01070132 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10162 BILICH PL WATER QUALITY PLUMBING 01070132
OWNER'S NAME: APPLICATION SUB DATE
CHIN WAYNE F AND JOAN L 1860 ALMADEN RD 07/26/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 267-9330
w O O ARCHITECTIENGINEER: BUILDING PERMIT INFO
a, F BLDG ELECT PLUMB MECH
n LJ C__I IJ LJ
i LICENSED CONTRACTOR'S DECLARATION
o y I hereby affirm that l am licensed under provisions of Chapter 9(commencing Job Description
p v_:e-w with section 7")of Di,hdon3of the Bu.,mess and Professions Code.andmyfi.m. REPIPE
a m S
is
full force pi cycn. s - gg�p® p
to ec z License lass�� S Y!!,Y 4w
K O a O Date S DECLARATION`
ECLG n
W 3^• ARCHITECT'S DECLARA t 2002
En g I understand my plans shall be used as public rcmNs
ia,O Licensed Professional
LLn� OWNER-BUILDER DECLARATION ��'
I herchy affirm that 1 ant exempt from the Contractor's License Law for the BUILDING
1-Z>` following rea=rm.(section 7031 s.Business and Profe.sion.Code:Any city or county, $3000
xE� which requires a permit or construct,alter,improve,demolish,or repair any structure
to3 .,prior to its issuance,alsorequires theapplicumforsuch permit m fileaslgoedsmtement
that he is licensed pursuant to the provteionsoffa Commencers License Law lCbapter9 ,,est }�a��r-pp ppppa
(commencing with Section 70001of Division 3 of the Business and Professions Codc) Valuation
;'Y „31�2F1lSxF, UV,:,.; k. : B(
or Ina,he is cumpn thcrcdmn'and the basis for the alleged ctenipilr6.Any violation 1
-of Section 4031:5 by any applicant for a pn
ennsublects the applicant to a civil penalty
lrrnofmomlhanivehundreddullers65001. Occupancy Type 202APNE�41ff�Li2FLOOR PL BING''
❑1,as owner or the progeny,or my employees with wages as their sole compcnm,ion. _
--will-do'the wok-and the structure is not intended or offered for sale(Sec.7044, _
,Britimss'and'Pmfcssioas Code:The Contractor's License Law does not apply to an 502 - FINAL' PIR r1dJ0sIRNlDRGY'`' B ,u r
owner of property Who builds or improves thereon,and who does such work himself
or through his own employees.pm ildcd that such improvements arc not intendedym of 507 - FINAL PLUMBING
,old d t said-.ITh - - ,h 'b r,e p IIs Id ,h one year of ,�,• �.,1 '3',t','
b611cprove for
the owner bufdcr ill have tM1e burden of proving that he dad mol bu'Id or
improve for purpose of sale.).
.__._._..._.-.._..._...._._—....._. __.._._.__..-_.._.-_.___ __.___ __.___...___.._...._. __ _
co Lasowner M,M1eprvpenRam Businvdycommfe"im,with licensed Thwnmaceen to 11 \,i P'.r
- _ cunswn the project(see
appl to a Business midpro Picsarty who
b ills of impTheroves
nes tmnton.iCs
License Law docs not apply, an owner of progeny who buiids of imprrvcs thereon.
_. ..and who contra¢for.such.pmlcds.with a.rommcmrts3.l¢cn¢d.Purauam.Irshe t
Comreem,;License Law.,. ______-__._.-__._.._.._.__.___-._._-.._.—..____._.._._.__..________ .
_ ❑lam exempt under Sci. ''f" ,B&PC forthis reason J:IU Inti c ':[;:sll
t
..�_ Owner.-'.. ' r;. •:. . .:: ..:Dae - .f.
WORKER 5 COMPENSATION DECLARATION
re
I IxrebY off,.torderpFrally of pc l_Y f sac foil g dual ,ions
p 1 have d'will onamodei Certificate of c nsem in self-iname for Workers
• Compaoad as-pro den! to, by Senim, 3700 of fair Lada Codc. fm the
_ performance nftne woakior.wbich ten penny is issued:.:
❑I nave d'ntl will aiuin15in worker:Comlieiommn m'smance."as required by Sectio^
37W of the'Lknrr Cride.for Ire pifonrfi ce of the wuik',fof which This permit is
m d Myr'rler iwCompen,ation Insurance c Ak/rand Policy'nomiter am
Cane icy N�'E/�� I +f¢ _. ... _
Put .. ._ __ ....._... .: - - .. .. __._._..
