02050032 CITY OF CUPESION, CONTRACTOR•INFORMATION:
....,. HUILDIIsl a DIVISION, PERMIT
BUILDING ADDRESS: ' PERMIT NO.
10149 S BLANEY # 3G WALDRON CONSTRUCTION COM ANY 02050032
�L�ICAILTMORE APARTMENTS P O BOX 598 APPLIC TIONS BDATE
0507/2002
PHONE:
(408) 377-8186 SMITARY NO. CONTROL NO.
w O pOARCHITECfIENGINEER: BUILDING PERMIT INFO
UkJ BLDG ELECT PLUMB MF;CII
-', r7 L7 L_J
,S y, IJCEhat I a CONTRACT'OR'S DECLARATION lob Descr] tion
jZ-p Section
7y mfirmmmin 3 Of
he Business
provisions Of Chapmr9rmmmencing INTERIOR RENOVAVATIOIr
mew with Semiorceand of Divi on3of me Businessand Rofeszions Code.end mylicense
x y,< is in full force and effect,si
0V Licari Class
LIc.I KITCHEN/BATHS REMODEL, NEW WASHER/DRYER &
134" D"` Contractor WALL A/C/FLOOR
so
ARCHITECT'S DECLARATION
'a;O.g ""I undersand my pions shall he uneJ os public rccnnls
,Licensed Professional .
X 3 iec - that I a exempt from
DECLARATION
I"-y - I hereby,off foot I am exempt from m<Contractor's License law for the
t_ a following reason.(Section 703 .5.Business and Professions Cade:Any city Or county
"O
which ne,ninas prmutIrov,,r , atcl.holovo,.demolish, P y fracture
i 3 Prio , 1 , al q ,he PPI'antf bpe 'u fl g ed m,m ,
Incl he is licensed_ *ov ant 16 me -' .rmeLnaIa (Cn pm 9(commenting p Se t 7000) fDs J m Business fa. CJ)
LJ id xS:Q
' FSt.lFlGot Area
Or that h exempt m and he b is fohe alleged eY
Q ] i
.
-.
$--3 4-
0--0- ._a.tion
f5 un by by applicant fora permit subjects Ne°pI
almr
mnmmmethanhennnmrma5oo) civill cmm a penalty 369 �Wbgr
❑1,as owneroftey.omyemployees with wages that; s compensation Occupancy T_
ype
will do the work,and
dthe structure
ru ' not intended n ad or sale(Sy 70
44: FO
NALIgan
a Profcsions Code:The Contractor',License Law d not apply m an 101 - FOUNDAT �lred IISpeCtlOnS..ne -rampantlyWb Id 'mprvesme and whod ch ,it n
ff
Orth, ghhisOwmply provided tlnt himprovements t' teadedor 102 - PIERS
Offered r - m lrn ld th building improvementis sold withinnneyeaeof JUL, 24-2002
completion,th rbu ld will have the burden fp proving didn not or 103UFER
mposafpm ' .rsale.) _
ar
104 — REBAR
as C m-tA r rt ehoraw - 105* ANCHOR BOLTS — -BUILDING—,
t ,the Project p(See 7044 Business land Profession'with
The Commcmr's t - -
icnuse
Low does nota to on owner o epeby who builds or improv,ea mercnn. 106 — SEWER & WATER .
[: and who contracts for such cods)liccosed.pursmnt m,he.
Comracmra Licenajovi. pmPer,y .202 UNDER FLOOR—PLUMBS�NG- -
P1
❑lalnexe,ntynnersee. B&remrmiarcaaon 203 — UNDERFLOORI' MECHANICAL
•ow"" Doti S=9—�Y 204 — UNDERFLOOR FRAME
gpUu Fp RNYN PENsnnoNncc nRATTON 205 — UNDERFLOOR INSULATION
o l have
incl'aalffAirodim.ril,penacl,r.r per;,,ry ori or n,�rallowing aeelaration.: 301 - ROUGH PLUMBING
snttoseinsurc for Worker'ss
3 02 - TUB & OR SHOWER
Yom• Campenaatiov, as Provided for by Section 37M of the Labor Code, for the
Performance of work f.r which his Permit is i,x.,L 3 03 — ROUGH MECHANICAL
❑1 have and will maintain worker.Compensation Insurance,as equimd by s&ran 3 04 — ROUGH ELECTRICAL
3700 of the Labor Code,for the Perflimance of the-work'for which this permit is 3 0 5 - FRAME
lisp ad.My Workers Colnpenshion'Insurance amnia and Policy number me '
306 ,:— OLDOWNS'H ._..-... ..- ... — , _
• Policy No,' t ,•
CERTIFICATION OF EXEMPTION FROM WORKERS•, - b, '.a• l3[]7;' '„•Ff•INSULATION}',4.1u'
. COMPENSATION INSURANCE m` ' t -
-308_---iSHEET'ROC.K,...--- ---..-..
