01020112 (2) CITY OF
NSSINPERMIT -CONTRACTOR INFORMATION: ,
BUILDING ADDRESS: PERMIT N0.
22350 REGNART RD f, ly� Es Gcalo, 01020112
OWNER'S NAME: / APPLICATION SUB DATE
ISHII , SAM
Z2,z 210 Sa % �fN^J °/R I?4 02/21/2001
1 PHONE: SANITARY NO. CONTROL NO.
O
ARCHITECTMNGINEER: V BUILDING PERMIT INFO
BLDG EPLUMB
G _ 3 � I (
O m= LICENSED CONTRACTOR'S DECLARATION IOU DBSCrl hOn
i z= 1 hereby u]]hm that I am licensed under provisions of Chander 9lcommencing -
_t8 withScnion71MAi1o(Division3oftheBusinessandProfessimnxCndeandmylicenu 5700 CONDITIONED E, 800 SQ. FT. GARAGE
jk., isin fmcmu and effe / ,a„-
:at.,
W U License Cl ass Lica 7 "�
O n O Dam_�.�- f2/ Cis r
ILL c. ARCHITECTS DECLARA OM "� 900
1 understand my plans shall be used as public records C
1 O O Licensed Prelessional �u'`L/I
'3 o OWNER,BUILDER DECLARATION NG
I hereby alfmn that 1 1. exempt from the Gamins Co :An,c Law for the $997500
F Z_< fallowing rwson.]section 7831.5,Business and Professions Cade:Any city or County
um1 pdo h o ....permit t construct.wct alter improve,demolish or repair any structur - _ —__- - --'-- +
alsorq rca 11m."Iicant forsuch Pennumbkasigaed smwimin __ ,. .. . . _
e - (cosrr cit mN pSectioftoth p i sion Ne Cortiactor$L¢enx Lewon,Coe) pp pts y,a
(commencing wish Smn 17808) (D Division 3 of the Bus mess end Profemom Code) � T•fb' '- Valuation
or thin He ss exem nhercfrbm and,he basis fur the aIle W exem stun.An '” "' `S. t.a ,- k,4i.. ,l l a ,
P 6 p Y Pennon
of Section 7831:5 by any applicant for a permit subjects the epplicam to a civill penalty
I or not mote than five hundred do]]..($5(10). 103�PN �ILI74IDATION Occupancy Type
LI 1.as owner M the property,or my employees with wages as their sole compensation, 102 - PIERS t
'wlll'do'the work,,and the'swctureis not intended or oflmd for sale(See:]044;
'Bmin6i'and•PmfeaionsCode:The Comnctor's License Law does not apply man 103 - UFER Required Inspections'' s' Q�@e�,A�
ow or property who builds or lmproves work himself
and who does such whimself
ro _ 104 - REBAR
or through his own employeas.pvided that such improvements are not intended or _ _ _ _
'-offered for-1.1i:If,however.tFe building or improvement is sold-within one year of -' - 1-05-
- ANCHOR -BOLTS •�..':.;'., ,. r..•[ rd ,��
�completion,the owner-builder will have the burden of proving that he did not build or '
mprwermpurposeof.m<.). 106 - SEWER & WATER MAR
-._.__ .... 7 Z003_
_p J
O1,as owner of the property am axdusively contracting with licensee contractors to -- "ZOZ ' UNDERFLOOR`PLUMBING`-'-'"---`—:i'
cunatract the ni eci(Sec.70 ,Business and Professions Code:1 The Conwcmr's
License Low does not apply to an owner of property who builds or improves therecu, 203 - UNDERFLOOR MECHANICALI'f ry�y
_a _contracts.for such projau.wida a commctor(s)licensed pu.aanr.to the —_ — 204- UNDERFLOOR- FRAME--- -- ----, - L,//NG
Comracun's License Law.,.., ��s
nd.who --"
111 am exempt under.Sed - ;B'&P C for this meson 205 - UNDERFLOOR$ -:INSULATION
= bwirf5ine301 - ROUGH PLUMBING
"'WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
thereby affirm once rPenalty ofpedur3one ofthe following deachations: 303 - ROUGH MECHANICAL
❑ I have o6d wdl'mnintaln'a Ce.ifidme of Conxert to self-Imam for Worker's 304 - ROUGH ELECTRICAL
Compemation, m provided for by section 37W of the Labor Code, for the
✓� performance of the wurk for which this permit,is issued, 305 - FRAME
_- 111 have find wIl niainmm Workers Campcnseuori G"suranm,as mgairc4 by Section 306 — HOEDOWNS
r- 3700 of the Labor Coda,for the performance of the work for which this permit is 307 - INSULATION
issued.My Wo k es Com,ansmiom I surance cam i and Policy number ase
308 . . SHEETROCK
Cir]]Is i./ "Pojm>'fuo '7�3-� f/II�/7, s ,i. ft t q• (,
EMPf1OISFROM.w RKERs: t .} s I ;`3'09f f=xiEX'.PERIOR- LFiTH
"., r i r IfCERTIFlC SOMPENS TION INSURANCE �gg.7 - ... 31,0- --INTERTOR� LATH• •'-,•-
sen
Mss mri need not be comPlned if the pe.it is for one hmMrtd dotim 1 7.- - I:j ]
meol I ss.) 311" - SCRATCH COAT
» 313 ---ROOF -NA-IL_,,. .
