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02050111 NO CIBC DNG DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 10080 N WOLFE RD APPLIED CONSTRUCTION TECH 02050111 )WNER'S NAME: APPLICATION SUB DATE MENLO EQUITIES 10050 N WOLFE RD, SW2-280 05/20/2002 PHONE! SANITARY NO. CONTROL NO. (408) 252-9990 ARCHITECT/ENGINEER: BUILDING PERMIT INFO E BLDG ELECT PLUMB MECH U a a 1_7 u u u_1 LICENSED CONTRACTOR'S DECLARATION z 5u,? Job Descnppption O z_0 1 tion 7 a)cf don 1 um licend under provisions of Chapmr. (commencing a p HCw with Section Iof Divisionl orthe Business aProresaona cml<, emy fi<emae ADD RESTROOM aces is in run r rc lie erfe �w .1.^� JIH hili aces, LiycJrnU�u la Lic. `1ContrafOl ,x^ 3 LL g 1 underssand my plan Chug Ise sea dOas publicA22, 1 N 01 ,,,a''uY 1 SEP p 2002 �:.0`^ as Gf u �r w ,o Licensee Rofessiond °'6oLL OWNER-BUILDER DECLARATION BUILDING I hereby affirm that 1 am exempt from the Comeaanr's License Law for the t_ < following mason.(Section 7031.5.Business and Professions Code:Any city or county $60000 1 x 0 which requires a pcm,it m constrict,tiller,improve,demolish,or repair any structure. to d mus issuance.alsoreformsth ap,l sf such permit m fl grcd inuemem a. thahe fl a uipursumn t.ft poevisio fm C uanof L 1- pOmpan9 pr ppl�ea Valuation (<m -acme mhse<r 7D0)f fDivi. \ f'he Business. ydP r .nm,Csbo Z;{3` $:laWto.tf :iU�-ri:i1ak v;. or bar h e pt tti from' d the ba f the11 ged G pdun Any violation of Senlun 703 L5 by any applicant for a permit subjects the applicant to a civil penalty t.,•. of not mere man five hundred dollars($500) 101 APNMdRATION t'..'.I . �.,: Occupancy Type ❑I,d sewerserthe properly,ornire 1, a.,intwiderages eedrsole n,mos:70 U will do the work,told the awnurc F mot tee's J e e Law Tor sant-(Sec:iDLit 'Bnerof anderty Who Codc:The Commuter's Liana law a«snmapply man 103 - UFER Required Inspections"" -11+:"'r owner of his own Who loge s or improves thereon,and who discs such work himself or through his own emplver-t provided mm such impmvcments within not in2neea or 10 4 - REBAR _ " - f --I-"IL howwd the bu ldm uii,-,.Id-wishm one f "'-- -� - - - -- ---- �---- ------- ,offered ge burden mo 105 - ANCHOR BOLTS completion.m u <e huJder will have the nuNen of prvvmg mm he did nm build or improve for purpose ofollof 106 - SEWER & WATER - - — . aI . owner of P prty a lr< t era etre acontractorsto 202 - UNDERFLOOR PLUMBING Liccnu`LoweJoe.enoda cl See l' Bcrland �rno In la°d,r)m C tn�I�oema 203 - UNDERFLOOR MECHANICAL " pp Y n proper y w pmv<s wn _ 2 J. ..and-who contracts for.such.projects with.a.conuacmgs)licensed purstam.m.the ____ Contmnoru License Law. 204—= UNDERFLOOR ,FRAME_____. ❑I mn exempt under vest .B&P C for thi,mason 205 - UNDERFLOOR `INSULATION come{ "" oaie 301 - ROUGH PLUMBING WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER _ I hereby affirm tinder,p<nmty of ix rimy or of the following declaration.: 3 03 - ROUGH MECHANICAL ❑ 1 have and atm maintain a Certificate of Consent to sdf.insure for Woh<rs 304 - ROUGH ELECTRICAL Compereation, as provided for by S<nion 37W of the Labor Coda, for the 'performance of the work roe which this rem ait is issued. 