m l ci an need n be complemd'f the peri, s for one hundred Jolters 7
(slop) neaa.) 309 = EXTERIOR LATH '
310. —'.INTERIOR-.LATH
1 n'fY,h lmihep f^o° ann'Ih' kf'r wh ohm pmft is"ssued'I
of
'shall o,_ ploy y tiers. any "e so as to become subject t.the Workeri 311 — SCRATCH COAT ' , '
ComPc sat On Laws of Cal f m s.Date - '
Applicant
NT . .3,13. — ..ROOF_ NAIL_....
NOTICE TO APPLICANT If after k g,hsC of mofExemption, - - - -
you should
z bccamesubject o,heWork r Cmn,pachasalion provisions afthe Labor case you most 501 — FINAL ELECTRICAL ENERGY '
z fo"h'uhcin,-1;with suclp n,'Ou or(h p 'I shall be red .keds
� ___502 — FINAL PLUMBING ENERGY
-CI A
E„ - 'CONSTRUCTION 1.ENDING - ' 503 - FINAL MECHANICAL
m
' Bagcnc for the performance' Ih by ❑ ,hat0e c , , nl Jn
w Lent SAarwhichm' t ,.,aw(s .3097 civ c.)Y ° 504 — FINAL BUILDING ENERGY
c '505 FINAL ELECTRICAL
o die k
Lend N
.dress ... - �� -
C 1 ccnify mat I have read this°,plication ann nam mm me above informaiion is 506 — GAS TEST
0w E, correct.I agree to comply with as qty and county,ordinances and nine laws relawg 507 — FINAL PLUMBING
.f) m building amstruelion.and hereby°mhmirepToxsentaives of this city,.emanation
}} w_ me above.mentioned,Propeny for inspection purposes
- 508 — FINAL MECHANICAL
L.0.i: (W )agreemsav indemnifyand keep hfoie ,he City' rC p neo against
''rr vy
liabilities.jachaderns.ofn, dexpenseswnpn y nany way c against said 509 - FINAL GRA E
U'r� City I c q c<of me gran, g finis perm t S 1 0 N NG
'SOURCA INDE SANDSAND WILLCOMPLY WITH ON POINT'
soulteei EuaA ;' �`�_G� Issued byl _ Date
signorine of AppncandContmcmr J. . .Dice. Re-roofs
' HAZARDOUSMATERIALS DISCLOSURE
Will she applicant or forurc hillding occupant store of handle haivddus malarial
'
as refined by m C Pam" M I Coda ChaP,er 9,12 m d m H ❑b J Safety
Type of Roof
Code.
Snd ,255i2(a)v �yr/'J' (..i r. . . -
Elyes
` All roofs shall be inspected• nor to Jany roofing
want .applicant hiphire ee , - .matena erg installed.
go p y p m a i< If a roof is installed without first obtaining an Inspection, I agree to remove
n heard us a rnnmm n as demed by m Bey Area A Quality Management
all new materials for inspection. Applicant-understands-and will comply with
all non-point source regulations.
`- - -
er+' 1 h etread the intentionalm,rials requirements under Chapter 695 of the -
Caffo Health&Safety Code,Secans25505,25533 and 255341 understand that
if me building does not currently have a,emm.trial it is my responsibility to notify the
.ccapan,of the icqu'rsour s which must be met Pro;to issuance of a Certificate of
c
-
. CCentrality. .. ,
Signature of Applicant Date
owner , m sed agm, „ o-te All roof coverings to be Class •`B" or better
:. OFFICE