. mf teas to Per(an' E`ofthe okra whichIts,ct $hosed 1' 501 - FINAL ELECTRICA'L•t ENERGY'' ~
shall I yo w, any m one so a. to become subject to the Worker
PI Y Y a
Comp, uo law,ofCalifornia Date
NOTICE .. _r ._ _ - • ,. -, 502 ..FINAL. PLUMBING.. ENERGY_...
become
eETOAPPLICANT If C kingiliaCmficemof hould 503 - FINAL MECHANICAL "ENERGY " ' • `('
becomeh cmitpt the .In
sCompeman provisionsll be dLabor Count,you must
tZO (ooh ,h c.mply: 7h ch pr t_mns or this Permit shall b<aremea revoked _ 504-,-,_,FINAL,_BUILDING ENERGY_ ___ _ _ _
V�d " S `lc6NSTRUCTION LENDING AGENCY - 505 - FINAL ELECTRICAL lam' t -
1 h mby affmt thin they t a nsw.ton lending agent f the rf t•" ,, r,
m y " 506 - GAS TEST
W f the ark fn wit ch this permit as cd Sec.3097 Civ.C) _ w
•'••�.•,-��,• - _ •. ..._..
7-Z Lender•sAaatess,'*• 507' - FINAL PLUMBING. . _ .._.
V'.'G _ ' ,,;;„�,.,,,;. ,::,','. . . , ,... 508 FINAL MECHANI'CAL',:,
canify Nat 1 have read this application and some that the above information is
tL (•^ earrcct 1 egme to comply tv th all. )y arta my oN wnca and one laws mlading 509 - FINAL GRADE
i t.7 to building con.,tructi6c,a6d hereby a tlimie represe t tives of this city so enter upon
0. theab ,ent,ndpr nym speaao p p _ 510 _ FINAL PLANNING n
L eWefag tit sae de fya a which
hama in the Crty a(Cuperimo against 514 FINAL PUB IC WORKS
VJ I'hy t 3 dgmesns'c . a pe N h¢h may n any way accrue agnnn said
U 7�. City q tit tan nnLtpew,t 602 - OF NAIL
APp1:ICA' 1.
i41LL COMPLY WITH ALL NON-M11NT"''
S cP c:_ Issued Luc) Date /Zf/§—-Ol
ate Re-rof oO'sill
- ROOF IN-PROGRESS
HAZARDOUS MATERIALS DISCLOSURE �.'t "
WII the tippficam or fmm building'Custo s store at handle hazardous material Type of Roof
ss def ed by th C pen M n t al.C M Ch pt 9 12,and the Health and Safety ,;. •• s. , t,o: -.--- _--
Code OCed
Yea 2553(It1 N 'a pr -` , 'PI.I-.i`�•��yv.
_ All roofs shall.be inspected prior.to any.roofing material being.installed.
Will the applicant or future buildingoccupaso useequipment or devices which If a roof is installed without first obtaining an ins}3 eehon;Pa ree to"remove
emit hamssolus air contain a t ai defined by the Bay Arta Air Quality Management
g
Dis <tall new materials,for inspection.,Applicant understands and will,comply.with .
❑Yes -
R all'non-point-source regulations., _
Phavs m.,Co.,munimennesm,under Chapter'fi 95 of Ne' v t•'
Calif mm H filth&Safety Cade S'dons 25505,25533 and 25534 1 understand that
bgldin do menti live atennnt.thawnm - ' -" - - ---
g Y Yssuance bl crnflusi the'
cup is sof tit egoir s h¢h ust he tan poor to issuance of a Cetiificetdmf
upancy -_ a .. ..
k�•�/e�
Signature of Applicant Date
net tnnn agent .., Data All roof coverings to be Class'B”or better _
...OFFICE..