02040156 CI BUILDI G DIIVIISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10849 BARRANCA DR 02040156
OWNER'S NAME: APPLICATION SUB DATE
GIBSON & MARGIE HATTERY 04/29/2002
it ?HONE: SANITARY NO. CONTROL NO.
s Z ARCHITECTIENGINEER: BUILDING PERMIT INFO
uOj O BLDG ELECT PLUMB MECH
a U r-) L._j I
r. LICENSED CONTRACTOR'S DECLARATION
o L- I thereby million'hot 1 am licensed under provisions of Chapter 9(cammencing Job Description
�,Z_ntv�i with Section]000)or Division 3 of the Business and Prcessmes Code.and my license FENCE (8 FEET)
SS is in full force and effect.
1 at W License Class Lic.e
o O a Date Contractor
uO�' ARCHITECT'S DECLARATION
,g I understand my plans shall be used as public records
i t
1 a O O Littnud Professional
'%R OWNER-BUILDER DECLARATION
tiWt 1 hereby.furan than 1 am1. exempt from the C Professions
o License Law for the
C < following mown.(Sutton 7031.5.Business and Professions Code:Any city or county $4500
I ❑
which requires sissuupermit t co.tunoberimprove.demolish, fieatirunyumcmrt
priorwklice nce,also rcgmtesthe busuch Con emu?roicen n redsutemem. ._..... _ _... . __ ___—
Natheieftt,vW pursuAniro lr4 DN isrons of Ne Conwctofs Land Pr Lew(Chapter) _ _
Icomme c n6 with t dm amanofhe W is 3 of the Butanes And PmfA ons Code) t I`, ,-A. , r' n , r i ,v4: Valuation
or he Is exempt therefrom and the Wmx for the o11egM er)dnpubd.AnY violation
-3�'���-����°���` �'l l s�"
-of Section]031.5 by any applicant fora Permit subjects the upplicant to a civil penalty {e�
'o(not more than five hundred dollars($500). 101 PN DATION ' "''"I Occupancy Type
01,as owner of the property,or my employees with wages as their sole compensation,
Businell ss
s anwa,6h' nd stirs Coca:The is not mmnam ene Lawered does snorts«:]Baa, 10 3 - UFER Required Inspections"' ^'I
Business end Professions Code: int sthereContractor's License Law does not apply m an
owner of property em builds m improves thereon,andmpr who dor such work himself
or through his own employees.providedthator
such improvements see ria intended or -,_ - 104 - RE-,BAR _,__„--__.-_-_.
rii is sold�wiih,n one-e i of -��'_. _ .__...-- _ _—_.___. ..__.__.
-.cornpldron,theowner m will
v y 105 - ANCHOR BOLTS
'cempleuon the ow ter b Id r JI nave the burden f proving that he din not bold or `"
improve for purpose of sale). 106 - SEWER & WATER
oas ons, herofthepropny,amexdus,velycommningwnhl¢enWconwcmrsm 202 - UNDERFLOOR PLUMBING
1,7.
1,
conswn the project(S« 7090,Busm«s and Prof«uom Code:)The Comnpmr s .
License Low does not apply to an owner ofpropenywho builds orImproves therenn, 203 - UNDERFLOOR MECHANICAL .
and,who contrusn.for..such.proj«a with..o.comncmrtaLlicensed.puresent.ta.the .._ - - __......-.__...._.. - .
canwnarl Irene Low. ..,. 204_.__._UNDERFLOOR--FRAME
L 0❑+/`!I—emJ,/,exempt mod,rSec ,7/"///y/�B'&PC(emirrep:an 205 - UNDERFLOOR"INSULATION
_ `v " - R ERhahae
Coy HN ONDECLARATIN; 301 _ ROUGH PLUMBING
L/ /] rm30.2 BITt7WER
Ih thereby alTmm ser pe y.of Rj ryone of the Toll gd 1 , posse (tP 1+ 3-03 ti (I 0 MEC KCAL
❑ I he a andwill maintain e Cenificam of Consent to self inure to'W kers (� P
Compensation. as provided f by Section 37M of the Labor Cod !fcr,the 3.0 TRI' AL
_ performance o(the work for A hJhis Pc t nsucd .Vl 3.
