02050092 (2) CITY
BUII DF G DIVISION
PERMITCONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10580 TANTAU AVE GARY LEPPKE 02050092
OWNER'S NAME: APPLICATION SUB DATE
ARY LEPPKE 10580 TANTAU AVE 05/16/2002
:BONE: SANITARY NO. CONTROL N0.
:.
BUILDING PERMIT INFO
O O ARCHITECDENGINEER: ELECT PLUMB MECH
LJ
z S y Job Descrip o
LICENSED CONTRACTOR'S DECLARATION
O i t— 1 hereby affirm that 1 n 3licensed under provisions or ns Code.(commencing
�:� is in fulliorceandefect. onJoflheBusinessandProfessionsCodc.andmylicrnx ADD 804 SQ. FT.
'n tall force and effect.
OCT f 2004
C < License Clc,, Lic.4
°'O a O Uric Contractor
3 a vt'i ARCHITECT'S DECLARATION
'n O g undersmnd my play shall be used as public recoNs ■I
mx} BUILDING
i p O Licenced Professional
c K a OWNER-BUILDER DECLARATION
w= 1 hereby affirm that 1 a erupt from the Con[rdnor's License Law for the
�z a following reason(Section 7031.5.Business wal Profession Cade:Any city or county' $98241
Sat D which requires a fusion construct.alter,improve,demolish,or repair any structure su
a304 '
poor toits issuance.also requiresthe applicant for such Permit o file a sig,:ed statement - -- --
-
that bit itlimnudpurairmtotheprovisions of the CotnracmfsLicense Law(Chapter 9 ,- Valuation
(commencing with Section]000)of Division 3of the Business and Professions Code) t.It 'a 1 ;37839,R(9°1�i:Pt';'k
.,,,at
he ii exempt th mifiom and the basis for the alleied Snmtantsm.Any violation t
-ofSection7031.5 by any applicant,for a pe.it subjects Ne oFFI corn m a civil penahy- gge1Jmee _
of or mart than five hundred dollar,(s50o). 101 APN k 6b§SATI ON Occupancy Type
❑T.as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is intended or offered for sale(Sac:')0H, - - - 92 PIERS
Required Inspections
"
Business and Professions Code:The Contractor's License Law does not apply to an 103 - UFER q p '
owner of property Who build or improves thereon,and who docs such work himself
or through his own employees,provided that such improvements arc not intended m _ _ 1.0-4. _-._REBAR ,
...-ear of _. . . ... _ .. .._...__._.__.
"offered
omple for isle:senor-loin.f. the building or improvement cement is cold within one y ,
completion,the owner-builder will have the burden of proving that he did not build or 105 - ANCHOR BOLTS
imp forpurpas of sale.). 10_6 _ ,SEWER._&.WATER .._I _
of p prapertaamezcjus Iy ti g ithr n. d' loact,;,1. 202 - UNDERFLOOR PLUMBING
construct the project(See.70a4 Business and Professions Code)The Contractor s ,• W
License Lowdaes not apply to an ow rafphnthem
on,who buildsor prove+theon, 203 - UNDERFLOOR MECHANICAL:'
.: and hn co acts(or.teE.
