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BUILDING DIVISION PERMIT
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PERMR NO.
N STELLING RD, BLDG 35
WEST BUILDERS, INC.
07120106
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PERMIT ISSUE DAIS
VILLA SERRA APTS A CA LTD
1608 4TH ST STE 120
09/26/2008
mown omni
SANTTARY NO. CONTROL NO.
(510) 525-9378
ARCH=t7f/ENGI,rEM:
BUILDING PERM7r INFO '
BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
Chapter 9
Job Description
Imming P
1 bereby arnrm that 1 w licensed under pmvitians or (comm
wit SesdanTOW) of Division 3ofthc Bottom and Proressiom Cade. and my license u
NEW APT BLDG, BLDG 35 A—B, 4741SQ
to fail aneeU��g gZs�
$/25/08 SEE #07120212 FOR SUBS.
Dam— Conuacmr
ARCHITECT'S DECLARATION
1 mastermind my plans Mall he used L public retards
Licenced Professional
OWNER -BUILDER DECLARATION
I herehy olirm Nat 1 am exempt from dae Conuacmts License Law for she
Fallowing wan. (Section TW 1.5. Business and Prefessiom Code: Any chy or county
which requires a permit to construct, ober. Improve, demolish, or repair my structure
prior to its issuance, also nurtures the applicant for such Permit to Bk a signed statement
char he is licensed to the of Ne Conlacmr's License lsw(Chapter 9
Sq. Ft. Floor Area
- Valuation
pursuant previsions
(commercial, weds Brion 7000) of Oivision 3 of the But. and Pnommons Cade)m
$555555
Nn he is attempt therefrom and the btu fm the staged escmptiOn My violation of
Occupancy
Pane Y Type
Scctm 70513 by any applicant for a permit subjects the applicant to a civil penalty OfNumber
not mart dr.m five hundred dollars(SM32609056!
❑ 1. u rote of Ik pmpmy. a mY wPloym with aagm L Neu sok compewdov,
Required Inspections
will do the work and the abucmm is not intended or offered fmsa c (See. 70M, Business
and Professions Cade: The Commetor's L:»... Law does tet appy m an Owner of
property who bis Ilds Or empmvm thereon. and who does such wart himsel f or drought his
awn employees. provided dam such impmtemenu rte not intended moire ed for sak. If.
however. to building or impmvemmt is sold within am year of completion, the ownv-
builder. will have the burden of proving that he did cot Wild or improve fm purpose of
La.).
O 1. L owner Of the property, am amlusivcly...ratting wit Beamed contracmn to
construct the project (Sec. TO44, BmincL and Prafessians Cade:) The CantactmS U.
.
cense law does rot apply to an mvnm of property who builds ar irepmma daemon, and.
o conusetsfm suchpmjeces rith•eonuacmr(s)lks dpursuantmdao Co.n ,
ense IOW.
Tsar acmpt undo See ,BkPCfar thiamdum
iner
Dam
WORKER'S COMPENSATION DECLARATION
I trreby a(Bm under penalty Or perjury One of the following dNantkm:
❑ I hawand will mmnWna CatiBmmofComatm Ylf-atom fm Werkcfs Compen.
sadon, as provided for by Section 57M of to Labor Cade. for the performance of the
work far which this pmmf is issued.
❑ I hate arb will maintain Worker's Compereadon Inman¢, as required by Scedon
3700 oft eUlmer Code, fm Om pm o.. offt weak fmwbieh this permit is issued
'
My Worker' Cam emadon '�. c/pg�nimans Policy numh`c art'
Cartier. g Policy No.:
CERTIFICATE OF E7 FNMON FROM WORKERS'
COMPENSATION INSURANCE
rlhu mods recd am becompleted irthe permit is foraoe hun0eddoWn ($100)
or len)
1 mm(y Nat in the perfomma of the work fm which Nis Permit Is, issued 1 shall not
employ any person in my summer an as to bceame subject as the Warts' CompenLdom
Laws of California. Dam
APplicam
NOnCE TO APPLICANT: If. aper making this Ccnificam of Exemption, you should
become subject to the Workc(s Compensation provisions of the labor Code you most
forthwith comply wids such Provisions m Out permit shall be demand an aked.
CONMUCf10N LENDING AGENCY
I busby affirm dart them is a construction lending agency for Nc pmromance a
the wart fm which this Permit is issued (Sec. 3097, Civ. C.)
Lendaes Name
Lender's Address,
I redly that I have tad this app kauden and sum char this above infomatiun u
roma I agree as comply with dand county city acounty Ordinances orb Sam taws rtladng m
Wilding construction, and hereby authorie, mpwntsum of this city to enter upon the
aMw.m coed Pmp " for iropecdon purposes.
rte m Lee. indemnify and keep hamdeV IWC Coy Or Capemao!gaiter
liebilidesi enu.cmmmdexpenL ichmaylnmywayamueaggmtmdCity
mee tha grmting or this permit
AP IC U ERSTA 8.5 AND WILL COMPLY WITH ALL ON -POINT
Issued by: Date
SO U TONS,
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Re -roofs
Sign a fAppli omracmr Data
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicants or foboe Wilding occupant stem or handle herudam material
donned by to Cupenina Ind Code. Chapter 9.11, and to Haat and Safety
-ask.
smdon sss5z(a)7
❑Yes MK
All roofs shall be inspected prior to any roofing material being installed.
Will to a Beant I min mea and nm e b
pp g p y pmcnl or dcvimv which
If a roof is installed without first obtainingan inspection, I agree to remove
P
emit hvudom air contaminsncd by the Bry. Arta Air Quality Managcmcnt
IN
all new materials for inspection.
P
Dim a7
❑Yes
I unatre hacladuu matedau nernmmew under Chapter 6.95 ofths Califor.
nu Hcahbik cl Smimu 2550!.25537 and 25534. I uMrnand dm if the Wilding
dw rot d tet, dsu h u my rtsponsibilily m n dry this pmt of dsc
rtyuirtmen h t et rmiLtan¢anccp�g, �actOcy�
_ t
Signature of Applicant Date
GLo
.
All roof coverings to be Class 'A" or better
Owner m autharir pate