01 have end will mvlmam W 1mr s Compen tion Insurance ea regwred vSoon 306
OR
3700 of the LOM,Cale for the performance of Ne workf i which ihi kn ut is 1
issued My Worker's Compenast on Insurance carrier and Policy ber aFll 3 0-7
Cal ..roheyNa. -3018` v$HEETROCK .__..
CERTIFICATION.OF EXEMPTION FROM WORKERS';" - ( (�f`' = t309ltttEXTERIOR'LATH'
COMPENSATION INSURANCE, "
-- -
oesem *'INTER - ._...
(9 M) hs en need not be cnmpleteJ J the permu -31-0; IOR-LATH
is for one hundred dollars 3.11 - SCRATCH COAT
-. . _ _..,
1 ttnify that m the pcifomwnce ohhc work f x which this perms n issued 1 313`"' ROOF' NAI L ( ,,, ,; -
shalrnot employ any person in any masse"..as to became sabj«tis mg Workers, 501 - FINAL ELECTRI CAL 'ENERGY'
Coinpen aeon V s of Califon 'Data I•
Applicant 502----FINAL--PLUMBING- ENERGY----.
,NOTICE TO APPLICANT If,after making this Can fcme of E empt on'you Nrould ....
z necom subjnt th'Wokdl Co pcnseuonpron oftheLabo Code.yen must 503 - FINAL MECHANICAli"ENERGY
OO r17dnn m mply ''tnsuch proiinsaetmaPermit anallM1eeumWrtoked. . FINAL..BU
ILDING 5 4 505 FINAL ELECTRICAL ENERGY-...
CONSTRUCTION LENDING AGENCY _ l + 1
i 1 h hy'Tran that ibere I, command.a lariding agency fee;be peofixrtfismca
ofthew kfr hich,hi, mu'tst ud(S 3m] Ov.c) 506 - GAS TEST
yy Lendee.Addeas 507 - FINAL PLUMBING
U'O I agree thatone hall y andonanandinaretheaboe f anonis 508 - FINAL MECHANICAL ^(�
1.Wilding
il 1Ogreet comply shell city andcounry Ord nm d t t 1 enter
atxm 509 - FINAL GRADE
O U mbu Id gco i t randherebyspectirepresentatives of this city.to enter upon
yyaw theM .)agontopmpeny for npentonp rpo 510 - FINAL PLANNING
L� -(We)egrterosave,indemx,and kehihomaya.thewayioCupertino agarose -
L6se Vi Ci ay!iun,judgmants.ensu end expenses which may ip tiny way accrue against sora 514 F INA PU I C WORKS
U'7J. City in aonsequcnce oRhe ggmntinB of Nii permit.
5 P7EICANT UNIpE itDSRh'D WILLCOMPLY WITH ALti NON-POINT' Issued by: r Date
r. attire drApp'an ""tor
. I:' ❑Ynensn_z5'sp32f al C,' '
Re-roofsHAZARDOUS MATaRIAL§ LOSURE
theaplicantor future Type ofR
toof
Code.defieWW1iby HealthndSofety
sec
All roofsshal.rbe- Inst pe-ct—'e°d
..
- '
prior to any roofing material being.mstalled._
r .
Win theaPpI p I orTut eb Id' to opera useequipment devices which If a roof is installed'without first obtaining an Inspechon;'I Bgree.to'i'emove
t t haxalloua 1I mammants es d ed by the Bay A a'A Quality M nagement
e. mei all new materials for inspection. Applicant understands11-1and will comply with
"' oY " . all non-point souice`regulations..
Ilhave�eaa me nate Otis maierials no:Iuh col,under Chapter 6,95 of the '
California Health&Safety Code,Sections 35505.25533 and 25530.1 understand that
if)he building does na curtenity have s wision,that it is my responsibility to notify the -
'occupent of the rejuiremlpts which m st,M1a'mn priono issuance of a Cenifute of
Pe II + _ Signature of Applicant Date
er or
It a m itDam.: All roof coverings to be Class "B"or better
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OFFICE-
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