01070016i
CITY OF CUPERTINO
BUILDING DIVISION PERMIT 'CONTRACTORMORMATION-
BUILDING ADDRESS. PERMIT NO.
10133 AMADOR OAK CT TOM'S PLUMBING 01070016
OWNER'S NAME' APPLICATION SUB DATE
NAUM ROYTMAN 12246 SARATOGA SUNNYVAL RD07/09/2001
PHONE: SANITARY NO. CONTROL NO. -
(408)867-6010
Z ARCHITECT(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT -PLUM MECH
L1 IJ _ CJ
i LICENSED CONTRAC`fOR'S DECLARATION Job Description
1 hereby million that 1 am licensed under movi"um, of Chapter 9 (commencing RE P I PE .
u❑i oh Set 7000) CD 3 nfthe B"mes"Palliofe...
casCWe. and my license
innselClaseand �ea.�� Lia# ISbf F'14AL'ED
y 'ate 7�h-as Contractor
ARCHITECT'S DECLA ON
1 understand any plans shall be used as publi records J U L 2 6 2001
OLicensed Professional
pm, OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from tnc Contenors License Law for the , BUILDING
following reason. (Section 7031.5. Business and Professions Coale: Any city or county $7050
❑ which requires a permit to construct. alter improve demolish, or repair any sweture ;
-..pr t't'ssuance,elsorequoestneapphcent Rattnpermuo fit ... gnied state mem,
-
'hat bislicensed pursuantto too p -xions of the Contecml L' ase Law (Ch pt 9 % I x Valuation
(c mm 'ng wah5 ton, 7000) of Division 3 ofthe Burin mad Prpf,sameaCode) i `j=�+4, t 3`Yi�3 ����i�a 'I B"��yT '
n that h is exempt therefrom and the basis Por the alleged ex pd n. Any violation - - -' "
of Section ]031:5 by any applicant for a permit subjects the applicant to a civil penalty '
'.I net mare man Eve hundred dollars (S500). 2 0 2APNbNii9RFLOOR PL B ING' " Occupancy Type
01. ex owner of the property,many employee with wages a6 their able compensation, 301 R PLUMB
- w 11 db he..,k,-..d th 'structure' . not intended or Offered Law for snot (See' to an 5 0 2 - FINAL NAL PIA 0BffiN rsPb1RRGY
owner n s , d Profe. n. Code Tn C es their s License Law does not apply m en ' -
ughopety emplho oyees.
thatsuchmprvemerim, and who nes tsamnWOrktimrelf 507 - FINAL PLUMBING 1
or er through h' a ply provided thvt such improvements e t m onintended o
meha s Id th n one f
-
,off d f I. If, h [h building mp y -t
"i ple[ionr the ore bra Ider w'll have 0e burden of proving [hat he did not buiM or `
improve for Purpose of sola). '
I
., 01 as owner of thecontributing- _._,_.... ..._.._. _...,._.._,_-.._... _.. _.. _.., .._._. _.... ..,....._ _.__ _ .. _.__...._
ed
property, t70 exclusivelyions Co :) Thu Contractor's
onti oro toLicconense
Lawt the does
project (Se ]044 Businessd e Professions il dor The improves tmcmr thereon, ) -,
dB di'dD
License Law docs not apply to owner with
a catty who builds or imam or ,,da
„
..and who License
such projects..wth.a.wntracmgs).licensed.pueuant toahe.
Contravenes LttnseL ..
_ 01 m exempt underSe 6&PCfor this rtason ,,, C I.
