01080002 CITYBUIDING DIVISION
PERMIT CONTRACTOR INFORMATION:
BOI{.DyNfyMR"isOWN CENTER LN # 6A PERMIT No. 01080002
Owt,6WIMECENTER ASSOCIATES APP},1[AT)Dfl§U�t Tot
'HONE: SANFEASR�YNNO1 LU CONTROL NO.
msoi ARCHITECVENGINEER:
BUILDING PERMIT INFO
�O BLDG ELECT PLUMP MECII
>252y Z LICENSED CONTRACTOR'S DECLARATION ]��p�scrlptlon
z:8 I hereby arrm that I am hmm
eed under provi.iun.<„f Chapter 9 eanmm
meing TENANT IMPROVEMENT
with Senion"l0001 of 0rvision 3ofthe Business and Pmlessiom Code.and, yliceno,
axi reean 33 GIS
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yw < uinnu Class
Li, a O�y U ITECTECLA!
n a v ARCH 'SS DECLARATION FINALE
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ny Mnx x
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l h<u.,a aanic recants
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25 o LlamsalPbom"imerl APR 0 4 2002
e.e.e I., OWNER BUILDER DECLARATION
m I hereby offinn that 1 am exempt from the Contractor's License Law for the
(=za following reason.(section 7031.5.Business and Pmfesdonx coda Any city a county $118 9 4 4
Z✓:o which roquircs a psonnito consumer.sh uprose demolish,or repair any lorm.are E wg(�
t�r3e, .pnmt ..tegtt.th ppl'am for such pervat to file a simedsmm ' ®'N
teem L G __._.____._
- tpatTe5lceutdpunmors IOLIe'Pm%1$tMSOfNeConi=toesLicenselaw(cnapter9 �,: 3�AtOFY4aAmx-, t'r•;n•" Valuation
(oom ncng w'bSect 7yR),fDnsion 3.(,he B.,irm.mil Professoos Code)' I s{sk•.. i.„may. ,4, ,ti;, ,L .t[;
cr that he'i�exempt thimfmm ind the basis far the alleged emorpa m.Any viol.tion�
- of S«tion 7031.5 by any applicant far a pem r subjects the amliconna a civil Penalty
ornmmare Nan Bvenandt<daallaos S500). l OAPN NS'OUNDAT ION Occupancy Type
❑I,as owner of the property.or my employees w ith wages as their sake compensation. 102 - PIERS
,willdo the work,'und'the evucture is not intended or offered for sale(Sec.)614,70
Businessland Professions Cod,:The Contractor's License law does not apply to an 10 3 - UFER Required Inspections, - ''•'
owner of propeny Who builds or Improves thereon.:md who does such work himself 104 - REBAR
or through his own employees, building
that such vemiovctnems as not intended or
'orca,a for>a1e:H,nowevtt.the nuimmg m improvement,s sold-within ane rear of . . .. 105- - ANCHOR-'-BOLTS
iompletion,the owner-builder mill have the humen ofpmvtng thin he did not Wold or 106 - SEWER & WATER
mprove for purpose ofsme).
”- - - - 202 - UNDERFLOOR PLUMBING-
C) ;
co h ss owner of the p(Smny,am exclusively d prrzeting with licensed mnu«fon m t
707070 the project(Sm.you,Business dna professional;who s case:)The Cammemra 2 0 3 - UNDERFLOOR MECHANICAL':r
�. : m foes .,
License Law bee not rapplysuch
man owner of property my who builds or improves thereon.
and who License
far such Pmj«n with a mono tuna)licensed pursuant ro to 2 04 UNDERFLOOR--FRAME-
Contractors _ ...__._. -.... -_._. ._._ .._
OfiLiccm,law.
- -_ olameaemptane,rs«. ' ' .a&pefor this reason 205 - .UNDERFLOOR INSULATION
OwMr' - Date 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
I h,mby affirms under,,or ty of perjury one oftne following doctoral... 3 03 - ROUGH MECHANICAL
0 1 have and will maintain a amficam of Consent to sel6Nsum for worker s 3 04 - ROUGH ELECTRICAL
Compensation, as provided for by Section 37N of the Labor Code, for the 305 - FRAME
performance of the work for which this ponait is issued.
