00050148 CITU OFCUPERTIINO CONTRprT(,R iN ��pTION:
tiW 00,!!rllf WOLFE FURMIT —ELITE— LNL&q I�, 00050148
BUILDING ADDRESS PERMnNO.
SAND HILL PROPERTIES 140 URSHAN CT 05/22/2000
OWNER'S NAME. AI'PL1CA'I'ION SUB ILCI'R
(408)226-5868
PHONE. SANHARY NO. CUN'I'ROI.Nu.
o C ARCHITECIENGINLER: BUILDING 1'RIMITINFO
❑❑ BLDG ELECT PLUME ii
v
Gua
y LICENSED CONt'RACTOR'SDECLARATION BUILT UP TO J(311;11AE"5i5
I hcrchy air...I thin I on Goa,,d andel'provlxinnv est Chepter Y(mmincncinp
=LL with Seciion]Illllllnf Uivision7af the BusincssanJ Professions Codeendmylicense
SSI,to full knee nd effort.
S w V Llcc m Class Lic.a
Date Contractor
S ARCHITECI'S DECLARATION
1 onderxtmtd my,pant,shit be used n,public lee I'is ,
ae V�i Licensor Pralie,ur nal
aim
OWNER-liIE.DER DI?Ce C diraON
w ,� I hereby allirnn thin m .6 fnnn the Cnn urn,Cos e:An,
Low'for the
following moon.(Scmiun]33L5.Ilusineu and Pmfessiunn Code:AnY city ar nmmy
se a
YF p which requires a pannit to cmv,tim her,improve,demolish,or repair Lilly structure $50000
N priorvi its issuance.also oxmims thea,plicunt tit m
im.mch,l i plot sign ed aatemm
e
a. that lie is licensed pursuant In the pool know,of the Contractors license law(Chapter 9 Sq. Fl. Floor Area Valuation
(annmcnaing with Section 7000),q Division J of the Raciness and Pmlessiam,Code)
I,,That he Is estrous thercho..I and she ball,I...the alleged ismair, Any violminnCom.
of Scaion 7371.5 by any applicant for a penult subjects the aPPEcum it)a civil penalty 117,19rWI - vim
of not more than five hundred dollars(s530). APN Number Occupancy Type
01.as ovnorof the proiarc,urmy cmployces with wage,as mar sole compcnsal on, ? FRAME
will do the work,amt the utumum i,not intended or offered for sale(Sec.70L1, 05
Bu,inc„and Profe„hm,Code,Tho Common Lirenso Law does tel apply to an 307 — I NSULFWteWnspeclions
owner of.mumy Who hands Lir ingmovcs thereon,and who does such walk himself
or through his own employee s......tied than such impro.emems am non intended or 601 — ROOF TEAR OFF
offered fm snlc.If,however.the hoild'mg ar improve rem i,said within one year of
,mlacdmi,(lie owmr-buildir will have roe humero itprrwing mat lie did rel builder 602 — ROOF PLYWOOD NAIL
innpnotfarpar`wenf,ale.). 603 — ROOF BATTENS
❑I,Lis owner of lIe to,sc ty,am mdmivaly eout raefm8 with licmnecd tontracton to
construct the ar t(See.]BW,Business and Pndn.dons Crde:)The Contractor', 604 — ROOF TN—PROGRESS
License Law does not apply to an owner of property who build,or improves thereon.
mJ who convoO,Jnr wclI pr jemn with a sonmal Moonset ..roans Lit the
Conircr License Irw.
Omes1 aexempt under Sc<. .B B lie for this main
Owner [).it
Dam
N' COMPENSATION
URKr:R'S COMPON DIiCLANAl10N 3
1 hcrchy ufYnn under penalty of pe fury one of she tolluwing deelamtinns:
f'7 1 have and will maintain a Certificate of Cmixetn in self-insom for Wmker's
supensafinn, al provided fur by Secular 3700 of the Labor Code, for the
orf mmanec of the work for which this pernit is iswed.
❑I have vnJ will nmlnmin W aker's Compensation In,nnnec,ns required by Section
3701)of the Lrbor Code,for the pormorLance of the work fur%Inch this permit is
sued.My Workers Compensation Insurance carrier and Policy canner aro:
Caricr. Policy Na:
CCRTIIICAI'[ON Oil EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE -
(This section need not be aomporod if the permit is for one hundred dollars _
IS I IgE of less) _
1 unify mar in the perfommnec of otic work for xhich this permit i,issued.1
shall not employ any penon in any manner so as to become subject no rhe Workers'
Compenoto I.nws LEE Calilorm..Lane
Applicator
NOTICE TO APPLICAM.If,ifulrrnuking this Certificate of Emnnpnion,7nu should
become xunco to the Wnrkcr'n Counpcnvadnn pr ,m
ivisn,of the Ichor Craft,you uss
Q O fent ith coned,with,uat provisions onhi.,permit shall be dreented revoked.
F ty
CONSTRUCTION[.ENDING AGENCY
I homily ullinn than there is o mnsmunlon Ieadiag agency for Ile p,,oralance
W ofrhe work far which this.emit is issued(Soo.31147,Civ.C.)
P. ❑ Lender's Name
z [.ender',Addw,.
U 0 I minify that I have read this applicatinn and state that the above information i,
W E. er,rem.I agree n,,a,i,ly with 1,11 city and mumy urdinunct,and%(Eric f w,rcloting
Q V m building conamcrion,and hereby umhorim reprewmativcs of this city m enter upon
:n: rbc ubuvic.memioned.mumy for inspection purposes,
(r
P. IWc)agree m,ovc,indcninil'y and kcr Itrmlcs the Cityot Cupannto against
In liabilities.judgments,conn and es.rnse,which.nay in any way ucemt again.a said
11.1 i City in consequence of the granting of.hil .it. a
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Signalmcol Apprean,07 ream, Date Re-roofs
HA/ARDOIJS MAI'HRIALS DISCLOSURE
Will the upplicunr Lir future hooding occupant store Lir handle lNumlous materia Type of Roof
a,defined by he Cutworm,Municipal Cale,Chapter 9,12.and the Hcahh and Safety
Code, Po 255t2(all'
Yes
ED No
All roofs shall be inspected prior to any roofing material being installed.
WiIIthe applietntrurtoore arldingrirtunartm,eemromtntordevices ishith Ifo roof is installed without first obtaining an inspection, I agree to remove
emit hmmdom air enamninil a,defined by the Bary Arca Air Quality Management
DLarierr all new materials for inspeciion. Applicant understands and will comply with
❑Ye, 0 N all non-point source regulations.
1 have read be haeamow,mmcrials requirement,acidic,Chapter 495 of the
Califamia Health to Safety Crxlc.Sccmmn 25505.25533 and 25514.1 trade c¢and mar
if the building dors Lia cumemly have a m rtal.that It is Illy responsibility m nmil'y the
oxcupxnt of The requirements which must be met prior to issuance of a Ceniricme of
O,L.ErNi Signature of Applicant Date
Owner o,aathmimd rgent. Dme All roof coverings to be Class "B” or better
OFFICE