02040119 CITY UIDFNG DIVISSIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
11561 SEVEN SPRINGS DR JNSJ, ROOFING INC 02040119
OWNER'S NAME: APPLICATION UBD
METE & SERPOL KARAHUCULE 1268 LINCOLN AVE, SUITE 2090422�f2002
PHONE: - (408) 279-6171 SANITARYNO. CONTROL NO.
0 zO ARCHITECT/ENGINEER: BUILDING PERMIT INFO
�{r BLDG ELECT PLUMB MECH
a 6 U CJ L J I._1
LICENSED CONTRACTOR'S DECLARATION
v 1 helm mtm that 1 am licensed a de reha ler 9(commencingJob Description
ovrelay, sFro.ismnso F RE-ROOF
mr ��e elicit Division Sof the Bun and Ptufessiom Code.ond my license
�in,[an force and�Jf 9
s c< L't�ett^se CIZ, ` Lic.a '3 U Q _
O a U - Com�aa((
3 a•G ARCHITECT So A
1 underused my plans shall be used a Fubb
oi
we c o u«nxd Professional n
oIS OWNER-BUILDER DECLARATION
6 f-' 1 hereby aTnn thvl Iain cncmpl from the Conlrvctor's License law partial
t 3 a following reason section 7031.5.Business and Professions Code:Any city or county $6900
Y S`e which requires a permit to construct,altar,imprma.demolish,or repair any structure
�3C2 Prior to its issuance,also requires the applicant for such permit to rile a signed statement. ------ _ Valuation
- that Amin %ih Sactiadj70 a pfDr%tnsof the the
Business
al Prodnwlns Ci 9 _ - on
N .r 3�t6�2 6VP�.!��'- • � �_' : , a nation
(commencingWs chip t the;anp 00and the bails o the a leged ss mp Prafcuy violation
i Cade) „�1, j� r ,'�
or dm he i3 31.5 b zany
ny applicant
and the basis for Ibc alleged e4licarn h.Any viola lty
of Seniore than by anydred ollfor iianitsayectslhevpplicvmmacivilpenalty-
roriiotmdemanraeWnareaaanat3asfa). 302�pN*If4h4'9E :PER„r,.e. Occupancy Type
0I,as ownerofthe property,or my employees with ragesus their sols compensation 307 INSULATION
will-do the I o k:and the structure-is anal imendid or offered rea le(Sas 7Oa4;' 6 O 1 - ROOF TE� f�Lip
'Business nand Professions Code:The Contractor's License Lew does not apply to as uQ91 nspectlons
owner of property Who Wilda or improves daemon,and who dos such work himself 602 - ROOF PLY[alOOD NAI L
or throagh his own employ. provided th t h improvements t intended ..mass..
offend far�ilc.I(howe of-the building i t proen t is sold 'da- - year of "”" _. s ass sacs _-__mass ..-.
603 - ROOF BATTENSkI;
mcompletion,the owner-builder will have the burden of proving that he did not build or '•� "%�� '�'
prove for purpose of sale) 604 - ROOF IN-PROGRESS
1, _elaca .._amex exclusively c__.._._' . ._ .. -- - --- - - -- -- '
O1;as owncr,a(she OropenY,am cmlusisd contracting with licensed contractors to � �--�-- --_ _ ------�--------''� '---'---"
Y Swt IL,I.V. �.,
i conswn the door
(Sec.appl]00.1,Business aro Professions who
Cade:)The ver tenor's E�n'i ^a'•1F .'s'1:
and.wc Law does not apply loan owner of alcor Y who Wilds or improves Ibereon,
=- _and.who.ca Licari
fLaw. .pmjeeta_wnh a.conmacdot(g.littnsrd pursuanbw.dae. sass_.._._.__.__-___ -___-.._.____ _
.•.� ❑lam encs License Law...,. ..____.__..__..._._...__ .__._-._. __..__.._...._.._...
.. .. . .. ¢ r .:�
_ onuanor
rept antler Sec." .. :B'A P C for dais reran
Owner Data
Ct "WORKERS COMPENSATION DECLARATION Fit N I ALF—D
Ihaabydfmn nde,pcnalty.of perjury one of the following declanlions:-- CNN��
0 1 have andwill maintain a Ceniftcaln of Conant m self-insure for Worker's APR 2 4 2002
4 Comperuation-m provided for by Section 3]00 of Ne Labor Code. for the
Performance of the work for which this Femur is issued.
