02090055 CITYUILOD GDIIVIISIONNO CONTRACTOR INFORMATION:
PERMIT
B IL IN ADDRESS: PERMIT NO.
��5� BERLAND CT SMART WINDOWS & DOORS 02090055
5yNEBS ,E APPLICATION SUB DATE
riC�L M,-E F SCOFF 6305 DOUGHERTY RD 09/09/2002
f PHONE: (925) 556-6010 SANITARY NO. CONTROL NO.
o z z ARCHITEC(ENGINEER: BUILDING PERMIT UNFO
O O « BLDG ELECT PLUMB MECH
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z yi LICENSED CONTRACTOR'S DECLARATION Job Description
p z_o I hareby,affirradim lam liccmed under inions of Chap¢r 9(commencing REPLACE WINDOWS/DOOR
with Sanwa Oo0)of Division3of,e Bon nil Professions Cod<.and my license
=yyj otrfumll ad t. CZ
ac a, L ,n n ue.« 73s3
i;uo
LLF Da, a -G Can,
F O va ARCHITECT'S D RATION
,� I understand my plans shall teased az public records
Y
wp p Licensed Professional o
w r OWNER-BUILDER DECLARATION L P 18 2002
I hereby affirm Na,1 1. exempt from 0e Cormorant's Co e:Any c U.far the
F Z a which re reason,(Seaton 7onsi Business and Pro@cions Code:Any city orcounty $12000
I x o which requires a permit m mantel,alter,improve.demolish,or repair any swewrc
w3m .Imo,m, ' once.at revIo.thea,ficam for such .it m fle.alandsmmmel _ _ _ __ - _. .-.__ .
sl the Igen-epurommusita ni...of,he Conateors L¢ er
nsselaw(Chaln9, ^
(co cngwitdSeclon71100)ofDivision 3ofNeBusiness and PmfetsimsCadel ! tA0/9j.,;�S;j'!,);� Valuation
or that he is efempt tha auiro Swathe basis fm,he.11c ed ucmpddn.Any violation, ,
-of Section 7031.5 by any ti,licare far a permit subjeon she applicant,o a civil pcnahy:
,of a.,mamthat fvehundred aanan(s50o1. 101ApNk)TtMATION 1F1'''rf'"' Occupancy Type
❑1.az owner of me property,or my employees with wages as their sole mmpenmtion,! 102 - PIERS
-will do the wod:and the Structure'is'not intended or offeredfor sale Ism:7044. 103 - UFER Required Ins actions
"Businesi and Profesions Cad,:The Contractor's Lima.law docs nm apply m an q p
owner property Who builds or improves Nm such
thereon.and who docs such work himself l 104 - REBAR _
or through his own employees.provided improvements arc not intended�ded a
',,uTnd for sale.IL hawc"vd,the Midding or improvcmcm is sold-within one yeir off—...___-...- .__-._.. ..
105 ANCHOR BOLTS
'comylmion,the owner-builder will have the burden of proving that the did not build or improve
improve for purpose of Sale.). 106 - SEWER & WATER
--- -
Ol;aucttheulject(Sm.7044.uwsessammme,flons radi heamn,iorsiu' - 2.02__-.._iJNDERFli00R_..PliUMBING-"- ,•.il.::..or::::.: fr
construct,rte project 6ec.7t%4,Business and Professions Coiled The Conwaor's;
203 - UNDERFLOOR MECHANICALp:.nc '0li, "':If
r r Lieci Law does not apply man owner of pr.,a,who builds or improves hereon,
'" ..and who conlmc¢.for.such_projeca,wals a commcmgs)liccnxd.pursuam to.she'
?.er ",.,.I I',1c:1Cs D:,' `•,"L .., .r. .....„. -`-- -2'04- - -UNDERFLOOR FRAME - -- -- ._...- ---=
eanta<.xeminenaetaw.;, 205 - UNDERFLOOR!i'INSULATION
❑I am excm t under See" B&P C for this mason i '
"` `": .,. 301 - ROUGH PLUMBING
'own Dale' .•..".. '
" ' WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
Ihereby,ftintunder peaahyarre arybdeofthe following ee,lamimes: - 303 - ROUGH MECHANICAL
0 1 nave'ann w01'main6in''a'Cenirteme'or cuhun,in mIfu me for worker. 304 - ROUGH ELECTRICAL
icy : Compensastom-az provided for by Section 9700 of the Libor Code, for she
performance of the work fartwhich this permit is Issued.,. 305 - FRAME
,171n e a li,w t w k c pe5aionla'r�n< sts306 - HOLDOWNS
'n0o 'r m<�bo,coder m pert nn,work m which mea Perri as 307 - INSULATION
iz veil.My Work rs C pc t I su c a and Pol cy n,- re'. -
c ,- .. ., ,}Pba Sb-ao oo/cY(o$ - 308, _�—SHEETROCK-._. ._.:__..�•___._ ==,ius;inr _..,�...,....,._..
