00120110 CI TYOFNG DIVISION
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRnSS: PLRh11T NO.
22140 WALLACE DR TUFF SHED 001201. 10
OWNER'S NAME: APPI.ICAI'ION SUIT DAPI?
MATKOVICH ROBERT B AND R .TA S 490 GIANNI ST 1.2/18/2000
7,CONwL: SANITARY NO, CONTROL NO.
(408) 727-8833
HITEQI'/ENG INIiIiN: HUILUING VIiHNII'INFO
F.LECI' PLUMB MICH
_ 1=1 I_1 1=1
LICENSIOCONTRAC"TOWS DI-CLARAHONlob DESCTIpt ❑
I erchy att int that 1 am licensed underpmvisions ofChapter B(conmunang
h Socllon]IXM)I of Division 3 of the Hudires,and Profits+ions Cute,end my licensem fall force amt effect. SHED
emClassLic.Xte Contractor
F LL e.I<e ARCHITECT'S DECLARATION
I undcrsemd n.y gln' hull e had x,pnhllc nenN.
m
ceat pO /8
�
Lim,ed pndc..ionul
a a OWNER-exempt front
DECLARATION /7
o 1 hereby.(Sru on 1 1. exempt ,,an ane Cnnnucu,t.LiAnyc Law for the V I/
f_ a following rearm.Rection]031.5.Buaine.i and improve.
demolish.
h.or Any city structure county
Y x which myuim a permit e,ronslmn,since improve,drmolisb,or repair any swemrc
a
3°_ prior m its issuance.oho rouldreslhe applicant tineuch warn itto Me aligned tem
shaem
that he is licensed pnmmntto the provisions of the Contractor's License Law(Chapter 9 Sq. Ft. Floor Area Valuation
.mncaravan,with Section 9(XX))of Doi,on 3 of the Bust new and prnfcssions Code)
a Ihat he is ewmpt ltvzmlmuu and die hauls for far alleged earmption.Any violutinn $74196
of Section]IRIS by any:p, Jc d tar a permit eubj,uf,the ap,li,min Ir a civil penalty
:,once more than Ilse hundred dolmrs($550) A PN Number Occupancy Type
01.as inner of the property.or my employees with wages as their sole c.m,so.ation, 7ap.1 :5 0 7.71 lel til
will do the work,and the suuctm,is not intended m oRered for sale(Sec.7W6.
Business and professiam Cute.The Cunnunn,s License Law docs not apply to an Required Inspections
owner of progeny Who builds or improves thereon,and who dues such work himself
or through his own employees.provided that such improvements am not intended or 101 — FOUNDATION
offered for sole.IL however,the building or in.pmomncnl is sold within true year of
nm
nplem,the owner-borer dwill nave one burden or proving than he and not balm or 102 — P I ERS
improve fmm
ppo. ,n.:de'j' 1.03 — UFER
r o1 she pmry'ny,am ennusively contracting with licensed contmcb rat to 104 — REBA R
,n. ue be mcrvO ISec.](W.Hn.vinc,.v and Pmfic,dons Code.)'Ike Contractor's
molse Law does nor apply toanowner ofproperty who b,dd.or improves mmeon. 10S — ANCHOR BOLTS
who contracts for such projects with a cohnractud.)licensed punuant In the
Conv'tor,Lieemelaw. 1.06 — SEWER & WATER
❑I� n.nJcr,��`"-�� .B&YClor this mason
�I c,. D:ht �pn� 202 UNDERFLOOR PLUMBING
woRKEHSCOMN DD uecLARATION x'03 — UNDERFLOOR MECI'IANICAI-
Iherebyniim,ander peralf.,of,maptrone of the wnow;ng dreh:nmoo.: 204 — UNDERFLOOR FRAME
I 1 have and xm1 inaintain a Certificate of Consent to.elf-in.me ria worker. 205 — UNDERFLOOR INSULATION
ompemutlon, as provided fur by Section 3100 of the Labor Cale. for the
m,rmance of me work ha which this penoit is issued. 301 — ROUGH PLUMB I NG
