02070199 (2) CITY
DINGmESIOVO
SINPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10746 LINDA VISTA DR 02070199
OWNER'S NAME: APPLICATION SUB DATE
HARRIS KENT S 07/30/2002
:I HONE: SANITARY NO. CONTROL NO.
MOO ARCHITECT/ENGINEER: BUILDING PERMIT INFO
8�u FF BLDG ELECT PLUMB MECH
N Z LJ
LICENSED CONTRACTOR'S DECLARATION
Z�N Z I hereby Rum than I am licensed under f Chapter 9(commencingJob Description
O Z_ y es provisions o p
F=Cro with Section 70W)ofDivision 3 ofthe Business and Professions Code,wd my license REVISION (FOOTINGS) --IN HOUSE USE ONLY
:mfg is in ranforeeanaeffem. (ORIGINAL #02070016)
ns
z z 6 Licee Close Lic.g
O U Date Cottonton
ARCHITECT'S DECLARATION
r-03LLy
gg�a O 1 understand my plans shall be used as public records
u+�p O Licensed Professional
c o OWNER-BUILDER DECLARATION �\
1 hereby affirm that I am exempt from the Contractor's License Low for she
C Z 6 following reason.(Section 7031.5.Business and Professions Code:Any city or county
$F O which textiles a Permit to construct,one,improve,demolish,or repair any structure
prior to its usuoree,also rcgwtes the applicant for such permit an fil...gned nommen, -
-
thstneitl'censedpursuknt 19 the pfovlsmmofrise Contractors License Law(Chapter9 Sq.-Ft. Floor-Area• ,,! A• Valuation
IC6;7icingwith Seengn,7000r of Division 3 of she Busmessana Professions Code) '�'p�_})'is(5
or shat he is ekempt inercfrom and the basis for the alleged ciao op.Any violation
-of Seedom7B3L5 by any upplicens fora permit subject,the applicant o a civil senelry
Brom marc than five hundred dollars($501)). A um her j•rar.nr.n Occupancy Type
❑I,as owner of the property,or my employees with wages as their sole compensation.
-wilt do the w°rofessi's Code:The isnot tar's icer offered Law foes et.not(Sec.7044," - - y It C,q r
rBbsiness'and flofessions Cade:The Consmctor's Land.Law dao not apply to an 102 - PIERS Required Inspections "•
owner°f progeny Who employees,
or improves at such,end who does such work N ed or
orth for
his own cmployces provided Nat h rsemiseai are of ratified or 103 - UFER_
"eco ed f n,ale if:owner-Wilder
i the llave the
prove mints Id within'not year of -- ""'""'-' .. t• n
completion,the owner W Ider will have the W Nen or proving that he did not Wild or
104
improve for purpose nraale). 105 - ANCHOR BOLTS
- - --- ----- - ----- -' ..._ .. - - .._. _- .. ._. - — -
Olcas owner of the pmpeny,am exclusively contracting with 0eensed contractors to 106' - SEWER' & WATER-
of 3:'r.r:'`Z rmr.r
- consumer the project(sec.7w.t.Business and professions Cade)The Comer's 2 O 2 - UNDERFLOOR PLUMBING
License law does not apply to an owner of property who Wilds or improves the mon,
and who,co mustu for,such.projects witha.contractorts)-IicensW puetiam to.she, __.
Conuaaors License Low.,,,
- - "203-- UNDERFLOOR MECHAN-ICAL-----
�; ❑lam exempt under Sec.-" '' °" ' •";B'&PCror this reason 204 - UNDERFLOOR'�i F'RAME(�"ri
wiser .: •...,.c: :.i .:... .... ..
WORKER'S'`"'File' 205 - UNDERFLOOR INSULATION
WORKER'g COMPENSATION DECLARATION-- 301 - ROUGH PLUMBING
-therebyinfluntmaderlictuh, pcluryone Tromso mgdalantions: 302 - TUB & OR SHOWER
I n e will men a cenifra nr Coni m to telt inure for workers 303 - ROUGH MECHANICAL
Cnmperidni nr arprovided for by Section 3700 of the Labor Code. far the
:L;_ 'perfamubce of enc work,for which this penni�,is issaee;. 304 - ROUGH ELECTRICAL
❑1 hi and will'm sin Workers ColpiPinstin mninmmmra,C,at mutinied by Section 305 - FRAME
3700 of me ISWr'Code;for the perfomtance of no,worlkfdr which this Permit is
306 - HOEDOWNS
Issued My Wo k riCo pc ti Ins nra:i Carrier and Policy n mber ark ,: '
TN$ULATTON,'
Cam 1'i 4`2 j{P:.iP bey No'-
11 FICATION.OF EXEMPTION FROM WORKERS 1 S i5s F 3 O S„F j 1SHL,`Li'TROCK
INSURANCE+
....
