01100069 CI saOF E
BUILDING c DIVlsN�
ioNPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
21170 CANYON OAKS LIFETIME POOLS INC 01100069
OWNER'S NAME: APPLICATION SUB DATE
AML BRAD & DEBBIE SNOW 910 SAN ANTONIO RD 10/10/2001
HONE:
(408) 738-1576 SANITARY NO. CONTROL NO.
G ce z ARCHITEC(ENGINEER:
Lu O"cut BLDG ELECT BUILDING PPLUMIi INFO MECH
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LICENSED CONPRACnder p DECLARATION Job Description
Z y O 1 tionhereby70 affirm Na I un,licensed antler provisions of Chapter 9(commencing p
; m is. f11iun]WO)ofDivisinnJoftheBusinessandProrodon'Cock.andmylicense NEW POOL
c y ac-! is in lull fora and eR C
=act0 u< Li<rnse Clas Lic.p
a.n u
3u3a. Date S DEC'-' RCHITECT'S DECLARATION
y
O 4 m my pl n all be oyd as public records
T
3 a pp 0 Lic Pro s at
m OWNER-BUILDER DECLARATION
u ='a I hereby affirm that I am exempt form the Conism or's License law for the
t R a following rt n.(Section 7031.5,Business and Professions Code:Any city no county $28000 2 8 O O 0
f o which y Permit t t construct, Iter,improve,demolish p y structure
a3°_' pct t t ' c 1 q 'res them
pplcant for such permit M signori sat t.
Nat has lb,rted pursajad thea tions ofth,Contractors License La (chap 9 t r', a e , Valuation
(commencing with Sect 11)00)of D' son 3 of the B rsmesy and Professional Code) (''g 1,I.� 5 9� ,e(ga i l Al i l z`}-,
or that Ae is exempt th relit n nod the bass Smile alleged exemptiod.Any violation
-of Section]031.5 by any applicant for a permit subjects the Applicant o a civil penalty'
of not room than five hundred dollars(s500). 10 3APN tV&r .r Occupancy Type
.❑I!as owner of the property.m my employees with wages as their sole compensation, ;
will do the work,and the structure is not intended-or offered for safe(Sec ]BM,'
.Will
end Professions Code:The Cmund mr's License law does not apply to an 107 - POOL/1301sladNfdddnsp'ections'
Owner of property Who wilds or improves thereon,and who does such work himself
err through his own employees,provided Out such improvements an not intended or 3 O 1 _ROUGH PLUMBING t
;ofrereasursale.If,huweve4the wadingorimprovementissold withhone year or - . .. 3O4 - ROUGH ELECTRICAL ,;
Wimple ion,Or owner-Wilder line w
der will have e hen or proving ghat he did not waor d
improve forpurposeof sale.). 502 - FINAL PLUMBING ENERGY
ol; own nfmaprop ny.'amexewsiveyeo tr dnewiNr«n a nn oath in 503 -- FINAL MECHANICAli-ENERGY
construct the Project(Sec.7Ba4.Business and Professions Code:)The Contacmr's
License Law does not apply to an owner of property who builds or improves thereon, 506 - GAS TEST
_`. ane who.cnntracts for.such projects with a commends)licensed putsuant.to the. -
CommctorYLicenseWwf, 510 -FINAL' PLANI
❑Iamesemptunder Sec.'" ' ',B&PCforthisrtason 511 - F .
owPer " are 516 - F INN
AL� BCU D 2 21 It�T
'- WORKER'S COMPENSATION DECLARATION ��� 2U7f
,lu., I hereby affirm under penalty of perjury one of the following declarations: Lp�UU
❑ 1 have and wilrmaided fa CcnifSecti n Clement to sdf-insure for Worker's BUILDING
( \ Compensation,as provided for by Section 3]00 of the Labor Coda for the
_ - perfa,mAnde'ofthe vomkfor which this permit is issued.
•" �: ' ❑I have and v ill'iniilaaa.Workv's Compensation Imtiran cc.as required by Section
c 37gl the laver Code:foi,he perforeance'of the work for which this permit is
is" d,MY W k isC p tan In urs c er inti P U y n mbe re
F No(/
Cis
1: g7FICATION OF EXEMPTION• OM ORKEf i.i�a � :!;',Is-I.;, E(L tY�tl t�f�'` S err
_COMPENSATION INSURANCC'1, 1 _
. . r _i. ... ._.. . . t `._
r,('i"icctioti ties';m bodom lnM if Nc . , .-;.,-,1.
(SIM)or less.) p Permit is lm one hunertd dollars '•l .t p„�r�� .i`,
11+r Y'I rt that mtti Performance of the kf M1<h thispet di .. .• ••. . . '• _ — iii x'91ti -�•-• T.
shall 1 mpl Y any pey sun n }J om(yibyat t the W k ii
Comps. do 1 f .D to 1
APP(
NOTICE fC �'lf t k g tRlR to tExemption,You should '-
Z becomesubjauo the West Compensation provisionsoflhe laver Coell must
0 0 forthwith comply with such provisions or Nis permit shall be,deemed revoked. '
CONSTRUCTION LENDING AGENCY -' -- - -
a'j -” thereby affirm Nat Permit is construction leading agency for Ne perfoimdnce
of
Ne walk fell which N.Permit issued(Sec.309];Civ.C)
,J t,''0 Lend .Na ..,... ... r. ...e. ..
.tti-z Lendcri Address••,..,„,..: . : ,:. .. ... . .. _ .. _. .. ....._. .... ._.._. ..
s I certify that I have read this application and slate that the above information is '
n'kT+jE.t coiled.)agree to comply with all city and county ordinances and state laws relating
0�[J to building construction:and hereby authorize oposentadves of this city to enter upon
>.:W the abom-mentioned,property for inspection paames.,
.ly (We)agree io save,indemnify and keep harmless the City of Copcnino against
Fr'IA liabilities,judgments,costs and expenses which may in any way acame agvns said
U .Zi City is can. nc<of the graining of th15 P tiC•-' -
APPLICANT .'DER. NDSAA '1 OMPLY WITH ALL NON 1
s e n s.." ,yiN�'� Issued by: Date
] ,,., P 'H OUS MATE LS DISCLOSURE. ' Re-roofs
o A p canUComr
a”'
HA or Name
RIA
l the a Ctieam o.Mum puildin ' opaht itore dr handle hizardotis material
as defined!ny the caper M );opal Chapt 9.12 Type of Roof.
Calc;Sea on 8 3z(e) ane th x lin aha surety .._
❑Yes . f :) s 'rl'{N; pi' � . 1 at .'1. t a,4 s. i..q'
All roofsshall be suspected prior to_any roofing material being installed.
Wrdth app)astio li t rewId,n t sceaAir t devices sem nt If a roof is installed without firs[obtainint an inspec[io"ri';I'agiee to remove
.OYs No -aA Quality Management g
myhu illus to tsesA byNBayA
°""' all new materials for inspection. Applicant understands and will comply with
all non- oitit source re ulations: ., r
' sIIh read lie hazard s. re'41 requirements and Chape 695 of the
p g
Cnli(om,a Health&Safety Code Section 25505,25533 and 25534.1 understand Nat
ifNeba"hug does not currently have a tenant,that it is my responsibility to notify the
captor of requirements whic me,prior to iasoanM of n Certificate of -
tw oz
Signature of Applicant
Date
:..
ren an ate All roof coverings to be Class "B"or better'
t� ...
OFFICE .. . .