02090010CITY OF CUPERTINO
CONTRACTOR INFORMATION:
. BUILDING DIVISION PERMIT
BUILDING ADDRESS:
804 BETLIN AV
ALLIED AIRE SERVICE INC
PERMIT NO.
02s0��90010
'MbWEVENUGOPAL
661 SINCLAIR FRONTAGE RD
TI
APPLICAOMTT4 2002
PHONE:
(408)934-8844
SANITARY NO. CONTROL NO.
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ARCHITECT/ENGINEER: #
BUILDING PERMIT INFO
' .. ..
BLDG ELECT PLUMB MECH
h'=LICENSED
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CONTRACTOR'S DECLARATION
I hereby affirm that l am licensed under provisions of Chapter 9(cammeming
with Section 71g)(3).1' Division 3ofdie Busineseand Processions
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REPLACE FURNACEJp/AD)�seripC n
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Cod,.and my license
Is In full forceede
License Cl x n � C Lle.as 'uoo 3
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ARCHITECT'S DECLA TIO
• I understand my be
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plans shall used as public relnrd.s
SEP 0 9 2002
pLicensed
Professional "
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OWNER -BUILDER DECLARATION
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D naso .(fieri that 1 1. exempt from the Contractor's Co License Law for the
following hereby
(Semon 7031.5. Business and he Contras Code: Any city or county
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�' a ®��� $3272
n
which requircs a permit to construct, alter, improve, demolish, or mp?ir any structure
3m
-
.. priorto itsne,abo 9 W pplicant forsuch permuofile as,gnedstatemenr
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r, 6gn4noc &Oal, �! 4 i (L1T
L"Q q•s { -,V sp.
Valuation
that unxdpuisuamteU-p i' matheCarniLicenseLow(Chapter9
(ca menmp8 iNSr{ 7000) fDivision 3.f the Bustnesspnd Professions Code)
or he is exempt therefrom and b for the alleged ex
pat
x.: cam. s arae a. so ,,
Sm m li t ria ,y
of Benion )BJ L5 by anY applicant fm a permit subjecu Jrc appliam m a civil penalry-
lofnmmarcNonfivahandreddouars(S5oo).
301AP-NKOftH PLUMBIN'rnx'.dii
. Occupancy Type
a
❑Liswnerardreprope"y.orm>employeeawithwagsz< ir<mecompenmtion,
303 — ROUGH MECHANI
AL
wIILd"'me '.nd'Pk:i,imxswnurc'Camcuxnde or License Lmv1cred foes a. apply to.
1 Boeinus'e7itl' Peofe .d h Code The Com, inter License Law does not apply m an
304 — ROUGH EI{ F4 ctions"-•
owner of property Who builds or improves Wemon. and who does such wank himself
505 — FINAL ELECTRICAL
othrough his own employees. provided Nr such arch or
'bf@rtd for'sale if, ho - th'ti"Id'ngonmprovemcnf sold within Linc year of
imlimmprotis sols one year
'completion, the owner builder will have the burden of proving Wal he did not build or
-.---507---=-FINAli"'PLUMBING -`"- _.. ._.... .. _...
,SA<t, kl ,'.?l i,. '•'.
improve far pmpomof aale.}
508 - FINAL MECHANICAL
❑I as ..x,.fthe propertY-artl lr t t ithl a oatimacsia
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oia.v
Liner ct the p 1 ct Tapp 7044, Bus nes rid
RosinessProfession, Cod ) Thtmcro
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License law dins not apply to an owner of property who
etywhoIds or improves Wercon,
improves n,
and.who-emmm�se ch_pmjecu wiNa.commnogA.licensrd.pursuant m Ne..
).
_. -_________..-._.__.__...-____...-_____._____.___._,....-._.._.._.�________._.
