02060135 (4) CI BUILDINON CUOPERTPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS', PERMIT NO,
10188 RIDGEWAY DR 02060135
W NER'S NAME: APPLICATION SUB DATE
ROBERT GREEN 06/21/2002
'PHONE SANITARY NO. CONTROL NO.
aZ0 ARCHITEC'OENGINEER: BUILDING PERMIT INFO
0
BLDG ELECT PLUMB MECH
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a C' I.7 1.1 L"J LJ
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Z 8 o i LICENSEDCONTRACnderp DECLARADON Job Description
O Z_ I hereby 7000)of
that 1 am licenced under imvisiofe ofChaptcr Code9(commencing
mmenei se
ilhSection]IXO)ofDivision}ofthe Bu ss and ProfessionsCoJc.andmylian.e 3 SLIDING COORS/ 7�7I Sl�
is m full fim SA`rd effect. r
z z a Li nse CW Lioc.x yyIIrr
3 u U ` ARCHITEC"'S DEWARATION �11N 2 8 2002
I undemtand my plans shall be.,ad as public records
S
u�+6
CC Licensed Professional
OWNER-BUILDER DECLARATION
vai^6 I peaso.!firm that 1 1. escmpt from the Gonias C a License Law for thefollogUr,LD
r=z a which ac reason.sectipermit
to
]ons. t.over,andmp Pm,demolish,
emo!.cede:Any city Lir county $5000
yF G whim rits irec a permit ce con t a,alta,improve,Jem.It 1 fl repair any structure,
6 3 z,prior units lssuame also requvee the applicant fur such pe for I License
se Law,
a,(Chapter
C trimmed 9 -
tbat�ei�liaosvuhSarno— the provisions or the Contractor Littme Lawons Car9 �S F[. FoorAA��N ,, Valuation
(co nesaingwithSationMbtlOfDivision3oftheBusitatsagdHofessionsCode) !;()\'7k3,4•�41 1 8:•rt00,.t;A'I:\33(�'ti'
.,,bar he is ezimpt diamfrom'ond the basis for the a116ged esimptbm.Any violation
of Section 7031:5 by any applicant for a permit subjects me applicant to a civil penalty
mf mtmorethamfive hundred dol ars(S5W). 101APN� bATION Ifo,•;. Occupancy Type
01.as owner of the property,Lir my employees with wages as their sale compensation,
-will do the work;and tne-structure isnot Intended or oRead'for'We'(Seee.70,W. -
Business and Professions Cade The Contracmr's License Law does not apply
to an 103 - UFER Required IDsp ections'!
owner of pmPeny Who builds or improves thereon,and who docs such work himself
or through his own employees provided that such P m a are not intended°r . .. - .__1.0.4,...- ..REBAR._ '
completion,
oPople for sale If,erb- thb have
t p e i n IJ M o Y a or „ r .
comply on.me owner builtla will have the burden of proving that he did not buil)or 105 - ANCHOR BOLTS
106 - SEWER & WATER
❑L s twmr tdmwimopsany, m ratchauvely mvcdms withl wit chmmasoniro 202 - UNDERFLOOR PLUMBING I '"
construct the P J t(Sac,70zW Business and Prom.ssions Code The C t cork 1 11
License Low does not apply to an owner of property who builds or improves thereon 203 - UNDERFLOOR MECHAN__I CAL
:. -.and who.contoders.for such prolan ma
with a cotnor(s)licensed pursuant to the .- - - ----- --—� - ----- - -
eqntmrrpraucen.elaw. - - -204 UNDERFLOORI,FRAME.
'ramcscmptyu�tairSh.
0
,B&PCfonhisrcason 205 - UNDERFLOOR INSULATION
'— 3 01 - ROUGH PLUMBING
WOR S Co.<CENSATION DECLARATION
= ' 'nx11 302 - TUB & OR SHOWER
I hereby affirm under penah,of perlm,one of the following declarations:
303 - ROUGH MECHANICAL
❑ 1 have and will maintain a'cdnircam of Consent to selfinsure for Worker. 304 - ROUGH ELECTRICAL
'J Compensation, its provided for by Section 37M of the Labor Code, for the
performance of the work for which this pvrmi)is issued..,.
