01060025 .CITYBUILLiN c DIVISSIIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10130 CRESCENT RD FOUR SEASONS ROOFING 01060025
OWNER'S NAME: APPLICATION SUB DATE
• TOY ANTHONY AND CHAN GRACE K 645 HORNING ST 06 05 2001
/ PHONE: SANITARY NO. CONTROL NO.
(408) 278-0330
,2 V ARCHITECT/ENGINEER: BUILDING PERMIT INFO
U BLDG ELECT PLUMB MECH
I7 y i LICENSED CONTRACTOR'S DECLARATION ]Ob DCSCTI Il ❑
i Z_L, 1 hereby off rm that I am licensed under provi.ions of Chapter 9lcommencing P
m F-s with Scelion)00o1 f Division 3 of the Business a a Professions Code.and my license
o W V , cn^<ilca=an n`'`t3 u<.. z-1 O RE-ROOF, 20 SQUARE F ET
1 0 LL 'el[ Cnnlmctnr
ARCHITECT'S DECLARAT Oh
1 tod—o nd my plans shall be used as public record,
�a
P L<cnsed Padcssmnal
om
OWNERt eoconDGR DECLARATION
I greasy,(Seth that 1 con efrom the Contractors License Low for the
followwhich ire reason.(Seaton]onsorBusiness.atr. and Paldemols Code:Any city or county
x C which requires u permit m gastrum,neer,improve demolish,ore It so any structure
u 3 m prio t t I. q ell inion t f n pc I n is L ( ,the t -- - _
mato sl . on a trothp ,. . nn Contractor sL L (Chapter 9 $ Ft Floor Area
(commencingwlhschn omandthe theca ilio re. a Code) [ 9 p r.t,.r .;t. .• $6SA@anon
or that the is exempt nhn cram and the basis for the alleged applicant
on.Any iviolation Pealty .
-of Scnion 903 LS by any applicnm for a permit subjects the applicam m a civil Penalty
or not more than Fie hundred dollars($500). 3 2 E64f`bNAA Ib Occupancy Type
❑I,as owner of the mipcny,or my employees vrith wages as their sole compensation.
will do be work.-end the'swcturt isnet intended or oRered for sie'tsec:')044;'
Business and Pmfesxions Code:The Contactors License Law does not apply to an 305 - FRAME Required Inspections
es
Owner of property Who builds or improves thereon,and who dosuch work himself ,
or through his own employees.pmv,ded that such improvements are no,intended orINSULATION- '
-,offered for sale.IL tiowever,the building or improvement is sold within One year or 3 O 7 ...: . --_._.,
completion,the owat,builder will have the burden ofproving that he did not build or 601 - ROOF TEAROFF
mprovemrpngro or le.l. .6,02_-.-_ROOF..PLYWOOD _NAIL
--- owner of
- - — ---
❑L commo eItheof the pmpeny,am Business
comaaing with rd,)The
m -
.: _. Ueensiet me present Tapp. ;a a,owner of arta emyPnvwho
illi or The centhemod. 603 — ROOF BATTENS
License Low does notapplysuch
man owner h property woo builds seimproves thereon.
_Cotwht ,eLicensTLrw nprjems.whmanenantonsl.r«n apnrsnantao.me. __ -. 604 . -._ROOF._IN-PROGRESS .
0
Contractor's License Law. - •u o, -
Of..exempt under Sec.- _,H&P C for this reason jn^,• .- /�/
Owren Date"• fl�
WORKER'S COMPENSATION DECLARATION
-I hereby affm,under penalty of perjury one,of thefollowing dccbvazimis:'
yy ❑ 1 have sI muirltim a Csnifcam'Of Consent I.self-insure for Worker's
Compenmtioq as provided fill by Section 3900 of the Labor Code, for the
PetPornmnc:of the work for which his permit is issned.,,ir.•
❑I have and will In3lntain Waikcrk Cnntpcmafiun Insurunie,as required by Section
_ 3700 Of he Later Code,forthe pmfunnvnce of the work for which his permit is
s u pe f I rat c and Policy be e.
