00080184 CITY�OF CUPERTINO `- : .f•'
BUILDING DIVISION PERMIT~ M : CONTRACTOR INFORMATION: -
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ImJTLDI NO A I)DRHSSIs PERMrrNo. 000}}IT1.04
1039.5" ANN ARBOR AV .
.ON'NhR'S NAONISH IR' CHAO :. a"' l t,. � s , AP ➢L.PLICATIO (8 ,5. 200VI
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PHONE: ♦.- SANI'I'ARYNO. CONI R91,NO
In -
O a Z ARCHITECT/ENGINEER: '- BUILDING PERMIT INFO '
ELDG ELECT'. , PLUS, MEPIwr
.moi,a a on
'ZO S y= LICENSED CONTRACTOR S DFCI ARAEIONr ,'- ': (, -]Ob Description -
11 by B 1part I licensed Loaderp fCn p, q'( nc ng p
p C sums , 7xlo) fD , n3ofIn,En r and st :Cd,n"dnylicense ENLARGE KT AND FAMILY ROOM, FIRST .Sl
=aS, .Sintpforce nd ettet _ • ,
a NN d Liume Claws L'c W
x o Date Can,raamr TO 2ND STORY. HOME
ARCHITEC'T'S DECLARA9'IONL,
•`5�yy 0� 1 undealimd my pbms shall ne used as public mrord , , - t '
a"p'O
Li,maddP r: al
OWNI R RUII DER DECLARATION s „
u� I M1 by_ fl n, bar 1 5marital from the C 1 t ,Lacomw Lou,for he
foil g . m'(S ( n 7031.5.Flosion, ad Profession,Code Any lY in,lounly -
5g �
which reqre permit tconstruct, IId,improve,It orm,airany.t cmre
prior to its e,alsorequires the applicant toramit.r 'I In rl n mod,immincrit s '
'in,'[in Ifootstool tthe p of the Connadta,License In (Chapter 9- 'Sq. Ft. Floor'Area ation
(o,ommorneun, uh Sem 7tk)p) f position' 3 of tire H 'nest,and Professions Code)
orthe(h pt dieredromandth basis lot tou allegede pt Ay,'nPl'o, _
ofScandal 703I5by any ,,Irmahf awrour,atobjer, he appl' 'm„ aci it penalty
($500) APN Number _ - , anCy e :,
ofn t ,oa dhantve hu Umd Jnlh rs . d (' ,
❑1,as owner of the pmpenr,or my employees with wages as itch vole anapensmibn.
will do the w k d the comatose ,imandood 6,oflared for ile(Sec.7044
Business and P f:', Cal no Contractor's 1 d Law d , pply to an 12equired Inspections - - -
owner ofOopenyWh trials p Cheroot,Eind who does"such workM1 If .�
or through h'. employ .p'morded that. I 'ml l intendedtor
aru I f .Ir h m building' r at p roue t : Id 'th y I .. 10 f. —FOUNDATION
complernn the"Wild,
mar hn Idar still In,,..die harden ,f pmv nm ha,he did,md ba ld I, PIERS
P for P P Isale). f + 102
i Ire_ 103 —• UFER
pl y Y m 'lhl ' I t , .d S
P J (S y to a B. d e r : il 1 r D C , t '
Llcedxe Lnwdam hot far such r-, nrpmpardy,lnoh,builds rmprwevnt t - , 1IZ!tt ,P,EBAR _ - d'
and win contracts for each'pmjeUsnwi,h'a ammcmr(e)licensed @trsunm m the .. , •
Contractor.License Law � . lID5 —_:ANCHOR BOLTS
'ol (FOR,Stc - � r' - ;BkPCn,this i . . `106 — SEI.IER 8...'IJATFR ' . -
°w
WORKER'S COMPENSAI CON DEION X02 -. UNDERFLOOR PLUMBING
II hY Il - undcrpc mhyof pm( y 'flh f ll Ia'
yl (
203''— 'UNDERFLOOR, MECHANICAL
+ 'as
204 .•` ;UNDERFLOOR' FRAME
'❑ 1 h J 'hl , n Ce(re', f C t t s If'n. f Workers, _
Con p .a( founded f by Section 37(H) f the Labor C le, for the -�
c05 jr UNDERFLOOR INSULATION
pert money of the work far wh'ch dM1 s pe n t,�lsxued r _
❑II and will main,M1nWorker's Comp . ( nme..ad ,muiredbySreaon 3,01.-- AOUGH `FI Ulhn1BING
3700 at the Labor Cade,to,,the parfa.tnanre or-da,'Ink ear which this perl,at is .302` TUB 8, OR, SHOWER
issued My Workers Compensation 1 surance Ziorrier and Policy ramrhcr arc -
303 = ROUGH ,,MECHANICAI_
Carrier policy N.,
CERTIFICANON OF EXEMPTION FROM WORKERS' _ -� 3011 ROUGH ELECT RI'CAL
s COMPENSATION INSURANCE ter' �" '
t 305 - ' :FRAME
PEI Un need nn he completed it the permit is for hundred dolla- $ -
($10m I a.)' 306 — HOLD01JhIS -
Icunity that l.the prrnoarce,I be orkfar wmahtin, announ, saA,1 307' — 1NSULATI"ON
shall not employ any person in any immur so as to become subject to the Workers'
Corp ......aLaws afCalifornia.[)am 308 —: SHEETROCK
Apm1fiNOTICE 70 APPLICANT Il ❑ kyd Ctf nf
ar'n
NOT1 - • ,309.,—• EXTERIOR,, LATH .
