02030045 CI nuIFN DIVIISIONSINO
BUILDING CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
21724 REGNART CT 02030045
OWNER'S NAME: APPLICATION SUB DATE
=NETH & BETTY CHENG 03/12/2002
PHONE: SANITARY NO. CONTROL NO.
Q O O ARCHITEC(ENGINEER: BUILDING PERMIT INFO
a,u- BLDG ELECT PLUMB MECH
fa<G LJU I LJ 1_J
FF LICENSED CONTRACTOR'S DECLARATION
524M 1hereby affirm that lamlicensed under provisionsofChapter 9(commencing Job Description
'y t u with Senion 7")of Division 3 of the Business and Pmfessiom Cods.and in)aicense ADD 417 S FT.
--1 in fun force and effect. Q
0 w U License Class Loc.R
Data Contracmr
i u a .Y<-i ARCHITECT'S DECLARATION
J 1 under,iand my plans shall he used ax public records
)�T
i a.O O Licensed Professional
'n= OWNER-BUILDER DECLARATION
1 hereby.(On�win 1 1. exempt Irmo the Comrun Co :Any c Law for the
C z 0 (allowing reason.(Section ronstr t.alt es mJ improve,
de io demolish.
Code: pi city err county $55000
E x o which inquires o permit m<owlmvcl,alcor,improve,demolish,or rtpair any stmaurt
a3 prion I - c< so reg m th pprcvnt roe Contractor's
Lardalalntr-9 les
(hath nc g withrsasrl ,soda II p softie theBusiness
Lind Professions
royw ons Car 9 (y ( p p p�@a
(commencing with Section IIA,) of Metilija ssadprof shoos Code) 4.�*•'• p�g�u�yY:'�JIv t"r,'-t Valuation
I .v s. f-3§.' f�.:{ .. ICT:: .
or that he li 3L5 by hdefml icand the basis for the at the c pliant to Any violation
-or Section 1031:Sby any,applicant for a permit xuM1jeas the applicant m e civil penalty
of more than live hundred down,($50n1101),PN lsf�15t�ffDATI ON T"' Occupancy Type
°1,as owner of the property,or my employees with wages as their sole compensation.
will do the work:and the structure is not intended or offered for sale(Sec:1014,' - - -
'Busincis'and Profcseionr Code:The Cnmmcmr's License Low does not apply m on 103 - UFER Required Inspections
ow ties of property Who builds or lmprwasthereon,and who does such work hlmsel f 104 - REBAR
or through his own employee,.provided that such improv u vemenam not intended or
-.offered run sale.If.Hi,wcvcr,the bundon Mint ovcnmm,ssold within one'"' f- ----- "---. _—_ _'. __-
completion the owmer-huildeT will have he burden of proving that he did not build of-
105 - ANCHOR BOLTS '����"LE 100 improve for purpose of sale.). 106 — SEWER & WATER
---'-- - - ---
I wrmnme�;Gpenr.a�nexcw.meryeumruccngwabhccnsenc„ntraeu,rstu 202 — UNDERFLOOR PLUMBING----._-- -- --- -- ------..--
- - c strucl the project(Sec.7041.Business and Professions Code:)Ts,Convenor's DEC] . p
License Lawdoexnot apply toanowner orpropenywhowildxorimprovesmereon. 203 — UNDERFLOOR MECHANICAL �++ ,2��2'.:
aoil m contracts for such Frojens,whh acomranods).licensed p....st to the. ._.._. ...._- 204_.—”"-UNDERFLOOR_'FRAME. ...-.._...---_.....___.._._.---.._. .- ..
Co
01 said catch IIndi Law.; BUILDING
°lam eem lensersee 'li'&Pe Tannic rtason 205 — UNDERFLOOR INSULATION
on .3 'tQ?r>" 301 — ROUGH PLUMBING
'tW'1Ce RKER'SCOMP ATIO DC R T N 302 - TUB & OR SHOWER
Ihereby armmunder peraltyerPerjuryone arras following deelamtions: 303 - ROUGH MECHANICAL
° 1 nnve'and will Manor.is Canificma of Cowart ,alf.i...M Tor Worker's 3 04 — ROUGH ELECTRICAL
Compensation, as-provided-for by Section 3100 of the Labor Cade, for the
pempamancc oftha work for which dii,pem,it is„sued.3 305 - FRAME
01 havm end will maimnio Worke's Compensation insurance.bs required by Section 3 06 — HOLDOWNS
3100 of the Labor Code.foo the performance of the wrk'for which this pinhad,l, 3 07 - INSULATION
dual My Worker,Ca pe I In'..n - ntl Palsy be.11
-
I, a t f +. :S•PoI R , 308 ' SHE) TROCK
Ca CERTIFICATION OF EXEMPTION FROM WORKERS a - 1jE
' ,I
COMPCNSATION INSURANCE- '' 3 1-0 XTERIORS"LATH
,_. __.. ._._ —r--'-INTERIOR' ..LATH "" ".
