02030121 CITY OF
FmsOV0
DINPERMIT CONTRACTOR INFORMATION:
j BUILDING ADDRESS: PERMIT NO.
11230 BUBB RD JUST WATER HEATERS INC 02030121
I OWNER'S NAME: APPLICATION SUB DATE
BIGLER ROBERT A AND PUNITA P : 1764 NATIONAL AVE 03/21/2002
PHONE: (510) 293-9901 SANITARY NO. CONTROL NO.
O O ARCHITECTENGINEER: BUILDING PERMIT INFO
m - BLDG ELECT PLUMB MECH
vy=i i LICENSED CONTRACTOR'S DECLARATION Job Description
1 hereby aM.that I am licensed under provisions of Chapter 9(commencing
Nt. with Section?tae)of Division 3ofthe Business and Professions Code.and mylicense, REPLACE WATER HEATER.
I,in falle Cl.11 and eRecaffect,Licenu Clrss Lica (5 0 GALLON, GAS)
S O roe. Dam
- °•N ARCHITECT'SS DECLARATION
Contractor
RATION
- w,aj I undcmend my plans shall be used as public rtcods
p O ,LicensedProfessional
°.p oOWNER-BUILDER DECLARATION
u1
to I hereby aRnn that I am exempt from the Contmctor s License Law for the
L:?a following teaser.(Section 7031.5.Business and Professions Cade:Any city or county V —
ER{ O which q permit to consumer. Iter,improve.demolish,or repair any structure
_Pro tot e..uls°req the ..leant for such permtm file.milteduuumens -.
dwth is.dp:ir;untstlepronswnsofJ,eCommemhLmenuLaw(Chepmr9 „• S S 't: FloorArea,t a aluation
(co m mgwth.Section7-")of Division 3 of the BusmuF aM N,meroons Coda Q�.}'_'y 1.3d.s q, l}:1 or.
or thin he is exempt therefrom end the basis for the allejed exempting.Any violation "
of section 9031.5 by any applicant faro Permit subjects the appluni:t to a civil penalty
IofTN mora than five hundred dollars(s5(nl. APN Numberrv;; Occupancy Type
°I,as owner of me property.or my employees with wages as their sole compensation. 1ENERGY
i will do the work,and the structure is not intended or oRered'for'sde(Sec.7066;' -
Busmeatand'Professions Code:The Contractor's License Law does not apply as an 506 - GAS TES'lRequired Inspections,c• '` -'f°
i owner of propcny Who builds m Impmvea thereon,and who does h work himself
f _or through his employees.provided that such improvements ended or 507 - FINAL PLUMBING
ff . .._. . .._.. _._ . ..__.__.._. ., ...._. .. .___. _.
he
ng or
nent
,o ereJ ors le I(huwever twill havethe burden
provis so s'n - of ..,i , �.,,
improve on,for the owner-budder will have the burden of prav,n6 t he did not or
improve for puq,ou of u1eJ.
Con as owner of the.msec, an exclusively and Profession
iccnu
- _ consumer the project(Sec.]thin Business and Profusion odeJ The Co r, ,
,.
-- License Law gas nm apply to an owner of Property who 'mpm on, ' - '
'( .,nnd.who contracts for such.Prepetc.soult a.comW,tmI,)I t the
Conuactors License I,aw., 7
Ijl ❑I am exempt under Sec b ,B&PCfonhis o .i'.
Owner -
Data
.., .
_ - p WORKER'S COMPENSATION DECLARATION
I thereby effim,under penalty of lierjuiy one of the following declamsions:
° 1 hove and will maimaid a Gambino of Consent to self-insure for Worker's
• Compensation, u,provided for by-Section 37W of the Labor Code, for the /
performance of the work for which this pemm is round.
`- °1 have and will mvntnin Worker's Compenmtiominsurince,as required by Section
v 3700 of the'fibor Code.for the performance of the work for which this permit is
_'- -' y pe Insunnee'carrier and Policy number
C d M W°hefs Cem nut bra
'�'ec -o'.CERTIFICATION OF E%EMPTIONFROM.WORKBRC
',^__COMPENSATION INSURANCE' I3'.
(This senior need not be completed if Ne permit is for one hundred dollars . .
(Sltt)ar loss) '
_ __ _ _ _ .rm.: •... .m...o........ .ea..•.
s 1 cenpl that in,he performance of the work for which subj perm a Werke,1
shall not employ any person in aDole ter so u to become subject it the Worker'
Compensation Laws of California.:Dace'
Applies.[-
NOTICE suOAPo the Work If.after Compensation p Cisionsfi o of Labor Con.de,you mule ,�/. 1. . ,tin P,:"•
becomeh comply
the Worker's Compensation provisionsofthe Labor Code,you must
OZ forth nth comply with'such provisions or this perms shall be dared revoked.
