01050066 CITY ofcopv RoNO
NPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10162 BILICH PL TIMELINE CONTRUCTION 01050066
OWNER'S NAME: APPLICATION SUB DATE
• CHIN WAYNE F AND JOAN L 14589 S BASCOM AVE 05/07/2001
PHONE:
SANITARY NO. CONTROL NO.
— (408) 356-1790
Wo 9 o ARCHITECffENGINEER: BUILDING PERMIT INFO
&m
fiLK ELECT PLUMB ME IT
Brad
" LICENSED CONTRd under rDECLARATION
�S 4' 1 herby affvm Nat 1 on licensed under provisions of Chuptee. (commencing Job Description
F��m with to hanl000)or Divisi.n3 ofthe Nuniness anJ Profession CWe.and my license /
M
mmnr.reea «ca. S9 ADD 300 SQ. FT.Licca la Lioc.M Daen ARCHITECT'S D CLAOTI KITCHEN REMODEL &Iundrrsmndmyplansshllbeusedaspublicrecords RAISE CEILING.
a. LteenseI hereby affix
OWNER-BUILDER DECLARATION
��-' 1 hereby affirm that 1 am exempt firman the Contractor's License Law for the
C?a following reason.(Section 7031.5,Business an'Pmfcsions Coll Any cit o e t
as er
F D which requires a permit to construct,alter,improve structuredemolish,of repair any structure
Prior ant aal.,o req The applicant fh parmin to rile a surpeadcomment. -
a�-
fail like ndpupward nqThe po cur to C t a 1 L (Chapter 9 Sqv 1,I P100r A1'EJ o r c tion
fe. a mso, t7oal) fD r 3 fn u aprofession,Code) C-os- z f.;.,, . ?a or Area "(t7'1 :
I,,that be s eve opt therefrom and the best,far the alleged exemption Any violation
--of Section 9031.5 by any applicant for a permit subjects the applicant to a civil Penalty
.of not mm man rive hundred dollars(5500). APN Number $8 A)Wancy Type
01,as owner of the property,or my employees with wages as their sole compensation,
will do The work,and-the'xtravare is not intended or offered for sale Sep,7011; - -
Businns aril Professions Coyle:The Ciann ox's License Law does nor apply to an 31621064 . 00 Required Inspections
owner of pmpeon.eny Who Wilds or improves therand who does such work himself 1
or through his own employees.provided that such improvements wi no,intended or
offered for Shcc If;however,the buildin--�- -� <t is sold within one
gob'men idpn year of
'improve ion,the nwncr"builder will have the burden of proving that he did not build or 301 - ROUGH PLUMBING
cop r p p.se.r,mel . 303 -._ROUGH_.MECHANICAL-
- -
1 n fth p . amcsdne sly t i g ith ensedcomroaorsro
_...
__-----__---.
--
construct thep J t(Sec.7 Burrte,. e P R:urns Code:)The Contractor 304 - ROUGH ELECTRICAL
License Low does not apply'--n owner ofprognwhW Ids improvsheron t '
who contracts ro ,aen Projectswith a..nmmemq,7 licensed pursuant m.the -5,05---.-FINAL,-ELECTRICAL,License law, '
- --
0IamevemptunderSec: B&PCfor this reason 507 - FINAL PLUMBING .
Ower " '' date 508 - FINAL MECHANICAL
WORKER'S COMPENSATION DECLARATION
..I hcmby affmm under pewlty,ofperjury, onc,of the following declarations: -
0 (have and will maintain'a Cmifin,e el"Consrnt to self-insum for Worker's
Compensation, as provided for by Section 37W of the Labor Code, for the
prrfomeince'af the work for which this permit is issued.•
'- 01 have uowill armumin Worker's Compsnsmton liisumnee,as required by Section
3]W of the LaMsr Cole,for the porf lrmance df the work for which this permit is
sued.My Workers Compensation'Insurance carticr and Polity numbcrare:
Ce ttJ7
l'CERTTaI-FICATI ON:Ol F EXEMPTION
XEMPTION FROM WOR OR S�'jr--g71 J s TT
'-�f 1,s; �.`� •'tt t. ::. . .Q ' y,'IT\tCS.i a. D I i
CITY ofcopv RoNO
NPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10162 BILICH PL TIMELINE CONTRUCTION 01050066
OWNER'S NAME: APPLICATION SUB DATE
• CHIN WAYNE F AND JOAN L 14589 S BASCOM AVE 05/07/2001
PHONE:
SANITARY NO. CONTROL NO.
