00100006 CITY OF CUPERTINO
Dun:mNG DIVISION . •, PERMIT CONTRACTOR INFORMATION:,
BUILDING ADDRESS PERMIT NO.
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OWNERS NAMEA - .r n APPIUCATION SUB DATE.
1480. ASTER GT BOB GERE MASONRYx 0010000F� -
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SANITARY NO.. CONTROL No,-
Yl ' �SL ES DR 10/02/2000
O-O ZARCHITECTIENGINEER. e . 'o BUILDING PERMIT INFO
^r ly � y,• '..i "ELECT —PLUMB MECH'
(408).975-1285
i LICENSED CONTRACTORS Df CI AR'AHON P lob n
Descrl on
II hereby, rre1141! Icenned t p .. rCl p1 9m re the g - - P
OZ IthS'I II 0) D n3 fineB 11 f dmyl ct '
is P
N.K)ON
Lir CIM - I$AG
B 0.n RCHITECT C 1SY
�nJer I any d h II b e I pld ec rd.,� REPAIR CHIMNEY FROM SHOULDERS':
f:c n:d P I' al OWNER BUILDER DECLARATION the by R._ that exempt front the Contractors U Law lot the - fl
toll 'ng reaskn (Sect 7031.5,❑ d Protractors C J Any city county -
fS❑ which'q period t-Construct, T pr J lbri y' Ya t . . ' ' ..
a3'
aim to I ' I. q tl -BPI tI' :IihP m t rlsignedat n .
thiel licensedp tt th p m fd c t 1 la (Coa v Sq,Ft: Floor Area • - Valuation .
(Lon incnbwth Seetnn 90dub fDavie 3(1 the Bas'ne dl tnfeev'om Cvle) ,
or that h exempt brain....and the h; f r the alleged nxcntpl on Any vada(ion •I - - -
of Sinatra]031.5h a u Ila ttfurn it stliu.o tire _
n a I cool tn,civil iudi
_ r ,r pp p t_ pp pe v
` .a actinium man r nandrcdukunrs($son). APN Number - Occupancy Type
- P Y YP
-
El 1,avower,ofthe a err o ci l c xid,claim,asm` .leant etsnfnn - -
P P > r nye P Y p
5000
well d thek I thet t ( t i r almost!f " d, ]o w
outn :a n't''. cd n Contractor',a .a 1 I `I pply _ Required Inspections ,
f ogh his.j Who holds of npn ve me u n and vhsocbsL on, m act iwork li od ,,
uttered to fo sal npbydt pr olden(o t n p t. r r y d or 3E,E 160118.'00
la f .al II lowered me building p - 1 is ekla within(are year f -
hou,noem thapiewo nate.).wall haveth h Irut of pro,'ng(h.i the did not hu'Id of
imp of ppnse of sole!
101.'.- FOUNDAT 0
I N
El 1. Tal maproperty, nt exclusively 'attracting xnh licensed com ncmn to - ' • r
Ione
icensed he LawJoe,actTTIytoa,Blaine,attddPry, It((nsCoinaTho rmC herawas 3].� .— CHIMNEY REBAR'•8' STRAPS'
License L3 J :act apply( sn r f p pony he d;-Ia. e armor" a tit,
Iron h rens r p1 (e with en,i : 1 p nnnt m tea 514 FINAL PUBLIC WORKS .
Co nraukra llcuac Law.
- ❑lam exetnm ower ser.. • ,B&Pemr ori.�<a.an
Goner
- WORKERS COMPFNSAI ION DECLARATION '
I hereby offrnorderP nU y f Daj Y f lh f ll b deala cti „el t -
❑ I h d , t Ce 'Cc t 1 3Consent t IC' f Work,,',e
Cnn l : p d d 1 by 9 t s 9011 I theLabor Coca f he 1. ..
Iart n' fth work for which pe I 1. n , -
r 'O
I I d II ( or air's C mp t Insurance,r w1h,h his eSection
time Labor Code f to performance I er oakdor h this Pe t'.
ixs d MY Win kcreC P I nlnshm arrler�un`J Policy number are
Carrier�T_� - Pol icy N'
CERTIFICATION OF EXEMPTION FROM WORKERS' -
vn9COMPCNSAfION INSURANCE
(T eu kn ,,ad I ti �omple(c l f tI p ,il is Fed h oared doll .v
($1BF rless
I
1 eerily that in thep f rmmace of the work for which d -'p nth is ic.aed.I
'hall not employ any person in any manner so is to became subject m the Workers'-Comminution Lvws A C f Date s n -
Applicant
c NOTICE TOAPo Tho WoT,IL a Compensation
thexaborCa ,yuhmuld' -
hocsubjectl Tho Worker C p :t p t the Labor Cole you must -
'Q fonnwmcknply x%Ih ¢n Pr or permit shall be ace nal re(kked. -
,�•o-y u
„Fti CONSTm,,it ONLENDING AGENCY -
INearby II thatII .t t dog aye Ylittleperformance •r,
a,A kern Roo whirl(h spumt ensued(S c 3(19] CIv.C) ^ �wf
G Lend None
Z Lender Adlrees' - .. r } t • .
V thatIerryIM1 dthis aplcl and state that[lie hinformation
•-�
arrival. b I ply with II city J countyordinances' d thanl ( t5 .. r
I C.7 mn ld gc t I n andher,, apseno a P -t t fm scrymomer upon -
�y W me all mount tedp-I (yl Iyied p......
1
Ey y (N ) g I .a mJo 'Ty' d keep l rmlc.. the C ly C pe t g d + '
tr Vi Iiab'If I d I c t I pe e h 1 my in any Y c. 'tea est.aid
V ,� Ctry' e encu th ian� 1 tl is p 'I -
^•" AP Co TGN A 14 WITHALL ON- INT n
Rc r ` a Gv Issued by. D.
Z' '
Si trot! fAPpl cnndCnurattar Date' Re=roofs .
HAZARDO MAI TRIALS DISCLOSURE, - -
" Will the app!cam Drum building,.Fact I handle h N iedal Type of Roof. e - '
as Ireland hyme Capers )Mutepal Cod Clrptr9,12.wdthe Health and safety
Cal Section 25532(u) - _ , - ' - - --'
Dye, ' •: �;ElNa + All roofs shall be inspected'prior to any roofipg material being installed.
Winn app t f t bidding occupant equal t a which If;a roof is'install_ed without first_obtaining an inspection,] agree to remove '
mnilIt J_ n nom dtete seined by theBay Ani Quality Mumg@anend
Diol t - - ` all new materials for inspection. Applicant understands and 'will comply with
o vane -' ❑Nn` all'non-point source•regulations. -
in '" 1 h cud the d n t q ' u''ind Ch pt F 95 of(he •`
Glif tnmHealth&S f ryCode Seclons25505 _5534 md25534 imajohdradth.1 ' " v A -
Bonnnminng�keenaearrendynnv6ata;mtn,mathiemymePa;�mnuh>mnkhryma - - . -
'vP' a rcyuire enL wl' n e net pr or to txcua e of t Cerdfcat f '
8ignatureofApplicant ,± Date ^ -
r
+
wn roraatnnr etas nt ', Date All roof coverings to be Class `B" or-better,