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CITY OF CUPERTINO
BUILDING DIVISION
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PERMITCONTRA.Crd'OL2-•BdVLa,OR�4IA'FLQ)N
BUILDING ADDRESS:
PERMIT NO.
MAY CONSTRUCTION INC
02040100
OM`NrER'S NAME:
APPLICATION SUB DATE
'ERIC HO
210 SAN JOSE AVE #23
04/18/2002 .
PHONE:
(408)294-6763
SANITARY NO, CONTROL N0.
ARCHITECDENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
u L_I L. J u
LICENSED CONTRACTOR'S DECLARATION
1 hemby affirm that I coir licensed under provisions of Chapter 9 (commencing
I
Job Description '
with Section)DDO)af Division 3 of she Business dProfessions Code. and my litter
isin (�Il forte and'eRcct. 1�s C�y CS a
LrT<nyCly J
UPGRADE SUB -FLOOR, ADD GAS LINE.
Li . / I
D ` o u< s
�B ii R q B
ARCXITER.1 DEC4 01 �
1 understand my plans shall be used as public records
W �' Y �ae ED
JUN 2 4 2002
L«nxd Professional
ON BUILDER DECLARATION
law for rhe
I hemby re thin I .(Si .. ore uusin from he Conions
following reason (Section 70313, Business and Professions Cade: Any city or county
Co e: Any c
which requires permit m construct, that, ober, improsa, demolish. or repair very swcwrt
1 O O O O
B UI
n
-pd touss aen rcqu rtune.Plant for such pemuuo file a signed ornament
_ ._
--
LDJ
rhoo he. s licensed purieart sa the Pros stuns of die Ciao x[W 9 License Law IChepter 9
(com heiii strS-noon]DOD)OfDn'isoo3of,hcBusiness adprofisihmsCade)
or that he n exempt uerefrom and the bass for the alkiial
Q `t� `� i., f3iJl'Z t%43 L•Ul'J�'1 t \.a, Valuationv
" * :\ 11. i r
mmpslorL My violation
-of Section T03t1 by any applicant for is permit sabjms she applicant m eTml penalty -
'of
,
riatmamrhanr.enandredaanba(ssoo).106APNSEtvS�2,
p'tu,�h�
& WATER
""''"'" Occupancy Type
- [] 1, as owner of rhe progeny, w my employees with -ages as their sole mmpcnsmion.
i
will'dol In and I smiciure is not Imended w oRcred'fos-sale (Sec.'70ag-
Business and professions Code: The Contractor's License Law does
-
p rk..a as
301 - ROUGH PJJi$1 WOlMspeCtlons
net apply m an
owner of progeny Who Wilds or impro%es thereon, and who docs such work himself
-gruroughhis-own employes. provided - that such imprommems am nor intended or
-If,
3A.Z QR_
Is ra ole. howem the building or impmmosem is sold within one ..
'cdmpleto,ue
_.C,__TUB_&
__ .. __. ... . _ ,.
-$ROWER'
owmrbunderwdl nave the Wden orpmving met he did not Wild or
502 — FINAL PLUMBING----
improvc for Wrpom of salcJ.
--- ---I......----- - -- - --
506 - GAS TEST
_... -
CuowneraLdre'propennam-aalusivdycamractingwiulicn) ThO ntraaomso
project (Scc.70aa, Business and0ofessio Contractor's
- _..._._..—..------------ —PLUMBING—----
507 - FINAL -'__. -• L..,'. „�,..
License Law builds Orm,
and.whlawdoesnotapplytoot Owner Of WopenY who buildswimproveucreon;
.ard.who.conwcu.fw ouch. ecu-wiu.a.conwct or(s)IkeoaN.purswnoro the..__..
o '• lil.: i.
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ConuanotsLicenuLaw.�_�l
❑lam ---reps updei Sok"•. -_ a'de fn
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PC this
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`� MWORKER'S
COMPENSATION•:,
-., N DECLARATION
_
-1 Hereby aRrm end erpeiialty of perjury one of the fo0owing declaration: --
❑ 1 Mm andstill 'rsoinuin i'&.niBcam I
of Consent self -insure for Worker's
Compcnaation, ne;proAded for-by-Somion3700-of she Labor 'Code; fbr me
-
piformmsce of Newark for w" this pemmt is issued._,,. ,
O I ham and will maintsm.Warkers ompcnmTio Insumnre, u ref red 6y,5c ion
{
3700 of the Labor Code for ace perfomranc- of the, wads for - which this pemus'I,
issued. My Wohers Contipansuadlau 1 sorarem camcr. aM Policy umbo ace
....'