— (408) 356-1790
Wo 9 o ARCHITECffENGINEER: BUILDING PERMIT INFO
&m
fiLK ELECT PLUMB ME IT
Brad
" LICENSED CONTRd under rDECLARATION
�S 4' 1 herby affvm Nat 1 on licensed under provisions of Chuptee. (commencing Job Description
F��m with to hanl000)or Divisi.n3 ofthe Nuniness anJ Profession CWe.and my license /
M
mmnr.reea «ca. S9 ADD 300 SQ. FT.Licca la Lioc.M Daen ARCHITECT'S D CLAOTI KITCHEN REMODEL &Iundrrsmndmyplansshllbeusedaspublicrecords RAISE CEILING.
a. LteenseI hereby affix
OWNER-BUILDER DECLARATION
��-' 1 hereby affirm that 1 am exempt firman the Contractor's License Law for the
C?a following reason.(Section 7031.5,Business an'Pmfcsions Coll Any cit o e t
as er
F D which requires a permit to construct,alter,improve structuredemolish,of repair any structure
Prior ant aal.,o req The applicant fh parmin to rile a surpeadcomment. -
a�-
fail like ndpupward nqThe po cur to C t a 1 L (Chapter 9 Sqv 1,I P100r A1'EJ o r c tion
fe. a mso, t7oal) fD r 3 fn u aprofession,Code) C-os- z f.;.,, . ?a or Area "(t7'1 :
I,,that be s eve opt therefrom and the best,far the alleged exemption Any violation
--of Section 9031.5 by any applicant for a permit subjects the applicant to a civil Penalty
.of not mm man rive hundred dollars(5500). APN Number $8 A)Wancy Type
01,as owner of the property,or my employees with wages as their sole compensation,
will do The work,and-the'xtravare is not intended or offered for sale Sep,7011; - -
Businns aril Professions Coyle:The Ciann ox's License Law does nor apply to an 31621064 . 00 Required Inspections
owner of pmpeon.eny Who Wilds or improves therand who does such work himself 1
or through his own employees.provided that such improvements wi no,intended or
offered for Shcc If;however,the buildin--�- -� <t is sold within one
gob'men idpn year of
'improve ion,the nwncr"builder will have the burden of proving that he did not build or 301 - ROUGH PLUMBING
cop r p p.se.r,mel . 303 -._ROUGH_.MECHANICAL-
- -
1 n fth p . amcsdne sly t i g ith ensedcomroaorsro
_...
__-----__---.
--
construct thep J t(Sec.7 Burrte,. e P R:urns Code:)The Contractor 304 - ROUGH ELECTRICAL
License Low does not apply'--n owner ofprognwhW Ids improvsheron t '
who contracts ro ,aen Projectswith a..nmmemq,7 licensed pursuant m.the -5,05---.-FINAL,-ELECTRICAL,License law, '
- --
0IamevemptunderSec: B&PCfor this reason 507 - FINAL PLUMBING .
Ower " '' date 508 - FINAL MECHANICAL
WORKER'S COMPENSATION DECLARATION
..I hcmby affmm under pewlty,ofperjury, onc,of the following declarations: -
0 (have and will maintain'a Cmifin,e el"Consrnt to self-insum for Worker's
Compensation, as provided for by Section 37W of the Labor Code, for the
prrfomeince'af the work for which this permit is issued.•
'- 01 have uowill armumin Worker's Compsnsmton liisumnee,as required by Section
3]W of the LaMsr Cole,for the porf lrmance df the work for which this permit is
sued.My Workers Compensation'Insurance carticr and Polity numbcrare:
Ce ttJ7
l'CERTTaI-FICATI ON:Ol F EXEMPTION
XEMPTION FROM WOR OR S�'jr--g71 J s TT
'-�f 1,s; �.`� •'tt t. ::. . .Q ' y,'IT\tCS.i a. D I i