02030050 (2) CITY
mERUNo
NPERMIT CONTRACTOR INFORMATIO
BUILDING ADDRESS: PERMIT NO.
10239 S FOOTHILL BLVD 02030050
•vNER'S NAME: APPLICATION SUB DATE
:HENG GARY F AND YAO HSIN-SH N 03/13/2002
PHONE: SANITARY NO. CONTROL NO,
1 O o ARCHITEC(ENGINEER: BUILDING PERMIT INFO
p u BLDG ELECT PLUMB MECH
o zLICENSED CONTRACTOR'S DECLARATION Job Descri
,Z N n I fares,affirm,ha lam Bono d under pmvi,mos of Chap¢r 9(comen
mciag
„F;, withSe<tion7001Division3oftheBasinessandPmfesomwCme.andoyri<ease ADD 382 SQ. FT. �� A�e®
m E:i is in full force and effect.
re ce se License Class Use.a '
i L v Date S DECLARATION
MAY 2 4 2002
00i ARCHITHCT'S DECLARATION
j
r I 1 u d in plans shall nO,,d rubfieneWid,
i6pp L
� OWNER
-exempt from
the BUILDING
so 1 hereby ufhnn that I nm exempt from the Vann License Law for the
r?¢ following reason,Section 71131.5.Business and Prof ms Co e:Any city oreaunty [[��
x O which requires v permit m ninxvucn cher,improve,den 4itlt repair any swnure y 4 5
i3 .
prior to itsI... y retheapplicammrsuch permil to rile a signed.tatim ,
fthe
pro,.m el a eah ant the p: n3ofhe Business
aLicenseLa (..pt 9 p A�
io that < g ms , crina rhe nronhe Bgeod eaaMProrc em ) �'s:i`y�};�3' g21�4, 9 .-SU ;71�^y�?' ft= .. Valuation
or that he s c m rine front and the bear,for,ha aIle a exem ,ion.An
s pg P y violation
-of Section]Oa P.5 by any applicant for u Penni,wbjcas the applicant to a civil penalty q N,, ,�
nrnot once man rive hundred dollars(s500). 101 PN - p�N&DAT ION r''"01" Occupancy Type
_❑L as owner of the properly.Lir my employees with w ages as their sole compensaion, 102 _
PIERS
will do the work'and the'shucmre is no,intended or offered for'sale'(Sec.]I)ii, - -
Busineis'ond Profusions Cods:Thi,Computers License law rices nut apply to an 103 - UFER Required Inspections 1, st L::
owner of property Who builds or improves thereon,and who does such work himself
o,,hr..,h his own employees.provided that such improvements are not intended or _, 104 - REBAR _
-oRcrcd for sale:If.6owa<r,the bdildin -- —-vemeni is sold wiihin one - "-"' --- - _"'-"-- - - -' ------ — — ---- --_._
'eom leuon,theowner-huimerwillhavetheJom<nor ri,ldor - ' 105 - ANCHOR BOLTS -
p proving that he aid not bode or
imp,ove Tari parpose ae:,m.>. 106 - SEWER & WATER
- ❑Lasowner project
progeny,ao Businivelyconcoctingwithde:)The°nuaamrs,o - ...-- .-- - - ---
- = 202 - UNDERFLOOR PLUMBING -
- onsaua,he proju,(Sec.]Ofd,Bus and Professions Code:)The Convector's
License law doss no,applym an owns,of property who builds mimproves thereon. 203 - UNDERFLOOR MECHANICAL"
and who ermined forsuch projects with a cnnuachary)licensedpursuam ro.Ne
Commctors License Low., - . - " """----20"4 -UNDERFLOOR FRAME
❑l am exempt under Sec. ' �� ' ,B&P C for this mason 205 - UNDERFLOOR `3NSUEATION
.mer Data 3 01 - ROUGH PLUMBING
_ WORKER'S COMPENSATION DECLARATION
affirm under _ 302 - TUB & OR SHOWER
Inereb
Penaltyofperimyoneonhefollowingaeelaanons. 303 - ROUGH MECHANICAL
-, ❑ 1 hale and willmaintaincSecti nr37M o, in seLaborre for workers 3 04 - ROUGH ELECTRICAL
`✓ Compensation, as-provided for-by Section 3]W of ,he Labor Code, for the
-_ venom,aneenrmewnrkRnwnii,n,nispermhiaissnea. 305 - FRAME
D 1 have d ill -dint w kers COO,pa,miturihOmmice,atocifiled br Sechbn 3 0 6 - HOEDOWNS
370(1 of lc bLabor Civic,fur the parrormancc of the work'l5m which,his permit is
issued.My Worker's Cn Tnoa,ion Insurance carrier and Policy number are 1 1307 INSULATION
cm
11,; pa':(PolmyN ,- .... .3;08::.--�'SEEETROCK,t. ._ ... . ..,.