CONSTRUCTION LENDING AGENCY
K: I hereby-IEm but theinis'a comm'ki on lend g agency for the performance t ..
ufthe okfr hch the Permit is tsoed(S 3N7 Cs CI
Lenders Name
L'Q
U. 'a Addrtu• - .. _ _........ _ .__........ ..—_ .. ._
U'.7..
e I agree th t 1 ha teatl tht ity and d tree thin the oto a laws
moon g
0 1wi oWil Ogg to comply it hefl,all city and county ordinances andstatelaws relating ////i`_I%,.rG/l'_�i"/\V/•'-' ".1/`—
-
OTJ thein,ongcossdct onanrherttiyamhonuposes. vu ofNsc,ymcnmr upon
the echo a me i orad property f inspection purposes.
,y judgme'bse a ndemNfy and keepwhich
h may
ss theCity of true against
vg min
Z, Cliabilitiest judgments.Cost.ad expenses h¢h may n any ay accrue against ae,d
Viz 'Cpp'ity n conseqPPILICANTuence of Neppgra t g of thio Perm t - '
~_ $OURCEREGULATIONS"D�AND WILL COMPLY WITH ALL NON POINT Issued by: Date
Signator of Applican,/Commctbr +' S - ""t tOam,• Re-COOTS
Cade Sebum . or
S lining c. DISCLOSURE - - "
pplidints r future buJding arcupm,s none dohattdle haaardous malend .Type of Roof ,. _ ..�._ __
sdefiWill thea (] P pur9lZ ,rad theHW,n and surety s -,. o .; ,.. ,.,. Pj: r••
nedb Ne CLpcn,ru Munm,pal Code Che
°4 ;3a'p 't °rvo T 7 All roofs shallbi; rispected.prior tp any roofing material being installed.,,.,_ ._ ,.
t Will the a lirant w,fuwrt oil in occu em Liu equipment or.devices which
PP B PIf a roof is installed-without first obtaining an'inspection,I'agree.toiremove
not hcerarJws Lir mnum,titits is deface b the Be Area Air Quality'Management
o y all new materials for inspection. Applicant understands and will comply with
°Yes, ,.t�,:,, 13 No . ...
d . all non-point source'r8gulahons:. ' , ( .,.•,.I:,, ,,,
1 have'on, ,rte haurdous'memnuh¢quirementa under Chapter 6.95 bP,lie
Califomis Heabb&Safety Code,Sections 25505,-25333 and 75536:1 understand that
If the building does not currently have a tenant that it iimymparrusibility to notify the
occupant of she requirements which must be met prior to Issuance of a Cartifieam of
Signature of Applicant Date
owneror:rmo ,d,gent Date, All roof coverings to be Class"B" or better
OFFICE ._ _ .. .. . .. ._. . .. . . . ._ ._. . . .__.. ...... . .
CITY OF
FmsOV0
DINPERMIT CONTRACTOR INFORMATION:
j BUILDING ADDRESS: PERMIT NO.
11230 BUBB RD JUST WATER HEATERS INC 02030121
I OWNER'S NAME: APPLICATION SUB DATE
BIGLER ROBERT A AND PUNITA P : 1764 NATIONAL AVE 03/21/2002
PHONE: (510) 293-9901 SANITARY NO. CONTROL NO.
O O ARCHITECTENGINEER: BUILDING PERMIT INFO
m - BLDG ELECT PLUMB MECH
vy=i i LICENSED CONTRACTOR'S DECLARATION Job Description
1 hereby aM.that I am licensed under provisions of Chapter 9(commencing
Nt. with Section?tae)of Division 3ofthe Business and Professions Code.and mylicense, REPLACE WATER HEATER.
I,in falle Cl.11 and eRecaffect,Licenu Clrss Lica (5 0 GALLON, GAS)
S O roe. Dam
- °•N ARCHITECT'SS DECLARATION
Contractor
RATION
- w,aj I undcmend my plans shall be used as public rtcods
p O ,LicensedProfessional
°.p oOWNER-BUILDER DECLARATION
u1
to I hereby aRnn that I am exempt from the Contmctor s License Law for the
L:?a following teaser.(Section 7031.5.Business and Professions Cade:Any city or county V —
ER{ O which q permit to consumer. Iter,improve.demolish,or repair any structure
_Pro tot e..uls°req the ..leant for such permtm file.milteduuumens -.
dwth is.dp:ir;untstlepronswnsofJ,eCommemhLmenuLaw(Chepmr9 „• S S 't: FloorArea,t a aluation
(co m mgwth.Section7-")of Division 3 of the BusmuF aM N,meroons Coda Q�.}'_'y 1.3d.s q, l}:1 or.
or thin he is exempt therefrom end the basis for the allejed exempting.Any violation "
of section 9031.5 by any applicant faro Permit subjects the appluni:t to a civil penalty
IofTN mora than five hundred dollars(s5(nl. APN Numberrv;; Occupancy Type
°I,as owner of me property.or my employees with wages as their sole compensation. 1ENERGY
i will do the work,and the structure is not intended or oRered'for'sde(Sec.7066;' -
Busmeatand'Professions Code:The Contractor's License Law does not apply as an 506 - GAS TES'lRequired Inspections,c• '` -'f°
i owner of propcny Who builds m Impmvea thereon,and who does h work himself
f _or through his employees.provided that such improvements ended or 507 - FINAL PLUMBING
ff . .._. . .._.. _._ . ..__.__.._. ., ...._. .. .___. _.
he
ng or
nent
,o ereJ ors le I(huwever twill havethe burden
provis so s'n - of ..,i , �.,,
improve on,for the owner-budder will have the burden of prav,n6 t he did not or
improve for puq,ou of u1eJ.