••.r.1 (Tws'eecuoadeed norbecompiedrrhe permu
, sforonehundreaddollarx 311 — SCRATCH COAT
(EIPA)or les ) r h `
.. lenlrrtht mart - nn pkrr,:�mrnmispermii `- 313-.•_.::ROOF`-NAIL.-.:` .. - "-
P Y yx r issued.I
501 — FINAL ELECTRICAL ENERGY
'shall t I n come subject to the Work rs
"o-Manwtion Lvw.of California
Dvlc - '
. Applicant,
a a�lab< . .. ----....._.502----- F-INAL--PLUMBING- ENERGY - _ _. ..
!NOTICE TO APPLICANT:If.after making this Certifiable of Exemption,you should 503 — FINAL MECHANICAL 'ENERGY
O pbecome subject to the W coke/s Compensation provisions of the Labor Code,you must
forthwith comply with inch provisions or this permitshall hedeer red mooked. _. _.504. —. . FINAL .BUILDING ENERGY__ .,.._._
CONSTRUCTION LENDING AGENCY
In ny if,.that tn tructonlending agency for the performance 505 — FINAL ELECTRICAL ,• it
"'
W ? oftheworkforwhich this p ' itisissued(Sec.3097.Civ.C.) 506 - GAS TEST. ..---- . .._. _ -..._ . .. . . ..__._. .. .. .._
is Name_::,: :, a_ , ._,,,:. ..r.•_.
0. 0 Lnot _ ... -
P,Z Lenaq..naer�s,�„•��, � � . 507 FINAL PLUMBING;
U-O 1 verfifyffiral have mad this application dxmte that thm ' foormauon is 508 — FINAL MECHANICAL
4a•:F inioct:l agree to comply with all city vad county ordinance and sure laws inl.,M, 509 — FINAL GRAD E
to building construction,and hereby nathoriee representatives ofthis city to enter upon
p w the an mpm,n,for ir,,acnimrp rp510 - FINAL PLANNING
F P:• (We)agmIi come dmnify andkeep h I : the city f&upmco Aganst
to
liabilities.judgments.countor expenses which y any way asecriagou oust said 514 — F I NA PU IC WORKS �f
U City neo 9 5.�fthe Brant ng oRhis permv -
SPU6CENT KDERSTSNDSANDWILLC0MPLYWITtAlLNO Poirvr ' Issued by: r Date
Applic onlmn .` Dale .. Re-roofs /
ZARDOUS MATRRIALSDISCLOSURE,
wn Ne
,cantor Name Wilding ac pant short or Handl havtdods I
nt al Type of Roof - - -
aa def cd bpiC pen no Municipal Code Chapter 9.12.and the Health and Safety {
Coo S°cyn 1553Pp11 y,t P.N the 14 ! a`i ) >.:vl�q! ti I+.TVSo I -'�; •t,, { .
u m h i r d All roofs shall be inspected poor to any To material being installed.
wnm ppl t r I enle g p t qup em arta «when - If a roof is installed without first obtaining an inspection, I agree to remove
III hazardous commnimum,Its defired by she Buy AAir Guilty M agent nt
oist n - all new materials for inspection Applicant understands and will comply with
A��� yyyl °YeSic
°N all non-point source regulations
� ad dre,h eardoucmaier al,requ«Wend under,Chaplar 695'of the
California Health 3 Safety Cade.Sections 25505:25533 and 25534.1 undersuiM that
if cone building does not currtnlly have a¢win,that it is my responsibility to notify theoccupant of there, a nt Inch mica he p I in of CenlGcm/oof
L Signature of Applicant Date
Owner or thorread agent, . Dine All roof coverings to be Class "B" or better
x � I
OFFICE