'CERTIFICATION OF EXEMPTION'FROM,WORKERS 7 ns J �3r091{ ""EXTER'30R' •LATH
COMPENSATION INSURANCE " "
(Thsseci 'eednotbecompleted if the penn,is far one handmadollars 310;}`%�_�'IN•TERIOR—LATH -- -- -- -----;'
311 - SCRATCH COAT
i arra , me perm, 4*h ;k r mom perm, issaea,'i - .. ...: --313"'- ROOF -NAI L-
snag_ t ply yfCali y nuc ' mbcomesubrt�othe Workcrs' 501 - FINAL ELECTRICAL"'ENERGY -
italln vonlawsopChf .Date -
Applicant
pplt '- -- - '---502----FINAL--PLUMBING_,ENERGY-- -
�NOTICETOAPPLICANTIfmommakingtaCnficeof Ise pi n,you should - -- - - -
Z hcomesubjcntotMWorkeesCompensa,ionpmvismnioflhc"brCMem
youust 503 - FINAL MECHANICAL ENERGY
00 rortnwir-", ywimrymsmna
ehpnethispmitmlbammreokea.
. — 504__..-FINAL.. BUILDING- ENERGY.. .. . . .__. _
s 'CONS9'RUCTION LENDING AGENCY - .. 505 - FINAL ELECTRICAL,
�. '1 Eereby ffrm than th - eadzwm on lending, gency fo thpert nnaa e'
Deme oke hien th, perm i rs issued(S c 3897 C' C.) "
F nd
+D -Les aName '•,.•.,. - - ..506._- GAS _TEST
Londe ' _. _ ..__........_ .
—� z Ada I 507 - FINAL PLUMBING,..
'U O . I- nrythatln em ppleat ana ,t mato m r .non is 508 - FINAL MECHANICAL
W FF orree,11 g , mply th ell city ane county db d state rows refining 509 - FINAL GRADE V ,o Wilding Witsvuciion,and hereby authorize represmuuves of this city to amerupon
the abov e)t'joaneq rip i for lns olio" 510 - FINAL PLANNING
[ria-Ri (We) gee, seb� de fypndkcph�yi the city !Caen against 514 - FI PU IC WORKS
V) liabilities,judgments.core and expenses s which may any way cc ga st_said
V Z City in consequenceof,he Starting f this parch - - i " V
AP ANT UNUER.TANDS
)WILL COMPLY VJYTH'ALL NON'POYNT�''
Issued by: Date
-;gna of Applica"'Cn to '. Data •. :
` as clearedw n m 1<nt mm buil n FIA1 s rnseeosuae f Re-roofs
HA7 DOUS TE
pp s cap , ,are ,handle n aril m t 1 _ Type of Roof
by,he C penin d Ch pt 9 12 and theHealth d Safety
- -- = -
Coat,Section 25532(.)? -
e- Q !>, el ,ns Y
Distil C.
OYe L '.
'' ,.. All roofs shall.be mspected• nor to any roofing material being installed..,__ _
Oilwnm pal_ 't futurebuilding fidbyt P q' it a warn If a roof 1s installed without first obtaining an inspection, I agree to remove
vd s cram ,so def dbyh BayA ArQualityMng em
�^� _. "' _ _ all new materials for inspection Applicant understands and will comply with
lye riY� N all non-point-source regulations - -
I h rt d,he ha d aerials nillmicrinarid idler Chap, 6 95- f the
Califooda Health&Safety Code.Sections 255G5,+25533 and 25534 1 understand that
ifthc Wilding does not currently have a renom:tha,it.,my responsibility m notify the
occupant of the requiremcros which must be met prior to issuance of a Cenificn,of 5 - -
:✓ nay. .: . . , 1 . . - ...
• - 3.-y�. - Signature of Applicant- - - _- _ _ — _ Date _
0 nerorpathpaeadag , ,Dare„. All roof coverings to be Class "B" or better
OFFICE
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