Con as owner of the.msec, an exclusively and Profession
iccnu
- _ consumer the project(Sec.]thin Business and Profusion odeJ The Co r, ,
,.
-- License Law gas nm apply to an owner of Property who 'mpm on, ' - '
'( .,nnd.who contracts for such.Prepetc.soult a.comW,tmI,)I t the
Conuactors License I,aw., 7
Ijl ❑I am exempt under Sec b ,B&PCfonhis o .i'.
Owner -
Data
.., .
_ - p WORKER'S COMPENSATION DECLARATION
I thereby effim,under penalty of lierjuiy one of the following declamsions:
° 1 hove and will maimaid a Gambino of Consent to self-insure for Worker's
• Compensation, u,provided for by-Section 37W of the Labor Code, for the /
performance of the work for which this pemm is round.
`- °1 have and will mvntnin Worker's Compenmtiominsurince,as required by Section
v 3700 of the'fibor Code.for the performance of the work for which this permit is
_'- -' y pe Insunnee'carrier and Policy number
C d M W°hefs Cem nut bra
'�'ec -o'.CERTIFICATION OF E%EMPTIONFROM.WORKBRC
',^__COMPENSATION INSURANCE' I3'.
(This senior need not be completed if Ne permit is for one hundred dollars . .
(Sltt)ar loss) '
_ __ _ _ _ .rm.: •... .m...o........ .ea..•.
s 1 cenpl that in,he performance of the work for which subj perm a Werke,1
shall not employ any person in aDole ter so u to become subject it the Worker'
Compensation Laws of California.:Dace'
Applies.[-
NOTICE suOAPo the Work If.after Compensation p Cisionsfi o of Labor Con.de,you mule ,�/. 1. . ,tin P,:"•
becomeh comply
the Worker's Compensation provisionsofthe Labor Code,you must
OZ forth nth comply with'such provisions or this perms shall be dared revoked.
CONSTRUCTION LENDING AGENCY
K: I hereby-IEm but theinis'a comm'ki on lend g agency for the performance t ..
ufthe okfr hch the Permit is tsoed(S 3N7 Cs CI
Lenders Name
L'Q
U. 'a Addrtu• - .. _ _........ _ .__........ ..—_ .. ._
U'.7..
e I agree th t 1 ha teatl tht ity and d tree thin the oto a laws
moon g
0 1wi oWil Ogg to comply it hefl,all city and county ordinances andstatelaws relating ////i`_I%,.rG/l'_�i"/\V/•'-' ".1/`—
-
OTJ thein,ongcossdct onanrherttiyamhonuposes. vu ofNsc,ymcnmr upon
the echo a me i orad property f inspection purposes.
,y judgme'bse a ndemNfy and keepwhich
h may
ss theCity of true against
vg min
Z, Cliabilitiest judgments.Cost.ad expenses h¢h may n any ay accrue against ae,d
Viz 'Cpp'ity n conseqPPILICANTuence of Neppgra t g of thio Perm t - '
~_ $OURCEREGULATIONS"D�AND WILL COMPLY WITH ALL NON POINT Issued by: Date
Signator of Applican,/Commctbr +' S - ""t tOam,• Re-COOTS
Cade Sebum . or
S lining c. DISCLOSURE - - "
pplidints r future buJding arcupm,s none dohattdle haaardous malend .Type of Roof ,. _ ..�._ __
sdefiWill thea (] P pur9lZ ,rad theHW,n and surety s -,. o .; ,.. ,.,. Pj: r••
nedb Ne CLpcn,ru Munm,pal Code Che
°4 ;3a'p 't °rvo T 7 All roofs shallbi; rispected.prior tp any roofing material being installed.,,.,_ ._ ,.
t Will the a lirant w,fuwrt oil in occu em Liu equipment or.devices which
PP B PIf a roof is installed-without first obtaining an'inspection,I'agree.toiremove
not hcerarJws Lir mnum,titits is deface b the Be Area Air Quality'Management
o y all new materials for inspection. Applicant understands and will comply with
°Yes, ,.t�,:,, 13 No . ...
d . all non-point source'r8gulahons:. ' , ( .,.•,.I:,, ,,,
1 have'on, ,rte haurdous'memnuh¢quirementa under Chapter 6.95 bP,lie
Califomis Heabb&Safety Code,Sections 25505,-25333 and 75536:1 understand that
If the building does not currently have a tenant that it iimymparrusibility to notify the
occupant of she requirements which must be met prior to Issuance of a Cartifieam of
Signature of Applicant Date
owneror:rmo ,d,gent Date, All roof coverings to be Class"B" or better
OFFICE ._ _ .. .. . .. ._. . .. . . . ._ ._. . . .__.. ...... . .