01110121 (2) CITYBUILDING DIVIS ONNOPERMIT CONTRACTOR INFORMATION:
B`nIsMT14TOKES AV CUSTOM KITCHENS & BATHS PERMIT No 01110121
°NY't`2;'_maffUGENE C AND CHAN-LEE WI 581 CALPELLA DR AP}ISAA�NSug2001
PHONE:
(408) 829-0078 SANITARYNO..1/ CONTROL NO.
pBUILDING PERMIT INFO
W O FO ARCHITECT/ENGINEER: BLDG ELECT PLUMB ME a
J
z
LICENSED CONTRACTOR'S DECLARATION ��bb tt�tQ�
jz Iherehyuffumthat I.mlicensed unaerpmvisions6fChapter9(c...ening REPLACE CABINE4VCpt�S�$fRS/APPLICANCES .
wiNS 'nn70(10)of Division 3 of the Business and Proressibns Code.and my license
fy5, isi Il fnneand effect' r"I 9./
y p 22�V C nse Class Lic.x �V
am contmcmr
30 G ARCHITECT'S DECLA
S a O g 1..dart...my plans shall he mud as public rtnsrd
u
u 6 A p Licenced Professional
K e
OWNER-BUILrope f DECI n
w- I hereby.term that I am cnempt from Ne Com m's Liens w f e
?< folluwing reason.(Section 7031.5,Business er Professi Co.,eAny or my $25000
3_ momma a permit to cnnstmn,alms improve,de parr cm
FSO which
totsumantt,.lromgmmathe applicant r«muco t1 tame __ _ _ _ .--- - -----
c_ .
EE that rts 1 Cares]piusvam tb uK p;or s ons ortne can nr a IaC napier 3 -,� Valuation
Icomm0 ing nth Section 7100)of Divison3of me -Iec a r4 x l , st':A�, .C.
or that he . pt therefrom and the M1aus[or ny 'alai !
of Section 703 1 5 by airy applicant for o permit suFlc Is he ppI e ci 1
or not mom than five hundred dollars(S5 1 D ION Occupancy Type
01,as own.of Mae property,or my employees with wages as their so le compenwian, 1 - PI RS
-wen-do the'work...d Me st.ct.m*is-not inlemkil'or.mored for sale'ISee 7616,' 1 3 R Required Inspections
Business and Professions Code:The Convenor's License law does nor apply tom q p
owner of property Who builds.improv.thereon,and who docs such wink himself 104 -
or through his own employe.,provided that such improvements arc not intended m -___._,_
offend nor sale.If,howcvez the building or improvemem is sold within..a year of 1 O 5 - ANCHO BOLTS •Y.
completion,the owner-builder urwill hove the burden of proving that he did not build or 106 - SEWER & WATER
improve for ppose of sale.).
- 202- -. UNDERFLOOR-'PLUMBING.._ - — -
LI 1,as owner of the property,can exclusively contracting with licensed contractors to '
consumer the project(See 7066,Business and Prefes.iom Cada)The comreemr'a: 203 - UNDERFLOOR MECHANICAL
License law does not apply mon owner of property who builds or improv.thereon,
endwho contracts.Farsuch project.with a contractors)licensed pursuant to the 204 -- UNDERFLOOR FRAME---- -- - --'-'- -"
Commerce,utt...Law. 205 - UNDERFLOOR INSULATION
01 am exempt under Sec. B&P,C for this rtomn
'owner Data "" 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
1hereby tefrrtunder penalty ofpermr.ons&M.following drtlaimei...: 303 - ROUGH MECHANICAL
❑ 1 neve and will maintain Certificate of C...an,t.selcimura far Watkars 304 - ROUGH ELECTRICAL
campcnsmian, m Provided for by Section 3706 of he Labor Core, far the 305 — FRAME
performance of the work for which this permit is issued.
