02060096•. 1-l; ,,v' :.:.. .. -.:V_< :... - _ : I.- i.... ..._...OFFICE
CIT OF CUPE
BUILDING DIVISIONSION PERMIT
CONTRACTOR INFORMATION:"
BUILDING ADDRESS:
PERMIT NO.
10050 N WOLFE RD.
02060096
OWNER'S NAME:
APPLICATION SUB DATE
• MENLO EQUITIES
06/17/2002
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PHONE:
SANITARY NO. CONTROL NO.
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ARCHITECDENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
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IM1ercbyaffi that lamli«nudunder provisions orChapmr9(commencing
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with on3of the Business and Professions Codc. and myliccnu
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fail Interred affect.
ra i full force and effect.
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Liccnu Class Lic. M
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ARCHITECT'S DECLARATION
9 2002
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T understand my plans shall W used as Public records
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Licensed Professional
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OWNER -BUILDER DECLARATION
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1 hereby u1Bmr that I um exempt from the Contractor's License Law for the
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following maven. (Section 703 1.5, Business and Professions Code: Any city or county
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which requires a permit m convect, altar, improve, demolish, or repair any structure,
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..priono its isauance.als. requires theapplawal for such pcorrduo file asigrad sm¢ment,
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Valuation
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mr,belsthcedAolpaicas,iq� ppr,sionsoftheCoduactorsLim^uLaw (Chap ¢r9
(c.mtgepcingwnh Section,'IU;1,O),o[Division3of lM1<Business and7799fcnio^sCWe)
at this, he is exempt thele Wm and the basis for the alleged esdmAtb/. Any viulaiva
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--of Section 7031.5 by any applicant fur a permit subjects the applies., .. civil penalty-
,of hot tome than eve hundred canar.(s5M)
101 t3`PN069ftAT ION
'.�k`�'; ':, Occupancy Type
° 1, us owner stifle prow , ,, my employee, with wzgcs.s ffir, sole c.mpemmion.'
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-will do the work, and them aed or'ofered'for sale (See. '70,14:
stcture ,s not ,mrd
'Business and Professional Code: The Contractor. License Law does not apply to an
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104 - REBAR Required Inspections t ^t'I Lnl l
awn<r of,,.,ny Who builds or improve+ thereon. sena huhu docs such work himself
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or through his own employees. provided Nat such improvements am no, intended or
rc4'fa I If however,the hu'Jms np .. IJ within one a`
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co ilf he er W Idem II ha a the b N proting that he t Wild.,
roil f profuse il
505 FINAL ELECTRICAL
ly cotrect gwth i«udc to tato
514 FINAL'-PUBLICWORKS
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i tt th p jeer IS '1844 B . J P f . me, Cad ) ThC t actor'snu
WWdoes not pply m owner f p pony ho W Id top outs thereon,who
contracts for.such mabons with.o contmew(s),Iceoscd.P moa ^t to Or.
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,actor's License Law.,;
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"—WORKER'S
COMPENON D� RATION
I hemby affirm undo Penalty of pcijury i see of the following drelaratiom:-
° 1 hdve and will maintain a-Ceriific6m of Consent m'self-insure for Worker's
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Compensation, u-,msi&d for by Section 37M of tbe-Labor Code. for the
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performance 6f the work for which this permit is issued.) ,
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° I have and will meintilm Worker's Compensation Treatments, az required by Section
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37011 of the Labor Code. for the performance of lhework for which this permit is
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neural: My Worlicei Compensation Insurance cairier and Policy umber am: '
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.. CERTIFICATION OFE EIMPfIONFROMWORK e
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. .' COMPENSATION INSURANCEI`• VV,
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rfperhis scaio°'need not be completed if the t s for one hundred dollars
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(51(K)orless.) _
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1 card, hat in Neperfonnance o1 the work for which Ins perp t is i....d I
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shelf not employ'an arson m any subjca m itis Workers
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�.'pTICE TOA PLICANT If, !t gll). Ir to fE empion'you.ho Id
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sssYNht6ltro» subs n othe Ws kers Compen.m lAo m 'of theLabor Code. yot
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fonhw tti comply with such provisions or this porn all W dtttned revoked,
-'' CONSTRUCTION LENDINGAGENCY-
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I herehy air, th uh - '. a canstmctim le^d ng agency for the perfairna^cc
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of the work for'which this permit is issued (Sec. 3097. Cie
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s Address,
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l ha a a't riW: state that@ aW i a.e.
rte 'a comply with all city d countyordinances dane laws ci
taWilding . n adh outh rim pm move fth city in enter upon
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th h r nlPropertyfor rv,apurposes
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(W)-Smriaiia de and keep h City far._t
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liabilities,judgments cost d pease which a) in any y comagains, .aA
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Cty« Rhe gmni ng of th <per it
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DERSTp!, tD A. ,LL CO\t WITH ALL\ONPsx 't
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t Issued by: Date
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ntt2 ApplicanVCnnactor m
Re -roofs
HAZARDOUS MA71iCLOSURI „
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WJlthe apple t or fmicWilding uacpat.t ° handle hazvdousmal al
_-Type -of Roof. ------ .----
as def. J by th�e Ca,minri Municipal CM Ch pt i) 12, d th Health and Safety
tilde Scct on 255J21a)`'t t 1 -1I , , 4 I t �
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All roofs shall be inspected prior to any.roofing material being installed,
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Will theapplicant- future building occupantuseeq pmentserdevj«x which
th ardor';era Imnnms as dcfned by the tlaY Arc A Q31ity Manaeemem
"If a roof is installed'without first obtaining an inspection; I agree to remove
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all new materials for inspection. Applicant understands and will comply with
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all'non-pbin['source-regulations:
Itce. mad the`Ytarardms miierials requirements under Chapher'6.95'of the
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California Health k Sufay Code. Sections 25505.25533 and 35534. I undemand that
iftpc Wildin docs not curtemly haveatrnam.thal it is mY responsibility to notify the'
acupatit of uimemat c mux, et prior to isiban2c of a Cenifcate of
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Signature of Applicant Date
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Al] roof coverings to be Class `B" or better
Ownero
autha rima agepr -
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•. 1-l; ,,v' :.:.. .. -.:V_< :... - _ : I.- i.... ..._...OFFICE