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Contractor's License Law.... .. ,.;
❑lam cmpt ince(5dc'' - '("r"'"` �9ffi P C for this mason
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Ownce :... au.„'?•„ -:..;,:,Date":. ,!:..:.... r
t ' WORKER 5 COMPENSATION DECLARATION
I harebyrt(firand pen Ity. f pc0 ry a f N foil -ng d I dons:
\
I ha -'nJ III m msCe'rt f m f Consent m lelf-mom, for Worker's
Compensation; as provided for by -Section 3700 of the Labor Code. for the
performance of the work for which Wis perms is is Lied; ., ,
rI h -'d II moist W k e,e Comp t 'I kuranc_ required by Section
IN) f W 'L' M Cod f r thepelf f
th perm t is
rkf which
issued My W k s Limpet t I irons carrier d< P611 y bel uc
C amer�l OF PI<yN %/y' -OJ ✓O �l
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'...j'.�.�1
Orman
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i CERTIFl ION OF EXEMPTION FROM WORKERS3
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E3:.k.,,;f,3:6 /P9yY�. fig r,?-)�+:, '
COMPENSATIONINSURANCE�y
(Thin unian'nerif not tic coin leied if the
p permit is for one hundred dollars
"t' a-•' I � � . uC '�'iC" '.)rk`••rrlitC`. IF,',`
(SIOOIm IessJ ,It, I. I,
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_ 1 n'fyN tmshe pcif Lim of [he ukf- hchW ps `usiued;i
-'ploy
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._ -e ...._.... _., ..v
ihall n t e any. Perron n any manner so as to become <object m the Workers'
Compo ut laws ofC I fo '. Dec, -:.
-APPI <a t ... .... .. .. ..
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NOTICE TO APPLICANT If after makingn lilii mtx pfn'yoshmulst
beet mf wb)eci to the Workers Compcnem n prov s ons of N Labor Cid_, you'must
fniNwith'comply with such provisions or this permit shall be deemed revoked.
.. ._. .. ..... ....
ahV'CONSTRUCTION LENDING AGENCY
.._.- -.... _ .. - .. ......__.__.. _..-..,.... .. ..-_
,�
herehY`rflrinWshe erm"ruct lending agency far the performance
;Q
N ork fo which N s perms ,s issued (Sec 3097, Civ. C.I ”'
• nder's Name.,..,_......._.. ...,_-�...-, _..._,..... ..:d.. �.-_-c,.y:_..
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Lender Ad -dress -
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I
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L. i 't<... .. ...
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certilyNac
have Rah this application d sum the W. naive irifivioncomm is
carrier.1 get comply withall c ad mances and state taws
UsoWild
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Wilding suuprtyby uhpsreetri es f h city to enter upon
sodeubsd
O
ropef peuonp
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(We) grt t sa ndemnfy d kahodes Nc City ofC per oaganu
h
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cost d expo h ch y n any y uagainst rote
Cityliabilities.judgments,
City seq ca of the gins ng (this petro t ^
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APPLICA6TllNDEYtSfA� WILLCO LYWtTHALLNOTPOI Ill
SOURCE REOULATIONt
Issued by; Date
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Signature otApplcant/CoI t �::: '..'..,. Drat,,,:,;,
Re -roofs
HAZARDOUS ATERIALS DISCLOSURE -
i..I WII We ppl onto f t w'Id g cuwm tine Linn ole hazvdou natenal
riefined
.Type of Roof _-
try th Cupen Mun c pal Cole Ch pt 9 12 d We He IW and Safety
I ` =" - - 4—mw...- ^
Code S coon 25SJ O .,
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l e II f r, 11 -
ir)q�trrl1]S/'-t
All.roofs.shall,be m(spected.prior to.any roofmg.matenal being installed._
• rwBtneapphpent.arrmreWBaipgmapantpseequ,p ,a, which
<mn her -and - it c m -ants -e toed by We B y Arta A Q al ry M t
_
If a roof isinsialle'd,withoutfirstobtainin an'ins ectioTi