02070028 CITY OF CUPERTINO
Btm,DING DIVISION PERMIT CONTRACTOR INFORMATION:-.°I ,
t"MI'MRIANA AV GREGORY D CAMPBELL P �D2070028
4 �Y D CAMPBELL APPLICApOp y BHAyE 0 0 2
PHONE SANTTARY NO CONTROL NO
G 0 zo ARCHRECi/F1:GINEER' I BULLDING PE.Myr INTO
LE' BLDG ELECT PLUMB MECH
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LICENSED CONfRACTOR'5 DECLARATION
l bOti lifr m thnt l.rn eeensd,der pa„��.a CT,gv 9 Uammman, Job Description
� BACK YARD SHED
.v�ru.,
wnh Smiort af DinuonJo the Buurcu,d m Code.wd mlcense
ucsrce deR t.rH;i arse ck
FINALED
C uu,m
ARCHITECTS DECLARATION AUG Q 6 2002
”o S 1 uMCniand my pan.shall he used as public record.
f E c F Lcensed Prafevwrul
OWNER-BUILDER DECLARATION BUILD Eno
v I hoci glum on I 1 bump from tM Couices C License city Law o for the
mllonng rm.m (Smi t IDJIS,Business n,Pmfeaiom Cade Any wn a county
5,F e whicM1 rtquirts i permn to t e4 slier,impose,h terOmb,«rtpev any niconee
u 3 pmorusuo.u.mcc.tealso rtgwns lame c.w for mehpeemt wBk.ugod u.uoem
moral.�dm+na )())of lgom3oconBiom,,;milf.L,w(ehqu9 3�g21QD@�rAE�a I Valuation
(rotmnemcise with Semwn]000)of D,logic 3 of the Bgocl m m,Profcuy vi Code) '
a Sect M1e i.bump thcrtfrom.nd or I e fm the.11e,d nemgim Any noWmn
0 Section �IK(L5W)).ivbj""m`•PPhonttm.ardlpuulry 516APN NU&L BUILDING
Occupancy Type
[11.as owxr colic pmperr'or my cmrlarn5 wmh wales a thur such,compensn't.,
cia r,eo ° c Lic«s 71g.4.
Run. ufassmCodeThe c n. aIx,ert : .�Awl w on Required Inspections
na of propuw Who b,IM a rmpmac.Bar..such mr tr who doca such wort ncle,l f
. SemuS5M1 him own unporas a buldd inn such i Math irs sol.see not.m a.m
cmerd fIX ule If,howamr,thell haw ar i r Seem u.wld wrthln m¢yew or
cornpkt for IM owner-border wdl hes<de buNen°f gaving ihet he dW nth W dd or
improve for pwpose a uln)
O1,a,ownOr of me timpi rm mdo.ively mnvncun,with hcemd conus,n to
omuun the ,,act(Sin.](ea,Busmes and Profnsioru Code)The Comnaor'.
_ License tow dae not.prlY Se im owner of,open,who bulls oc unease oercvm
.nd who sontr.cu fw.uab Fact wnh.costun r(a)licensed pmunmt to Be _
IXs Lkuue Luw
I w eempt under Sit. B R P C for this rtuan
'I��P
WORKER'S � 7�� t�
WORKER'S COMPpT10N DECLARATIS]N.3�0
I bcaby Affirm under pmoilt)of mi one of use following declennoos.
/' ❑ 1 b.vc ud will regr un •Ceruf we of Cavttm to.elf-mi fm wuAU's
Compenuuon, its provdd foc by Section 3700 of de labor Code, for me
perform,rrcx of the work for which hi,permit,s ...,d
❑I have od will numum Waters Compenwion lruurerce,u requird by Secuan
37()0 a the Vgor Cade.I.de prfamuce of Be work roc whim But Ogg,r.
. - resod My Wader's compenuuon 1 .see curia ud Polity numbs see:
Ctori ., :r' Parry No.: -
CERTR]CATION OF EXEMPTION FROM WORKERS'
-_ COMPENSATION INSURANCE '
('11ui.mion need rotbecompkted JO pcmut is forom hundred dollus -
(SIM)ocku)
'1 is ufy Ow in Be perfamaoceQf dry war.fa which�BWm permit u'wud,1
shill ployploy.G �' °M �/we=a SeC Wateri .
