02090120 CITY OF
]BUILDING
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10139 RIDGEWAY OR DRAEGER CONSTRUCTION INC 02090n120
° APPLICATION 605 COMMERCIAL ST 09N g/1 78/ 2002
•HONE: SANITARY NO. CONTROL NO,
(408) 536-0420
C z i ARCHITECT/ENGINEER: BUILDING PERMIT INFO
C BLDG ELECT PLUMB MECH
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5 N i LICENSED CONTRACT'OR'S DECLARATION Job Description
Ihereby affirrodimIs.Ecensedunderprovislonsofchapter9mmuncreing REPAIR RETAINING WALL P& FOOTINGS
wF-w with S«tion] )o nnJofihe Basines(gfd Professions Co nJ my license
m f ism to ✓"
m z< L'�acc.0 Lie.w
m Comracmr
o-fi, CHITECT'S DE ION
�'='0 g 1 understand my plans shall be uses as pub rc r and,5�2NOV O S 2002
ne
.0,C O Licensed Professional
n.a OWNER-BUILDER DECLARATION
sal m� I hereby:form that 1 am exempt from me Canmanor's License Law for the BUILDING $19000
z a following reason fSection 703I.S.Business and Profession.code:Any city or county
f x O which repress a permit to construct.alter,improve,demolish,or repair any structure
pd t w ' .al y 'tb pplicant fur ouch pennni fl Low
edm-morem f�.., bb��pl,. - -- - - - ---- ---- - -
ihmharll -w dpurs, tid)lic pron.yonsor for Contmnor net Lo (Chapter9 -y;, r 34ft ft Elgor(�ea,' v Valuation
(.amnrxl ggWth Suaia,"M)) fD vision J of the eu'I aP An,
CMe) l_5 ,.��) ,.. , � r .n• V4a J]S.tJ1}a'i�i.
or thm Ire is! nod i"mhom and the basis for the allegedst on uon.Any violation
--or Satins J.,I.S by i nY'noWicnht for r,peon subjects de applicant m a civil penalty..,
of net marc shod'five hundred dollar.($500) 101 APN$`bDhUATION "`f`I:I'W Occupancy Type
C3 1.asowne,ifinetraineny.arinyemployeeswidywage.a.theirsoleenmpen..odnn, 102 - PIERS
'-will"da me'wark,-.nd the'someture I5 not intended or offered for amu(Sec.Tau,- 10 3 - UFER Required Ins ec[ions""''•-I"`' '
'Buiine'ss'and,Pio e,mons Came:The Contractor's License Law does not apply to an Q p
ownc
rod property Who Wilds or improves thereon,and who does such..,it himself 104 - REBAR
or through his own employers provided that such improvements erc not intended or _ -
ulf<aa'fofsdle:If,however,the buildin-'oe"ins mvemcnt Wield within one yeti of -'-' - ___105_-:_ - -------' "
-o lotion.th<uwney. 8 v r ' ANCHOR"-BOLTS-"` .'•.'r..n y i t., .,y
crop for eofWilnerwillhuvetbebuNeno1provingthvthedidnmWildur 106 - SEWER & WATER
improve puypx ).
-. _._.__- --__._._
c ;. °.Ill owner,of the property mm
am exclusively contracting with licensed contractor,to
2'02"--=-'UNDERFLOOR-"PliUMB3"NG"-"---`c
rLL nOLF. . fI'+-`
constmci the project(Sec.7064.Business and Professions CWc:)The Contractor: 203 - UNDERFLOOR MECHANICAL,'l��•'I T-1:,"'3 '•'
-' andl who,
Law docs not apply man owner with,
tympany contr who l.ilds or improves Neuron.
_Cnd.who.comrecnse nnsuch.vmiecu.with.0 comnemrlaLlieenxd.pursuant.m.the_ -_'__._.__.204 --'"'TJNDERF-LOOR-"FRAME-"'-
. = 2' Lyrw
p Sec. "' 11 't" :B&P C for this mason 205 - UNDERFLOOR+ bDNSULATION
O l vm e,rem f under .:....... ._..
pate y. 301 - ROUGH PLUMBING
";'+;, 7io O ER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
ser, lnmbyafr(munderpep.aRynfpuiUbeprathe fnnowingdeclamoona: - 303 - ROUGH MECHANICAL
(C: ° I h5oe and wdl mairm. a cartincme of cna.m a.seleinwre In,Workers 304 - ROUGH ELECTRICAL
Compensation, its, provided for by Section Job of the Labor Cone, for the 305 - FRAME
pert red cel of the sours f r which this su t ed ,.
