01100034 OF
CITY
I BUILDING DIIVISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7447 WILDFLOWER WY G �� — �1 Ce�5 r 01100034
S� _ IS' �Q/ 10/05/2001
sONE: SANITARY NO. CONTROL NO.
0 0 ARCHITECT/ENGINEER: /s/s C� BURRING PERMIT INFO
w- � ✓¢ I Z L EL CT
PLUMB MFCH
Qu
fuaa. ... _..._.._. - f_ - � L_I - I_ ]
LICENSED CONTRACPOR'S DECLARATION
5„= Job Description
{z_�, I Hereby Harm that 1.m licensee under provisions of Chapter 9lc.mtnennng P
withSmion](b0).fDivixi.nlofine8usinessandl4okszionsC.de.anemylicrnc ADD 315 SQ. FT. &
i is in IA11 force and after 7
!0RU uaene a=.n PARTIAL ROOF REPAIR. INAh_E®
0 6” Date Cammnor utyy-[}.(—�I
% ARCH( LT'S DECLARATIONE:0 Ce„V j7-` _ r/
;,� _ IurMersmnd mp plane shall M1eused.s public rtaNs 1 , MAR 2 7 2003
Y
i O Licensed Professional / ,
' o OWNER-BUILDER DECLARATION
I hereby affirm that 1 em exempt from the Commcmr's Limine Low for the BUILDING
h i< Ibllowing reams.(Sulion]031.3,Business ane Professions Code:Any city a c...D
MF O un ch qts rc a permit, .t t alter,improve,demolish,-o pa any structure$ -poor to iis-suac Also requires the applicant for such permit to file signed statement - -- - - _ ........_-. ___ _
that hq T I' CJ 1 Tiffs am to th6 provisions of the Con.auor L n L w(Chapter 9 5rr'„Ft FlooerAr
Immmencing with Section 7000)Of Division 3 of the Business and Professions Code) �ylsstl( q�l ; id'l a(;k /1C;'!4_ Valuation
or thin he is exemyi ton,fr.m end the basis for the alleged caempilon.Any violation
'of Section]0313 by anyapplican,for A permit subjects the applicant..civil Penalty
f A.,m.remen Ove hundred dollars($500). APN Number .nal Occupancy Type
❑1,os w rnf the pmpmY•ar my employees with wages as Narsole ampensa,inn,
will do thework and the stmcmre is not intendedoroffered for sale(Sec.7041,
'Business And professions Cale:The Contmcmr's License Isw does no,apply to an 102 - PIERS Required Inspections -
a
wner of property,Who builds m improves thAA,m,and who docs such work himself
.,in gnn- employers.Provided nata n_ ,, m tare Ton odor_ 103 -_ UFER
,offered - n will building
mphemdr 'sold edwithin Aneytar or 104 REBAR .. •:� , : .'I->.
completion,the owner budder will have the M1UNa of proving thin he did not bold or
impevefarp.pose.fsale.), 105 - ANCHOR BOLTS _____106❑k as owne pr the progeny, 4,Business a contracting with licensee Conti of m - SEWER & WATER :
-= mmwct'heLaw
does
nT tape.]toA owner
and profession:coder The Contractor's
n, 2 02 - UNDERFLOOR PLUMBING
License law does not apply man owner of progeny who Wilds seimproves dtcreon,
i
and vector's tm[e for-such projecu.weh A.amrdcmrtU licensed pursuamw. .m.the _. .-_. 203 - - UNDERFLOOR--MECHANICAL —-
13 ' -
C 1 am ex Y License(see -
lemexemptundergce. ,.B&PC(onhisrcason 204 -' UNDERFLOOR'= FRAME `l'
'own "'- 205 - UNDERFLOOR INSULATION
RKER'SCOMPENSATIONDECLARATION 301 - ROUGH PLUMBING
I hereby alarm under Penalty of perjury one of the following declwations:" SO2 TUB & OR SHOWER
G I neva^and will mJm.in'.'cenificme'of Consent 1.eB.ins.AA for Worker. 303. - ROUGH MECHANICAL
Compensation, he provided for by 'mint nor or me tabor cine, for ma 304 - ROUGH ELECTRICAL
Comp n sats n,the verb for which mix permit is issued.
°1 have and will maintain Worker's Compensation Insurhnge,us required by Season 305 - FRAME
3700 of The Labor Crile,for the performance of in work for which this Permit is
306 - HOEDOWNS
issued My Wodcr's C p .l
c Insurance carrier and Policy tie ate:,�_ _. .•.
