02080055 CI BUILDINGUOPERTONNO a p b PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT N0.
20730 STEVENS CREEK BLVD JM STITT CONST 02080055
P1f5tNA1E IMPORTS 580 W CENTAL AVE #C APPLIc08NSUB/ 2002
PHONE:
(714) 255-0226 SANITARY NO. CONTROL NO.
GOO ARCHITECDENGINEER: BUILDING PERMIT INFO
utf BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
1 hemb ffmn that Too licensd under f CW,Ir,r 9(commcncin Job Description
O� pct°"'i°°'° Cod, ic TI--REPLACE STOREUF,RONT n t�
'W Section]000)of Division 3 of the Busi�n 5 d Professions Cod'ej nd my license U a,I,,VI. 4 l Liv m
z�� Lr< f In sand ellen' Li(M�4�Z7G �-
O c U D _ Gommct
'uf3u� ARCH11 ho av DE(�ic..ad SEP 1. 72002
1 understand my plans shall W used as public«coNs
�N
wa.i p O Licensed Professional
oLL OWNER-BUILDERexempt
DECe Ciarm ON AYIp DIN$V000
la
u�=' 1 hereby effiml Nat I oro exempt from the Conuanor'a License Law for Ore GO g� �y
F•Z< fallowing rt n.(Section 7031.5,Business and Pmfcasinns Code:Any city or county $5 0 0 0
SFO n,or repair any swnare
a3 prior
uo file a sigrrdsatement
w p iamtarmlo pmarinims.f P�sucenselaw(CWpar9 .3,5 �(OEl�or�ea ., r r'h Valuation
which rtgmms a pc pmac, mo rs
.. nonoiu issuance,alsort mm Nea applicant for such
pSe do m the pkvisioru of Ne Contractor M e
(cbmmesrcin8 with Section]tri>)of Division 3 of Ne B,uFlness nd Pmfessions Caeel t„r,}_� [ ,v_v l;Iv.
or that he is exam't tnenc pain and the basis for the all¢aU xUraption.Any violation
of Section 9031.5 by any applicant for a permit subjects the applicant a civil penalty
ofnot mortman five hundred dagam ts51)o,. lO 1 AeN ft TAMAT I ON Occupancy Type
0Larawnerofthepropert%armyemployeeswithwagesnlheiraol¢compensation. 102 - PIERS
-;will do'the work.and the structure is not manded'or offered for sale(Sec.]DSJ,
Business and Pmfessions Core.The Contractors License Law does not apply a an 103 - UFER Required Inspections.
owner of propcny Who Wilds or improves thereon,and who arcs such work himself 104 - REBAR
or through his own employees.provided that such improvements ere not imandead
ar or
-offered ithe:ICnowaildethe WildingoriirdenU eatrg sold:within a.W11iof -
completion.I,,,the owner-Wilder will have the borBcn of paving that Weir rid Wild
-a2
`mprn.=rmpaga,aear.de,. '^_� 106 - SEWER & WATER
202' -UNDERFLOOR--PLUMBING
-
• -.O1,as ownerof tM1e pmpeny,em exdusiv<ly<ommednB with lianaed convactarsm ' � " - ------ -- -- -�_._. ._.
construct the pmjmt(See]Baa.Business and Professions Code:7.Thc cOmira6um's 203 - UNDERFLOOR MECHANICAL
Lice.Law does not apply to an owner of property who Wilds or improves Merton,
f - _mad-who.cammcts for Inchprojects with a comm am(s) hasionsed Puau¢m to.Ihe _... _...2.04--_. -UNDERFLOOR...-FRAME'-
E3 Tam License Law. 181
9 Io a
- ❑Immexemptuneersee' -'�iaHansre,Stij$ma,.an 205 - UNDERFLOOR-''I'NSULATION
Owner Dail 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
Iheaby alarm undq peaalry or perjury one oLlne tonowing e¢laations: 303 - ROUGH MECHANICAL
=1 ❑ 1 have and will mainain a Cestifcate of Consent to self-insum for Worker's 304 - ROUGH ELECTRICAL
Compensation, u provided for by section 3700 of the Lanor CWc, for the
Performance of the for whim this pemdt is issued. , . 305 - FRAME
❑1 have aad will maintain Workers Compensation[as umare,as required by Section 306 - HOEDOWNS
3Il0()of the Labor Cade,for me performance of Ne work for which this perman is 3 0 7 - INSULATION
] rssu d My Work<rs Come pion Inmm'e cam and Policy number bre
308 - SHEETROCK-
_ .
