02060124 CI BUILDING DIIVCoISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10590 WUNDERLICH DR STEVENSON' SN 0206 24
OWNER'S NAME: APPLICATION SUB DATE
PHIL CHOONG P 0 BOX 1641 06/20/2002
PHONE: SANITARY NO. CONTROL NO.
(760) 339-0090
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
— BLDG ELECT PLUMB MECH
ds.ad
Z O El E LICENSED CONTRACTOR
under r DECLARATION Job Description
Oz—0 coma} affirmthat 1m 3lif1heB under provisio! of Chapter 9(commencing
FvtF; Liinen" on 7tg0)of Division3ofthe Buxines dPml ions Cod! and mylittnx REROOF gCD
z s�;nr«I fere an err _ '� Liehe� .__ �js� - F1N�a�.rG
o a t Comr ,RAT( `--"
ARCHIT[CT'S DE ATION
O naentand y plan s II be.;&,public rtmN JUN 2 5 2002
r
w at O O Licenu ro« ones
°' o w OWNER-BUILDER DEC ATION
1 hereby affirm that 1 um exempt from the untmctor's License Law for the BUILDING
(_,z following reason.(Section 7031.5.Business and Professions Code:Any city or county
E e which requires a permit to cementer,alter,improve,demolish,or motor any strucwre. $2000
; its c ensed p ab o re 14 the me applicant for soon permiuL file se Law( -
3� 1hahG's licensed purl n 70(f previsions ions of the the Hantro and Pr Law(Chaptere,Co ) S Ft Floor Area , „ I Valuation
(ca a tlstat ,fNn)mrDiviRmn3nnneananeuenaPmr<.,ionse"ae) {;f�'yh' -nc, t )t�'„ti't���'j'j'e: �'
or that he i.exempt theref ) a the bass for the i leged exemption Any v olmiun '3.T CJ L 7026 .'
-' Q i
-of radion]031.5 by any applicam for a permit subjects the npplicam m a civil,malty
or ma more than five hundred dolma H50b, N 305 APN FRAME uumb rOccupancy Type
ElL as owner ar me pmpesy,or my employees with wngea ns their sole cumpe v,stion.
will do the work,and the emature is not intended"or offered for sale(See 7041, - —
Ins ect10DS
Business dna Ptofcssions Code:The,Cron m.on-v License law does not apply to an 601 - ROOF TEA 8614 P -
owtm
r of propc r,Wh,builds m improves thereon,and woo daa such work himself
terthrough riaown however,t promdinmat such iemntisgol wioatintended ter . -.. __.602 ---ROOF- PLYWOOD—NAIL---.
..arr<md rdr aale-lt However.me building improvement is gold within -��of _. _.._. _. ._,. ..__-. .. ...
garirdenofproving yar 603 - ROOF BATTENS
completion,the owner-builJcr will have the burden of that he did not build or t "
improve for purpose of sole.). '
604 - ROOF_ IN-.PROGRESS.-- - - _--_ ---- - - -._--
❑1,es owner pr the property,am Business
contracting with licensedcontractorsContracts m T
License
the project(Sec.
appl ,,a Bumo o and Professions Code:)The Contractor's t ,,, I y
Lid who
Law Jae nut hpPIY m .j owner of,mommy who bullas or improve,,ontthereon,
_and who cmmmnse La such projects with a.commetur(s)licensed punuan to the
_
Contractor's do muds Law.
Qlam exempt unodr Sec, ,B&PCfor this mason .. .. . . ' I i'•r'
Owner Date
"WORKER'S COMPENSATION DECLARATION
_ I hereby affirm under penalty of perjury one of the following declarations
❑ 1 have and will mainwin a Cendicaie of Consent to self-insure for Workds
Compensation, as provided I'nr by Section 37W of the Labor Code, for the
performance of the work for which this permit is issued.
is
❑1 have and will'maimain Worker's Coax Nmemern Insurance.has required by Stttion
- 3700 of me Wbui Code,for the performance of the work for which this permit is
T - issued.My Worker's Compensation Insurance carrier and Policy number are _
`_._ ,odi:Y' � ��a 45 .-Snv --•F•1? 4 F" i
nm:
it CERTIFT1•F UEMPrION FROM WORKERS'(' 1. t.%. a i SS. L'.., -.in. 1. 1' .JRN,
COMPENSATION INSURANCE" "°t. ' _
tfThts eLn"n'need not be completed dine permit is for one hundred dollen
(SIM)or less.)
i' . 1 codify that in the porn mmnm nn the work for which this permit a Worker 1
.Eal)'not employ any person in any m.mner m s m become subject m the Workers' "
eesatinn laws of C,lit .Doc
APIA earn I I
NOTICETOAYo the Worker'sIf. om,civation rCedficate or Labor ior; hu,youmulst
Q OMcomth exec y the Worker's pr Compcnmti is provisidna of the lamer revok you must
fnnM1with comply with such provisions or this permit shall be deemed revoked.
'CONSTRUCTION LENDING AGENCY
I hereby affimt that mem is a construction lending agency for the pre fornance `
of the work for which this permit is issued(Sec.3097.Civ.C.)
7:z Lc I All L.a
U 1 certify that I herveedtti.city
applicationdttmatth b r torn
tz'E•t corrin I gree m Comply hereby
D ad county ordn nee.and t y relating V
Q'L) to budding comwninnoperty for
rcpmsentmives nr th.zCtytn erten pan
Acthe nM1rvcme gree to property for Inspersion pugxses ,.
Ln• (KB)agree t"save,and a try and keep h:tm y in the City of Cup,.,.j against V
V) liabilities,judgments.costs and expenses which may in any way accrue against said
u',z City in consequence of the granting of mise omit,
APPLIC "":.' "'^cTASDS ASD\VILE.COMPLY WITH aLL FON-POIT Issued by: r( Date
.F' U_5...' ` .. � � y'
11 am cmunscon D
Re-roofs
RDOUS MATER(\LS DISCLOSURE '
..
Will to pylic t f t bu(ding 0 t store or h ndle bathroom medical . .Type of Roof_
as&flood by he Cupertim,Melyal Code Chapter),I3.and the H ulth and Safety - p -
C'tl Section 25vJ2[1 1„ r .., j 5 `4-+' s S t,'1•I'rf.
CYhx " G All,ro6fg shall be inspected prior to any,roofing material being installed.
H'dime-applicantorfuture building occupant use equipment or devicesahich If a roof is installed without first obtaining an inspection, ('agree to remove
emit nvardous air comaininonta as defined by the Bay.AratAir Quality Management
Dntrm
°Yon all ion- dations.
I baseread me hazardous materials requirements no&,Chapter 695 of the
California Health&Safety Cade.Sections 25505.25533 nod 25534.1 understand thatif the building does not ctmently have a tenant,that it is my responsibility to notify the
accupant or th .. s which nae be It pilar to i'mance nI a C'cc
e of
°p Signature of Applican ate
owns ar anmutizm ag-rat. ate All roof coverings to be Class "B"or better
.OFFICE