,� Y CERTIF�y Pat ieYN .W�'�y/���'/. _ .... .. - ..._ .e
C m 'R�•k(1
ICATI N Of IiXEMP`flON FROM WORKERS eb1. e•� �. 'f 1/. ' .,r %h�, q , ;Y�h,� l t
_r-r}...... 1 ._COMP' Permit is for ....................n,�..-...-___._..�..._..._._�_...__ .
.._ SATION INSURANCE"', .r.�...__......_.. .. .. ..........._._.
—.-..
"' n t'IThis action nmd not be completed ihhe one hundred collars
fSIOD)or lea.) - "
r.'. - - . .. _... _.- ...._ ...._-...... ._--..._- .
s 1 nfytht nthe Performancethe work for nesPermitis"swcd I
shall not employ,any pe on in any manner so vx to become mb3ca to the Wodcis
Compcm.-- Levis o.Cal ifomia:I)me
Applicata._:....,. , .,.
., r.. _.-. . .. -.. .. .. - __ .
NOTICE
Q ' TOAPPLICANT.']
YT aft making this Ce mofE pC 'kyM;u.uM1ould
Z fico it ub3 nodheWrdea C t pro sito of the lobo Cod you mus
les.,Q forth th ply with s<h p ms orh permit shadlibi,
- " '-
--
-N ..' :•• '"' .CONSTRUCTION LENDING AGENCY' ": .."• - . . .- __ _r_. ... . .-. _ .-
x-7 "I herebyaftinm that then isaronstmctionlendingagercq fordbeperfoimmme „
G 'tender's Name'which this rennin ix issued(Sec.309).Civ.CJ
. __...._ ...,,_..u._..,.. ......_.... ..,_._�.._`_•_ --_._.. .. ___
Lehders Addrtss •' i . -�
U 0 I certify that 1 have read this application and slate that the above informe, is
w'Fr counsel.I agree to comply winh all city and county ordinances and state laws relating
O'V to building construction,and hereby-ivodii ze'reprcsemdtives othhiiciry mentor upon
the above-mentioned pmpeny for inspection purposes.
rE.=h IWq ugreeamre.indemnify and keep harmless the City of Calruno'aginst
h Iiabi lilies,judgments,cot d expenses which may in any way accrue against said
U City, co n<c oh g tang of cis permit. /(
APPI CA UNDIr. to
'Or
�S m/ Issued by: Date
signal re rappfcr,u/c I vm .- ':�` . . ',i..,.. .Danz.;.:,.,
HAZARDOUS MATERIALS DISCLOSURE .I RO-IOOfS
W II N pprc nt future latildfin,occur n soom or handle n sof tenalT e of Roo
sdefinedbYth CPn Mu cplCode,Cheater 912 and he Health tlgfic YP
COct.S❑ecY 25532( la f sxt. s r
All.roofs shall.be mspected.prlor-to any-roofing,material.being installed..
'Will to t f t building gp use Occupant equipment g vires worm If a roof Is installed'without first obtaining ani'inspection; Lagree to'remove
it courtrooms ircontaminants
tnm is as defined by by theBay Area A' Quality of nag m t
°sec all new materials _r ins ecnon._A licant understands and will comply with
Ores. �N P .- PP
all non-point so ' regulations. .. -
Plare omd.ffichaimadmil'roam I relumnica,anile Chart 695 of Ne '
Ca'or H Rh&5 fetY Cad Sect 5505 25533 �25534C nd ran nd th n
I
h bu 1ding does not currently have a tenant.that it is my responsibility ori jy nee
I
of the areae ech must he n prior to issuance of C nifcam of
pan
Signature of Applicant
gDate
vireff m oat onmd.,car Dgte . All roof coverings to be Class "B" or better
:.' .... - OFFICE . ..