02070029 (2) CI OON
UPERTNO
BUILDING PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7720 OROGRANDE PL JUST WATER HEATERS INC 02070029
OWNER'S NAME: APPLICATION SUB DATE
LI CHEN 1764 NATIONAL AVE 07/03/2002
PHONE: (510) 293-9901 SANITARY NO. CONTROL NO.
w O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
m BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
OZ
=o I hereby°Kron that I..f mnud under provisions of Chpmr 9( me
comncing
FH fjw with Scaion]000)ofDivision3ofthe B.,mc,sond P.m,,inn,CodeanJ my license REPLACE WATER HEATER
x s m mu rnrde anu a eat. (5 0 GALLON GAS)
—ce re¢ License Class Lim.M
X a O Data Conv:tcmr
w 3 u.Fn ARCHITECT'S DECLARATION
C 5 1 understood my plans shall be used as public records
r
K O Licensed Professional
.
a a o z OWNER-BUILDERexempt
DECLARATION
`—'a 1 hereby affirm ohs I ton
m exempt fmm he Cmnl°CI Liclaw for the
f-�_a following mason,(Section 7031.5,Rosiness and PioCo ense
mfcssns Code:Any city nr county
p, D which requires a permit to comma,alter,improve,demolish,or repair any swaure.
i
3 m .poor to in issmnce,also squires Ne applicam ror such permit a f le a sigwl smmmem. ..-. -
hot heisumen.,edpad..,ld the pm,r,,,msmthe Cnmramno',LlacoadLaw(Chapter 9 S Et. EloorArea.,, Valuation
ed8rdmfmai,with smwri,lb ?ar Dwi.dnn3ar me Bn:ine,a end PmrmwmnaeWel T.'i.Y:^.' j"j?_i,q`• ;,)k�_ �.,r.P t11t;l.(a 1i(.1.'° •
or that he is excmpt'mefmrinm at the ba,ia ror the n h jp a ekmpdnn.Any vinlalon ' 1
-of Section 4031.5 by any applicant for a permit.subjects rise upplicam m°civil penahy
of not mom than Bee hundred dollars(5500). APN Number f'„ • . Occupancy Type
01,as owner of the property,or my employees with wages as their sole compensation. S02 — FINAL PLUMBINJ ENERGY
will do the wart::and the structure hoot intended-or offered for sale Rel:]ata.-
ss does, - --- 5 0 6 - GAS TE STRe wired Inspections
Busineand Professions Code:The Contractors License Law anot apply to en 4 p `
r of property Who builds or improve,themon,and who does such work himself 507 - FINAL PLUMBING
or through his own employees.provided that such improvements ore not intended or t
"offered for sale.If,h6svever,the building or improvement is sold''Rhin'one Year of
ompletinn,the owner-builder will have rhe burden of proving than he did to,build nr "
improve for purpose of sale.).
OLWownerof the '-- -. _. ... --. ._ ........ ._ .. _ ._._ _ ._ __ .. ._..._...... ._ _ ... _._.__.. ____ _. _ ____
property,am Business
contracting with Ilcensed Comemrs to „ r
con ns t the p jest(5« ]al{Bodnes and Prof lions Cade)The m,Ito mm, ..
Lid 1 d e. not apply m an owner f p petty oa ) Ids nr improves thereon
and who contracts.fofsuch.prolens with a conHanor(s)licensed Pursuam to tAe
Cnt t Li,cone Law.
❑lamexempt under5cc ,H&PCfor this reason P11
Dan,,
��QOfw/ . n
Owner Date a� L
WORKER'S CO.NPENSATION DECLARATION `\\
_ Y 1 hereby affirm underpeneltympepury one ofthe followingdindarainne �.�
0 1 have and sill'tiodomid a Ccrtiricmm'of Consent m self-insure for Worker's ` DOG
Compensation, ax provided for by Section 37W of the Labor Code, for the Q V
peroununcc of the work for which thi.perms is issued {J
01 have and will maintain Worker's Compensation Insurance,as ma,mind by Section
37M of he LOW,Code,for the p oftnmance of the work for which this perrm,is
i3sued.My Worker's Compensation Insurance carrier and Policy number are: _
Contact:'I1 CERTIFICATIONOFEXEMPf10NFROM,WORKERS'j' os+�y'! ? N\?J,�r`_jy'. I:N.a't.il: A, A) ti;
COMPENSATION INSURANCE
lThvs acu,on neeA n n rte urmplc�N It hd per n r o Por roe h:ndrmd dollms 1 .
($100)or loss.)
eertifY that in rhe performance of the work for which this pe nit i.s Issued,I y-
,hall not employ any person in any manner on as to become subject m he Wafken'
Compensation Lmvs of Colilomia.Data
.Applicant -
i 10
after
t.
ou
NOrme subject
APPLICANT:the Worker a Compensation
this Certificate emrsof
Labor o d,you mind
Q Qtiecome subject y then such pr Colons or this Vconot shall the timed Gide,you muni
fonhuioh comply with such provisions or this permit shall h deemed revoked. '
f•' 14 " CONSTRUCTION LENDING AGENCY
I hereby affirm that them is a cnnamc600 lending agency for rhe perfu6no.
.. of the work for which thispsamot is issued(Sec.3097,Civ.C.)
�.
Under',
A Leddai'x Address
V-� I terrify that I haverect dukd,liwia add late that fincalrI ation is
t>•'E. co t 1 itmea no comply with all oy and mumu oNmunc,and ost.l . mlmng n p
-O•W the ld -n t ad n, h ho P t f .fifth a tY t erurym - /' 1✓IY\/ _ �yam,
} r_ me M f d x'n" ty f i pd n Purposes
isL (WeJagreemsv.stmand indemnify and keep hich may
in an Cuyorcruertino3gmmt
N City Mica icquic nts,costs and expenses whmh may in any way name against said
U.Z A PPLIcAN7Ucncdofthcgmn ing of ANDr ILLperiod. r
CO
APPLICANT VNDC-RSTAND$AND WILL CO>IPLY'WITH ALL NON-POINT
'. SOURCE REGL'L,V IONS: '• � � ISSUed by: � Date
Sisnature dl'ApPlic HAZARDOU Data' Re-roofs
as defined SURE '
brise Cuja'mRbl n Building
I CW MATERIALS Che mr59.17o and he H Mous minimal ,-,,._Type.of Roof....-;_.. .. .-._ ._._ �._._... _...... . ... .. ...
Will pp g occupant store or handle hu .. .. .
y pe pa e, p ealth and Safety ,
Code S n n 75532 a '
o\ 40 No ; }I' "All roofs &Il_be tnspected,pnor.[o.any_roofing material-beinc,installed.,,.,
Will thapplicant orfuture building occupantuse equipment ordeeces which If a roof Is installed without first obtaining an inspection, I agree to remove
e -
m r hazardous ,rmntammann as defined by the R°y.Ajna,A Quality Management
District? all new materials for inspection. Applicant understands and will comply with
OYe. - CI No all non-point source regulations.
I have read the heualous materials requirements under Chapter 6.95 of the
California Health&Safety Code.Sections 75505.15533 and 8534.1 understand that
i f she holding docs not commonly have a mount.that it is at,reaponsibllity1.notify the - - - -- - - _- -
bc,m,ma of rhe requiremems wboth must be mdr Prior c,issuance of.Cemiheae of
°"e,0°°"` Signature of Applicant Date
Owner or aonlmnied agent ,aid - All roof coverings to be Class "B' or better
-' .. .. ._ . . . . _ OFFICE -. .