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01110122 CJBUOF CON UPERTNO BUILDING PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 11731 SOUTHSHORE CT DRAEGER CONSTRUCTION INC qq 01110122 COLLINS 605 COMMERCIAL ST A11C/29/2001 PNO,N'E: SANITARY NO. CONTROL NO. (408) 536-0420 wO O ARCHITEC-PENGINGER: BUILDING PERMIT INFO Fro_ BLDG ELECT PLUMB MECH I,5 u i LICENSED CONTRACTOR'S DECLARATION Job Description z_ 1 IRrens arfim,,w,I am bansea anger provisions ar chapter 9 mammen[mg RE-SIDING. with Sation]V001 fDi11 ppppppn,l of the Businea anJ mkssio sCafe.a dmylicense eyp� 'rs in full.li,aca rCp6 Licens mss Lic.p F INALE® 5°:C 1 ,am �_ cammemr ;HITECT'S DF.CLAR ON u a 4 1 um unand my plain shall be meJ as puM1lk fecal, n' FEB 0 8 2002 licensed Profes,innal EEC, c OWNER-BUILDER DECLARATION Her m I hereby affirm for 1 ant exempt from the C°mramar',License Law for the t,?a following reawn.ISectiun 9031.5.Business:md P,of x,icns Code:Any city or county $16500 YF0 whichrtquiresapernJtmmnnruct.alcor.improve.dcmoliah.orrepaironyswaurc BUILDING 3e' prior toitsiuuattcc.alum mquireamc applicant for suchpermiuofilcasigmd$comment �(�.r;.s��g,va, -- - - -- — -- -- - - - mat he is licensed promo totheaxwi,mr,of me C.at..r',License Law cluiptn 9 ,3 W9,?J;flr&' .1513a i I q'a s a Valuation (commencing withSection 70l of Division 3 of the Busine,s and Professions Comm _ ,. y is.. ar that he ii exempt timrefrmn end the basis for me allegfd exemption.Any violation of Section 7031.5 by any applicant for o permit subjins the applicant to a civil penalty of not mom than five hundred dollars($500). 10 1AP.N P I DAT ION Occupancy Type _ol.asowneronhepropm,manyemployeeswith%agesastheirsoleconnKmahom 102 - PIERS will do the work.gad the structure is our intended ar offered for sale Ise[.IOsa, 103 - UFER , Business and Professions Cafe:The Connor',License Law dues not apply to an Required Inspections ,. owner of pmrcmy Who build,or improves therean.and who does such walk himself 104 - REBAR m through his own cmpinyeas.provided that such impmcni am not intended or __ 'aTtiod far sale.If.however,the building or improvement is sold within one year of 105 - ANCHOR BOLTS — 'completion,the owncrbuilmer will have the burden of proving that he did not build or improve fic"arpo>e ofsala.). 106 - SEWER & WATER 01.ssm,mconheprop�rty.come,[loo, lycon�ra[tingwith licensed ormametomm 202 - UNDERFLOOR' PLUMBING consumer the projeet(see.]Bu.Basin.,and Pm3a,fons CwdeD The Cammmora 203 - UNDERFLOOR MECHANICAL License Law docs not apply to an owner of property who builds or improves thereon, bad who contracts for.such projects with a.contm[mgs)licensed pursuant to the 2 04 - UNDERFLOOR-FRAME -- - -...._ ... . .. . . _.. .. oiaw. mexemve��rsc. B&P C for thistisnn 205 - UNDERFLOOR INSULATION O.o<r Date 301 - ROUGH PLUMBING . WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER 1 hereby affirm under penalty of imrjury one of following dealaraeons: 303 - ROUGH MECHANICAL tt ❑ I have and will mailmotp a Certm=me of Consent m see-insula for workers 3 04 _ ROUGH ELECTRICAL F..1' Compensation. as provided far by Section non of the Labor code. for he 305 FRAME performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensatim on ln,unce.m required by Section 306 - HOEDOWNS 3]00 of the tabor Code,far he parfornuance of the work far which thi"permit is 307 - INSULATION issued.My Workers Compensation Insomnia carrier and Policy number ere: _ „_ _._ _ - _.. .