02030022 (4) CITY
DPESIONO
SiNPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10084 CONGRESS PL BATH ROOM INC, THE 02030022
OWNER'S NAME: APPLICATION SUB DATE
BONNIE TURMAN 1910 W EL CAMINO REAL 03/06/2002
PHONE: SANITARY NO. CONTROL NO.
(415) 968-7666
o ARCHITECDENGINEER: BUILDING PERMIT INFO
u G BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
0 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description
mt� whhsecann7b)olefD;xi� 3-fdaBarmw—IProfe"!no,Code.codmy],.nse BATHRM REMODEL.
inn ror�g ane errc<a k p q TZ
O c O yin Clrta ARCHITECT'S DEC RATION I FI O VIII q...x
1 El
u O,� 1 undemand my plans shall be used i s public records
roo Licensed Profession APR 19 2002
°' OWNER-BUILDER DECLARATION
o�
w 1 hereby affair that I am etempt from the Camracmr's License Law for the
z o following res-ran.(Section 703 IS.Business and Profession.Code:Any city or county $2600
wInch requires a permit t construct, l ,improve,demolish rep any structure
o .prio a t issuance. is 9 th applicant for such perms flsigned.tatement BUILDI
spat he s I'ee ced p rtu a the p si sof the Comrncmr:License Lo (Chapter) _
(commencing with Section7" t Division 3 of the Business and ProfessCode i' �i- Q,,sG[,f'pf tr,,yf]A 1 � , )�• Valuation
or that be rs eumt therefrom and the basis for the alleed cum ) S �' 41 '3' 'I�.J'S'"Y3••IV Ui(.•`�:•
p g pr oat Any Penalty-of Scnion0031:5 by vnY applicvm for a permit subjects the applicant to n civil penalty' t�L�D,�,��
8 of noumore man Five hundred dollars($5W). 10 PPN qyDATION ^'IT"' Occupancy Type
❑Las owner of the pmpen,or my employees with wages as their sole compensation,
-will do the work.mid the samnure'is'not intended or-offered for'sale'(Se c.-7014
1.02 PTRR
BusinessandProfessions Code:The Contractor's License Law does not apply to an 103 - UFER Required Inspections ,r-
ows,of propeny who build.,ca improves thereon,and who does such work himself
or through his own employees,provided ihpy such improvements am not intended or -, ..1 0 4 REBAR_..-,
offeredf 1- if.a the buildingoimprovementissld within - )car of .__..._ ..__ .. .__ ._ ,', r._._... .__. ............ ..
impletion the owner-builder will have the burden ofproving that hedid not build or 105 - ANCHOR BOLTS
mpruve for purpose or sale.), 106 - SEWER & WATER
_.. .. _- ---- — - ... -
❑ -
I:asowncrofthapmpcnY exclusively contracting u
g 'ihlcendnmaarnnva° 202 UNDERFLOOR PLUMBING '� •I `''I `' '
construct the project(Sec 7(AL Business and Professions Cale)The Cormmcar s L`_
and-whLowdosoatapplymanownerofpropertywhobuildsor seimprovesthereon, 2O3 UNDERFLOOR MECHANICAL •`'"'
_ .and who contracts.for. .project with a.<omracmr(s)IicensW.punuant-m.the
- _
01 amnors ucenu,l� .. 204--- FRAME..._
olam<aemvt unecrs - - ( "'-"'^,B&Pc,enols cease" 205 - UNDERFLOOR' INSUliATION
owes, Date 301 - ROUGH PLUMBING
<< - WORKER'S COMPENSATION DECLARATION
Ihereby=f aaurdcrp ltYorperjat on a of me1.fonowingdeclaations: 302 - TUB & OR SHOWER
❑ I have and will ma,iont 'cemfca c ar consem 5o elf-insure 303 - ROUGH MECHANICAL
a
for Wnrkcr's
*Compegrmiap, as provided for by Section 3700 of the-Labor Coda, for the 304 - ROUGH ELECTRICAL
- :'it,.arrormanceartnewark,rar.wmchmisp<rmi�_ir�.�aee:, 305 - FRAME
�DIh ..d'.ill aiot W kc�.'s Compien.sation insurrisca,a'required bj Section306 HOEDOWN$
3700 f the Labor'Cod f ih ;w f ce f k'f h h tl' perm i is
s eMyw ke se pe td I uunc<ca dPolicy number 307 INSULATION
ri u orcin Wt M 3/i02Q 308.