305 - FRAME ❑1 have and'wi0 maintain Woke,s Compensation Insurance;as moulted by section 306 - HOLDOWNS 3700 of the Labor Code,for the performance of the work for which this permit is s d.MyW k Com motion mcurancecar<rand Policy number are 307 - INSULATION c ��A V1Y�'.Po11 O IAB App t 308 = SHEET,I,OCK-:..; ....-stmt._. -. ...WH •: 1 _CERTIPICATIONOF EXEM FROM W RKE.S} 5+� 'Ltty + 369• %i-SE}C'I'ERI ORI'LATH,' ENSATI USURANC. -I' ._ _co . . .... . . . .. . . . .... — '- - ---' 310':-_.-'INTERIOR—LATH '(This-senium need not b<completed it the permit o forone handled dollars (SIM)or less.) 311 - SCRATCH COAT :... ._..31.3 ._..ROOF NAIL ... --- -. -...... _. 1 ceruIF Or a in me pert rinunce of m h f h M1 m pc tis issued,I - ,rl. t "abase o,employ an, c o m any frommer so as m bw ecome blecurso the Worked'!! 5 01 - FINAL ELECTRICAL ENERGY ml Compensation Laws oI Clddsu.Date= Applicant - - S02-- - -FINAL PLUMBING--ENERGY— - ----- +NOTICE9'OAPPLICANT:If,afternaking this Cwrfiam or Exemptlnn.you should 503 - FINAL MECHANICAL ENERGY become subject to the Workers Compensation provisions of the labor Code,you must O rortnwimeomplywim.u<nprovi:met.oemiapermn.nmlbeaecmeare.aPd. _ 504 --. .FINAL. BUILDING -ENERGY-. ._.. .F;m -_I -' CONSTRUCTION LEND]NoAGENCY 505 - FINAL ELECTRICAL tea.' I hereby affilm th i there construction lending agency for be,performance �. 'onhe work for hem' a i. Eu=a(s .vw7c ca _ 506 - GAS TEST - y ❑ Leder time 507 - FINAL PLUMBING UYA� LeJ \IJ o: � V�O 1= tyro Ih mad this application and state that the bo r r is 508 - FINAL MECHANICAL Tar t.. 'c'mrem lspice tocomply with,It edyand cmmmy md1in„es,and.mcIn,,mlatim, 509 - FINAL GRADE O U to Wilding construction. dh by authorize rep ve of this city to nm pen he nu t do peryr pcclonpm -. 510 - FINAL PLANNING H 0. W)ago.t d fvo dA which the Co, fC peri nuguinal / v mai s et ro t o d p n n > any y gains to 514 - FINAL UB C WORKS U Z City remc u h i germ 0 d �'� l AFNL As JI .t 1 VD N ',,4LC0MfLYH�)LNT' Issued by: Date SOU f-t I\T ), sig, fappn<anCARDO Date Re-roofs "� , ..___.. ....... HAZARDOUS MATERIALS DISCLOSURE -' W'Hm pphcmolt' nuimin;gh<mpaltamremehalo- ml u,mm=nal ._Type.ofRoof... . a;defn d by thmin e Caperton,Municipal CmJ Lindner 9.12, 1 the Health and Safety - pp rtrt C: Ie Qoctican Y..25532a): 1 Nn @If `. fI„ t, �}' , :. -t_ p 'r t,�:-.'.�.,:S Y• .,�., R _ All roofs shall be Inspected prior-to any rooting material being installed._. w111npPf t' lure nAla p tuse<q rI lit,eaevmetwni<h If a roof is installed without first obtaining an inspection, I agree to remove em t h Mous air cod t.as defined by theBey AI`ai\ Quality Mawg<n,cm Dislri<t. . all new materials for inspection. Applicant understands and will comply with c _ move. -- -- q,rvm - - - all-non-point source regulations.. -- 1 hove read the haiallous macrials requirn amts under Chapter 6r95 of the Calif redo Health&Safety Code.Sections 25505,35533 and 25534 1 undersmnd that _ -dime ildingdoesnmcurtentlylleaterant.that it ism,mponsibilitymnoi y he - - -- -- - " '- . -- - - ' - - occur t of rcgl eels whl , t be t prior wuan<c of Clod, m of coca )( © Signature of Applicant Dale or amhoneed.,an, Date All roof coverings to be Class "B" or better _. - -- OFFICE