02020054 (2) CIBUILDING DPERONO
NPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
in144 nRNTRQN All EISHER POWER AND DATA n2020054
OWNER'S NAME: APPLICATION SUB DATE
GAIL PYLE P O BOX 60442 02Z14/2002
HANE: SANITARY NO. CONTROL NO.
(650) 325-5768
o ZO ARCHITECTENGINEER: BUILDING PERMIT INFO
QU BLDG ELECT PLUMB MECH
N<co I "" O C-1 Lj
LICENSED CONTRACTOR'S DECLARATION Job Description
D Z=G I hereby affirm In.,1 am licensed under provi (continental,ns of Chapter 9(continental,
m
to with Seclim17000). Divisino3orlh<Business Professions Cw .. dmylicmu
<yf nafEfbr anaeffee 200 AMP SERVICE UNGRADE.
E ae < License Clm Lic,p
u3 c.a y Dm Cornua
^ ARCHITECT'S DE ARATION
"O1 nadfrional my plans shall he used an public records
fP5
i p re Liccnad Pmfcssionvl
OWNER a,BUILDER DECLARATION
o n 1 hereby.livor than 11. eBusin from he Gonias'tt License Law for The
t-?a following rcama(Section 703 LA Business and Professions Cod=:Any city or county
ce F C which requires a pemtit m consfroct,cher.improve,demolish,m repair any structure
er
$2000
3m ..Pro f oa Is req ' the pplicano for inch perm no Blca signed aatcrrrem. _ _ .. _. .-___ __ _
that he hilicereardp rs or,70heprovisionssion the Cranberries License Pr Wwons Code)
.� -, Sq ,Ft Floor-Area _,:'*t-t ,4 Valuation
(ln [ g oh Sect n](KKI) fD ismn3oftheBusinessandProfemonsCwc) {3".'iL�31t62` !
or that he w exempt therefrom end the bass for the alleged exemptum.Any v olinam 9 0 6 6':`0 O
of Sectio]031;5 by any applicant for a permit subjects the applicant to a civil penalty
I f Out mme man eve hundred dollars 1$500). APN Number .. I•I ;... Occupancy Type
01.as owneroftheproperty.atmyemployceax'ithwagesastheirsolecomatination, 103 - UFER
'
ill do the work:-and the evucame is nm intended m offered far sale(See 7044, - - ---' -- _
rBmincis'and Professions Code:The Contractor's License Law does not apply to an CIIOns
owner of pronery Who builds or improves thereon,and whir dot Itch work himself 50 5 - FINAL E �
or th gh h ployees provided that h p met t' tended or
otic df - le If n'xever.the bolding On improicemem :old 'ih .f .. __ ._ .____-
cot pl fon the ownc holder ,'II have the burden of s that he did not build or t I it ,
improve
p for
rpt of sale) proving 7 -
.. _._ _ .__. _ __ ___ __..__.__ ..._... _
cal a fthe p(Set.7•am eamuar,a t e, i th1 ri tan f : .1 t . .
C IS ]too B . n dP faoro Codr)Th i orao
on fact I project
Lid W doe of apply t Her f a pony who Wilds pro a thaw
. and who cot ns fo h p o)ect its. contortionist 1 d pursuant f the.
nm t License Law.
❑Ima pt undo,ScF.
'' 1 B&YCf ..his ac son
Dare:
'WORKER'S COMPENSATION DECLARATION /
ff I herchy ufErn under penalty of pc jury one of one following ae[l...firms: 7
p-� 7 I have'and will maintain a&mficate of Consem oto selpinsure for Worker's
Compensation. as provided for by-Section 37W of she labor Code, for the
fo
perrmance of the work for which this permil is issued, n
haveand will entim6in Worker's Compensation Insurance,as required by Section
J] of the Wbm'Conle.for The performance of the amrk'for which this karat is
':I`aaed.My Worker's Compensation In. ranee ca sena Policy number vee:
..rl _ . .r.. .-. LL-
Pattie it lit,
C I CI RT I-ICOATION OFF EXEMPTION FROM W ERS 1
.. ....... 'COMPENSATION INSURANCE f
) ;-,
In;si:;°�(fTis"eaion need not be vofnpleted if the permit is for We hundred dollars �`;it� •*��t'••'�• � :. r :. �
1g 1001 or less. -
I cif Sommth permit-s issncd 1 --
•is Y .pert - f, work HchO o
shall n f ploy any pe any monk as so become mb3ect fo the Workers 1
Compensation Weds of California.Dam
.:Applicant.:; ., : . ., .,... . .. � •
NOTICE TO APPLICANT If furna.kin,
tt co of of
pf n you nk
Z borsubject s) India ke Compensation hoion po ani of th Lancr CWe you musts,
forthwith comply with lick provisions or this
permit shall Ise therned revoked.
'.'.'CONSTRUCTION LENDING AGENCY
=_;o: f t I hereby-which
thank a c net h n I d'ny agency for @ pedOmtance'
of the k forhick this perm i issued(S ]09] Civ.C) "
RE
'.(� -Lende Ne ,.': - :.:. ..,... ".—r ... .. __. . .. _._ ._._.. ._..._.
Lender'sAatl 5 .. ..__.- . .. - .._. _... __.__ - _.
V 1 campy"af 1 have reed this application and state that the above information is '
W.E. corie'ci.1 agree m comply,with all city and county,ordinances and state laws relating
�.V m building amstrvction:and hereby'eutborize rcpresentatives of ibis[try oo enter upon
�„CLs1 the above-mcmlonwproperty for inspection purposes,
We
( )"igrceiosevdindemnifyandkeepharnilesstheCiiyofCupithm6egamst
_ VJ liabilities,j en s.costs and lipases which may in any way acerae against aid
City in corifti,licite of The Hating of this permi JAPPOCANDER$tA' S' NDN} COMPLY N' A C'NO. p t/LA TN . - k. •r:•• Issued by: Date
n<m,vcan�raem , .. DateRe-roofs
�HAZARDO SMATERIALS DISCLOSUREpCpl cam future g occupant state ha dl ho mate IType Of Roof ....pen M c pal CW Chapter912 d the Health nd Sof fy - ---- ..
Code S lion 2553 O7
❑Ys ttP ❑N ' t s, Tfi ly T+' � 3t�'• SE L! 237f�.) } _\L Y ! f rI
...-
-. - All.roofs shall be inspected prior to any roof ng material being-installed.—
'-it
nstalled_
ryid II n ppltaanlo future building occupant use A e. poent ordevices which If a roof is installed without first obtaining an inspection,J,agree to remove
e ifh icon ico sant fsebuilnw by occu ByA Air QualryM gement
all new materials for inspection. Applicant understands and will comply with
OYe r :;l ♦
ON. '" -- _ - - p .
all non-point source regulations. "
1 ria lt a Ise hazardous materialsrequirements under Chapte-tti95 of the
6f.. t .
C lifomta Health Sspiny Coda Sections 25505.-25533 and 25534.1 undctna id that
-dobe
occu a lingouentlyhavaonmmit oisr my spsibih,to notify the
ofhe cquirtmcros which prto uance of Land, le'
Oce iss
of ,,.
_
Signature o_f__Applicant Dale
QM 2
N: wo tri ri wag= f lay All roof coverings to be Class "B" or better
. -OFFICE-..