'.l-CERTICOMPENSATION
.,to
^"• tThis union need not be compinca'f tM1e permit is for one hundred d°Ilem i, f_t:'.l;1Pt I\t)C
310 „- 'INTERIOR LATH ,
-- - -311 '^-=-SCRATCH COAT
I c<nay m i m perf tmaniie of me rk'f i wh h rh permit is issued I -. _----' -- -
t.'b: s(.
C 11 t n. 'ny pe in any on iter m m an beto e i b) r an the Workers 313 - ROOF NAIL'
co K. upn ewe telt .Dee ___501... ._...FINAL--ELECTRICAL__ENERGY__ _
APPhcaai.. • ., .,.., ......
sNOTICETOAPPLICA If,after making this CerificeeofE pt, you should 502 - FINAL PLUMBING ENERGY' '•`') `�'
become subject tiathe Wi3rimes Compensation provisions of the Labor Cade y must
-O pz ,ren iso'complywmsuchpro'slamsorsort---Permit shallb--deemedre - _ _5Q3_-__- FINAL--MECHANICAL- ENERGY.-._„____,,,-
CONSTRUCTION LENDING AGENCY 504 - FINAL BUILDING ENERGY 't
ai .� I hereby affirm that there is a construction lending agency for the performance xb. : l. .•i .•
of the work far wnkhthis permit is Mind(Sec'309T Cia C) i �._. 505 - FINAL TRICAL
_ AELECTRICAL
W-Q _Lenders Name,--- i ' _ ._ _
Unde Address, 506 GAS TEST
art . •t:;'i,;:
v 0 rt fy hat 1 have read this application and sue that the above information is 5 0 7 - FINAL PLUMBING
s w-F„ correct.1 agree to mmply with all city and rounty,ordinances and.stae laws elating 5 0 8 - FINAL MECHANI CAL
�.U to Wilding c nssrucion andh eb mlfi nz 'epesmomves of this enter upon
m to pit
509 - FINAL GRADE
.._17y 1 (We)ogee jo m e. aemdiackap hannless'die C ry of CLpedino igmnat
liabilities,judgments costs and expenses which may,n any way accrue egrtn t said 510 - FINAL ING �..
U.Z city n sex eii-ce°rtn gre t goon pe t ” ' 514 F' F A WORKS
APPLICA\?U\'UERSTYNDSANDWILLCONVLYwrrHALL'.\'ON-mi..w Issued by:.
_ SOURCE RhGI'LATIDNS:..;I'i:' '' Date
Signame of PpPlicani/Conimetor \ - t'Dale
{, HAZARDOUS MATERIALS DISCLOSURE' - '' Re-COOTS
Ns'll the nppbc t oi firmire Wilding amPantt or handle M1ezatdous mmenel
j __Tof-Roof___... __
25532(ts 9l . Sr s i
..J.j.i.l O.�Nby ite Comfn Municipal,Code Chapter,9 12 mal the Heilm and Safety y
Cod San r\'CN ...e.,,,......�:,,..,..
._
to
All roofs shall be inspected prior to.any ioofing.material-being.installed...-
11
winm applicant or orr m building pant useequpmento devices itch If a roof is installed without first obtainin an'ms ectlon I a rem forremove
c i h.,m -a Commitments defi d by me Bay Area Au Quality Management g P g
District' all new materials for inspection. Applicant understands and will comply with
i dYe- c _ .- _. _ - _ _. -
°"°: r all non-p61m source regulations,_ '
d - ~ .s..-,i emomme �mider Chapter 6.95 of Ne,
` 1 have read'me haxallous materials' mremenu '
Califomia Heildi'&Safety Code:Sections 25505,25533 and 25534.I,to dee and dui'
. -i she building des not currently have orcnanr.that it is my rtspomibility neify me "-'""
'occupsnr of die equiiemems which mdsi be met prior to issuanco of a CroeniOcate'of `
= G Pay
Signature of Applicant _ . __- Date _
r' 'o neror;amn"xed gent Date. All roof coverings to be Class B o%6'etier "
OFFICE -" - is _... . . .. .... . . ....
':i1 :ii%7 -..-`_` �. _. _ U`-� -- - l - -- -`;-. is�Er•'14, ,.t