X .. , _ _......._.... __ _,___._._._.._
cva« S'1�FtTL-�+AtAa.11eyNO:k 2� 307.:.r ,.I,INSULATION
3CLRTIFICATIONOFEXEM"IONF OOMWORKERS � r 308
_CQPENSATOINSURANCE1 _
13°S HFLTZOCK
t , 309';t EXTERI0R7LATH v
' _...._._ ._._
(Thu scnion need nm he completed if the pemtit is for one hundred dollars s ,.• f'I_. . _ .. __.
00)ar faxes) 310 - INTERIOR LATH '
.,_ - ...31.1 __'SCRATCH-;COAT _ _..__...
1 of thrid th pHmT 'a of the work Nch iht pc t -issued;) '' •, ,I «... ....., ..
'I.11 Hat" OI y any p on In any manner so As to
become
b)ect¢,the Workers
313 - ROOF NAIL '
Co pens1140 Laws of
Gell'Orn) ale y1� 11a 1e1 ea '
_ApPIi,..Ys� -_Zau 501 -- -FINAL- ELECTRICAL -ENERGY-
'NOTCETO AP IPLCANT If'ofR mfig this Cenfcate of Exempunya.xn.am 502 - FINAL PLUMBING ENERGY -
z bac me sA,,cctt theW rk esC npensauo,psi 'stuns of the L bo Cod you muxn
CONSTRUCTION LENDING AGENCY 503- - ..FINAL..MECHANICAL-ENERGY-,
ENERGY_
O forth tti AAPly wit s ch prov s ons or his p rte t'hall be deemed revoked
a`l� oft (hereby Irrm
that 1sacnswnton lending agencyf theperformance 504 - FINAL BUILDING ENERGY`",
W, .kir hchIh no t AedIS 309] CTv.c) 505 - FINAL ELECTRICAL'
("), end nNem ... . . ......_. .. ... . .. .__ .. .. . .,. __....... . ... .. .... ..
z ndarxAddress,' 506 - GAS TEST
U_O I c mfy that I hav<rtad this opplicannn and stem nhanhe above infonneuon u 507 - FINAL PLUMBING '
:Qro-= ., coiled.1 agree to comply with all city and county,ordinances and slam laws relating 508 - F I NAL MECHANICAL
-U to building c.nstmciion,and hereby tiuthbrize represenmtives of this city To enter upon
>i,W me above-mentioned property for inspection,purpoxes.,, 509 - FINAL GRADE
L.T L. f Waj agrte m sae indemnify and keep harmless th[City of COWriin. into,,
G.-"I flab I t s uud,,7nm.costs
And expenses which an.)in any way a against said 510 - FINAL P ING
U M Ci,y m e equeA. I he'gent g of parol - 514 N WORKS
APPLICANT UNDERSTANDS'AND WILIf COMPLY WITH ALL NON POINT'
SOURCE RBGUCATION.. •�' ! o Issued by: Date
(' S7g..We.1 AppileaMC..trnn.r X ,. L • ' iS ' . Dam Re-roofs
HAV,RDOUS ATERIALS DISCLOSURE
Wndmo la t n b'Ia ..-Type of .. - ...
PC i on g Ace p t toe s h dl h ea a us Safey
•es deli ed iby on 2 Cnpcn M gel Cod Charter 9.12,and the Health and Sefdy '
colas t 253]2(e) r 3 [3,1 I. a.rk 1 , .1 1"(`! B
°Ye _ All roofs.shall be inspected prior_to.any roofing material being.installed.. .
y e equipment o de which s
Wdlthc air
r t rpbaAs dasap , If a roof is ins first obtaining an inspection;sed ree.tc remove
m t ham d s ev cnnmmmhmr' 13YxA >ns tle rttEd by tl a Bay Area Air Quebry Meniigemem g p g
)rxtna all new materials for inspection. Applicant understands and will-comply with ,
all non-point source regulal3ons, .
'.r. .. ..
1 ha a eud the haloid sea aerial requ rem sits under Cbapte 695 of:she
California Hllh&Safety Care,Sections 25505 25533 and 25534 1 understandthat
tithe Wilding hoes not currtnlly heveetena rehouses i,yrn ontbTlilymnotify,thc
Occupancy.
occupy
-� All roof coverings to be Class"B" or better
OFFICE