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02090051 (2) CITY DNGUP I BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 1451 S DE ANZA BLVD CHEROKEE CONTRACTING CO . 020900751 UB D J "TN THE BOX HAMBERS 1220 COLEMAN AVE APPLICATION 09� TR 09A/ 2002 r PHONE: (408) 727-9850 SANITARY NO. CONTROL NO. 1 O O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH tad 8F m m LICENSED CONTRACTOR'S DECLARATION o O m i I thereby, Birm that 1 am licensed unae p (commencing �, Job DEEP] tion o U_o �prvdPxxI,wdcMa Chapter INSTALL 4 LATERAL . g. FrnFw with Section]WO)of DivisionJofthc Basin and ProfessionsC dc,dna myliccnu _YEJ is in 11 ores eava elle aic to a Licen J 1 Lic. U Da O Comm o w 3 w s ARCIfITECT'5 DE RATION F=00 g I understand my plans shall W used as public records 3r wap O Licensed Professional c w o OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt form the Contractor's License Law for the $2000 r 3< following record.(Section]031.5.Business and Professions Cod,Any ciryor county I":] which naPermit to construct,alter.improve,demolish,or relator y strucarc i3 phrd ct t t abs y the ppr mfor such permit o fifilea signed statement. ..... ........... t to (Ch (commencing dpam n70 promo. fthe Contractors iceand la Corte) -,•r 3 .F<OAI�rrA aea Y s, ser' Valuation or ecngiem;See ]fA'ar ofDivision3 fin Business cimldProfessions Code) (�i y-A t -.s.0`,Olis`T` '''Ys -1, a. s) -J.A'J or Natio Is exempt mertfrom and the bans for the subjects the exemption Any violation - J. of Section 7031.5 iv any applicant for a Permit the applicant to a civil penalty ,of not mare man five hundred donors aslw). 106APNNgWlgR & WATER Occupancy Type ol.as mwn,of he peope it y.or my employees x ith wages as their sok compensation. 202 - UNDERFLOOR PLUMBING -Witt do'the work;and the structure isnot intended or offered for sale(Sec.7614; 3 O 1 - ROUGH P Business add Porfcsions Code:The Contractor's racr's License Law docs not apply to an EWInspections' owne rof pmpeny Who builds,,,improves thereon,and who does such work himself 302 - TUB & OR SHOWER of morugh his own employee,.a Imiided that such improvements are tw intended or _ .-___-7-17 7 _..71._-17._ \' _ offered for sale.IL hbwev<rf the l hast n den of leaving n sold within not '-' FINAL - - -- eamletmn.me awn<r.Wmerwin have m�bu.a�nnr rearm 502._.- PLUMBING- ENERGY"_--_. rr•I;;,,. p proving that M1c did not Wild or improve for purpose nr.ale.). 506 - GAS TEST 7-1-1-1 - - - -- ' - - pmpc Y Ycommcting with licence contractors..to. - -FINAL- ._-._ . ._- -1 -1 . _. 777. _-7777 lAta inconsumer the does no(Sec ]OMs,Business and Professions Cade)The Contrect s L r' Lc L e nor apply man ownerofprapcnY who builds or improes uant too �pmp p ® •'t Co h s License ,.such prvlecu xath.a commissions)Lcros<d.pursa,nt.t the Contractors Li<en¢Law...,. - --- OI a ssendersB&P C for this,reason ��� ^I' •.!SC. �" tui Gwner os,< 13 2002 WORKER'S COMPENSATION DECLARATION ' -I hemby aRrm under penalty ofpequryyine of Ne following dalarmions:-- BUILDING ='/ ❑ I lm ve'ond will n ai-main a,Cenificam of Convent I.self-i...re for Worker's _ Compensation.