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02080069 (2) CI BuDING DIVISIONNO BUILDING CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO, 10156 CAROL LEE DR A GOOD PLUMBER 02080069 V55�'ERICHARD R AND DONNA M 41954 BENBOW DR APPucA08/13A/2002 PHONE: (510) 656-0600 SANITARY NO. CONTROL NO. S p ARCHITECDENGINEER: ° BUILDING PERMIT INFO E BLDG ELECT PLUMB MECH y z ou -U LJ ILJ I'_I y�' LICENSED CONTRACTOR'S DECLARATION Q y G I hcmby affon that 1 am licensed under provisions of Chapter 9lcommencing Job Description te__t J with Section]BanofDivision 3oftheBusiness and Professions CodeQ ndmyheenae REPIPE C is in full force an de �r H9 V Fact 6 Licensc/(lass Lir,. X 3 LL V DnIC Y 1 (,'nnlmelnf F LL O to Tr— ARCHITLCT'S DECLARATION 1 understand my plans shall he used as public records an P1Y w 6 p p Licensed Professional OWNER-BUILDER DECLARATION w a I Wrcby affirm on 11, exempt from the C Professions o License taw for the k-z a' following reason.(Section]031 S.Bulinus and Professions Code:Any oily or county $4200 c1-❑ Ishich'claim-a permit m,mown.alto,improve,demolish,or repair any ammum co 3 Ours uires theandicant forsuch Permit file a signed summer � poor m sell issuance, req Nal he lliapiel -usMlude provisions of the Cmareames License Low(chapter 9 r ,a s Valuation (commencing with Seetiou.]00))of Division 3 of Ne Bui,imess end Professions Code) {'1,';'s;" '315612 0I'.L. FP,,F{jl�r�4'S•:�; or Thai he A exempt Ihemflom and the basis for rbc allegd caemption.Any violation s I, '" -ofSection]011:5 byenyeppliamforapcmdlsubjecmtWapplicanttoacivilpenalty anC T of not mom than eas re hundred donLS5000. 202APN(sjMIBRFLOOR PL BING • OCGU P Y YPe ❑l,as ownerofthe pmpcny,mnty employ«swiNvot'.as thcirodc compensation. 301 — ROUGH PLUMBIN �- T, -win do the work:and the'swcmrc it not Intended Or'oRertd for ode SOI.]DLLs; 502 — FINAL PL{T',�II]]T�]]u,,T�h� LL±±nn z. 'Busincu'and Professions Code.The Contractor's License Law does not apply to an W TeW`NIS FAQy - owne r o1 m,ny Who builds Or imposes thereon.and who does such work himself 507 — FINAL PLUMBING or through his own however. budded that such i anntmj mems am not intended to B P t s sold he did one yea of ... .. .... . ..._.. __ . ... .. .._.. ._. _. ..._,.. . .. . :off--df- I.IL ho di b Ida - - -- completion,lite u,c crude.). rud.).will have the bmtlrn of proving that he tlitl not buil)or improve for pugnne of sale.). ' construct e p pent' si ly< t it . thl en. d meet'sto ,', II (( ,gyp p nn.I 1 the p j 1(Se ]U94 B incl d P f sinal CW 7Th C Imcnrz s II 9�Sf A°�Rin License Law does not apply to an owner of property who builds or improve.thcmon. " - '2 _..and.whocontracts for such projects with a conlraaor(s).liremed.pursuant to the. _..___._ _. .. .. ... _ ...-_...__.... _... _.._-._.._._-.....,_-_ ' Contractors License Ww,-. -- _.....-..._ ....._._ -_.._..._. ❑1 am exempt undm Sec. . , , &P C for this reason AUC.'212.2002' . OwnPrPDate o ' t "WORKER'SCOMPENSATIONDECLARATION BUILDING I hereby affirm under penalty of perjury,one of the following declarations: - 0 1 nave and will maintain asCenificam of Corium to self-insure for Worker's Compemmon, as provided for by Section 37M of the labor Code, for the perrenaence of the work for which this permit is issued. terhave and will mainuiu Worker's Compcnsmion Insure ce,m requiud by Section % 37W of the labor Coal,for rhe pettmmanee of rhe work for which this permit is umcd MY rkersC pe fon lnaumcec e,and Policy bernm.ON ... .n ,.^ - .- .. ... ..._.. __.... No Cam rsLL �W'ORKRS'.'E .9 - ll,. ' ERTCATION FEKEMPolicPI'ION M. a� R,il'A ! i6. .�� :.2f, itYl I",V{> l ,,,k d;S,vL C ., IFlFROCOMPENSATION INSURANCE ITh s.uu m need not be completed if the permir is for one hundred dollars .tl (MOT or less.) nfy lM1l th p f Tlh work hob this la 1':'aacdI I - shall not employ any pe son`n any mann r so as to become roar, o the Wmrkas +• I'�` Compensation Laws of California.DataNOTIC ApPlicani ` " ' TO APT If, t k g this CaraficaurafE.Imption,yon'should C) became sbl rio the Wok Compensation ponvisionsof the Labor Code,you most C) fohhwiih comply with inch Provisions orthis Permit shall W d erred '- revoked. - _..._. _- .. . CONS ..._ _ . _ _DI __. .. .. ..... .. ..... _... .... ....._. .___....... .—...__ _. W ""iaby f' CONSTRUCUON LENDING AGENCY I hereby which Na Them is a issued(Sdon lending agency Inaba peAonnanee . of Lethe work for which this permit is issued(Sec.3097,Co,C.) - W"� -tinder's Name- on _: .. _._. _._ .:_._.,.. _..... .. . _ .. . _ .... .. .. .. .. ... .. . �" IarMer's Address U 1 ramify that 1 have ad this applicasure Na tion and stathe above infomution is ramifym meet (agree to comply with all city and county ordinances and.state laws telaling ^ V to Wilding cmrdmction,and hereby aulhons representatives oRnis city to enter upon }_W the above- a tinned property for inspection purposes. E.:O. (WS'all'e unitive,indemnify and keep hartnless,he Cay of Corcoran against 4 liabilitic,judgn ads,costs and expenses which may in any way accme against said _ V..Z City in'onseque cc of the gm ting of this cm, AP I.ANT DERS`FAN A:VD W OMPLY WITH ALL NON-POINT - - - ,uLnr .s '- `'�,' Issued bye Date C ata of Apphcan an,r 1 - S a° Re-roofs t HAZARD O S MATER( S DISCLOSU - . will the ppl 'm o r 1 b Id <p t 1 e or 1�a dle Iharard s material Type of Roof t ed by the Copen M c p od Chip h pl 9yY J theHealth anti Safety' Aod Section25532(a) y YP s ' ) 'a + pYe ' No I it _ $4 ) ..All roofs shall.be inspected.prior to any.roofing material being installed. „ Will Ih r ra t o future.b' nOccupant uuequipment- td ; n emn h aN a,cod tned by the Bay Area A Quality N nagemantIf a roof is installed without first obtaining an ins ection, I agree to remove District! Y No all new materials for inspection Applicant understands and will comply with all'non-point source regulations.. I have*read the hazallous macnals raquiminarma underChapter 695 of that Call Health k Safely Coda Sections 25505 5533 d 25531 Iunderstand that if (ding doe of cumcnl1,have a brant the i. y raspo billy tnotify- the ,de u f Ne ,morn ad, wh`h must he, el prior to+ssuance of a Crmficam of b _ Signature of Applicant Date , . t s os aumodu °Be^t Dam All roof coverings to be Class `B"or better OFFICE-.. _.._-.