01070026CIBUMFcDONO
IVIISSINPERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
3 INFINITE LP 3RD FL
SOUTHBAY CONSTRUCTION
PERMIT NO.
01070026
O}yy)<Ij,S,JdE:
FAiii1L1L
511 DIVISION STREET
APPLIC TION 5 B DATE
07,10%2001
PHONE:
(408)379-0400
SANITARY N0. CONTROL NO.
0 ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
w
r I IJ I-- t GJ
LICENSED CONrRACFOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions or Chapter 9 (commencing
Job Description
TI (299.5 9 FT
5 S Q )
with Section ]00find Division 3 of the Business and Pnsfessions Code,rd my license
is in full tone and cRem.
License Class Lic.k
. . .
Date Contractor
.fi HITECrs DECLARATION
n r n, f 11 be used as public records
,r
3/
Q
Li.AseYrofessional
O R�BUILOER DECLARATION
1 hereby affirmt am exempt form the Contractor's License Law for the
Y
(S
following remon. eco ]03,58 Business and Professions Code: Any city or county
which minims a permit to constmn, alter, imporve. demolish, or repair any structure
'
-._priono in iscuanc<,also require theappheirs, for such permiuo fileasigned smmmem
ly..,...I a7 ./ i
7 31SAOP�,1�Prt ��
..\s[4.is ,{s't
t
t Valuation
that he lS limnsed pmsuhnfid Elie provisions of the Contractors License Low (Chapter 9
(commencing with Senion,]t1f10)of Division 7of the Business and Professions Cade)
or that be is eseiM ez
mpt therefrom and the basis for the ahijemption. Any violation
-
of Section 703 P.5 by any applicant fora Permit ubjects the applicant to a civil penalty
.of nor more than five hundred doum, (a50).
101APN ftIO9DATI ON
Occupancy Type
C1 1, as owner or the property. or my employees with wages as their sole compensation,
102 - PIERS
!
will La - the* work.-aad the structure 15 not Intended or OR<Rd'for sale (Sec. 7W.
Business and Professions Code: The Contractor's License law docs out apply to an
10 3 - UFER - - -
Required Inspections
owner of property Who Wilds or improves thereon, and who does such work himself
104 - REBAR
ar through his own employees. provided th t improvements t intended or
-
;completion.me vn it to building" p ement.vola worn yer or
pr
_ _.... .� .'. ... _. - _-...... _._. ..._.._
'...._.105 ---ANCHOR BOLTS .. ,; ..
Imnove on, thep.sc ofbti Iter will have the burden of proving that he did not WiIJ m
not
mprove for pmpnu of ante.).
I
106 - SEWER & WATER
❑l.aanwa&,rine - n y gw;- --- _
-- s--Y_..n-e . - -.comm-ntract
P ennimetin with ss
-"- - - - -...-- -
. _.. - _- UNDERFLOOR --PLUMBING- - .. C L::.•: : Y .:
7044. Basin...
_ nsunmtheproject(Sec.]octanBusinessproertywo cWo:jThevesthermrs
Ths, Cmiussd
License Law does not apply to an owner of property who fids or improves thereon,
a
203 - UNDERFLOOR MECHANICAL:r tr
..ana.who.commns tor_sacRprniects.wnh a rnntraemdar.fi,ensea wanton, Ea me
E
.2.04... __UNDERFLOOR...F.RAME....--
Contractor's License Law..
❑Iameaemptorder See- I''_.,e'&pCtartufartean
205 - UNDERFLOOR?'INSULATION
Owner r Date " '''
301 - ROUGH PLUMBING
WORKER'SCOMPENSATION DECLARATION
302 - TUB & OR SHOWER
Iherehyafrtraanderpepahyml— n�Pfinefolowingderbatinm:
303 - ROUGH MECHANICAL
❑ I have ond'will maintain olCeniticme of Consent to uff-rnsnre for Worker's
304 - ROUGH ELECTRICAL
Compensation, as provided for by Section 77W of the Labor Code, for the
perfonnnnce of the work for wiitch oda IKrmit Is iaagen.
