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BUILDING DIVISION PERMIT
CONTRACTOR INF,OOR A.TIOIY
BUILDING ADDRESS:
PERMIT N0.
19648 STEVENS CREEK BLVD
JK BAKER CONSTRUCTION INC
08080179
NER'S NAME:
PERMIT ISSUE DATE
EVERSHINE GROUP
2175 STONE AVE UNIT 11
09/22/2008
PHONE:
SANITARY NO. CONTROL NO.
(408)882-0199
ARCHHEETIENGINEER:
BUILDING PERMIT INFO
BO PLUMB MEOCH
LICENSED CONTRACTOR'S DECLARATION
Job Description
I Wrathy alarm Nat I am licenced under pmvitions of Chapter 9 (commencing
P
with Section 7") ofDivision 3 of NC Business mid Professions Cade. and my license is
REVISION STRUCTURAL RETROFIT TO AN EXISTING
in fail roan aad eff.L
Licenm0ua La.g
BUILDING WALL—ORIGINAL PERMIT 08050229 NO NEW
Da¢
ARCHITECTS DECLARATION
PERMIT
I understand my plans Nall W used u public reanrd.
Licensed Pnsfrssi.nal
OW NE. DECLARATION
mar.DER
taw for Ne
1 Wnhy a(Rm Nat I am exempt Bum IW Cssion.
o e: Any c
mama. (Section ]m 1.5, and Pm. Cam: Any city m
a, rf uu, d...t repair et..
which improve. d...Rh.
which -s a permit 1.re cnrea
On Applicant t fila ed urcro ,
Odormisiensedpalsont Wthe OneismaaOf for such titer ofileasignedsuamcm
its our
Out is licensed pursvmulW of thenBusinmrand (Chapter 9
Sq. 1"'[. Floor Area
Valuation
ofDM.W Code) Or
520000
andmimS p,thertimriandtebasisofrofNeBesircvaption.cai.vCtde)W
thu W u Nnsefmm and au basis for Be allegarr eaernptim. Any violation of
tuber
Occupancy Type
Sced..1.. ]031.5 by airy, applicant fm a pemtit subjcma Ne applicant m a civil penalty.(
31.5 b
fat m.m Nan BK W.amd aouaa (ssmx
3 6 9 0 6 0 0 9 .�}���
❑ 1, u owner Of the property. Or my wPlo,ces with wags as Neu ole c.mpenadon,
Required Inspections
will She WOOL and the swctum u trot intended or offered for sale (Sec. 7016, Busirum
tib Prefessimu Coda: The Conucmrs Linrtu law docs Out apply th an owner of
property who Wilds or ire proves therm.,am! who does such work himself m thmuBh his
own employees, provided Nat such improvements are not intended oroffened forale. It,
however, the building Or Impmvemmt Issold within am year of completion. the Owner.
builder will law da WAen of proving that he did far build or improve (o purpose of
Safe.).
El 1. a owrcr Of the property. am exclusively containing with licensed conualas in
construct the project (Sec. 7066, Business and Professions Code:) The Commiserates Li-
.
cave law does not apply m an owner of propetty who Wilds or improm Berton. and
who contracts; for such projecB with a conui ctova) licensed parsaant an Be ConVYtor's
Li.. Law.
lamnem In' der ,B&PCF Nis moon
-
61T2L(DX
w.er ✓ Dau
I WORKERS COMPENSATION DECLARATION
1 hereby, a1Em under penalty of perjury m of the (allowing declaration:
❑Ih[waM will malnuin.Cutif.ateof Unummulf-0vme fa wartels Compco-
ation, u pmvidW far by Section 3700 Of the labor Code, far the performance Of the
work for which Nis permit is iat a t.
❑ 1 have and will maintain Workers Compensation I.., a mounted by Section
3700.f Ba labor Code. far dm parfamanru of the wart for which this permit u issued.
'
My Workers COmpe ast.n Bmuance artier and Policy number art:
Caner. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
,
(Thu seed. aced trot W completed if de permit la forma hundred dollen (5100)
or mass)
1 catuty that in the performance Of the work for which this punnit is issued. I shall Out
employ any pa, in any men WW gc caIt dte Workea'Compenudon
laws of Calif aDau y, L�6
NOTICE TO APPUCANT: If, afar mitring dtis Cenifiau of Eaamption, you should
become subject in the Workers Compcnsudon provisions of On Uttar Code. you muse
comply with nen Provisions or this permit shell W deemed revoked.
CONSTRUCTION LENDING AGENCY
I Wrathy a(Rrm that there is a comtmeriun marring agency fm the performance of
the work for which INs permit u earned (Sec. 3097, Civ. C.)
Leaders Name
Lender's Addrea
i certify Nat 1 hose mad the, applicromn aM sou thu Be Now information is
comst I agree w comply with all city and county aNivncet and sus laws relating in
Wilding communion. and hereby authorim mprematim of this city in anter upon On
ahldhinkJodgra property for inspection purposes
(We) agree m saw, indemnify and keep harmless On City of Capartiaa agaimt
and expenses which may in anyway aa7ce against aria City
in caide;judgmenu, linu
Of the Ranting of this WIL
A
APPLICANT
APPLICANT UNDERSTANDS AND WILL COMPLY WITH All NON -POINT
SOURC ONS.4-4
Issued by: Date
_/ 1 Z L (' [
Re -roofs
Signuu afApphaHXDi,RD Or Date
HAZorfor. MATERIALS DISCLOSURE-
^ '
Type of Roof
WIII applicant or (muse hmudous material
Ca oaupamuore w Aad
4
da Municipal Ba
Sed y t Caperton Municipal Code, Chapter 9.11. and Ne HpIN and Safely
IS.
ode. 0y. 15531(x)7
Section 32(a)
❑res )�jN.
All roofs shall be inspected nor to an roofing material bei.
P P� Y 8 g installed.
Will Na applicant.' futurem Wilding Occupant uequipment or deviceswhich
If a roof is installed without first obtaining an inspection, I agree to remove
emit haurdnv air co amimmue as defined by the Bay Area Air Quality Management
all new materials for inspection.
P
District?
❑Yes fI No
1 have mail dre baarduce materials requinmena under Chapter Q95 of the CNfon
nu Hvlth h Safety Code. Smuau]5505,25533 and! 25534. l unmumrr Na ifdu Wilding
does fat currently haw . tenant Bar it as my nsportsiNlity in mdry use aavpant or the
nm7U/:hfy9mestWmetpriorromuanceofaCerfa.mofa
� ��ZiluY
Signature of Applicant Date
All roof coverings to be Class';W' or better
Owner Tamthomaaagent Data