__. ._ ... _ 308 - SHEETROCK I ' 'CERTIFICATION OF EXEMPTION FROM.WORKERS', 3O`9 EXTERIOR LATH'. COMPENSATION INSURANCE — 310--,- INTERIOR-LATH--- •.'. mus'sactiaoneednofe[onf binedineper nmitisfor one hundred dollars 311 '- SCRATCH COAT .. . . . Islw)orless.), 313 - ROOF NAIL I Mm y that in the performance M the work for,Mich this permit is issued,I shall not employ any perwo in any manner so as to become subject to the Wmkern' 501 - F I NAL EliECTR'I CAL'`ENERGY Compensabn Lawsof California:Date. 502 - FINAL PLUMBING..ENERGY ..Applicant. - -- - NOTICE TOAPPLICANT if,after makingthis CenifictimofExemption,you should 503 - FINAL MECHANICAL ENERGY Z become&object m the Workers Compe...firm provisions of the Labor Carle,you mux, rm O Cfawith[amplywithsarnprovisionsorthispermitspanlxdeemedrevoked. 504 - FINAL BUILDING ENERGY V1 CONSTRUCTION LENDING AGENCY 505 - FINAL ELECTRICAL x ticrchy ulfinn thauhcie is a c°nmmginn lending agency for the perfo mance 506 - GAS TEST or the wad for which this permit is i>sucd Iscc.309]:civ.C.) y `p LhdersName' 507 - FINAL PLUMBING ;D Z Lender's Address 1 mf, otlhavereadmisepliillmoenda,am thm, x.1howeinformationis SOS - FINAL MECHANICAL corrin,.1 agree,o comply with all city and county mdinancm and mate laws relating 509 - FINAL GRADE O U tabuilding conswction,and hdabyauthoriurcpamemauvesofthiscity toenter upon 510 - FINAL PLANNING ythe abnve-mcntloncd propmy for inspection purposes. (We)agree a.are indemnify a ad keep hmmle,sthechyofC.,mroagainst 514 - FINAL PUBWC WORKS .�., In liabilities pdgmcma costs and expenses which may in any way accme against said V-Z city APPLI in CANT UNDER.TAuence of rise NDS1AND WIL ng of this OMPLY WITH ALCNON-POINT'' I s eaatu r.Ter I, Rous MA Issued fs Date � amn-- TwrtM Re-roofs TERIALS DISCLOSURE © Will thl apph[am or future buildingowe....I sauc or modlo ha.,adaus mamdal. Type of.Roof �— b ,. - ./_� .. �..�'• -- ..� . . as defined by the Collection Mudeipa�Chapmr 9.12.end the Health and Safety Cade.Section 255321U9 I g ! 1• .,!•.: \ . oY=> "°t I, c,-'�,'' ' All roofs shall be inspected prior to any roofing material being.installed. -.., 1 Will the aypLeamorfrom building occupant use equipmem or devices which If a roof is installed without first obtaining an inspectlori;'llagree lO remove emit hazvdous air contaminants as defined by the Bay Am.Air Quality Mamgemem Diablo?. all new materials for inspection. Applicant understands and will comply with y ores N° all non-point source regulations: 4.1t I base lead the hala,dmw mauriak requimmerm under Chapter 6.95 of the California Health&Safety Cash.Sections 25505,25533 and 25531:I mtdcrtumd that - if,he bullding Jin,not currently have a tenant,that it is my responsibility to notify,he ticdupem the ragdir en,s which mus,be met prior to issuance of a Certificate of ney.. _ Signature of Applicant Date 1 SOI All roof coverings to be Class "B" or better 0 cr or aumoria n Dam - - OFFICE -