305 - FRAME
❑ I have land will meibwin Worker's Cmon riauon Imma
unce, s iequired by Section
3 0 6 - HOEDOWNS '
7700 of the Labor Code, for the performance of work for Worm this peroin is
-
307 - INSULATION
issued. My Workers C ce cation Insurance and pot arrive are
-
308 SHEETROCK, - _
Can r CCRTIFICATION017EXEM"IONFROM WORKERS j'
--
f,11 A3 65 k 'EBTERIOR.'liATH
,._ cgmprrysnTloNlesulxnNge ..
_ .. ._ INTERIOR ---LATH.. -.-_ ....__._._.....
310 -_.
rinlatedn,dneeano�Gecamplerect-nnepem,itiarr,nenanareaammn
,. it, ,l r_I�.tr' l .-1.•.
311- SCRATCH COAT
tsloor 1 1
.„
_ 313 ROOF..NAI.L _- -
1 cem fY th t' ter pe f mmnce m r k f r h h u ce r is oven'
`stialintemply .6, person n nyman -,enbemmesbl n,meworken
501 - FINAL ELECTRICAL`'ENERGY
Compo t nlaw.ApplUmit.,pfe t r,.,gme,
..502 - . F.INAL PLUMBING ENERGY... _ .
NOTICE laOAPPLICANTIf,Cu,sukmgih'Cmra.fire empicalk.y Fhould
dubject m the W orkeh Cnmpensm on provivons of the latior Code, you must
503 - FINAL MECHANICAL�'ENERGY
jbecoine
fn:d,wim<nmplywitnsachpm�i,mn.nnhi.pennu,nanxdammt<,r,k<d.
5.04 _- FINAL BUILDING ENERGY
-
rco4srft C 1oNLENDINGAGENCr '
-- ----
505 - FINAL ELECTRICAL
I hc,byatfum that there is a consomaction lending agcrrry for the verfrnal
't
506 GAS TEST -'
nLfenihders ArkJJf'mres.�h'Ieh Edk, ....
edSCc..l.0,9]GmCI
Lender'sNa;
.._._,... .....507 FINAL PLUMBING .. _.. .....,.' ._
(•l:
508 - FINAL MECHANICAL
l certify thatlhwc mad this application anJ tram thauhe above information is
cones. 1 agate w comply with alPcity and counry,Ninancclouds..., laws relating
509 - FINAL GRADE
to building connrdation, and hereby authorize representdtives ofthiscity reenter anon
the above-mentioned porpenpur
y for inspection poses.,,
510 - FINAL PLANNING
(wet agree to cove, indemnity and keep hamtlessme Ciiy of Cupenioo ii,insE
0
514 - FINAL PUBLIC
ah I't j Ig rcntc, e t ay 1 e h h t Y -in nnY Y gain t lad
Cit '_ yethey �ynl thsp .t
APP,y
+, IU F T (NDWILL CoMpUrz N� WITH ALL O
. INTr
s R
Issued by: Date
.: D
5rignatrc ( ppl nlut o W
1
HAZofs
A OUS
MATERIALS DISCLOSURE
II th 1 pl'cant hourt b Id' g P t t m chanJl haiaN s m i I
Typo Of ROOF -
asdfndbytheCupsn Mn plCsd Chpt 91],:ndthe HeliltondSftY,
Code Section255J21a]
,, t s rt,,
'' c n
❑Yes r a{':1 i't1
a".vY ♦: i s
__.All roofs_shall be inspected prior to any.ioofingmaterial being. installed.,_
;.will theepphrourn or future Wilding ecculti equipment or devices which.
If a roof is installed Without first obtaining an inspection, I agree rto Yemove
. emit haindo sair contaminants as defined by the Bay Area Air Quality Management
or,
all new. materials, for. inspection Applicant understands and will comply with
1 .-, ot
all non -point source regulations .,., .
.l, I tra mater, requvemema
pun
' n
. Health Sat Code. 2 d 25534.
255A and 25575. 1undemand that,
that,
fomm Health & Battery Code. Sections...
t Ne buJdtng daci nOwurrcn arc a tenant, tom iE is my mspodzibiliiy m notify the
0a
'occupant
.. -
men
e rc tch mus" he met prior m issuance f a C ific'to of
' '
.Occup
.:. :"
7
Signature of Applicant
_. '. _.. Date_
All roof coverings to be Class `B” orhetter';'
m 1 < n <nt
on g .., :,/•„„,..:-. �Dore
...H . .. ...._.._.._ , ..__ .. -. OFFICE._ _