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01110062(.: a CITY OF t DING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT N0. 1598 POPPY WY A PERFECT CLIMATE 01110062 'MFR'S NAME: APPLICATION SUB DATE ,ALA SHOUKRY 10570 S DEANZA BLVD 11/14/2001 PHONE: (408) 861-9545 SANITARY NO. CONTROL NO. Z ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH I I I L I, LICENSED CONTRACTOR'S DECLARATION I henchyalfirethat l am licensed under provisions.f Chap¢r 9(commencing nD Iob Descri lOn p 4 withSmtion7")d) 3.ftheBusincssandProlcsi°mC dmylicense in n1 fn and REPLACE FURNACE/ADD AJC UNIT 1_ic. aCoairor ARI CHITECI S DECLARA 41101� I undemmmJ my phosshall ve axd a punlic rccaNs Licensed PufaWlaralOWNER-BUILDER DECLARATION to 1 hereby affirm that 1 am exempt from (he Comm[wr'.s License Law for the < fallowing m.,,m. Sccaon 70315, Business and Professions Code: Any city or county $8270 p xhich requires a pernot m mnsuuct, alms Improve, dermdish, or repair any structure - - -- .._... _. _ ____ ............. prion s 1 q thepPI'un for such punt to flet signed statement 8%f qt p.. pq �i3tlID it© �O'.�V I)I.t,ff Valuation — toa,h sl'ee igJl nanit dap t. .f the Comramrs L'ce rise Ww(Chapter9 (comncocmSwth Secuom]Ofq)ofovision 3 of the Business and Professions Code) r,)t CT,: y..° tribal be is exempt therefrom and the basis for the alleged ciemptian. Any violation - of Section 703 LS by any applinnt far a permit subjects the applicant m a civil penalty of not thomthan five nundreddollars ($508). 301aPN�d*1UH PLUMBI "i "I-' Occupancy Type ° 1, sat owner, of the pmpcny, or my cmployca with wages as their sole compem.th n, 3 04 — ROUGH E&BflTE21Ilb �rtions will do he work. and the swcom i, not intended car aR ed far sola (Sc : 7ow, 'Business and Professions Code: The Contractor's License Law doe, not apply to an owner of Property Who builds or improves the«on. and who does such work himself 505 — FINAL ELECTRICAL or through his awn provided that such improvements aro not intendedyr or __ .- . - however.- n sold within "offered for sale. IL however. -he building or impen one year or — 507- - FINAL PLUMBING `-•.s ,( er tv of Prot d oprovefn, the owe xfosl,er xan have m<namen or proving that he ere not bald .r improve FINAL MECHANICAL rrn pamose nrsale). 508 - eonstruowner ofrhe p(Set.7am exclusivelyd wPill CWa:)sTo, Coaaonro construct the present (Sec. Business and Profession, CW ca To, Contractor's ,. d who valid, or improves thereon, to a erty who ,- License Law does not apply ,u an owner of a.cmay _ ..and whm.contm<ts.for such. protects. with u.conuunngs) liaenscd pursuum m,thc - C ntracaor'x License Low. °nI a nn itmoth undo Sec: .B&PCfor this«ason Dae” WORKER'S COMPENSATION DECLARATION I hereby a ion under Family of pe jury one of the following declarations: 1 have and rill maintain a Canniest, of Consent m self -insure for Worker's Iivner„ ompensation, as providN for by Section 3700 of the Labor Code. for the ir marrcc of the x'.,k for which this permit is issussi Cl 1 have and will maintain Worker's Compensation Insurance, as required by Scctioa W of the Labor Cade. for the performance of the work for which this Ixrmit'is Policy tpbc issauTdrMY W Icr a� e. ' )al Policand CLRTIFIC TION.OFEXEMI'TIO On WORKERS ;,, IN—COMPENSATION INSURANCE _ .y. ....... _. NO, t ITh s secuon need not be cbnpineJ f tM1e pend t s for one ht ndred dollars IS 100)or less.) I ttnpl that in the performance of the work forccom, This permit e. .,ker I Calhna arson in any manner s, as m berome subject to cher Workcri " " Compcmation Wwx of Califamia. Dne' .h. Lpws .Applicata ANM this Certificate m of ld NOTICE TO APo must after mallangCompensation ` LadmiptioM1 ,youyou become subject m the Worker's Compensation provisions of rhe Wbor Code you must the Worker's forthwith mmFly with loth Provisioner this permit snail be deemed revoked. 2 '� ' �'' --CONSTRUCTION LENDING AGENCY - a- '•'I�he«by affirm that there is a construction lending agency for she performance , y of the cork for which this permit is issued (Sec. 9097, Cie C.) Lead,,*,Add ress 7 I ccamfy,ha I have need this upplihaom and nun. that the above information is correct 1 agree to comply with all e ty. rid county ordinances d state lawsrelating ttbuilding m.wcfon, dh by torie p tt sofths city to trupon f the also e e l ed property inspection purposes. y (We)sigma1 s.,a ndem fy dkeep h mkas theCry ofC man against n libilr jdg t. cot adespc uh hmay, in nywy ec againstesad = City . q ere of th &sun n f 6"' pe.it.' r CAP i )ETRSI'AND A•'DWELL h 1I' N'ITHAL��'s(�-Poj�M11t1 ISSuedby: Date rA oa``ta I1cO\ ✓S tmadA nti .to ,. •. '•'.:. Re -roofs HAZAI S MATERIALS DISCLOSURE - •,.-, will to ppllcam err true bolding occ pat storeor handle hazardous material . Type of Roof - ai claimed by theCapt, no Municipal Code Chapter 9.12. and to Health and Safety `., -x I_-, '•- :i , Me. Section 3553. i°� I( ry ..� . ., ... °Yes ) °;"° r., r"�,-. „ ;. ,.-r. _ :, 4,,:.i ._ All roofs shall be inspected. prior to.any.roofing.material being.installed. ,r w u.n Fpr t r l Jdig p t quip t d _ hien If a roof is installed without first obtaining an inspection; I )agree to! remove cnit itrlb!"u r soman 1 ants as defined 6 the Bay Amn A r Quality Mum,ement District? - - all new materials for inspection. Applicant understands, and will comply. with _ °, all non -point source iegulalions. ., L 1 It x; mad the lmiallous acts efials m4i,ircmems under Chapter fi 95 of the California Health & Safety Code; 5ettims 25505; 25533 and 25534: 1 understand that _ - - if the building does not currently have atenant. that it is my responsibility to notify the - - , odcupanr of da quircmc is IBch must M met prior to iswal c ',f C nifcam of `. 4e•=yp`y' 1' i-)1 �I� Signature of Applicant _. -. Date All roof coverings to be Class "B" or better ammo r ,a thorn:ea agent OFFICE