'vCERiIhlCAT10 OP PILON FRQM WORKERS•. -.
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t -t'\ I v _ i. °' f r., r. l.i r.. ;. r •.1 •` Yi....�.r....
_.. COMPENSATIONINSURANCE "- . d "•
- �.
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-oder need n t beoompleicd f rhe permit is for one hundred tlollers
'
._...,.� .. �._�.......... __ -_-.
' ! \ I 'v � •'
Ig100)or less)
m l
� r
tr , >r 1 c rufy Net In rhe perform n the rk f A ch urs t a ed, 1
a n ct
shall n regi Y my person f any manner s t bcc me sub) t to the Compensation Laws laws of CaliforniaCeLDam''-
-Apppp1 -._
NOTICE TO APPLICANT If a¢ making this Cemf me
_ -_�-- ------ _—..__... _.
ofE -rept on you should
bicomesb)ecu'ue WorkersCompenxouon prover briCof ace LeWrCdde;
,--
''"-'`( ""-
you mum
fonhwru comply with such previsions or urs permis shell h domed revoked.
e�CONSfRUC710N_LENDLYG AGENCY° .., '"
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a°
1 hereby aAf�{nlhat uerc conswdl on 1 d ng agency for ueperfarinance,
of Om ark
- Lender's Name•.•..•_............:...:............__..-v..:_�_..:_:a:,:._s..
i
._ _...... _..__.. _._.__.—_
Leadcr'iAddresi
I can fy u t 1 have d u s applicat o rid stare Net ace aW a reformation is
coirctt-I agree m comply mth all my end counry ord nares ard�um hws rtlnmg
to Wdung mnmmnion, and hereby auuoriu reprcicnutives'of
IThis city to enter upon
aboyememioned•property for inspuOon Purposes,
_-..,. _._.-
(We) eine- is sed-; Indemnify end lump harinleas the City of oupfiiiiio` against
liabilities, judgmenu, costs end efpenses which may in any way �xmetaganat said
C iy n consequence of she gaming of this mut
'
_
APP RCA NDp_RS U'DSAt\1}UTI,L`CO\tPLITIt LTH ALL\Ol- L\'i'y
r%
RCE R ATi s
Issued by: Date
grgnaoue ofAp an m or 7 r .•'
'+ RDOU; MATER]pLS DISCLQSURE 1 "l
Re -roofs
wnme,ppla tmrd ride gtt p tscamm�.tllenumdadI .Ma
u0 Bned by ace Cupemrm Mumc cod Ch p¢ 9 R aha me Heath aM Sarety
Code Seeuan 8332p) { 3^ Ne.I N L i > 4tt-r� s
F r
TYpeofRoof'- -------------- ----- - -�•--
'v I Ila
A1Lroofs shall.be inspected to.any.roofing
6 WJI u eppl cant o f rc W Id g ac P m a eq rpm< t or d res which
Ie t hazardo c tem era u u ed by ace Bey Area Arr Quality Mahaj
prior material beteg installed.-,.
f but first ••�� •�-•
If a too 3s installed with' t obtaining inspection,
mem
° e '
xm-nm'n
an bagree'to ieiiiove
all new.materials,for ,inspection. Applicant uand wi
l] omplywinderstands
''';Sr;
RhaY J�e'In
all non -point source regulations. _th -- -
^❑InYan
a , aaa mNaat
rcga E r en,p,n evsl m m-
Glifomr H lac@Safely Cod Secuans 3530323533aM 3SS3a.l
1• 1f i
understand mm
1faceart does erne enene Nat us my usponrblryto nu(yu""-
-
which
acupmt Ne rcqu sereno h ch no i be re t per u, }sac a of C -n fckm of
Os'fupanc 'r
r .r "
st / /
- \
SignatureofApplicant.,_.__
�B✓n7
Date
0 n« ° 1C *---,
All roof eovennes to he. Cla<e ' u n: l.e..e:. - • • -- - " "
--.. OFFICE...__-.._ ....._