01090111 TY
CI BUILDIINGUOPERTONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMUTING.
10467 MANZANITA CT. SWAN POOLS 01090111
1495 S WINCHESTER BLV 09/25/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 866-6893
z Z ARCHITECTIENGINEER: BUILDING PERMIT INFO
W F� E ECf PLUMB MF.CH
Z�i 1 hereby silicon LICENSED
licensed CONTRACTOR
provisionsleof Chapter 9(commencing Job Descriptio
RATION
5tn Lr�ju with Seclim7M)of Division 3 of the Business and Psfnsions Code.said my license SWIMMING POOL & SPA.
in fall @rea and effect
:0rca LianaClas a- if L'.a '7u INGROUND 365 SQ. FT. SWIMMING &
o W v Dae )z eonttaeemr �__ POOL & SPA.
3 LL O I—n ARCHITECT'S DECLAR ON
g 1 understand my plans shall be used as public records
T
i a.p O Licensed Professional
OWNEm examDER DECLARATION
P I herby,(Er that 1 exempt from the C sous is License Law for the
t_•Z< following reason.(Section H131.5.Business and vet dermli Code:Any city or county
,.m
x 2 which requ'res a perm t m conawet alter spec,demon it or spay any swemrc
a.3— poor d t. n eq pr ppfcont far such parrot to Bb s Law(aeteme, - _ - -. - _....__
(comm'dhat 1 o panaant, to p' visionns 3 ce ilia Business and PrL.scions pt 9 r e Sq.Ft Floor Area,, - nation
team ensexemsecltmoan rOmsaaotheallgedcimdim.Anynscod) V, i.D `. ied. t :5J . _ .. .,`i �S. ,r,n ' ; $2601Vi°�
or that he is exempt therefrom and the barns for the ullagN nempion.Any violation '
of Section 7031.5 by my applicant for a peri,subjects the applicant s a civil penalty
or nm more than five hundred dollars(S500). 34 Agbli"Ynll5F3 i ' Occupancy Type
01,n owner of,hc property.or my employees with wages es their sola compensat
will do the work, it the .,tum is fat intended or affianced for sale(Sec.7W.
rona,Business end Professions Who
Codec:The Cvas the i x Liccnu Law dear not apply r°m 103 - UFER Required Inspections """
owner of and Pro Wi°Wilds or improves thereon,said who don such wank himself
or through his own employees.provided that such impvcments as not intended o 104 - REBAR _
offered for sale.If,however,the Wilding or improvement is sold within one year or a '
completion,the owner builder will have the burden of P107 - POOL/BONDING
ring thin he did not Wild or 1 -
imnrorefar pugwantal°')' 301 - ROUGH PLUMBING
eCl 1,ox owner of the inoomy,fat exclusively coniracdag with licenead coarmuma to - 304 — ROUGH ELECTRICAL •'.'fir' .• .
contract the project(Sea.two,Business and Professions Cada The contractors 502 — FINAL PLUMBING ENERGY"
License law d..oat apply or an owner of pmpimy who builds or improves thereon.
.ad wha contracts for such project,with.conductors)B°emod.parsuaa to,ne 503 - FINAL -MECHANICAL ENERGY- -
_ Cnnuacmex License Law.
❑1 am eaem t under Scc. .B'&P C for this reamn
p 506 - GAS TEST
_ - = Owner Done 510 - FINAL PLANNING
WORKER'S COMPENSATION DECLARATION 511 - FINAL POOL
1 hereby alar mcl pcenatty of perjury ala ante faio vin,dealarrtirs: 516 - FINAL BUILDING
0 1 have mrd will maintain a Cedificnie of Consent to ulf-insure far Wokers
Compensation, m provided for by Section 3700 of the Labor Cod, for the
performance of thc wart,for which this pandit is issued.
and will muinuin Worker's Compensation Inmsnce,as required by Station
_ '/00 of the IaWr Code,for Nc peRortnarne of be
work far which this pertnit is
issued My W k 's Compe,i i brain"'ranee -
Cam,% -• 'Policy Nn: /�i t 5-s.' t is e., fit. 14•�'sr v3l t ii yy, l,3• _ s.:.. hll fi t'.
'CERTIFICATION OF EXEMPTION
COMPENSATION INSURANCE' ""
(Tho sen o ) dollars no,he completed if the Permit is for one hundred dolle ^' ( ' - t t !
(SI00)or lean . .
I certify the,in
ers pe in any tt n the words,for which this peril is issued.l
Compete employ any person in any menner,a as to become subject m the Worken'
Applicnst 'La' of Celiforrda.Data
Applicant ' _ _ _... . .
NOTICE TO APPLICANT.the Workees after compamakingotin s Certificate of e Labor ion. .Ycar ould
most `
baomch comply
o the such Pr vision or an provisions of the Labor Code,you must
�
Forthwith comply with such provisions or his pvmiuhall b<deemed revoked. '
CONSTRUCTION LENDING AGENCY" -
F'' 1 hereby affirm that them is a construction lending agency for the performantt '
a' of the work for which this permit is issued(Sec.3097,Co.C.)'
(] Leader',Name -
.7:Z Lcndcr's Addmss '
Ut,�Q . I caddy that l hioamid this application and state that the above information is '
correct.1 agree to comply with ail city and county ordinances and state laws relating
Q U m building construction.and hereby authonar reprexntaivee of this city to enter upon
r� the abov>mentloned p,.,oy for inspection paryosas.
I>`,.,p, (War agree tisave,indemnify and keep haradcssdW City of Coleman,against
t0 liabilities,judgments,cos,and eapenus which my in any way acme against said
U'Z., City in consequence of the gs lar f Nis peril "
DISCLOSURE „
-.wdm appraat fftoeWilding aau�tammcrhandl hasNdnsmateial Type of Roof
as def ed by the Cupertino Municipal C Ch pt 9.12.am the Health and Safety
CoA R t 25532(.) 1 •,i •� - ?, f :l. y ,
❑Yes s_ LI"° _ ,.All roofs shall.be inspected prior to.any roofing.material.being installed. - .-
Willtheapplicant future building cup t eeguip t 9 which If a roof is installed without first obtaining an inspection;Fagree:toIremove
cold h b it coularramurox s def by the Bay Area Air Qual ty Management
District - all new materials for inspection. Applicant understands and will comply,with .
cr°': "° ° all non-point source regulations.
1 have''rced'sh6 hasrdus cannot lsrequiremrnu undcr'fChap¢r 6.95 of the
California Health&Safety Code,Scctiom 25505,25533 and 25534.1 understand that ,
ilihe building d«s noscurrently have a tenant,tha itis my msponsibiliry m antlfy the
occupant of the,equincmrnu ich must be met poor to issuance of a C<nifices of
apuwnc' Signature of Applicant Date
e :gar
Date. All roof coverings to be Class "B"or better
.. ? .. OFFICE .
t .