1 r HCERT[RCATIONOFEXEMPI'IONFlt MWOR� KERS—-� *1...'.%:'`.? 309 ('`".EXTERIjOR ��L'ATH+
COMPENSATION INSURANCE
- -- -310 „ -
.. .rot. -
QTis'seciion'necd'not be complcicd if peoni,is for one hundred dollars �
'. .(s,aalarma�I, I 311 - SCRATCH COAT
nif �— "3-1'3----ROOF,.-NAIL
-_
I rtlo any ,com1, "nn okr h nm5pe tri, ke i' 501 - FINAL ELECTRICAli`E`�TERGY
'4n r t pl Y >pe iw m become blew, theWorkers
n, `
•c pe sat ala arch .Dine ..-_ FINAL.. PLUMBING--ENERGY---- - fa
Applicant- . . - ____502
;NOTICE TO APPLICANT If. makingafter ,hsC nfct fExemption.-you should 503 - FINAL MECHANICAf ENERGY
O forth m o ply� be bI<n w th work r C pe ,on p o 0 of tM1e tabor CMc Ya .,
in nvrat,:an.a ,n pit haubed«mil d
504
- FINALBUILDING._ ENERGY
NERGY -._..__.
tCONSTRUCr10NLENDIhGAGENCY "' "' I -. 'I'505 - FINAL ELECTRICAL _
> I hercb)' ffmt th t th n,met I trill g g n Y fo th perform ace
of the week far ohm permils6lued(S 3000 Civ 506 - GAS TEST
ISi Q ..Led Name' w �. -_..- ..
p z 'unae I.. ".. - 507 - FINAli PLUMBING -
U O 1< rr natlla dint: pphcma astatematin bo l rma,ron s 5*Roof- -.....ECHANICAL
W [.. '<ortect I g t _mply lh all c ry d un,y M'n ce d t t srefining 50 GRADE
-OU mb 'teg t t nil hereby th a prcunm, " fth ry,o<te upon 5 gstrs,said 5B RKS
V "' 7' gD $ LCOMPLifLP1\Tsol LT n7 n +"'' Issued bDate
m.,,r Re-rooft I Type,of ... , .
'Code,a« y 0 Cupertino Mu c p I Cad Chapin 912 d,he Health d Safety
S , n 25532(al e t 1 1 W5 s t �. s 7
°v 1 °�" ..All roofs,shall be inspected prior to any roofing.material being installed
wain ppl'c , r(t b idi g , p t eq p em a e,which If a roof is installed without first obtainin�i P an ins action �I Itg tee i',remove
cm t h aMous o f ant.as d fn d by the B y Arcn A r Qual ty M ndgcm<nt
°S ct _all new materials for inspection Applicant understands and will
❑Y r.� ' , RN , ' `,i �`'.' -'all non-point source regulations.' '•. h . k r;,, . .. comply with
. ...
1 h ve read,M1 h zadous match h requirement,orderChapter.6,95'.f the
Cal I H lth&S t,y Code,S ci onv 25505 25533 and 25534 I u d m i th,
ifthe yf th not
wyhaveas tthat t .yrsP bltyt ally the
QscaOcc t be , t poor m iv nc f C ri team of
4 g y
i DJ I Signature of Applicant Date,
G2 . .
9
t owmon7e/, t All roof coverings to be Class B or better
OFFICE-...._... _.