH ALL NOY-POINT -by. Il tefL•e (0
S /K�Q 0 lrtVL
all :areas Dare Re-roofs 506 — GAS TF_ST-
IIAZAtDOUS MAI FRIAIS DISCLOSURE
Will the applicant or Emote buildlns„a'co,fir,.lore or handle hamrdaas all Type of Roof . 507 — FINAL PLUMBING
as defined by,he Capeniuo Municipal Code.Chapter 0.1 2,dad the Health rend Ski
code.SwYeoNm 25532(.)7 508 — FINAL MECHANICAL_
0 -
All roofs shall be us 5t(tl p0cp ftLiygF ftEnaterial being installed.
Will Ill. lot ndortmruaingoneammloo"'ug,mcmd,de,'ce,'Iid, If a roof is installeµ� WJ{J1out Tarr, �(�' unkgQ g�tlon, l agree to remove
it harmdous air conhunin...1,as kill I,the(fay Arca At,Quality htunasemnn 'k1�ILt 0, jr-�r- F'��� �f`"'
District? all new materials t" 15�spectipn :An�311L t�L1r to y-Isw.11 comply with
❑Yes 0 N all non-pointsourL ;e6ul5lio sY
I have reed the haousbas nnaterials mqulcal under Chapter fi 95 of the
Cnlilbmia Hwlth&Sufcry Cale,Scctionx 25505,25531 and 25534.1 undemwnd,nm
il',hc huilAin,Jm'nm cumntly hove u,c n,,InIn, ymspnmihillly hi nrnily the ,
4plat
rtyui I ice metprior m iasmnwof a Cenilicme of
„ Signature of Applicant Date
o ".gest
— — /�Rle All roof coverings to be Class `B" or better
OFFICE