ch.projects with a contractor(s)liccn.ad.pucsamm to the_ _ . ._ .,..... ... _. .,.,....,._
Cynt t rs ipense Law. ., - •.`
Ki204 - UNDERFLOOR
_ unde Sc B&PCfo this a�nn 301 - OIIGHFPOLUMBINMINSULATION
/
WOR NDECLARATION
7✓1. ., 302 TUB & OR SHOWER
Ih rehy e0i under pcnahy of perjury ane o(she followingd 1 tic,:- 303 - ROUGH MECHANICAL
r' ❑ 1 hasc and 'will maintain a Certificate Of Consent to self-insure for Worker's
.. Compensation, as-provided! for by Section 3100 of the labor Cade, for the 304 - ROUGH ELECTRICAL
performance or the work tai which out perm,is is ued_ 3 0 5 - FRAME
❑1 have and will maintain Worker's Compeniedon Insurance,as required Ey Smion 306 - HOLDOWNS
37W of the Labor Code,for the performance of the workfor which this permit is
issued,My Worker's Compensation Insurance carrier and Poliq number are: 307 — INSULATION
c l'+1pEyN :' 308 < 'SHEETROCK • :, I r
.'j CERTIpCAT10N OF ESE FROM WORKERS'!` � 4s 31 [ 1' ' s1,''
COMPENSATION INSURANCE s +- 3-09 `EXTERIOR LATH
310 ,[ 1= INTERIOR LATH
(this section need not be completed'(the permit is for one hundred dollars '
anwlmleaal _ 311 - SCRATCH COAT
OF
AIL
n% hrym" m per California. c rtes akf 5 pens n d i .. . 503 - FINAL
ONALNMECHTRICAL ENERGY -
/7 z t
,hall n t erupt y er on y ma I b s !h mW.k Y
Cnp nmtl m
App's BING ENERGY -
N PL I d g , teof Exemph yo ho Id t
beco bjec to th works +Compen au npr vmm�.i'af the Lobar Code you moa ANICAL ENERGY
Q Q forth th ompl,with uch ma ismrs or this permit shall her deemed revoked,
504 -- -FINAL BUI-LDING -ENERGY
CONSTRUCTION LENDING AGENCY " -'
(•+ - I h rehy affirm that there is o'onstm,dim lending rtgpmy for the pedorm'nea 505 — FINAL ELECTRI CAL„
of the work for which this permit is issued(sec.309],Civ.C.1 -
y'.q de iName., .+'.,.. .. .. ..._.._. .. _. 50.6._-. GAS .TEST. -
p;Z Unger',ndgdsa507 - FINAL PLUMBING
U O "imi"mat,have mad this application and'state that the above information is 508 - FINAL MECHANICAL
w;F 'co ct.I ngme to comply with.11 city and county aNimmmes and state laws relating 509 - FINAL GRADE
ro building cannon ction.and hereby muthorise representatives of this city to enter upon
y,w, 'the above-mendpnedpro pnyforinsyccdonpurposes, : 510 - FINAL PLANNING
d_ (We)agree msnve.indemnity odd keep harmtess the City of CoFwuho against
it Vl liabilitie.,jlXJgmcnts,costs and expenus which may in any way accrue against said 514 - FINAL WORKS
City in gnence of thegmming of'his orm.
APPLE .TINDFpsT :D$AND WIT 'COMPLYWITHALLNrJ I-POINT ' f
s E rULX D Issued by: Date
.. - nnrenfApp . U rut sof 'j
- t pHAZARDOUS
AZARDOUS MA:TERIALS DISCI Re-roofs
Rlh'. muI .Type ofRo'
ofWII tln t F w building oc p [ mica hand . 3 1 . ., l
� t
. .r.,.,
dt �ry[is°�itM p IC d Chapter 91z,writhe santc l Qts "' fs shat1 be inspected priorto any.,roofing.matena.beinginstalled.too
--,.....,..._.....
_
W'll d e iqpplt o I t rebuilds g cupam use equip t devices which If a roof is installed without first obtaining an inspeetion('I-agre"e'to`remove
' m t h rdous air' otammants as defined by the Bay Are A Quality Management)
—o t ,to vL9 _ ❑Ho - " ." all new materials for inspection. Applicant understands and will comply with
" ' A.� mf
ce regulations,,,
1 have read the haaandous materials requirements under Chapter 6.95 of Ne'
Coca Y.
Califon' Hearth&Safety
Code,Sections 25505,J553J and 15534.1 understand than y _
ifineb+ ing does not currently have a om`at,that it is my responsibility to notify the "-
.occup the requirement which mu met prior issmnce o!a enifcate of D Q
ic [ ate
rte ammo me All roof coverings to be Class`B"or better
OFFICE - .... ._ ... ......