SHEETROCK
CE TII ATION OF.EXEM ON j ROM.WORKERS309 `•' '"'
COMPENSATIONINSURANCE'-.`_ '.,,.; __- _-_ ' , ' •'EXTERIORLATH`
`
s�i
p permit is for one hundred dollars 310;�� -,:INTERIOR—LATH---------- — ---"- '-`--
(This union nc d a be coin Incd f the la
($1w0trlle".) 311 - SCRATCH COAT
nfyNt nth perfo fthe�work f n hrh pc tis issue d-t. 313`"-` ROOF"NAIY `
_._ ,,
�i'nf plo nn thecoma bjammewpk`n mmon Laws.1California Dole 501 FINAL EI]ECTRICAL� ENERGYApplicurn
— -502---- FINAL--PLUMBING- ENERGY—
,NOTICE TO APPLICANT If. 0r making IhiscCri feats pfE pt you should
z heroine tribjec,t the Wok a Cma,spsiaimi Provisions of he Ladver Coee,youmust 503 - FINAL MECHANICAL ENERGY
p
forthwith ply with such '.'o or permit hall be deemed revoked
z .. ..... _�.._..._.. ._-._.__.. __. __. ..-504 -- FINAL-BUILDING ENERGY- - -_-._... ._._...
— -
', 'CONSTRUCTION - o,,, r •;� .
ai Ili by R matthere sessuedS I dog gnncyf,trispert,that. 505 - FINAL ELECTRICAL. - a ,.
0.'ooath 'Na h hath peant issued Sec.3097C'.C)
-Lepel N _ . .506 . 7, -GAS TEST....
Z Lpe< Add at507 - FINAL PLUMBING -
UQleenifythenlhave dm ppi r d,,.t,,h.r flue abover armors 508 - FINAL MECHANICALrs
fs. E.r correct. i agree to comply lith all city and county d nee d ,are law,rehiring 509 - FINAL GRADE
V mbuld building cion and hereby authorize p ' tiles fNactyt t.upon
j.-W th<abov<m< t wpropenyr inspection pipe 510 - FINAL PLANNING
f..t W
(We)ag nail sae dem ilk ph Ise iheCry of Cupenrno against
f•�-m liabilities,judg n¢,coat an pensee w ¢h may in any way cecina against said 514 - F INA P IC WORKS
:U,Z Cityin<on. ncc ofthe mg afthis moi': "" '^ f 1/�
'APP III NDERST SAND W .L COMPLYWITH'ALLnrON- 0 T" 1
S Rc -GOLATIo- ( ; 6 c Issued by: Date
s
- - - :r•',i.. ;o tic throne, D a
RRC-LOOTS
.,•a r DQUS MATERIALS DISCLOSURE- - • '
atl the pp am o f sum building occ p t to r handle hazardous r<'1. Type of ROOF
as dor <d by the pan o Mnal'Corl Chapter 9 12 and the Health d Safety
Code Sect on 25 3 (al a e a
ov s N I( ? .. '•, ' ! , All,roofs shall be inspected.prior to any.roofing materia] being.installed.% __
r
ly'k Will the applicant iararabuedingocc panru,aequ;pm<ntoraevace9'hichI If a roof is installed'without firs[obtaining an ins action;1'agree'to remove
emit ha tlous a r<oniammanu as dcfned by th Bay A a A Q I ry M nagcmem g P
Disfnn
Na _ all new materials for inspection..Applicant understands and will comply with
❑Y
t all non-pomt'souice regulations' "
1 h vc d'tbc b air o s materials sc iremems unde Ch purr ti95 of the -
California Health&Safety C .Sri ons 25505,-23313 end 25534 l understand that
Bent build 8:does not aurae h am 'nt.that it is mY responsitiilitym ndi ytheIrecu
Oce prim acquire �md. met nor tonsuance'of C<nif at'of
y ` _ - o'^ ' ''• ' Signature of Applicant- oZ' --. -g. .__. .__ ..PP__ Date
r, own r rauinada<a e - at .�' All roof coverings to be Class B"or better
• i� - .' ._ ..t.... . --OFFICE- - ._. ._..._. .. _.._.. ..