�� ( CF,RTIFlCATION OF E%EMYPFROM WMKRRS -- 1 'rs2 ` 3O)> fEXT'ERIORI.L}1THti
-� .. COMPENSATION INSURANCE _ .. �.(,/f, I:�!:-J 3.10-'-- .INTERIOR-LATH'-- -' -"
- ....
.., __ ...__ -
(TM1 wcri,rn need not be completed if the permit is for one hundred dollars _ t -'• .�.
I(slao) less.) 311 'SCRATCH COAT -
rr Snot ma,p rarmmna ar the wark'ror wn' n m'. P= 't &i .313 ROOF..NA.I.L.•,- •� •_� .. .--.-._._ _ -
ihall nut employ any person in any manner m as to Wcome mb,=et to me workers
501 - FINAL EL'E C'TRI CAL"'ENERGY
1= n
Compensation Caws of C.hfimale,Date, -
-Applicant ' "' _ -. ..... 50.2.. ..-...FINAL PLUMBING. -ENERGY. ... _.... -.
.NOTICE TO API'LICANT.ILdter making this Certificme of Eaemption.you should
5031 - FINAL MECHANICAL'' ENERGY
O D become subject to the Worker's Compensation provisions of the Labor Code,you must
famwnhcamplywithsuchpra isiansormispemanshonWdoemedrtvakca. _ 5041 - FINAL BUILDING ENERGY
CONS TRUCTION LENDINGAGEN CY SOS '- FINAL ELECTRICAL
1 hemby'aRrm that therse is a construction lending agency for tM performance
m(he workf which this pemtrlissued Sec3o9] cacj 506 - GAS TEST r
ytp l.c dr N me .. -... - 507... = _FINAL-' PavWO-,OFr,. I'ager maiW rtad Nis-appl ano-
nand rntheauraes
PLUMB
ING
z se Address 50 FINAL MECHANICA,L
,
of t l agree to comply cityand countyordinances and state
lIaws rlaling L G DE
to building contraction,and
heby -. _.".... -
eadl p - tdk tm'.city enter 510 - INAL NG
r l W the, W mentioned property forinspection purposes. _
(we) g to itinerantly and keep nl. the City re penino aga nst 51 - INAL RKS (, r
Vi
liabilities,judgments,c n and expense hich may in any y against said I
U'Z City in cu req ace f th g nt ng of N Permit.
APPLICANT UNDERSTANDS WCL OMPLYWITHALLNO, INT Issuedb Date
.. SOL CF ULATIOVS. 2 y�
Sglp of Applicant/oat tar,' ate R, roofs
H RMI MATERIA DISCLOSURE
Will'the applicant future building mon store o h -ole haenrdou9 mocrind Type of.Roof, - - ..... -as def d by theCupcn Nu �npdyCod Chapte9,12 an J the Health and Safety - - -- -- - -
Cod� 0Y.o 33532() I rml4hi5; - '1 � ' '�� F ,.•i,1
All.roofs.shall be inspected.prior_to any roofing material being installed__ _
W Il the'ppl c to r rare building naacupoo use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
emit WearrAmax.ireconaminarts as de ed by the Bay Area Air Quality Management
Drrrt all new materials for inspection.- Applicant understands and will comply with
.. ..
' all non-pore[source regulations.;,�;, �:J , 9,-1 ,
- I have read rhe hzva)daus materials ra macmenes under Chapter 6.95 of Ne
California Heklasc Safety Core,Seetuo,25505,35533 and 25534.1 undersand chat
if the Wilding encs not cunendY have a tenant,that it is my responsibility to notify the
occupant of th quireme s which mit et prior to isxm ce of Certificate of
p cups y.
Signature of Applicant - - _- _ Date t --
O%Wrorauthorizieffagent Dat i All roof coverings to be Class "B" or better
_. _ ._... . . .. . . . . . .-. -..OFFICE-.. .. .