-as Provided far by Section 3700 of the labor Code, for the _ perfoimanceofthewark,it ich Iml,cor it_isissuedis ,,, . ❑1 have and will maintain Weiker's Compensation Insurance,as required by Section 370Y1 of de lab,,-Carle f m pe fomunc f m work f which this pct- t sed Wk 's Compensation I-sun c cannot andRly nun, �f ;� •'I'I .__ -- ,. :, -1-1-1-1:, _ -1-1 -1-1 ✓�• !:�"CIITIICAIII 51E MPTf011AIC WORKERS M $' v_• I;Ia jy.y t-n ll. r�1a v ti !i.i \l, rh •• u COPENSATIOY MSURANCE' - L .eaion need nm W LomPlei d Rhe permit is for one hundred dollars 'r ..'.. IS or W)or lessl ' nn ly that in er Performance ofthe rk for which m perm i` ed,I '_� '•••_r-•*.•-••--1-1-1-1.. i6a11 not imploy aryi persornin anyte r s io became.wh)cct m me , Workem - �'y'' �' .,: t� Compensation Laws of C I fomta.Dara - r NOTICE TO APPLICthis s t _. --- Z ter .king his ou should zbee subject t he pyWorkers C pen tnp s onsof the Coe youmust fanhwith cumplY with such por i or th s perm t shall Ws deentod msroked.z -- _ _1 _ _...._ ._. ... _. ... ...._.--17 -17__ .._..._.-. _. -' -177-1..-_- . . .. _. .. --- iZ) t " "`CONSTRUCTION LENDING AGENCY - C I heby Ron m t th sumer on lending agency! the perfotim s t gI,r: ohh i k for which m—e t .issued(See'309L Civ C) ' 0..Q lender s N me-_ .___ _ .. - .. L.. . a.._ .._. ... .. ...._ . ..__.... .. -_ ........ . __- .. _ wiZ Lknd Add _ Is en fy mat 1 havencrofwith al s application dna sum trot the ebov<maws mtiooi is =[.. wrrece I agree to comply with all cap'and county ordinances and cute laws relating to building construction,and hercby'authorim representatives of this city to enter upon the above-mentioned rr for ins ptpoees., P!spe y inspection u - t-:.:Z) g come to deuti ,ormc,fy and which h rmle s he Cty ofC penfpdnit aid tq Clliabilities,I e e I. d pensa h ch m y in any y cc gainzt said V z City nsq nk of meg nfng of thsprmt SAPP \T UNDER TA\DSA ND WILL COMPLY'WTTHAQ Y-Pp Issuedby� DLvT"' Vat/�'• OU EG AT(�>�V ':O 'U� a : oj. S• /a1 ate gaamrc of ApprcarmCommeim _ �-,' �.." Date Re-roofs t HAZARDOUS MATERIA DISCLOSURE Will m applicant or future building caseco,amL store or handle hazvdpu ma,I . bond Type Of Roof. a defined b>th Cupcn no. c .Cade Charter 9 12 a d theHealth d Safety - ' -- - - '--= - Cod S t n2551 O I .f �a a fa'i't y jL_ r / t aY All roofs shall.be inspected prior to.any roofing material eing installed.. _ _ _ Will th ppl^rlaa, (t rc W g«c p t cqu p t e wn h If a roof is installed'without first obtaining an inspection,,ii6ree;io remove coo h b t t. fined by th B y Area A Q I ty M Management nt District? all new materials for inspection._Applicant understands and will comply,with. yen- '' 'N 911non--pointsolirceregulahons . - - ' .I h ad the h' and us nmeauls requirements and CM1 pt .6.95 of the - Cal fo m Health&Safety Code Sections 3505;3533 and 23534 1 understand ohm ,if the building does poi cameraYtime n¢namithm it is - '- - _ occupant f the«quire is which must be Met p y rc po 'bl ty t notify the Oce r to issuance f C nificme of 7 n ...: Signature of,__pAplicant., Date t' o ,qtn eeag t Dtic 1 All roof coverings to be Class B or.better ' - --OFFICE.-..