01090041 CI BUILDING DIVISION PERMIT
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS. PERMITNO.
22393 RIVERSIDE DR ALLIED AIRE SERVICE INC 01090041
OWNER'S NANIE: APPLICATION SUB DATE
WU MICHAEL M ET AL 661 SINCLAIR FRONTAGE R 09/10/2001
PHONE: (408) 934-8844 SANITARY NO. CONTROL N0.
�
O Ei x ARCHITECT/ENGINEER: BUILDING PERMIT INFO
O BLDGELCie ,ECI' PLUMB N
I_ J L . )
LICENSED CONTRACTOR'S DECLARATION
Z� (hereby of sat that l am licensed under provisions of Chapter 9(commencing Job Description
�t xfihSemim]a)(OofDivision 3of the BuameasandPmfe,sicn.Cwc,and Cry license ELECT PANEL UPGRADE &
,y� nraeam b �
Lie N 2 D3 REPLACE FURNACE (80000 BTU)
z a Licenx Clazx �-�/
'o u Date costa for ADD 9/C 5 TON.
I; H ARCHITECT'S DECLARATION
u O e, 1 undemmul my plans shall be used as public records
i e O Licensed professional
a' OWNER-BUILDER DECLARATION
i- 1 hereby,(lien,hut 1 1. exempt from tba Cessions o License Law for the
(which re masa.kation 7031.5.Business and Professions Code:Any city or county
s
which requires a pewit m construi alter.improv.demolish,or repos any structure
danbeis
Icned pnrstmot nthc invi,lines of the Convechn.,Lcense Low(Charter 9
' IStFt. Floor,Are.a. . ; $53�}ation
(contithscci ]ro) fDivision 3eftheBusinessamProfession,Code ;,I- 101 sC
or mai he is exempi tnemfrom and the basis far the alleie'd exemption.Any violation
- of Seen.7031.5 by Croy app!ieam fora parm,subjects the applicant in a Cvit penalty
of not more thamrve hundred dollars(SM. 3 5 mus!ber0 Occupancy Type
❑1,as owner of the nd that structure
mY employees with wages as thou vele eompenwtioo. t
Be'nie the wProfessi ns swcmre is no uLor's ice eLawred for sale ISec:to 14.
an t
Bua,,o and Professions Who b skit o in. Con,fluere License Law does not apply,a an 301 - ROUGH PJWt1iH�ddCdspections'"'
ownerof progeny who bdlds or in m«eonmrwho ent, seen workhimselfor 303 — ROUGH MECHANICAL
offered for
his own employee:.provided shat such vementis sol are nod amended or
-,
offered for sale.If,however.,he Wilding or improvement is sold waters one year of 3 04 - ROUGH ELECTRI CA'L'F t "t
iamplediun the owner-builder will have the burden of proving that he did not build or
mprove for purpose of sale.). 505 FINAL ELECTRICAL
0L,us owner of the property.am exclusively contacting with licensed contraction to 507- - FINAL PLUMBING _ . --
- ennstme, he project(Sec.]WJ,Business and Profession,Code:)The Cmtrw,sr's 508 - FINAL MECHANICAL" ' " '• '
License Law daces not apply',,ua owner of pa,m,who builds or improves Ncrcm.
_and xho conta[ts.focsuchptnjecus with a con,mmogs)licensed pursuantto the- . _ .... ._.... _ —. _ .__ .. . - ! ___... .........
Contractor'a Liaeree law.