01 be ad willandanteWorker's Compenmtion Insurance,as required by Scotian 306 - HOLDOWNS
37 r the labor ere.for the pnef..nm.<of the work r«which th.permit i. 307 — INSULATION
iss I.My Workers ompcnse
dmI mmccamber and Policy number am: 308.'-, SHEETROCK - -
- .mac 'Policy No. fls9fs S Y-,'.., ! •;309 :-' ERTERIOR1'L'AT2 '
_ COMPENSATION INSURA ON MWORKERS�
(This steric.need notheeompined if the Permit is . . . `.- ' .. . ----- '----310-t--.INTERIOR'-LATH._._....__ .._ _... ._. ._.__ ._...
L TIFICATI N OF EMPTI
i.foro.ehurmddou 311( = SCRATCH COAT
313 - ROOF NAIL
I owify'mei in the pe r«mma of the,work for which u is Permit n issued,l 5 01 - FINAL ELECTR I'CAli 'ENERGY s
'shall not employ any person in any manner so as to,become subject to the WarnedCompensation Laws ofCahrornia.Data 50FINAL PLUMBING ENERGY--
.Applicant-. ._ _. ...
NOTICE TO APPLICANT:.If.after making this Certificate of exemption.yore mama, 503 - FINAL MECHANICALENERGY
become subject to the Worker's Compensation provisions of the labor Code,you must
oG rennwthcomplywith such provisions orthis Permit Mail hed« rm
,nakr504. - FINAL BUILDING ENERGY_
M CONSTRUCTION LENDING AGENCY 505 — FINAL ELECTRICAL
'Ihreby M.int them is.cmwtme[adding ag yr' the performance 506 - GAS TEST
of N ork far which this permit ms issued IS 3097 Civ.C')
k7 p landeeiName ' 507 - FINAL PLUMBING
Lender's Z Lnaeaam.. ." 508 - FINAL MECHANICAL
U O 1 certify that 1 have mad this application and sum that the above information is 5 0 9 - FINAL GRADE
fs I cbmct.1 agree to comply with ell city and county.,di..,,and nue laws retell., -
O to building construction:and hemby.mhrm mpresentntives of this city to enter upon 510 FINAL PLANNING
til Me.bovemmttiomd property,for.insPection purposes.•
g}., It', (We).gtee to saw,indemnify and keep hamdns me Cityor Cuparinoagainst 514 - FINAL PUB IC
Fn M li.bilities,judgments,costs and expenses which may in any way,accrue against said
U City inc 9ucnce of th Bnmma of this permit
AOPPLUIENT REU R.N NDS AND L'COM LY'WITIi ALL NON-POINT Isslled by: Date
IFA_ ''Z .Q
S' mmreof p rn for Data Re-roofs
an
',- HAZARDOUS MATERIALS DISCLOSURE'
Will the applicant orfumm Wilding occupant a=or handle hmmdous material .-Type of Roof
z defned by.the Cu perhno'Mumcipul Code Chapter 9.13 and the Health and Safety ,
•Code.Serf
ec in 25532(e)v
0yei -(:.� .s,. f:;•: - '. -+i C' 1', 'r -
�LJ W - .. All.roofs shall,be inspected poor to-any roofing.material being installed._
f
Will the applicant or future Wilding aecupam use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to.remove
mit hazardous air contaminants as defined by the Bay Am Air Quality McNgement
District? all new materials for inspection. Applicant understands and will comply with
ores - No all non-point source regulations. .
1 have rend the hazardous materials rtquirtren6 under Chapter 6.95 of the
Calif. thing
x Safety Cry,have
Sections 25505, n set and 25536.1 responsibility
to mall that
occ ,ildine does not sums able a anL thmitisrymonce cis torallythe - - ---�"
occ nt is uhic Wren prior w i.mmtt cis Certificate of
u y'' Signature of Applicant Date-
Ow.....
ateOwners aura ed ager' /'m to All roof coverings to be Class"B"or better
..:. , : . . . ._ ., -.,.. ... ... . OFFICE.