Owner ."DI
- WORKER'5 COMPENSATION DECLARATION
' I hereby vffirm nd r peas ky of patient; f th following deela at ns,
0 1 hive and will' maintain a Cenil cam of Codsent to elf-imum for Worker's
- Compensation, as provided for by Seaton 3]00 of the Labor Code. for the
performance of the work for. which this permit is issued..,, ,
_ ° I have and will oma t n Work pr's Co p ton Idsurin ', os required by Beaton
3]00 of the Labor'Cude, for the performance of the -work to, which his permit is -
d My
Workers C aspen ati In! c d Policy M
Ga der!�CQ°'�' policy, Ne 91(.(yit I (I C -S` Y , t;'s
t gCERTIFICATION OF EXEMPTION FRPM WOB�BR$P °
'
COMPENSATION .INSII, _. .__.__ .... ..__... ... .�... ._ _._..._..._..
f" '(Th s $echos ted not be complied f rhe permit is far one hundred dollars
IS 100) . Icas�
I ndY,iha(n the pe forma ¢ of the k f when th s pe i is i6 d l
... ..,-.. _._ ..
shall n t employ any p y a so as to hecom S b)ecr to the Workers
Co p t Lows f C I t . ate ""
_.
Applicant
.. m. �, ... ...... _. ..__ ... .. .. _ .__._ ..__
Y _ ._._ _. ..__. ..__...... _..... ............. ...i, __.. ....
NOTICE TOAPPLICANT WmI Ir Rmakingn Certificate,Exemption,ooh Itl
i
becomeis c mt to the vIS r visitant t Provos oha of 'heWhof Code; y0h must
fool @ � ply with h p s one a [h. pe it shall b decreed revoked.
7 ' ad CONSTRUCTION LENDING AGENCY - 't '
w ..
' th 'or w n th t in a'con wa ' I 'iding-a8 y f [h p rGirmance . t '. .: .
Df th k'f Lich tM1
o pe m t v"is6ued (S e �U91, Clv. C t
,.... Leders Name:,,._ :... . .'t,._.!. _:.... .... ..... ._.__,. t _..._..__.,
Le"doos Address
I enlfy that 1 h c mad rhos vppl on� and state th t the vbovc mfnrmutlon is
est. I-agreo rt comply whM1 all shy ahJ county DNinances and rete laws relating
ro huildine ..ru minion, and nerebyautliorizn represenfmivea of this city m inter upon
th b f tl p p ty f Fit P m .,
1'agree
g -t d nnifya dkt ph rmle.ihcCry fCpn'no giaid
7 li t ht 1 dg t. t d p ase h ch Y n nnY Y c lost .ata
City
quinti fm g t got rh pe t ,.S Q 1
AP (CANT UNDERSTANDS A.ryD WIt COMPLY WITH ALL NON -POINT' `/
5 cEREcuL n s Issued by: Date
x,01,
g t r oft plica JCn vacmr;„ •,. .: Gme' � Re -roofs
_1 HAZARDOUS MATERIALS DISCLOSURE
W11 theapplicant rfmreb Idi oc p t t or bmilb,haxN int I Type of Roof
ns d f d by the Cupe t no M n c'p Cod Chapter 9,12, and the4 hh tl S F ty
'ca s ton 3od211 I (" sft hr.:. ., a..; 01..{
°P °N _All roofs shall be inspected prior to, any. roofing. material-being.installed ....
°Y t mmmb building p p !. al] n roof olnfsource re lotions'= obtaining an ms echon'I'agree tci"i remove
O iii %Will t t °t not dfndbyth ByArcrA Quality Management:
g) P
t peee equipment a which' stalled without first o
nth d rs
fl d" 1 all new materials for inspection. Applicant understands and will comp y with "
1 have lead the h z' do . tate als requirements under Chapter 695 of the P g .
CaliforniaHealth'& Safety C ode 5 ctio 25505-25533 and 25534.i understood that
'carat bildingdoes not currtnrlyh tram, Iaper, it my,rcsponstofa iobfi,ra the
ui p m ofthe regouemem9 hich�,mo t h et prior to i�- �tnce of a CediFe:nre of
- npae`y-' L41.
._ ._ ..,OFFICE.