305 - FRAME
❑l have any'wal rrii imt m Workers Competrsaaon Insurance.as heyuit<d by secdnn 306 - HOLDOWNS
r 37M of the Wbor Code,for the rformance of the work for which this permit is
7 issued.My workersCompensadonInsurancecarrier andPolicyanmbcrare:.' 307 - INSULATION _ __._.._ ..,.......:......_„,......_..-.,.._-...._.... .,. .,.
Clue a ' .'f> 1r lPoliyNo _. Vy,,.$3081.�. �SHEEThROCK'r�t'.�.• .., _....
1.I'1 .ICERTIFICATION OFEKEMPTION FROM WORKERS, i ” 309 `- EXTERIOR LATH"- _
COMPENSATION INSURANCE - -
r(hii kucti6,neod not be completed if the permit is for one hundred dollars 3 1 0 0`7-, INTERIOR LATH'
(g1n0)nrl..a.) 311 SCRATCH COAT
Icerinainthc ncednn< rkrr "M1m x i uea1313 ROOFNAI L: „ - ,;,n- . I• t --
Cs n n pdpl y ylr pc r manna rte
cnmpen(aa f/yd Calif ,D - TL`rb Workers' 501 - FINAL ELECTRICAL ENERGY
1 / - ' -.502 —FINAL PLUMBING ENERGY -
�N(Pf .,TO ICAYf if Get stn. a 'r ma.1 h pt y°t should
bcralv'subjecuntheWorker-Com nstonProvisions'oNh Low,Code,yon man 503 - FINAL MECHANICAL ENERGY
0 Z fonh.ith comply with hp .ons orN permit hall bed ed oked.
504 -FINAL BUILDING--ENERGY-
rZ. r—. - — •"'r^^. ,CONSTRUCTION LENDING AGENCY,' - - -- - - — -
a Iherebyoln nat
nitnea n.;iomsci.mleading ag<nryto,the if..mantra 505 - FINAL ELECTRICAL , ,.
of the work for which thk permit is issued(sar.3097.civ.Cd 5 0 6. - . GAS -TEST-.--. .- ..-.
S 0 Lender Name .. .. . . . -
Z Land Ada 507 - FINAL PLUMBING .,
U , Iri fy th tlh ere dth' ppl'< I nJ.fmth ube ba 1 't his 508 - FINAL MECHANICAL
fz F.I ro t 1 g t comply nhall city and ty Jnaces n ton I .welting 509 - FINAL GRADE
C) U .tobuilding strucIo and hereby authorizePc tatives otthis<ty to enter upon
y-� ;1he al.we.fusslmoad proper,for in.pecttnn P'W'O'.. 510 - FINAL PLANNING
F., IS Dk 1 8 to sec d<mmfr and keep h I s thi City of Cupcmnu.g.mst
rn h,l Ilims., d promints,cat. J asperse,vi rmov in any way am. against sail 514 - F NAL P WORKS
V Z CIy' q "Ith g f gof ml permit.
JS1NICIC PUNDERSI\ a WILL COMI LY WITH A LL N ON ONr" Issued b Date %
OUR I" It TI r 6 2/ y:
Sign ureofApplleon : ' Data Re-roofs
HAZA OUS MATERIALS DISCLOSURE
W II the ppl' t or forms.holding tsmipama.m r handle hoard m nmten.l Type of ROof_- ..--• ,. _. ,.,. _..
•aids edbytb Cpen M po G:J Ch II 91_ Jth ithh anASlty '
Cyd ❑It.Tabs 5s32(n) : f p .... Il Y r ! t !,u ` 4,'<jl i rt: i....'.'.
_ All roofs shall_be inspected pnor.to.any-too Ing material being installed.
wum PpOe t t g pan.useeryp t a which _ If a roof is installed without first obtaining an inspectiori,4 agree to remove
m t h �d mat t. d by theBay.A_ai Quality Management
District? all new materials for inspection. Applicant understands and will comply with
ove. VN. all non-point source regulations'.
'I have read she hazardous materials requiaments under Chapter 6.95 of the.
California Health&Safety Code,Sections 15505,25533 and 15534.I understard that _
'fth M1 ild' d not rte dyhve tenant tht t my M, .Lb'I tyt noufY he - - - -- - -
iz parrt t 'q t h M1 must h p' to is c f ('n,fca of
one
°mac/G_ i/ ,y --- �[Jb Oy$ignature of Applicant Date
t6F"' . �o,t< All roof coverings to be Class"B" or better
OFFICE
_. .. . . . . .