00050041W
. CITY OF CUPERTINO - " !' '
•' -
BUILDING DIVISION, .' , -PERMIT
CONTRACTOR INFORMATION:
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7
,
BUILDING
i02`ll is
4 ANN'ARBOR. CT,
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PEI1MIrN
i °00050041'.
owrdeR•s 1qft DOUGLAS AND, -ELAINE F
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Arrl.Icnn
`I'D'�°i� %2000.
SANITARY NO. CON9ROL NO,
f
ARCHHECS'IENGINF.F:Ro'. ,
,. -
- BUILDING PERMITINFO
PLUME 1F.0
= LICENSED CONTRACTORS DECLARATION
o u nr n 1n 11 r J a v.' rcl vl 91 .
Lob Description
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w wms I rino) rD �oaonnv Eng eP.err_rsu c a - any Ee e
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ADDITION/ 966 SQ.FT.
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lice: Close Liea
Data Contractor
ARCHI fhCr S DECLARATION
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CLicensed Pr,: i it
OWNFRBUILDER
Icy DECLARATION
1 he bya that I m p1 f II C L I L Lu f the
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fella g n (Section
I' 703I 5 B J Paul C 1 A y 1} ly
lhm h I c ' d P n tb P f eh C Incl L Lu (Cundue, 9
: Code)
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Sii�J799 JJ YYJJ
or lh h e PI the f and Ih b f Ih II g I x pl . A yvinlatioll
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of Se ton ](111.5 by aey ppl If rnpu I M1jmkx ihc. ppl an�acvl penny
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ornol m 0x200 e as u : (s5an) -
AP].I�'{tlrlb:erj S. 00
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Occuparicy.Type
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w 11 l III k 1 Ih 1 1 I d e cif o f .nl (S . 7d44
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oPply to an
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1 1 _���.[iE(],C �WS ections '
ft
lhrol h�oen en to rex pn 1h nnJ,' d work hi elf
ended
nrrereat : I.Irn x m b ur s P I'.. m -m'o yen f
i r. — .P
i, `'1022—' PIERS {
emnpl cion ulo owm.rn la rwnnaxe mon Ivo of Plnx'1s alnl bead ml bona r
Improve ,
rot pumoe
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103 - UFER.,r
° . rth I
Property, Y g lhl d I
.104_ 'REBARlar.
el 1 the pafterIS ](a'a p o d P f C 1) r C t� i
a o
LicenseL d I pplYl ( property I bile p `Ih
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1.05 —ANCHOR BOLTS -
wc i, a r wnh mem �e) civ 1 p . ni the
Cmh I ,RemeSe � R,
106 — SEWER &^ WATER,
°Innn,empl node, sd"'. --�`';E&Pef .tors re:
'*202.= UNDERFLOOR PLUMBING,"
Owne�WQRKERS OMPGN3ATI[nN I -f AR TlTOON
,:' 203 — UNDERFLOOR -MECHANICAL •,
Iberehynflrne J P Ity fp 1 ) rh fll Sd r-1
,
204 - UNDERFLOOR. FRAME,. '
have and wib p;n nl9 n a cvrrt enln I c m:enl to ellr :ore for wmk r.
2205 — UNDERFLOOR , I NSUL.ATI ON .
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cone -f e pr„v'd J r by Seel 1700 it the Labor Code for it,
Perform' f the work r h Infix "mit i. God.
''
.'.301 — 'ROUGH PLUMBING. : -
❑Inure nue will mom Wrke.elnn I hi ane"clinicalbySection'
30:?' — TUB 9' OR SHOWER' '
37W of me Labor Cosi I thep m - f 0 work r which In _ l cis
'Laid
303 —' ROUGH- MECHANICAL
My Worker, Coll 1 Insuranceroad PJ' e
.`
304 —;,ROUGH., ELECTRICAL
Gurria -
Inch, N.
,
CERTIFICATION Or EXEMPTION PROM WORKERS' -
1,1
- 305• —„FRAME
COMPENSATION INSURANCE -
_ ,
306'.. HOEDOWNS..r
s`
C1 his secnnneed not neeompletee fro permit is far hundred dollars
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(SIOn) I d -
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307. — 'INSULATION• .. .�
I rachly that in me'Perin�nmce none k f -nl n In permit '.`' d I
30A — ' SHEETROCK .
'hull 1 1 employ y Oar y banner. . t l come subject to Id WorkorC
Compensation -1 nfC`I'r 'n Dat •.
30§ EXTERIOR, LATH- -
Applicant
NO7 ICE TO APPLICAN C It, all king has C,,lificate ofE, m y :hind
'310.— I NTERIOR•'4ATH
become bj 1 the wok ' Compensation provisions of the Labor Cob., you mal
ronhwt mply i6puth pocconne,orthi:p 'Ihallbedeemedrevoked
'
- 1311 - SCRATCH COAT• ..
,CONSTRUCnons LENDING AGENCY e
31.3 ROOF NAIL '
- I rl
I herebynn 'flat them : lnef leading nguneyfit, Iieperrgrnn,ue
of Lha k f whbh II(p r t , iseucJ (S 1119]Civ. C )
,
- .AL501. FINAL ELECTRICENERGY '
Ir,
a
.50i' ' -',FINAL PLUMBING"ENERGYe
,
cmvpr- Inenn Ir t cn..
503 — FINAL MECHANICAL`ENERGY
rec1 l uF I pia to II J ordinances d coto sI I e
mbeltd connotation, Jh
04 — FINALBUILDING' ENERGY
..,I pmnmIIti
menl. e r ep I ry for ins,pectionp v
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-
-' 505 — FINAL' ELE CAI_
(W) g 1 o J Jk ph lethe Cly fCl I s'.I'
ramal i d8 h w,l d pea,ox which y ,y way so n,1 ee d
506 ' — GAS TEST
City' q once of 6' I s fth ep I -
AP ICA TUNDERSTANDSAN WILL COMPLY WITH AL NON. oDrr
"s0
Issued by: '507';- FINAL' PL
CE if IDUs 1
Date
Syne l'App1 `t �—
`. Re -roofs _
HAFARDOU AD.RInLSDISCLOSURF-
W ll th I' 11 1 buil fi ncat, 1 t handl h 'd
509,— FINAL GR E.' '
g or r I
eaeh eny th,penia Municipal Code
Typ e Of Roofs
Ch Plr 9, IA nml th Health and safely
Code Scratch
510' —' FINAL P NNING.
25512( )'.
°V °N
a,
1
All roofsshall'9fWect�dllWWtoFe JfinVkKi5ibeing'inst]ll(Fd,';
W de air co I future n 'Id g e sran tAtr e a Is n
lith a enrcnllnl' my ux Jenncd by the thy Area Air Quality Man=6eme1
If a roof is installed without first obtaining an inspection, I agree to Tern
g P
ilicant'understands
nim+
Oye, ON. r
'all new materials for inspection: A PP and will'comply with
I Ineenvand the hantiman, materialsof div Ch'Per 6.95 if the
all non -point souice regulations. '
C2111ormia Ilculth & Safely Code, Sections 25511.5 25513 and 25534 1 andestond that
11the h Id deemtcl currently have a tenant the it try
6 n y y upon Intl ty 1 notify
necupn et of the requirement, win en uwI be net PriorL e of a Certiffichic of
A.
Ovariancy,'
,
Signature of Applicant, „I Date
All `roof coverings:to be Class. `B" oc better
Owner no anmort.ed agent Date