' E
COQhaw l til theWorker C p t p fth Labor1dCd.y i'
farm a mprywln nv a prpt,o-ub I d kd. - 310 INTERIOR I:ATFI
CONSTRUC'EION LFNDINGAGLNCY 311. :'SCRATCH"COAT
II h fl rtl t 'a llending' for,hLperformance T ? e- -h'
cC >
if h 1 J p �da.issued(Sre 3097 Cm.C)y ],1 = ROfIF: NAIL,
zLard aN 501 — .FINAL ELECTRICAL ENERGY7a
Lende 'All-:'
O ' FINAL PLUMBING ENERGY
V wy 1 bfyth,lhae aJth'' ppl t d.dd thuh ab f c , 50�
PW F comeI moue t ply In II ,y d u lr I d eI la . r 1 l a 503 —' FINAL MECHAN LCAU ,ENERGY ,
O U• d,bu'1Engi n.huct,n u,erebyaumor prsenlad.ex nn e',y.mcu,.nopan .n. , -
p, ry ma ah d dproperty e p r I m f 504 — FINAL " nUII11 _DING EN_FRGY
� � labn'h�3)dgmenl'do Id py �klenom>iess m,City
ayrecord 1Cp1srnioa i�� S05 FINAL ELECTRICAL
C.7"� .Cit a sequence of tl romtm,of Chi.D rn l - - � 1_'�) tt 'f- /p r
PI ANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT ` rY Qi Oy '' GAS TEST
o r L Issiied.by: Date lV
�. �°;'� '
,. Signature of Ap,lumb Lnmmcmr Date Re-roofs ,.'. .
' t HAZARDOUS MAI TRIALS DISCLOSURE - 5!�8 — FINAL IYIECHAN.ICAL
Will tine applicant future building' we p'n store handle hazardous rotational ,'Type of Roof t , .
a.der IbythC p n M n t lCo C pt J.12 and d Health n Safety 509, — FINAL GRADE '
Code,Section 25532P7 •, I .
°Y °N All roofsShall b6 5A'y�yectedF>llR, PItAIiNi,$Zni to ,Sing installed.
wum ppl°'"' ret I Ia' g 1mus,.rgapmrl 1 which - ,IfaroofisinstalPdlithou fi�V%taiP16L5Anihsl 6 Pagreeto'remove
Ask' omit) zadnusurtam ants as darned by he Bay Area Air Qnalty Mln.gammt
cIsdrlg7 •all newematerlals for inspection. Applicant understands and will comply with' '
❑nn, ',I s ONo '"all non-point source regulations. : _
I have ocand the hamblons -materials requ'mmen,s under Chapter 695 of the -
I Calif Health&SaetyC 1 S ti ,.25505,25533und 155341 nl T dtht -
If,heh 'Id,gd : tc tenant,currently th t ,'.ary responsibility to notify the
w pant f he requ'ren ,. hich m ml h d p- r m i,su' L Cen feed d r 7Y f '
ccuC�.� _ /o(lG� Signature ofApphcaFu - Date
All roof co'verin sato be Class `B"nor better
Ow'n r Thor zed agent
Dam ,0, g
.� .OFFICE