02050182 CITY t DING DIVIISIONVOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
1496 ASTER CT GARY CORBETT CONSTRUCTIO 02050182
OWNER'S NAME: APPLICATION SUB DATE
FREDIANI VICTOR J 3 AND LINDA 413 ESMERALDA DR 05/29/2002
PHONE: SANITARY NO. CONTROL NO.
(831) 420-1148
PO6 ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
i I"' IJ CJ LJ
„2 LICENSED CONTRACTOR'S DECLARATION Job Description
0 Z g C 1 hereby alTirm that 1 stn licensed oder provisions of Chapter 9(commencing �a,��i C ,p p���'���'a
Phl-ty with Senior? of Division3of the aine6s end Professions Cade,end mylicense REMODEL KITCHEN sats,.ly�y +-9iT.yya�
IK$C7 i61n(all(o n�9 @sGO
O U License Cl c B Llc,a 4243*—”
Date Z Co me r -
c�0g am Ib g T'.rds MAR 1 9 2003
t69 O O Hud Professional
OWNER-BUILDER DECLARATION B'UILDI$72000n
1 hereby affirm thatOW 1 R-exempt from the DECLARATION
License Law for the
l=Z a following reason.(section 7031.5.Rusiness.fid Profcssiom Code:Any city or county
I F❑ which requires a permit to conswn,alter,improve,demolish,or repair any structure
m pnormrfisssuance,dsomquitnathe...Lcam for such pemult.Bk..tilted sutement - ----'-"
a.3--"I'a9liume,ed pursuant me previsions of Ne Convenors License Law(Chapter 9 ,-SIT.. y❑..a FI�Or ria ff ,.11 :.,f. w Valuation
(commencing with Section7000)of Divtson 3 of Bulineas and Profepsions Code) {`(�t's:h 3'O.D1tjO 4.?.���3g:L`rk::tl YQ�'+
or that he i9 exempttherefrom and the basis for the alleged ciempbo0.Any violation t
of Section 9031.5 by any applicant�for(pe;it subjects the applicant to a civil penalty w�t .m.sh,r,,`r Occupancy Type
of not more man five hundred dol en 5500. 101APN P'MUNDAT I ON f f \.
❑1,es owner of me property,ormy employees with wages a6 meir sole compensation. C V EIV S
-will do the work:and the swcmm isnot intended or offered for sale(Sec.70 4, Required Inspections
"
'Busmchw and Professions Code:The Comracmr's License Law does not apply m an 103 — UFER e 9 p
owner of property Who builds or improves thereon,and who does such work himself
01 md m
roupph his own employees.provideat such improvements are not intended or ...___.....1.0.4_r REBAR
'foT-ale:IL however:tM bdilding dr imProJemeht is sold-wimidonc yearof
ufigmd . .-,
completion,the owner-builder will have the When of proving that he did not build or 105 - ANCHOR BOLTS
improve for purpose of sale.). 106 - SEWER & WATER
. . . .. _. . . P. --
;. "oraa' hepmjcct(Sec.70",BcsinessandProfeinionsCode:)
licensed TeCoracumato 202 UNDERFLOOR PLUMBINGconstra
Lienee the oe,an(appplytoa Busmanproperty
ndpertywhon Cod )mpprvestmrson,secar's 203 — UNDERFLOOR MECHANICAL' •
License Law does not apply re an owner m ron who)lids or improves t 10.1,
1 and who conoacu for such Projects.wim a.contrmmd,)littnsed pursuant m.me. _ _ _. ... .___..-. ..._.._...__.. -
Comractors License law. 204 - UNDERFLOOR;FRAME " _"
❑lam exempt under Sce. ':B&PCfor lis reason 205 - UNDERFLOOR 'INSULATION
owner Data 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
" 302 - TUB & OR SHOWER
1 hereby affirm under pmaty of perjury one of following declamuom: 303 — ROUGH MECHANICAL
'r. ❑ 1 have and will'malntein'it Ceni ,to,of Comore m self-insure for Worker, 304 - ROUGH ELECTRICAL
Compensation, as provided for by Section 37M of the Lab.,-Code, for the
perfarmance or me work ter which mi6,permit i6 issued. 3 0 5 - FRAME
❑I have and will mainmin Worker'.Compensation Iniumame.as required by Section 306 - HOLDOWNS
37(111 of he labor Code,for the performance of Ne work for which this permit is
is eaMyWorker'sC p t Is'.�[tip andPolicy be 307 INSULATION
i7t it CERTIFICATION OFFJ(EMPNONFAOMWORKERS { ,;'•`:, q 3,08:_ i ,SHE2TROCK,.,„� ,i ..).,.. ,.` r
COMPENSATION INSURANCE " • 309 1- '_EXTERIOR"LATH '