Comperes ai fCad v/_ r
App c.v
NOr oI r, om Seek oSeUCemOnuof E,empaan.ywo mug
b)m y me such w Comm nubon pram oh,of de Iarba Code,you muse
O p faMwrSe comply Arm such pmnvom m inn pmN�Seal h deemd resoled.
CONSTRUCTION LENDING AGENCY'
} 1 Mmy arum tM tMe is.coo.msrum ItMm{{.,easy fm Sec perfomurec
of the work for which this plimt is iuocd(Sec 309),Cry C)
�'(� Leda'.Nurrr°-
Lande.Atlanta.
4Uu. 0 1 mi dw I h.se rr.d me.pplkwm.vd one Sea o<.Dm<mfornuuai is
circus 1 yrte to campy with al city.d roomy orduunce,"snse I.w,relnmg
to bald,,cannrucuom,nd hereby.othanre repreenwnes of ws city to enerti a
} W dc.bave-ncntiond progeny fa mspecdke puryous,
F. 6., (Wel.pee to vve,tMemwfY.md SPeP M1Vmdeu me City of CUpemno.,.mu /
Uh lubt iud,mensu thus end eperars inch Seer in.ny icy rcnrt.,uim uid
Z City in ron.egamc<ar the,muan,Of mnpe0
APPLIC M'DERS ANDx LCOMPLY xTTH EON- t+
SOU cuu A.r }� Issued by: ,'rf r it! .L--, Date
GCYc i / j
.a °^'^�'°r a^' Re-roofs
HAZVRDDUS MATERIALS DISCLOSURE
x50 thc.pplcant a future buddlo,acvrwd port or hunch,luurdau.muen.l Type of Roof
u dcf,d by me C. no Munrc Cade Cluper 9 12.d she HcilSe end S.fcry
Cade,S.25532(U] - .
�Y No All roofs shall be inspected prior,to any roofing material being installed.
wII See.ppBCmtm °mmbwld'n,.up.ntu¢equip ntw&vicewh'm If a roof is installed without first obtaining n inspection, I agree to remove
' emn lumrdoas ar amurrwums u defind by See Buy Art+A,r Quarry MU meth g 1� g
Diu+' all new materials for inspection. Applicant understands and will comply with '
X
❑Ye- - /�Xio
Q , . . all non-point source regulations.
1 hire red th<ely Coals msunas rtgm 25533 odder CT.pw 695 of the
Cahromu Hulo&S.fuy Cdc Sections 255(15,25533 ud 25534 1 o't.ro f Seu
throe band„don na cwenl)'Me.un.at thn rt a my rt.PPPPppp�oomsss MIitY w mtify the
arnpun a remc h must Sect Iota to nsuan 5f't Camfiute,a
/gyp Signature of Applicant Date
7
All roof coverings to be Class "B" or better
Garden 16' b oCs
T _ size 1t,x C.Of% e
eak with e blocks
proposed shed eight 6, at ar With conoret R Of
�►�18tQht 7,6 at(e AN D pRDIN
g� TE Must
+ 3fGNEV ns and sPeC.Wjc8l d. is un
a ®� TS' this se, nb at g14 Oleo at katwos 1
e t Un the es fkom
ke anY e�mssi n
E1e�ation bV40 to h ui w liken P tin
s Side on sabme' W tact°as
Ure11 khe u d , eP h�Qa�;d 9ectt be n
° 1'� ILn a r fti ll$ . Op.mi�
�PPam
� ' getbacK R mre mum3 sa ck. ve 7
3 Setba 7 at the te�ht abo
to eX�d. �toot of h 9 r Watt
�� Height n� 1 5, to( ea 4or 7,6 N rea Wall
{ \ a$es by aired H side
� � o Setba Min 6 7 6 Se tba c�.k t Vi ed 101 00 030
I � � , setba M ode
`� cuperfkn0
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THE SHED SHOP ; w z
37341 BLACOW RD.
FREMONT, CA 94539 F z
(510) 623-9100
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(510) 623-9100
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