I have and will maimaia Worker's C....tiven.atimh him....v.m rewired is, ly Section 302 — UB &' OR� SHOWER
Aq)of the Labor Cole,for fire prcmmwnce tri the work for which this permit is
.wad.my Worker.0.......nsatm,l.,vrarai,carrier Crud policy roomer i.e: 303 — ROUGH -MECHANICAL
crricr: PoheyNo,: 304 — ROUGH ELECTRICAL
CCR'I'IFICA1]ON OF LKEN119[ON FROM WORKERS'
COMPENSATION INSURANCE 305 — FRAME
(This section necd not be completed if the fiction is for orlc hundred dollars 306 — HOLDOWNS
alae ona`'1 307 — INSULATION
1 artily that In the Irerformance of she work for whim this anitit i.Issued,I
shall non unpiny any or..on it any manner ser as In beeomo.alert w the worker: —— SHF_F_TROCK
Cmaptromi hLaw,.tfcaliio...I..Dmte 309 — EXTERIOR LATH
Appbcam
NOT ICETOAPPLICANr:It,aBermaking this Cenilicate of Eacmlaion,you should 31.0 — INTERIOR. LATH
become subject m the Workers Compenmtion prnridom of the Lbo Code.you must
O2O forlahcomply w;msuch pow ision.or this Noun%hankie deemedre,v�oked. 311 SCRATCH COAT
Fco� CONS'[RGCnONLEN DING AGENCY 313 — ROOF NAIL
as ! 1 hereby at(..,that mem is a comametion leading agency for the performance
A the work Torxhicl.nthni.
penh is .ned fsce.NN7.Civ.C.) 501 — FINAL ELECTRICAL ENERGY
Lal Q I.endcr's N.nme
;Z) Lem(er.nddro.s 502 — FTMAL PLUMBING ENERGY
U O IralitythatIhavereadtdsupphcationandstatethattheabovelnfarmathmis 503 — FINAL MECHANICAL ENERGY
�. E.. coned.I agree to cmadv with all city and county ami......and sate laws relming
oU
in vilding construction,andl hambv authanim mpmwntativc%of this city it)enter upon 504 — FINAL BUILDING ENERG`!
ythe above contributed pn peny f .pectic p 0
(w ) g rasa d fy and k keep les me City ofc ,d run.,an't 505 — FINAL ELECTRICAL
V]
an
I'i ) dg I. c t nJ pe us h h r Y in unY Y m aBainn su.J 1
U Z coy' . Ill t d ' ti nnisg I 5PJ6 — GAS TEST
AI'PLICAN NO t AND W I COM11,V W' I ALL NOnN,P/OpINT __ T NI!)I pl) 1 INlltl T N 10 Date
r SOU F .A'r y' cS�
nhpii .t'Imen,r cane Re-roofs 50H — FINAL MECHANICAL
IIA'1. IHIUS MA'R3RIA1 5 DISCLOSURE
eulmeappheant
mmmrel„ddmgorrapanlsrmrorhrnelena.:udommatedal Type of Roof 509 — FINAL GRADE
as def sed by the Capeman Municipal Cak,Cnnpmr 1.12,and she I Icalhh and Safay
Code.Section 25532(n)1 510 — FINAL PLANNING
❑Ye. ❑No All roofs shall tRigspectgdpfjpIl_uo arl}S(LofiBg tgp3Tsj4 being installed.
Will the al,liramo.Imo.ehaddir,ocapant."rynirmemt...dnvierawmrh If n roof is installed without first obtaining an inspection, 1 agree to remove
enhil ha+nfduus;at conte tried.us defined by the Huy Area Air Ooably M:magemmirn
un,rid' all new materials for inspection. Applicant understands and will comply with
❑Ye. 0 N all non-point source regulations.
1 have read the havardou.materials mryirements under Chapter 6.95 of the
aliform.Her h er Safety Cost,Sections 25505,25533 and 25534.1 undersand that
10 the Fut g uc of currently have a nenam,thul'n is my responsibility to notify the
cu
I of a dolmans which most M mel prior o Issuance of CeniOcae of
Signature of Applicant - Date
rho o...:.r d rot- D:oc All roof coverings to be Class "B" or better
OFFICE