-
Signature of Date
g
�L..r
-Applicant
. _ . __
All roof coverings to be Class `B•' or tietter
t
r.aum ata g nt Dae =
CITY OF CUPERTINO
BUILDING DIVISION PERMIT 'CONTRACTORMORMATION-
BUILDING ADDRESS. PERMIT NO.
10133 AMADOR OAK CT TOM'S PLUMBING 01070016
OWNER'S NAME' APPLICATION SUB DATE
NAUM ROYTMAN 12246 SARATOGA SUNNYVAL RD07/09/2001
PHONE: SANITARY NO. CONTROL NO. -
(408)867-6010
Z ARCHITECT(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT -PLUM MECH
L1 IJ _ CJ
i LICENSED CONTRAC`fOR'S DECLARATION Job Description
1 hereby million that 1 am licensed under movi"um, of Chapter 9 (commencing RE P I PE .
u❑i oh Set 7000) CD 3 nfthe B"mes"Palliofe...
casCWe. and my license
innselClaseand �ea.�� Lia# ISbf F'14AL'ED
y 'ate 7�h-as Contractor
ARCHITECT'S DECLA ON
1 understand any plans shall be used as publi records J U L 2 6 2001
OLicensed Professional
pm, OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from tnc Contenors License Law for the , BUILDING
following reason. (Section 7031.5. Business and Professions Coale: Any city or county $7050
❑ which requires a permit to construct. alter improve demolish, or repair any sweture ;
-..pr t't'ssuance,elsorequoestneapphcent Rattnpermuo fit ... gnied state mem,
-
'hat bislicensed pursuantto too p -xions of the Contecml L' ase Law (Ch pt 9 % I x Valuation
(c mm 'ng wah5 ton, 7000) of Division 3 ofthe Burin mad Prpf,sameaCode) i `j=�+4, t 3`Yi�3 ����i�a 'I B"��yT '
n that h is exempt therefrom and the basis Por the alleged ex pd n. Any violation - - -' "
of Section ]031:5 by any applicant for a permit subjects the applicant to a civil penalty '
'.I net mare man Eve hundred dollars (S500). 2 0 2APNbNii9RFLOOR PL B ING' " Occupancy Type
01. ex owner of the property,many employee with wages a6 their able compensation, 301 R PLUMB
- w 11 db he..,k,-..d th 'structure' . not intended or Offered Law for snot (See' to an 5 0 2 - FINAL NAL PIA 0BffiN rsPb1RRGY
owner n s , d Profe. n. Code Tn C es their s License Law does not apply m en ' -
ughopety emplho oyees.
thatsuchmprvemerim, and who nes tsamnWOrktimrelf 507 - FINAL PLUMBING 1
or er through h' a ply provided thvt such improvements e t m onintended o
meha s Id th n one f
-
,off d f I. If, h [h building mp y -t
"i ple[ionr the ore bra Ider w'll have 0e burden of proving [hat he did not buiM or `
improve for Purpose of sola). '
I
., 01 as owner of thecontributing- _._,_.... ..._.._. _...,._.._,_-.._... _.. _.. _.., .._._. _.... ..,....._ _.__ _ .. _.__...._
ed
property, t70 exclusivelyions Co :) Thu Contractor's
onti oro toLicconense
Lawt the does
project (Se ]044 Businessd e Professions il dor The improves tmcmr thereon, ) -,
dB di'dD
License Law docs not apply to owner with
a catty who builds or imam or ,,da
„
..and who License
such projects..wth.a.wntracmgs).licensed.pueuant toahe.
Contravenes LttnseL ..
_ 01 m exempt underSe 6&PCfor this rtason ,,, C I.