❑lam exempt under Sic. D&PC fortis reason l.�Ct!O:1
Owner .,� U. l ..Date
WORKER'S COMPENSATION DECLARATION C ® ECS
I hereby alarm under pcmlty of N'6.ry one,mine following dcclarmom,: Irl^A. vI _�
�• Compensation.1 have and will rovide n o CenifSection 37M of ,t uL ibor for Workere Oe r � 2 2001
oas provided for by Seaton is wood.of ,he Labor CMc, for the
- performance of riot work for which this p«mi,is iasud.
j!have and will maintain Worker s Cwnprnwtien InsuiSncc,u required by Smtiun
00 or tM1e Labor Code,for the peRowmee of dhe work for which this pem,it is BUILDING _
aswed.My�W.o.�nyer'i C pc �urn -m
Garner�3✓(I� H°"---s'o1KY No �J3 / i „ (.r?.�. i a :,"I :'� I. _1.1ytc,Ti_`' )'..l
CERTIFICATION OF EXEMPTION FROM WORKE115 - -
COMPENSATION,INSURANCE- -..,.,q
'` '(Otis'udiion need nm be'cnmpleicd if the pewit is for one hundred dollen
ISI00)or less) 1
__ ..cent
-
Icerrfy,ihanthe
atin any
okr which th' pc tis ns Workers
sAhom cod tem 1 n ane m be oma s b) t to the WoikeCs' '
NOTICE TO APPLICANT If after k t ' out
Compensation p Wwa o al f D m,
pe
inion C skinso the mpd you a mind "
beewirn imoiywit such pr Compensation provisionsll theemed Cale.youmuu �
0 O fonhwith comply with such provisions or pewit shall M1e deemed invoked. ,
z',A esti}.y t�:r -, P. CONSTRUCTION LENDINOAGENCY,
F'- ` "''"1 hFre6y. nom Chat there is a conxirvnion lending agency lw the penuwance ( "'
�' Q of the wok 1w,
w which Chis t is towed(See.309],Civ,C I,
i i._
ti Lender's AJdreo" p�t v• 1, ! ,..p
Lender's Name"
U 0 1 terrify that I have read this application and non Nut the above information is '
fest-P correct.I agree to,comply with all city and county ordinances and state laws relating'
0 U .m Wilding cnnarvnion;unJ hcrcbyauthoriicrepresentatives of this city,oenterupen
9+ L37 the aWve-mentioned properry for inspection purposes.
(We)dgeee m save,indemnify and keep hawless Jre Cary of Cuperuas %gaunt
Cil) liabilities,judgment%,costs and expenses which may In any any accrue again,said
U..Z City in consequence of the granting ofihis per:u..; "
'API'LICAN7 U.' NDS ANDW L"COMPLYW'ITH ALC'NO'-POINT' Issued by: Date
SOURCE RE�TIO: S.' ,,A%N' "°, f, '^ y
Simulure.1 A,Pllcbn minernr;,,, : •'`•.r "' Date Re-roofs
d t HAZARDOUS MATERIALS DISCLOSURE A '1 •
H II Ne appliiard w future baildldg'occ pant state or hansho Initial m nimud. Type of Roof
-as def d by,h C pen Man a WI Code Ch pt 9 l2,and ted Health and Softy ._ s,Y. ;! t, t .,`
Cade,section 25532(a)ldtar Yrf: '. ,r;,::,•Ir•^I;ls'•{','
'�YCS •. o
.•' r,.—;^-.,:- ; _ All roofs,shall be,inspected,prior to any.roofing material being,installed...
+sWill,he npplicam onfuture building occupant use equipment or devices which If a roof is installed without first obtaining an inspectioli'I'agree'to remove
emit M1!=.'Ce air com,minSnrc as defined by,he Bay Ama'Air Quality Management
Distinct? all new materialsfor inspection, Applicant understands and will comply with. _
Cryo a. t t all non-point source regulations;, _ ,
1 h c read Ne haeards us'mmed Is rtqurri menta-Bode Ch pmr,fi.95 of the
ealafainae Heobh&Safoy Cudc.'Sec,ions25505:25533 and 25536:Lundemand that -
if the boalding does not eurrtmlY M1me n'W'.Chet it as my responsibility m notify he
occupam of,he requirements which mdst be tan prim m ismancc or Ceniftcate of
- '•' °""p°" " "' Signature of Applicant Date
/O G
owtnrwa,tnan: -•" "r':. " Dal
All roof coverings to be Class"B"or better
... _ . .. ., ) .OFFICE. . .. .
_ .