01060042 (2) CI out OF
omSSIONNO IT CONTRACTOR INFO ' TION:
BUILDING ADDRE5S: PERMIT NO.
10535 MADRONE CT LIFETIME POOLS INC 01060042
OWNER'S NAME: APPLICATION SUB DATE
• TYLER FLECHER 910 SAN ANTONIO RD 06/07/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 738-1576
❑aio ARCHITEC-PENGINEER: BUILDING PERMIT INFO
UC BLD HLECC. PLUMB- MECH
1 ,. Ln
H= LICENSED CONTRACTOR'S DECLARATION Job Description
0 z_,� 1 hereby affirm that 1 am licensed under previsions of Chapter 9(commencing
F'HFtu an Section 7")of Division 3of,he Business and Prefessioat CMM.and my liaarae
Q'Y J is in fun fora and eirm
i.., License Class � r3 Lic.k 7- Zd EZer NEW POOL & SPA.
o-� Dam Commem, Ie1T
ARCHITECT'S DECLARATION
C LL O g I understand my plans shall he used as public records
E i
i p O
Licensed professional
Oat I am BUILDER DECLARATION
II K I hereby uSect on 1 ren eBusia from me C...on, i s :Any
Law for the
t-=n followingSection
Permit
]ompa Busimxsmpr improve,
demolish,or
Any tiny or county
s which requires a permit m connma.cher,improve,Demolish,or rtpair any structure
w3m Prion t Iso q .Ih VDI tf Ape 11 fl 'g al ttemenl
that ne SI dp rw 316th ponvisimo fthe CiamorwrowsL Lms Chapter 9 .. , Sq. Ft. Floor-Area >_I - - $194bi�uation -- -
(mm mg withSocon 7000)of Div sion 3 of the Bushes ad and Professions CoJJ n 1� _♦: _.,
or that he is e.,aar"therefrom and the basis for the alleged exemption.Any violation I
—of Section 7031:5 by any applicant fora permit sub rel,the applicain m a civil penalty
frfn°t more than five hundred dollars rssW). 342161AYTm160 • ' Occup cy Type
❑I,as owner of the pmpery,or my employees with wages as their sole compensation,
will m u d cs odea on intended ioffered r 1 7o ar 103 UFER Required Inspections
Business tlpe f Code ThC t e L . J not apply to an
n f proscow employees,bti ld, p s th J e tl h k n If
or m n uthe deaths n improvements iintendeds 104 .REBAR" .._...
Y7 and f Ifo m holding ng tat tdi ere or _ _
pit me hila un the burden rpt proving da mlbuild nr 107 - POOL/BONDING '
mor f D sport r 1 r.
301 .-_._ROUGH "PLUMBING___.
°1, cr ofthe p(Sec.7 ane Business
with dr:)nc Coni rs to - - 1 t
constructmeproject(see7toaB dPr :onsild&orToevestmemr. 304 - ROUGH ELECTRICAL ' i ,, .t•
License Law duet not apply man owner of property who builds s .improves thereon
the_and rwho milm,mraers r«tom _. 5.02 _-.. E.INAL._BLUMBING.ENERGY . .._._"._... _._-
projects with a cnnvactnrl%1 liccnttd.pursuant.to rbcs
conimexemptcenuWw.. 1.
503 - FINAL MECHANICAL;.'ENERGY
❑1 am exempt under Sec. ,B&P G,forthis mason
Owner Date 506 - GAS TEST
WORKER'S COMPENSATION DECLARATION 510 - FINAL PLANNING
.� Ihatchyafrmmoor permhyofpc,j.,agcarrhefollowing kciwaltm, 511 - FINAL POOL
❑ I ba.e and won mvided rceyifiect of Coram it Labor a,e workers 516 - FINAL BUILDING
C dannarce o as work far for by Scctini, 37W of the Wbor Code, for the
perinrmonde of the work for which this permit is issued. '
oi
°I have and will maintain Worker's Compensation Insurance,as required by Section
3701 of the Lath Cod,.for'the perf°maina of the work far which this permit is
issued.M Workeh Com � tion Inzumnci carrier and Policy number are:. _
y Penni
nta<diirSF�i[ON 5F Puticy No. '/S 6 RKE S-o '.f r. .4., e; 's i'.v'•r i'. .
(""' CERTIFICA COMPENSATION
INSURANCE is
• • - ' •' -
COMPENSATION INSURANCE`; _" fir'• - _
(Thi.u'xectimi need not be completed if rhe permit it for one hundred dollars
ISllq)orloa) -
1, 1 rfy than the ,far.,
fth workforh hth pc t issued,I 't•.tt
,oil not a lduy any Pe 'a a ry w n het n n hli i o the Worker,'
Compensation laws W 'llfmnia.Datil r oat} _jt -ar
..Applica
tN If.after makirt.miv Cenificme of Exemption.you should '
cmmdi" mine Workers Cnnipens:ninn pmvi.ionc of the Labor Code,you most
Q forthwith comply with such previsions or this permit%hall be domed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm than Ifiert is b conamakii lending agency for the perforiimar
of the work for which this periodic is issued(Sec.3W]..Ci¢C.)
Lender,Name
a' A mLcndrCil Addres% t_
V! „1 certfy ithat I have mad this application and sure that the above information is
t:. E. torr t 1 g to
comply with 11 y county J d.l torelating
�1 'loWlt. g t JI abyi IFor p Pie ie I f .s fM telt upon
y fie, the eho e e t ed .,.v f inspection psupsover, /S
E., 0. IW 16 i s d ry d k p h .k. th City f Cupcn r against J
VJ hab ae%judgments,costs and expect w n ch nay in any way accme ga;net said
' L1:7
City iICconsequence NDERfthe gDSA Df ILL COMPLY
I ^tl '�^ CG
APPhncdbT WDERSTANUSA6DW is peorOhIPL1'W'RH ALL NON-POINT Issued by: A //,v V ` Date
- SOUR i —'a f Y'— e
c of Ant is emr - - .Date' Re-roofs
H,\L\RDOU$MATERIAfS DISCLOSURE .:
. . Ilth 'PP i t budding ace pa i.t r.n dl nanrd ,mat al ..Type of Roof
ns Jelin dby theCpert noM ncD IC hpt 912 anJ ihH Ith ndi fry a ,i i. ' _t t OJ I"
order:Section 2553_(a) -
°Y- °Dt '' - ...All-roofs shall be inspected prior to any roofing.material being installed. __,..__
monthapplicant future building occupant use equipment dM1 ice%which If a roof is installed Without first obtaining an'inspection I-a�ree to'remove
emit h d ons t def eJ n v the BayArea A y tl
District " all new materials for inspection.-Applicant understands and will comply with _
all non-point source regulations.. .1,,•_, '
1 ha e rt d the h mNLis materials requirements under Chapter 695 of the
C.lHomat Health lth&Safrfy Gale.Section,25505 25533 and 25531 1 morharanind,hat
if lne builJng dices none ndy base sten tthttis' my rcpo '61'ny no mot fy that
occupant of the rryuimmems which must be and priono issuance of a Ceniacme of.
Occupancy. -
S'rPP (cant _ Date
.ora agcm,' - Dau Il roof coverings to be Class "B"or better
,. OFFICE- - '