Thissection need not be completed if the permit i6 for one hundred dollar
310 INTERTOR LATH .
311 - SCRATCH COAT
rm
I verify that n the,pe f ence of theA work for h thispe u i .' .. 3 1,3..':- -ROOF NAIL.';. - - .. .. . '. .
shalltil employ'any person m any manner au a6 to become,subject dame Wonder's 501 - FINAL ELECTRICAL' ENERGY
Compensatw
ion Las of Ca if mm.Dile
-.Apple t - —'- '502- - FINAL PLUMBING -ENERGY -
----
NOTICETOAPPLICANTIf aftermitkin,th CenifirmetifEcmptian,ypuslrbuld
z became subject to the Workers Compeat pmv6omof the Lab.,Code.yamu6t 503 — FINAL MECHANICAL ENERGY
fdnhwima.mplvwitnaamprovi6iona.rmhp mdana0b dam dmv.ked. 504 -- FINAL .BUILDING -ENERGY
_. . .. _ .
"^ CONSTOCTIONLENDING AGE Ncr .' 505 - FINAL ELECTRICAL
I hb Rmuhm th cont ct1di
Lenders Name . .0 agency for the performance
of the work for which mil�non is reread(s 3037.,Civ C.) „5.06-_ - GAS_„TEST, _ ... ... -,..__
0
L d sAdd 6 507 - FINAL PLUMBING
V O �Cem(y that)hoe reW this application and state that the aboe information is 508 - FINAL MECHANICAL
6a, c rrcct I g to cp plywith.11 ch,and c my ordinances a d state laws miming 509 - FINAL GRADE v
'0 to budding construction:and hereby Huth representativesof this city to enter upon
,W the h ve m nt oned property f r inspection put p. 510 — FINAL PLANNING
(Wgtgro,n , indemnify and keep harmlcs9 theCity of Cupcnino against
W lialothfies,9dgmcros cii ml xpcm which may to y eogiinst.mid 514 - FINAL UB C WORKS
V;Z Cry to cansegenceof th goftit' rr
.- APPLICA\TUND C N'I ALLhONI''f vr� Issue
d by: Date
9JURCE'RF t Z
Si i` of M,kcum/ nrac.r'�,” " . 1 ore, Re-r001'S
HA]ARDOUS MATERIALS DISCLOSURE
Wllm appl t. f mm bulmng occultism tore or handle haaaNrius material .-Type of Roof ... . .. �, - .._.
az darned by the Cupcn no Mum c pal Code Chapter 9 12 and theHalm and Safety
Code SOeeYP 2ssJ21 1 No f),I t f`t M s J - ^-.I /!l ` id. '\'i'�S h' '
All roofs shall be inspected poor to any roofing material being installed_Will the aPplilert or{'urate building occupant use equipment or devices which If a roof is installed without first obtaining an'inspeetion; I'agree to'remove
emtheamdoua air containment el dbym Bay Are A Quality Management
Db,t n. all new materials for inspection. Applicant understands and will comply_with .,
❑vea 1014a' all-non-point source regulations: - -
.I '1 have read the haterdousimaterials requirements tinder Chapter 6.95 of.the
a
Chliforni.H..Ith&Soler Code,Seation625505,25533and25534:1 undermandlhat
Y ... .. _ ._ .. ..___
ifthe ebtiila does nim cuneml .¢tore, tis mu'umceresponsibility mtirym the
occupant of me¢quire me riot to issuance of a enifi.te of
Occupancy. j
xP/ Signature of Applicant All roof coverings to be Class Date .
g "B"or'better '
,h
caner or authorized agent r. ' Data
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_ --OFFICE - _