!T 1. I l RTIFILACOM OF COMPENSATION
INS FROM WORKERS F
Us
:T COMPENSATION INSURANCE' a'
t(Ths In'nccd not becnmplaed frac permit is for ooe hundred drlLm _ s \ 1 ". .kCt!D::"i) r,pl
(5100)or less.)
-
.. - Workers'
I qpl I*fury the perfo c f the cork fo h he u permit is Issued.I I r -
Com en tion L tR m a y a oe io bccdme subject nh Wark ri ISO tf .r i•'a .
compo ml on Laws of c 1 nes¢, _
-.'Appl cant- .: ..
NOTICE TOAPPLICANT If fan k' gIh Con Get of Ex<mq yW shwld ---'-" '" '
z O for hw th cnfroplmy wthieth Wsuch
provisions
siopnes lir this
ra pem I shall be
seemed revoked,keydo.Q
;. .
'� <,•+'CONSTRUCTION LENDING AGENCY a 1 h rttiY ffmi Nm N i-a constm<uon 1'aW ¢dgemY 1 die peB'ur intro
..'
r.s
rf the o k for titch nh per i 1 tisued IS .3W7 Can.C 1 "'
0..t "Lendtt Name ,..._.,. ...,i'� ......_.
Lender's Addrccs .. - _----.__- _._.... _ _. .__ .. ._. .....
U � I cenify toes thane mad This applicminn anJ.nae thauoe above infnmutiun is
"Ta[;-F 'overt.1 agree to mmplY^with all city and county oNinanees anJ aa,e laws riming
U o b Id < n t t J he by th pr I I s fit IY I t upon
he M d
t}.t G (W 1 g t sa Jeal fY a d kir p 6armle M C ry of Cupen gains
W liab lu e 1 dg m. co Is rid pe h h y n any y < g tnat said
U Z City c m prince ohh g ro g flM1ica n - � ����
PPLIC .}ANDS AND WILL CONPLYhi'ITHALLNOYF01\T h' Issued by: Date
i + T 1 Zij
Sigm ure.r ,fir lcr:."
HAZARDOUS MATERIALS DISCLOURam''.:I:`..
Re-roofs
E °
NII Nc appl'dmo flu building upam, 61 Idl h- -m
Ido a�enal of Roof.-..
s d l d by th Operon M f p I Cod Chapter 9 12 and theHealth and Safety
---Type. i .-�ar•;. , -._._.. .... _ t.. __ _ , .
Ci{de Section 2553 (a) Cvt
r ❑Yes t '0N sat (}\. , _ ___
' y is I - All roofs shall be.mspected.prior-to any roofing.matenal.heing installed.
lYll Ihapplicant future building' occ p nt u: equipment rde'ice.which' in'
stalled ata fie t In t. defined by theBay Area A a al-)M gement If a roof Is installed wi[fiout first obtaining an inspecnon;'1!agree'to remove
l Dar,ov all new materials for inspection Appllcan[ understands and well complywith
y l;' all non-point source regulations ._ -
" I h've rind the h=nN i materials q immenli and Chapter 6.95'6(the
- -
Calif uHcahfi&Sa1e,y Cod 5enionz_5505.25533and25534 I,understand flea,
ftfie Wfd gdasfioi c rttnOYh a ten t @ n -nif the' .__.. .. . . . .._. ...
Y . P sofaC y
cu I f q 'r' eta h h t be met p m oma ce f- C ntOcu 1 •' ':
ocna nc a.. ,_ e. pP _ .._.
� - './ �7�,-r9,i ._SimnatureOfA Brant Date
c
Owner Ino^=ea ag t Do,,,, All roof coverings to be Class B" oi'better
OFFICE. _. _. - --- - - - ... - - --- ----- - -- '- - -