00070078 (2) CITYBUILDING
UI'DIN DI IRONNO PERMIT CONTRACTOR INFORMATION:
BUILDING AUDRIiSS: 117ItNI1'I'NO. /
- ' S PLUMBING 00070078 V
OWNEW S NAME, APPIJCAI'ION SUIS UA'1'11
12246 SARATOGA SUNN VAL RD07/14/2000
910NI.. SANrIAIdY NO, CON'I'ROI,NO,
(408), 867-6010
G K z ASCII'ITCI'/1?NGINF.HIL ItUILUNO PERMIT INFO
G - 13LDG ELECT PLUNIII MUCH
LICFNSHD CONI'RAC'I'OR'S DECLARATION
a E I beren-rrnroe N,l I are lic,.,nl endo ,Chr tee 9(1') nein, Job Description
oz—o > mlei Po'ne,, P y
fir r3 h yt with Ssrtio el olld el Divi ,3 of rhe llueirmes:mA PmR,sions Codq�and my llmnnc
n fllll mrcr and rn,<
�a �e�enerClare �— Leek `1 Imo! INSTLL GAS LINE FROM METER TO FIREPLACE
❑ole�_1��D dur_
w I, v AI1Clll'niC9S DHCUHCLA�� O.
C 1 eodor,land 111,Fhrr,.nrh no wen fin p,Nlli encore,
to
pL¢rnnsd Pmfex,innul
O l'1 role OsoHR DUCe C'elo ON
see
o A I tmrehy,firm Ihm m crept fi'I 'hr e,sero1Co Lltse,c Less fur Ihu
Cly soil Illoli Iloliell II 9oollo Bn,in.. ad..I,den,ul h,or Any city sh1retne;
�O wh P I I .II 1 P igr )
�3� Pr I. I tl vpol a IIs, II y Iameern
Ile.,lie 1 'dF II trprr�„ fn c, mot I . (cmmoe) Sq. Ft. Floor Area Valuation
or n olee ee v II Suhun 9Wye of e sisis 3 OI a aBunid es and P Airy n,lance
oor dm,h,is rep,Ihny liplil,and the Maris los he us the r,mnFllme.Any virhrlor
f Seerot rrl e thghs it „oodredlennl r,e.rennll eelbirate r1,r aFpliea,r o-e a rich nertary Occupancy Type
I rot mere mall her bmmree Cornu,.(SsnB). A PN Number
131,mnw'e,,rof the proper,oro,y eol""yerw1h,v,Pe,nethrir sole romprrarhm, ;3C
will do Ihr work,and the sm..rvr i,nm imm�dul nr offend for roll,(Sec 9044, - ,. - -
losinne,:Ind Prae.,ler,Old, Ile'Coe,lracmrr Li,.m.e Ltlw doer nor apply,,,all Required Inspections
°�imr of PmPerty Who belles O,hnpmvr,Ihcrune.and who dors anel,work Ilimeclf
e,lgn I...own empluyre..prided mal�,en1e irFlefel mane are bol amended fir 106 — SEWER & WATER
offered fee saly.IL hnae-1,the handle,ur.....Ioelnenl is,old whhin one yes,of
,I,Il,born„ le,n„nifirNderwillhill thl ,a
ride.0 onamhedldn
rlotoe, 202 — UNDERFLOOR PLUMBING
lrr,ptle.r rnr nnmo,e ofrale.).
❑I,tmewrr,nlIli,mope,ly.rme,emsm ore,I....A"[Itdeer,edeommnoteto 301 — ROUGH PLUMBING
eiri„lee,Ne proien(see.7844,Ifo oaer rod Fmres,mes Code:)The Corhra,ers 302 — TUB & OR SHOWER
e ”elesterot airelllewowtrarcollorwho l,nue il,y,rrer,tIIIren, 502 — FINAL PLUMBING ENERGY
mel !L O cm,mrh he mel p j¢u w'uh a eoneoelmYe) Iiwu,cJ Funllrnt In the
Commers ee Licunec Lie.
