01030104 CITYBIOF LDINGuPFR rN1Vf) CONTRACTOR INFORMATION:
• PERMIT
BUILDING ADDRESS: PERMIT NO.
10500 RIDGE VIEW CT 01030104
OWNER'S NAME: APPLICATION SUB DATE
HEWLETT—PACKARD CO 03/20/2001
'IIONIi: SANITARY NO. CON'rRO1.NO.
G ago ARCIII'I ECI'IENGINELR: BUILDING PERMIT INFO
�v O O_ RL F.LIx PU NIECE
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LICENSED CONTRACulm,p DECLARATION Job Description
Ion.70anise Iwihm Ium.1he EdunJerpmv1,y p� g
ONTO with Seatiunc malcf Uivisinn lot the ltminex,17lYuklldns xle and li e
is icove film"and` LC li, n //_,! ([ _ ADD DOCK STAIRS AND HANDRAILS.
od I.Ieenw class_ — — _
3 LL N D:ue cIDnax Pfil
O ARCIII'rECf'S DECI,n )
I J I d vpI ':I IIn d nnI d'
zm2 �/
dao Cgs a t ,. I
OWN li❑UTI UI RDI DECLARATION ��/O
= I by (S Ili tl tltl Ili Carl I L I lot
marly
FZ>' ftlh g .pe i con5li a JI f CW Any say caum,
E O pn cM1 iv i,,m a x.m...m w nwiL ulmq r nprovc,demolish.or repair any xtmuurt
et. prinnoioisnsedpu anm to the ponjus,11%o for Commuminoicem se aw(Chten¢m
(commecamelSectiotn01hofDivixn3ocnn�usmrxuanwla..'tchCadle) Sq. Pt. Floor Area Valuation
or that he
(commencing with Sectionom and
ehj%is Jof the businessexemption.
Any violation
Cadet
or that he 7 exempt zany applicant
and the hud.x lin the subjects
the
exemption.Any I P natty
of Section7031.5than iv anydreddall for"pemtit nubjen,the applicantmacivil penalty
ofamanmt,tnanfvehanereddonamt;5tea APN Number Occupancy Type
C I,us owner ofthe P o,m ,or nay cntployecs wilt wages as then sole campensmimt, IGLAE042 01b
will do @c work and Ihe,oracaac is not intended or offered for salt,(Sec.7044, 13
unsi,w,,1 1 I'mfe"m CaIr:'I'In,C I'licatra Llecma Law duce ant apply Io un Required Inspections
r n1'p,opony Who build.on Itnpravee thmcan,and whu docs xauIt weak himself rmmugh In,into employees.hroxmed that+bah itnprmmtmts are aaI minded u, 101 — FOUNDATION
ohm,d ted sale.It,however.Iht,building to improvement ix sold within one rear of
ontplelion.the owner-huilder will nava the burden of proving that he did not bund or 102 — PIERS
m,oxe ftrpurlanseefsalc.h 103 — UFER
C L as owner of the pmpmay,ma exclusively varlow ing with licensed contractor;In
tnarust the project(Sec. Business and Pralmomns Code:)me Contmclers 1.04 — REBA R
License Law does not appy nt
at as inn ner of ppeny won Wild,or improves thco m.
and who contract,for such prniecs with a cnntmmer(q licensed pursuant to ser 105 — ANCHOR BOLTS
Contractor,License Law,
C l am exempt under Sec. .B&P C for this rea-n 1.06 — SEWER & WATER .