01 hale nand will moiaigin Workerfs Co.pane ttivn insutauce,ae required by,Station BUILDING
37W of'Ihc IaWr Co ki.for thi perfonvnce td the'work for which thi1.s permit is fir!
ae4 M WorkeuCERTIFICATION silaii f rod Policy number tie _
Y ^ __macs._. ..
' '� a WC2'f91®%y7 ,- - 11 r �,
.'.. OF E%EMPTI FROM—WORKERS—T. t r`s' t s - s. l ..t4.
CQMPENSATION INSURANCE_,_''.,:.."- y. _ _.__....
..._._: _ -
b' s section treed not be completed if the Permit is for one huMmtl dollars -
($I00)m k ss.),
x..
_... .. .. ...L_. ...-sass._............... .........,sass-...,.._.-sass
IP. r ..,......,.._. sass....-.-
'r s'....-1 entfy than theperformance de of thew o k f-which In pc t sued I r` nI,)`t0 ..._'
shall rood employ any person to any manna so as to become subject to the Workers
.. Laws .:. Dam .
Compensation of '
tNOTICE TO APPLICANT If,after making this Ceniflcom of Exemption.you should
Z become subjects theWolf C pe iso Provisional of she Labor Code,you most
0 0 fontiw th comply -th such pro t m thi perm 1 shall be deemed ked
__ ._....._ sass.. .., ... sass. .._.. .. _._- ... _ ..________... _,. _mamma.
�
�'tq '''C6NSIRUCTION LENDING AGENCY -
�' 1 hereby a1Rnn that dalmii a mai uciiori lending agency for me perfomomb', •r-__
w of Ne o k for titch Nis perm i s sued(Sec 109]C c) ''
14:G Lcnde aN .. _. sacs ._ .__._. .. .
D $G c Mall Ape t
U_0 1 ttn fy th t 1 have read da s ppb coli d tat Nu rM obovc mformwon rs
tz Fat iro building
uil Iagreem omply with II c it,and c a ty old names end nide Iew3 alar ng
�'U ro Wild gra teed property
birth,specrirt p uutivesor rhnnry ro cnkr upon
��..aa-04 the abo e t ed propcny for inspection purposes.
L d We)agrci to ave rode n fy and keep harmless die Ciiy bf C pent'o egaaid
LLLL..ws t/3liabilities Jud ts,costs a d rpm s s wh h my y way cares agar t said /
U Z Cl ins e n c-gre ng of this Poll - r o v
APPLt ANDS ND RILL COMPLI'WTI'H ALL N N POLNT
•:
30. REGULAu(. Issued by: Date
nurt Appl cant/ da for - Dat " " " Re-roofs
"' HA RDOUSN TEMAU DISCLOSURE
� ' I'•,' plical I hame ding accapant to o hurdle Ail Mcox match.] Type of Roof..
as
claimed by the ttrucipaid Code Chape 9.12.and the Health and Safety
Code:Section 25532p1? u k 1 s a. - - •• ,f _ ..i.; ;.
. oyes _ ... _All.roofs shall be inspected prior.to.any roofing.matenal.being installed.
r. lt. v installed.-__---
.fl Wllthespplitlnio fart Wilding occupant uses equipment or devices which If a roof is installe'd-without first obtaining and inspection`,�I"agree.to'removeT
emit hanmous ii,comaminams as defiled by the Bey Area Air Qualay Management
Mohr?
� t- � � all new materials.for inspection. Applicant understands and will comply_with
:;' all non- tiler source regulations. _ -'-- -_- .
h se rcvathe haaefdous ma¢n'I,rtqu rtments under Chapin 695 of the
_.
Camice Health&Sefcry e:Sections 25505p25533 and 25534:1 understand that
lif Cod
clh Wiltlin decimate CY^or which
arlr.Ib01 it i3 mYrCIpOn3ibility to noll(Y the
2_-
Oca e. t m ta,whicb mus.Fe met prior to issuance of a CcniOcetc of '
r Opc an ...g .' .
" , Si nature f Ap ]scan
_._ mass.. ......... .. . .......__. . . _
woe r aathona agent 1 ore ,. All roof coverings to be Class"B or better
mass
-OFFICE - -_ - ..._ ._. . .. _.. ...__._... . . .. _sacs