❑lalo e,rmp„lrder see. .a,w PcSir odr re„see 50E — GAS TEST
Gel„er Deo, 507 — FINAL PLUMBING
WORKER S CO\IPLNSAPION DECLARATION
ARATION
11el lifiler relell holleell,or pr' ) 1'Icfr11 yl 'I'-rrn.:
❑ e, II , C f1 '' 13 , I 11 l o Wn k ',
Coe , dl h) S
l - , ,kill f l I'b ( In tl¢
pen rd kI I'en I I- t I.
❑II d 'll ire W k C II 'q ' IbySelnr
3900 ,l Ill Later Lode,h r[Ile pertr , e of the ben k Ire Mich the,Frrrnn le
sound.My WIIoN—Crmt'ress inn Ineurw¢c career and Poll,n,rel,aro:
Cal I'll: q- pnl�yNo.: wc.Ll�4n� 3
CIiRIIPICAI'IONOFE%I?M PD ONIBOMWOR URS'
COMPENSATION INSURANCE
('fh'm Ildiell oiled nue be eleoploed if the Perni,is Ireores hundred d(llnry -
($100)orlces.)
I cenily Ihm in Ne pnfommrce of,hs work for which Nes penult is issued,I
short not empley any pe,see In rely ornrer so as Io hecomr srnlm't to he WOrIxes
Cen,prumris Law,of C:Jdnrniu.D:nc
Applicun,
N'OTICHTOAPPLICAN'I:lir lire,rell'ill'Cenificws of F treptirn,ymr uhnuld
heanr, ,,hje,i m the Workers Compersrien pmvi,inr,of the Lahm'Cede,you,rest
Q forlhwhh comply with rich I....I-Ii,fir this prone'shell be dmmcd revoked.
CONS'I'RUCI ON FUNDING AGENCY
I hereby:elan„Ihm Here Is a eonevmnm,"o'brg raeney or the perlemenmr
rf the clerk for bel ieh'his prnmGs Issued(Sri,3097,Civ.C.)
Q I,cndm's Nrnm
F� z Llot Addm.,,
L) O I cenlfv Fell I have rerd this appncelinn rod tole her Iheahow it—rely n is
W Fnen.I ngece m congdy wish ell city cun
I'll nrrIu
ly otdinatel and sell w,relming
tohuildi ,con.amnln.hand hrrebyrrlhuneereprosenmrives orrhisslty ro,mer upon
ry she ahm,*menm
esd Pvrp,lly for II p,
e-pra ...ro
ti a Moll ol,o sol J r...I,aredk I' ,theCty 0I C p ,ihoo igairest
IA lisndl Joel... t I elorellol losil ley'eilly oIlle Wrote se lestsolid
U City en........once Ill he gramrng or Iii, ,Irmo.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT [ssnedb
SOURCE REGULATIONS. y Date
S,,IboI of ApplicarUCenrcuc,or Delo Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will the appMart or mwre bending eeenl,nm sten;or I III w,rrler,r, iw Type of Roof
as defined by dee Coperire Menicipm Code,Cil x,9.12,oiled the Ileallh role Swe,y
Code,Sec'ion 25532(,)'
°Yee SILNe All roofs shall be inspected prior to any roofing material being installed.
bell nlr,Pplie,alerhrelehill ting eeroparl n,r e,lldPrenn or de,-icr,whirle If a roof is installed without first obtuinin an ins ec[ion, I a see to remove
,n,il hemnlnm airumlwninarr.rstelirelbyIhe'try Aree At r Qum ity Nl,Il,gererr g p .g
Doll all new materials for inspection. Applicant understands and will comply with
❑Ye, Nil all non-point source regulations.
I halo bed Ile Naardoue nm'r,I,]s reo,iremem,ender CIli,r 6.95 A the
C,liforra Iirolth&Is]ery Code,Sstloit,25505,25533 and 25536.1 tell'.sterd[list
if the hill diry dos,nnl arei have a comm.Ihm it Is my reepnmi hi Illy to,notify the
cc,prm of the rctryimmeme of leh rum,be Incl Friar m ixeuanee or r e I I- I ur
Oca,prncy..
„ /f _ fy/ate Signature of Applicant Date
e r teras hnnrrd[,gem OF, All roof coverings to be Class "B”or better