°I h d will indifift Worker'i C6io,mnm;ii6nhnsjradti,-as m4moml by Section 3 06 - HOLDOWNS
37W f h Lah y CW f the sae form , f,tM1c work'R,which this penins ya 307 - INSULATION
d M y w k I
i C t 1 bo ce c < and Pol y - W
30,8'
Car erg 3_ V.,Ih !I rill
R IFICATION OF EXEMPTION FR RK,RS�' �_ 3 3.09 k +EXTERIOR[rLATH�
- catimCNSAuON INSURA ;. 31'0�� INTERIOR-LATH ----- - -'—'----•'
' (Thssecti�nneednmbecomplcmJdthcpermtizduronehundrMdollars 311 - 'gCRATCH COAT ")I +-•11`' ��' `
m ;
ly ._. ,313, -" ROOF-._NAI-L,.
Icnfytht ih lierfi ya cel or the 6f why,htl pe sit ....d' �;'
'hall n employ h.ty p or n any bin <m ho on subject t to the'W ri s 501 - FINAL ELECTRT'CAL ENERGY`''
cn le i Laqsnrclrm .ptq; ..502." FINAL--PLUMBING. ENERGY_..____
'NWICETOAPPLICANrIf,titterk g ink Certificate fE pro you hould 503 - FINAL MECHANICAL ENERGY
Q Oecbsubject lathe worker C pe t p ns of th IaW Cod you nd:t
ome mAlididf comply with mych provisions othe perms shall he deemed revoked. 504 - FINAL BUILDING ENERGY
z.in --� - TcolgsT'RutrlonLENlnrrcncgNcv 505 - FINAL ELECTRICAL
'1 hhetiy' form that thfrc is a`6n i n n 1 J'ng ug n Y f' tM1 M f red' cc a _> inn krrwnrnm _ 506 GAS TEST
s.,, Ixrmu n msucd IS JfN],Civ.C I .,..insz.yu -
507-..-""FINAL--PLUMBING_. _
.�.Z La J SAadre.s,
U p c- 50 FINAL MECHANI'CAli
slsxmfr'ina�inavdrcaaminappficmwnanaamiemauneabovr{,dnrmany.is 5 - INAL G DE
�T+'t_'r cnrrecy.I agrte igcoipply.with all eny and couni2,ern inapcea and Stam laws relating
"Oi.O io Wilding conswction:and hereby Wtndri[eup .- moves nftni;city io char upon S OA- INAL PNGisagainst 51NAL B RKS
Vi hab In jag his i ed pcnsc mmmar any Y acme Bmost said /
'V.Z Cny q 'e fth �f�'gof iht perms' Vim,`//
.'APJ LICtiYf IIID+ �Sn�Yp WILL COMPLY WITH ALL NOS-MIM
:y ,J" Issued bye Date
HAZARDt/CmdurnOUS MATERIALS DISCLOSURE n u Re-roofs
{S' Will tti applic t or fot re Wilding occupant m nr handle hazard material ...Type of Roof. ..... .___ ._. _. . . ._ r _ ..........,.. ....,.
es defined by the Cupen Municipal Code Chapter 9.12, d the Health and Safety -
.Code.Secly n255J2( ) 1L I , • ' .
-r6 r, U : s + a„1' na r. .. <J'• •S C. :t.j ' s
°v4 i''' '`+'` I t All roofs shall be ins ected.prior.to an ioofin material bein installed.--
P Y g g
wRme pPfr ntor Bn n Id g p Luse equipment devices which If a roof is installed Without first obtaining an inspecti6ti, Pagree to'riirnove
h d
or nts as defined by di Bay Are.Air Q ItyMnag t'
o.tr t all new materials for mspechon Appltcantpnderstands and well,comply with
Ir ❑Ye'_ `, ° - '�” al]'non-point sour regulatio - •�,1„
have deod�th h- m s mate t q 'eny. u der Ch pt 695'of
C I f m a Health&Safety Coyle.Seciinnv 5505 25531 and 25514 1 u deem d thm
ifthe Wildingdoesnt torte atmtiimtt Y
occ.pant,of the re must be met prior w issuance of a C ifui of —�
S na re o Applicant, Date
- ; AI s to be Class"B"or better',,'
O umhonmJ get P, m
OFFICE