01 have and will maintain Workers Cion,rsllion Insurance,as required by Section 3 06 - HOLDOWNS
3700 of the Labor Cade,for the performance of the work for which this permit is 3 07 - INSULATION
issue MyWorker's CompensationInsuranc carrier,and Policy number are 3.08,. - SHEETROGK-.
r{{Ft�.fb . PalkyN CJ�'�ZZZ'07 ... .1- e .�....:
RTIPICATION OF EKEMFF ION FROM WORKERSi tk ' it3.O 9':r EXTERIOR' �liATH
_ ' ,action need no,MPFNS TIOifthe non is one hundread--- -------- 310-'- 'INTERS OR—LATH._.___.__._.....__...._
_ COMPENSATION INSURANCE^ _ _ _ _. .. . .
m - a a anon 311' - SCRATCH COAT :c
313 = ROOF-._NAIL.. .
iarufytn aNersnaarmy innr sas1.bfor
mbewhich I.jm.is t Winom' 501 - FINAL ELECTRICAL''ENERGY
sfihll not employ any Person in my manner so as to become sub3m to the Workers'
Cgmp,maGnn Laws of Ca0lumin Date __ 502 FINAL
PLUMBING. ENERGY . ..-._.. .. _ _
Applicant. making -- - p ra 503 - FINAL MECHANICAL' ENERGY
z IL after stthis ,i,imn of of Exam tion, u should " • '
r comply pr Compensation provisionsll the erredathour Code.you must
NOTICE TO APPLICANT
became object to the W ke
O � forthwith cont 1 with such .ions onht'pc t hull be Jeered revoked 504 - FINAL BUILDING ENERGY _
lZi " CONSTRUCTION LENDING AGENCY' 505 - FINAL ELECTRICAL
'�-
I hereby M.that theres a construction lending agmay for the performance 506 - GAS TEST
rz of the work for whim his permit is issued Sm.3119'1.civ.C.)
p Lender's Name., ,_:.... ._ .. . - 507 _ FINAL_ PLUMBING
... ..... .__._._. .. _._... ____ .-...
:�.Z Lendet'1.sAddre¢ -
.0 O Icodifythat Ihave mad this epplieaaodand state that meaboveinformaannis 508 ' FINAL MECHANICAL`.
W F., comet.1 agree to comply,with all city and county ordinances and state laws relating 509 - F I NAL GRADE
O r, tobuildingconstruction.andhembyauthorize repres rrativesofNiicityoiupon 510 - FINAL PLANNING
;,.:W i re above.meminned progeny for inspection purposes, .
CL (We)simbi,sme.indemnifyadd keep harmlesithe City ofCupeninoagainst 514 - FINAL PUB IC WORKS
Zi dilbililies,judgments,costs and expenses which may,in any way eceme against said
V Z City in consequence of the painting of Nis permit. r /Z.-a�
-y SOU.ICAN' NDERSNANDS'ANDWILLC fl WITHAL;`ON-POINT Issued by- Date G
T
wt cad. pp. nt to Perot Re-roofs
HAZARD . ATLRIALS DISCLOSURE
Will the,apph6nt or for..building compNt stat,or handl n.ramoum matet;,l .Type of Roof
as def ned batt Cupen M p 1 Cod Chapter 912,and th Health dads far ., ' , v .-.. ._ .1 •. .
Cod Sect on 255320) - 1 ',, ° 1 r .
❑vda"'" ' o �'° t::r
All roofs
shall.be,inspected prior to-any..roofing.material being.installed.,
T -Winthe applicant orfuture building recapantuse equipment ordeviceswhich If a roof is installed without first obtaining an inspectiori-,'I agree to remove
..is humrdauann s air mandrunas defined by the Bay A.Air Quality Management
Uimdm^ all new materials for inspection._ Applicant understands and,will comply with
Pima „ a - all non-point source regulations,
have read the`hamdous materials ropmemenn under Chapttt b.95'of'the
Califomia Health&Safety Codo:5«tions 15505,15533 and 25534,1 understand that
if the building d«s not cuamntl haveamwm;Net it ism -bilis mnotif Ne'
Y Y ssuance Y t ..
occupant of Ne requvemcnts xhi ch must e1 prior to issuance Pte Certificate of
0ocoup Signature of.Applicant _Date_ .
All roof coverings [o be Class"B"or better
xo ro a t Da¢
ry.
OFFICE .. .