Owner ."DI
- WORKER'5 COMPENSATION DECLARATION
' I hereby vffirm nd r peas ky of patient; f th following deela at ns,
0 1 hive and will' maintain a Cenil cam of Codsent to elf-imum for Worker's
- Compensation, as provided for by Seaton 3]00 of the Labor Code. for the
performance of the work for. which this permit is issued..,, ,
_ ° I have and will oma t n Work pr's Co p ton Idsurin ', os required by Beaton
3]00 of the Labor'Cude, for the performance of the -work to, which his permit is -
d My
Workers C aspen ati In! c d Policy M
Ga der!�CQ°'�' policy, Ne 91(.(yit I (I C -S` Y , t;'s
t gCERTIFICATION OF EXEMPTION FRPM WOB�BR$P °
'
COMPENSATION .INSII, _. .__.__ .... ..__... ... .�... ._ _._..._..._..
f" '(Th s $echos ted not be complied f rhe permit is far one hundred dollars
IS 100) . Icas�
I ndY,iha(n the pe forma ¢ of the k f when th s pe i is i6 d l
... ..,-.. _._ ..
shall n t employ any p y a so as to hecom S b)ecr to the Workers
Co p t Lows f C I t . ate ""
_.
Applicant
.. m. �, ... ...... _. ..__ ... .. .. _ .__._ ..__
Y _ ._._ _. ..__. ..__...... _..... ............. ...i, __.. ....
NOTICE TOAPPLICANT WmI Ir Rmakingn Certificate,Exemption,ooh Itl
i
becomeis c mt to the vIS r visitant t Provos oha of 'heWhof Code; y0h must
fool @ � ply with h p s one a [h. pe it shall b decreed revoked.
7 ' ad CONSTRUCTION LENDING AGENCY - 't '
w ..
' th 'or w n th t in a'con wa ' I 'iding-a8 y f [h p rGirmance . t '. .: .
Df th k'f Lich tM1
o pe m t v"is6ued (S e �U91, Clv. C t
,.... Leders Name:,,._ :... . .'t,._.!. _:.... .... ..... ._.__,. t _..._..__.,
Le"doos Address
I enlfy that 1 h c mad rhos vppl on� and state th t the vbovc mfnrmutlon is
est. I-agreo rt comply whM1 all shy ahJ county DNinances and rete laws relating
ro huildine ..ru minion, and nerebyautliorizn represenfmivea of this city m inter upon
th b f tl p p ty f Fit P m .,
1'agree
g -t d nnifya dkt ph rmle.ihcCry fCpn'no giaid
7 li t ht 1 dg t. t d p ase h ch Y n nnY Y c lost .ata
City
quinti fm g t got rh pe t ,.S Q 1
AP (CANT UNDERSTANDS A.ryD WIt COMPLY WITH ALL NON -POINT' `/
5 cEREcuL n s Issued by: Date
x,01,
g t r oft plica JCn vacmr;„ •,. .: Gme' � Re -roofs
_1 HAZARDOUS MATERIALS DISCLOSURE
W11 theapplicant rfmreb Idi oc p t t or bmilb,haxN int I Type of Roof
ns d f d by the Cupe t no M n c'p Cod Chapter 9,12, and the4 hh tl S F ty
'ca s ton 3od211 I (" sft hr.:. ., a..; 01..{
°P °N _All roofs shall be inspected prior to, any. roofing. material-being.installed ....
°Y t mmmb building p p !. al] n roof olnfsource re lotions'= obtaining an ms echon'I'agree tci"i remove
O iii %Will t t °t not dfndbyth ByArcrA Quality Management:
g) P
t peee equipment a which' stalled without first o
nth d rs
fl d" 1 all new materials for inspection. Applicant understands and will comp y with "
1 have lead the h z' do . tate als requirements under Chapter 695 of the P g .
CaliforniaHealth'& Safety C ode 5 ctio 25505-25533 and 25534.i understood that
'carat bildingdoes not currtnrlyh tram, Iaper, it my,rcsponstofa iobfi,ra the
ui p m ofthe regouemem9 hich�,mo t h et prior to i�- �tnce of a CediFe:nre of
- npae`y-' L41.
._ ._ ..,OFFICE.