02070108CITYBBULODING
DrExONNO PRRMIT
CONTRACTOR INFORMATION:
_
BUILDING ADDRESS:1ITN
.
52070108
19750 STEVENS CREEK BLVD
PACIFIC GENERAL CONSTRUCTIyJ
TkfflkINE VI L. P.
38350 FREMONT BLVD
APPLICATffyQlDATy2002
[S
PHONE:
(510)713-9343
SANITARY NO. CONTROL NO.
ARCHITECDENGiNEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
U CJ L"7 U
LICENSV70,WRACTOR'5 DECLARATION
I hercbyoffmnhm licensed under mvisi^ns of Chapter 9(commencing
Ob esCRption
TEMP POWER POLIJO'
with Section )of Did oflhe 8. arend Professions Cade. and mylianse
- ��
is in full fort Z
`asALED
tSa
License C x
D.epant ,A
CHITECT'S DE puhlR rtmNs
1 m demm� my shall be a
JUL 2 5 20 O2
plans
p �/'�
�u'�®�Cyl
Licensed Ref<ssional
OWNER -BUILDER DECLARATION
(Pom Ihm 1 from the Convns License Ww for she
1 hmusi
1.. Burin
a. . ]031.5, Business and Cos
Cale: Any city
$C
Y 1 Q
us Mewing requires mpr ve. demolish.
sPermit t repair any "rectum
which rcquiin a permit sec conmtucl, alter, improve. demolish. announce
fi mmem
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; 361�(6''6�fA&:Ai€A,•. �,t.,
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Valuation
maI.i (commencing lorntwaDivision oeCommctassuans<LswonsCn9
(vmmitecensdpaaauisoretutheiM1ivisionsofoe CoM1 tors LiccnsUw(Caesi
ing semion'1000).^fhBu Professions Code)
w{m isx ind
s he bsiso the Any vi
or that he i, eadmpf li and the basis for me Any
-
cialleged splicaaob.
any applicant l earby
- of Secdon 7031.3 by any hundred ll for n permit subjects me vppli<ans to a civil prnalry'
'drotnidntmanfvdnanareaaalarslsslro).
1031PNTIIi1Fti$&
:.:•rr`•: Occupancy Type
❑1, ea ownerorineptaperty,armrempinraswdhw.......
304 — ROUGH ELECTRI
AL -
will "Eo tha'u'ork.-and the structure is not imended or offered for sale 7011:-
Business and Professions Cock: The Contractor's License Law closer nor apply to an
., .
Required Inspectionsit ., -
owner of ptopeny Who Wilds or improves meson, and who does such work himself
or mrougIt his own employees.p ided �h t h improvements 1 mended or
If, w c Ise ]wilding improvement Id - within one year of
"offered for sale no
___ .. .. _ _.. _ _ .... _. ..._.. ...._l _. _ _... _ ........ ._.. _
comdedim. me owner -W icer will have the burden of proving that he did not build oe
- r'
improv<for purpose of sale.).
01:asowner eu6nessadPruting with licensed commnotam
P(Sec.
_41:_1'Iv P :l'•;1 ". u
7vin
project
construct shedoes Iappl 701Q Business and Professions
or
a•. �,,. .i pi : .,.,,.,I,, `.,. 4
impTheroves
of property who builds se improves menton,
Isco dos not apply m an aw ills ves moment.
. and -who uts w
fLaw....pmjttss with aswmracmgs7 licensed . pursuant m.du__._._.__.__.___
Cowhors Licens.
License Law. _
Col am exempt .. ,,....
❑lain esempl under Sec,--' � � '`':B�&PCfor chis reason
.. ., ..
owner ' Dae" '
WORKERS COMPENSATION DECLARATION
IhcrebyaRrmunderpemby of pcjury no of, the following declarations: `
0 1 have and will and roam 'e,Cmificne of Conscni to self-insum for Workers
"
Compensation, as -provided for by Section 3700 oftheLabor Cada for the
'
e work for which this is issued.
performance of mpermit
01 have and will matin ion Worker's Compcnsalion Insurance, as icyulred by Section
3700 of the Labor Cae f therformantt of the work' forwhich thispemm is
its u d to C(�.oTppyemauon Insure ce d'P'o�lley mbar
GM/yWda
`
C PofcY NWOMMOAAKERS
I - •'
/ ' I r' f . rb L t 'k l-
r t i NOF FJ(EMPf1 FROM.W.. KERS ,
- e
yCE". ".A • ....
V. ti "" "' COMPENSATIONINSURANCE:'-.`,—_''
_
fhionneed not be'complemdif the perms]is fist one hundred dollars
ISI00)or less.) less.)
i
11 tardily Js i n the Prof.rmanc< of the work for which iht pdmut is issued. ]
shall not employ any person in any manner so'ss to become subject to But Woken
Compenutian Laws of California. Data
APPLICANT.Applicant
If. after testing Certificate of Esc peon: you should
Ibecome
r i'
subject to the Workers Compensation provisions of the Labor code, you must
fofihwidi comply with such provisions or mis permit shall be deemed invoked.
,.d s^ %CONSTRUCTION LENDING AGENCY °
-
' 'I hereby aim Inas mere is's coruwcllon leading egenry f die performanceii
wodir wM1ic.innperms ixissueA (S,
Lender's Narms .. ..
_. _.__.. ._____._..._...__ .. ._. _..._..___
Lender's'Addkss':. '."". •, .'. :, .'.;, ..c .'
; 11
-
. 1 certify Nat 1 have card! Our application and 50te mat the shove information is
cosrtds, l agree to comply with all city and county, ordinances and nate laws relating
to building consuuction; and hereby authorize representatives of sniff city to enter upon
the above-mentioned property for inspection purposes. ,,,,-
(We)egrcemuvel indemnify end kap hemd&'s sbi tiiy of CLpen.ino against
thdilill judgnie s case an ai'mees xhneh may in anyway ..a against said
Cary in censequ ce of she sin nf mis pernil.';'
FP ER T S �4 WILLiCO�M� 'WIYHIALL' 'O
Issued b Date
Y
01146,2
Si ata rt Applicanderaera ter '.: '. , Dal .,t;'.
Re -roofs /
HAZARDOUS M
Hent orfum' A RIALS IS SU "'` '
ll the applies m bwld ng occupant to. or handle hawdoua materini
.Type Of Roof - -.
as defined by the Catoctin. Mirricipail Code Chapter 9.12. and the Health end Safety
Code. Secuvn 25532U)
❑Yes:..n-:) t. :.itu
All roofs, shall be, inspected.prior. to. any- roofing. material installed.,_......
vk•n. Will he applicant or fywrt Wilding ce,.nnt,Pse<quipmet or devicas which
-being.
If a roof is installed' without firstobtaining an'inspectidn,:Fagiee'to' remove
emit haserdeas Orcontaminants is defined by the Bay Ants Air Quality Management'
District?'" .:. I
all new materials for inspection. Applicant understands and will comply_ with___..
11 Yea ,. , -' r
-all non- oint source re ulations.,- -
,I have rc.Cdr, mustadous'materials ra,inummts order Chapter 65.4 the
Ca
C Ifomia H Ida k Sef yCode: Sections 25505. :1 M533 end 25531.unde t nd shot
_ .. — _
if the osn Yhavc sec t taut my rtspon bit ryt dirt
oc a, nSb ybemetprro tasu ce' f Ceificate !
iL-
Signature- of Applicant ,Date
.. ._.. .._ -. _.
All roof coverings to be Class B'r or'better ,.
ma
aiaed gem D t ,
= .:: ':': _:.:".::.':'. .. OFFICE