Owae, nate 202 — UNDERFLOOR PLUMBING
WORKER'S COMPIiNSAnON DECI"ARA71ON 203 — UNDERFLOOR MECHANICAL_
I be,chy af➢rm under poen,of pr'timy ml,ut he following declaraaom: 204 — UNDERFLOOR FRAME
D 1 have and will maintain a certifemc of Consent to elf.mmre for Workers 205 — UNDERFLOOR INSULATION
Compensmam, as provided for by Section 37N) ofthe Labor Code. Pa the
prrrnrmanceoftheworlforwhichthispemtnisi.sued. 301 — ROUGH PLUMBING
C 1 have and will maintain Worker's Compensation Insurance,as required by Section 302 — TUB & OR SHOWER
37011 of the IaW,Code,for the peanorm x,of the work far which this Permit is
"nal My rker cnmplenxayrymsamneecarriera�r Polic�yyn be m: 303 — ROUGH MECHANICAL
carder:_ _ / ''""say""� 6 O 1 ° 304 — ROUGH ELECTRICAL
CERTIFICAfION OP EXEMPT ION rROM WORKERS'
CDMPI;NSAIhONwsURANCE 305 — FRAME
frnis,exdlonneed ao,hexl"Irtedit la, cnnhislorone nundreddonarx 306 — HOLDOWNS
lSlgl)erlcxs.l
I nertify that in the perfomupce of rite wad,for which this permit is N,.cd,I 307 — INSULATION
shun am mtpiny any IMMtn at any n,amer xo as In become sal In the Wmketf 308 — SHEETROCK
Campcamllon Los,of California Dine
Applicant 309 — EXTERIOR LATH
Wn ICETO APPLICANT.I afar making this Certificate of Exemption,you should
kemnasubject tube WokerscontpxasalnnpmvaonxnrmeuMncrele.rauamst 310 — INTERIOR LATH
Q 0 lortnwith comply with such pruvisium lir this,permit shall be Deemed revoked.
Z _C 311 — SCRATCH COAT
F" = CONSTRUCOON LIiNUINC,AGENCY
C > I hereby of&m that there is a red stmrlimt lending agency for the peam —
nmt
ce 313 ROOF NAIL
w c aim„i. N frLwmrnmia onirsixxneJ(sae.3ug7,cia.c) 501 — FINAL ELECTRICAL ENERGY
7 7 fenders Address
U O Lemma'that Ihave read lhis upphraaonaadstmrmmrbt,alnvehot ommhutls 502 — FINAL PLUMBING ENERGY
D E. correct.I agree In ema,ly wise au city and enmtly nximarve,and are mw,miming 503 — FINAL MECHANICAL ENERGY
O v mbuilding comwcdon.and hereby aalon empm,cnmfiresufth;,cityInenteruPon 504 — FINAL BUILDING ENERGY
the"MA'ontentioned pmpcny fn impection Pu,Iatms.
Epr (We).9.tosave.indemnify and keep ha,mlt,xs the City of C,,pcnian against — iD
N liabilities,judgment,costs and expenses shah may;n any way accrue against and 505 FINAL ELECTRICAL LO
U z �y, +nsryuenU
lio• dsetix PermitTNSA D 'pumm" PLY WITn ALL NON POINT 506 — GAS TESTuLLN Issued by. Date
aLtm m,ptdr " tY-n.tta Re-roofs _
anzARnnll �IIMAINDISCLDsuRla 508 FINAL MECHANICAL
Will ltc appream or mea,m6 kiing„c,u,am sIare ntmnmle ha,atdoan romanal Type of Roof 509 — FINAL G RADE
"defined by the CupotliMnaicinaI Code.Chapta,9.12,and It,Heald,and Safmy
Cndu,Seed an 155320)?
0Yea 0 N All roofs shall be I1r,1i Lted lFriV19lanyPr6f r�fal Dial being installed.
W;Ilthe apphcam ,,fumrt building occupant use equipment lir devices which If a roof is installe5"InTut Frdl�ninRy9A-i .Cpe6APPIf gree to remove
inn hamrduus air comamiumms m defncd If the Bay Area Air Quality Management
„ixtnel all new materials for inspection. Applicant understands and will comply with
❑Yea ❑Ntt all non-point source regulations.
I hav ,cad the ha,mm us bawls requirements under Chapter 6.95 of the
Cnlifomiu fkuhh&Safety Crile Svaiom 35505.255D and 255)4.I underswmhhul
iIffiemilJingdoe,ma'immuly t vale um h:nitixntyrexpunxibil'ny lonatifythe
e a,,-`I �rest m nw i, t ct prior m i,a,mci,of a Centte lir
Ol a '" q/ I Signature of Applicant Date
511,c,m inulton, agent /t i,e All roof coverings to be Class"B'+ or better
OFFICE