02070060CI OF
BUILDING DP DIVISION
PERMIT
CONTRACTOR INFORMATION:
BUILDINGADDRESS:
PERMIT NO.
10172 BILICH PL
CUPERTINO PLUMBING
02070060
OWNER'S NAME:
APPLICATION SUB DATE
MARY & ROY TEAS
10297 S DE ANZA BLV
07/10/2002
PHONE:
SANITARY NO. CONTROL NO.
(408)253-0618
ARCHITECf/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
i LICENSED CONTRACTOR'S DECLARATION
] eSC tion
I hereby arms that 1 am licensed under Drovisions of Chapter 9 (commencing
[rr� .iT�
Sim Section 7eoe)ofDo, is,en3n1Bn: s: and Profession, Code. and my license
COPPER REPIPE tl10Y ��
in full a and effec C-
J
LLicenu L p
Dam Z 7r, 112 mr
ARC D. ARA ION
E
JI�I 2 S ZOO[
5 1 ndcma yp "II s tic
l
zLicensedcites nit
OWNER -BUILD DECLARATION
BUILDING
to 1 rumor affirm that 1 am exempt from the Comment's License Law for the
following reason. (Section 7031.5. Business and Profcuns ioCode: Any city or county
which requires a permit to construct alter improve, demolish, or repair any secrete.
$5000
R _prior to its issuance. also requires the applicant fch parmit to rile asgned sumncns.
that h Is historical pursuant to the provisions of Me th Buaors License la (Chapter 9
(c ' g s ith, Secuont76M) ofDv:- Jof lh Bustin nand Pefc ionsCWe)
CQ
f Valuation
1sYL FL EI�OIs�.[Ca>•, . I 3 t��f i
/f ?�L flub
`i,� i
or man h It exempt thtmfrom and In, bas f shealleged xe pt Any violation
1� V V
+.` - Jlt.�_:
..of Section 7031:5 by any appl earn for i permit subjects the applicant to a civil penalty
of not mfive than e hundred dollar, (S500).
_
202 APNNDhFL00R PL BING "' Occupancy Type
❑ 1, as ..net of Me prefatory, or my employees with wages as their sole compensation,
1
9i
-will 'do'tne'work, andthe structure is not intended' or offered' for salt fSec: 7(160;'
- -"3 "" -
Burleson' and P66fessions Cale: The Contractors License law dots not apply to an
502 - FINAL PLNM91g4 nsENAqVGY' r" 1 "'3 r
owner of property Who Wilds or irhi thereon, and who docs such work himself
ar Mraagh his own employees. provided that such improvements art not intended or
507 - FINAL PLUMBING '
-
offered fo, 1al'If'M1 th 'bild B P -mat Id M one Y ao
_------ ------ ----._.
completion,
a pimion, the owne builder will have the bnMen of roving that he did not Wild or
mpm e, for purpese of sale).
to------
Of he of the pmpeny, am aquiNcIT, t (g w M Tee:)
constructTh Contrmm
c o tie t aM1 project (sec 'loos, J f .. ins Cade 1 The
themes
i
I
License taw docs not apply reit.j owner e
owner o property who) Ids m rmpmves Merron
improves
1,.'
- s-
lh
projects with u.conhanm(s)licensed Pursuant.ro. the_r,r—..__.__--____-_.....
= _andwhors
I
License taw.,
License Laii,.
',B&PCforrhisreason[1C..�:�,�•:,,r
_. __...__. _..—.._..
❑lam exemrl under Sec:- "' s'
01 am exempt
_ OwnerDate
'_
i,_`;" WORKER'S COMPENSATION DECLARATION
T1
1 hereby IRrm under penalty or pc) ryone oflthe following dmre
lationx
CI have d will I a m m Cenific of C muIf re for Worker's
I
Compensation, m:pro dad f by Sect 37W of theLabor Code, -for the
_ peiformance of the work for which Mis permit is issued.
❑ 1 have 'and' will maintain Worker's Compenstrich Insurance, as required by Section
- 3700 of the tabor Code, for Me performance of the workfor which this permit is
issued. My Worker's Compensation Insurance carrier and Policy number arc:
ea is ✓%TEr(%N�,+PaleY'1/'' /
so, .
r ' • �,i
C' '
+ 'CERTIFICATIONOF E%EMDf109FROM WORKERS'i -
S' d * 1 r R r T D•^!
-.k i; 4 <t �._� i �' ,.Y11 ..F,. tL'i, \a fr
' 'COMPENSATION INSURANCE
"'(11iiisciaminn d notli complete([ if thpermit is for One hundred dollars
t' i i,l--"—"-"�`,i .__.... ,. ,,..._.
(E 1W-) or less.)
II nay that in the Performance ofthodcf oo hu perm
---
ih II employ any Aman any man as m become subject io the Workcrsl
, , ., • , ♦ f.. " ' ( '
eal
Cnmicant on Laws of California. Uam'
Applicant -
is Ceniticar
NOTICETOAPPLICAN'k If, afterperwo
-"-'
^h
the Laboru odeyshould
LeWr Code. you must
Wcomiffico
the Workers Compenuthi permit
shaoflhe
� foorhwiN comply with such provisions or This p:nnit shall be Jcemed revoked.
ply
)
CONSTRUCTION LENDING AGENCY t
1 hereby that there's educt lending agrnry for the perfonnansx
--
t
waffirrohich
I of the work far which ah x penal u slued (Sec. 7(197, Ci, C.1
e.
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'" '
I-- f.endcr'i Name'-- � ......._ .. _ _ ,_.... .. _ ..- . .._ _.... _.. - ^.,
Lenders Addrexs,+ "s ,.
...
I have mad alis and slate Ihm is
e, II agree
eve inaws
.'lr;Gil
�
coo anarien
correct. 1 to c
to comply with all city and
citys and
and vac taws miming
raising
on mprosenotinces
construction,and hereby ecaiiemposes. fives orchiscity reenter upon
to Wilding con..ioned
the abovementionedienionco propend lin inspection
prpertyfrinspugwus. -
-
ewe) g to sae tle- ify andk
rd sihe City acre tinbnga nit
uati I r e too "s nits c d aptnse. M1 ch maY n anY Y c gainer said
"heir may
C ty cos f I (dor th p rte I
>\prLIC V UN ST
n
DS. )\v COMWITHALLKON-POf.YT
UR tI nD
--
Issuedby: Date
1 V4�
goaL�r ofAppl'c11 nr
Date,;
Re-roofs'Ile
DOUS ERIALSDISCLOSURE -
ell the pplica t f t W Id g p t -i r handl loud m t I
d
Type of Roof .r
r cd byrh C n
.- -_ .p "
"
4/
_..
--_All roofs shall be mspepec[ed.pnor to.any rriofing,material being installed.
cm ah w'u the , i future bu SJ ng parousequipment devicesement
b � air e ore maw t defn<J by M Bay A`� r Q y'ry Management
if a roof Is ins'f lledf without first obtaining an inspectl6ri"I agree to remove
District? _ _ ..
-
all new materials for Applicant understands, and will comply with
1 h cad+Me wrnrdo mater' -
-inspection.
all non-poinfsouice regulations;. "--
s 1. j meats aural , Ch pt 695 of Me
Onl'[oruduHcalth&Safety C t, See n25 525533 and 25536 l understand that
; ff he buildingdaes ecu nd v at no , Nm it is my responsibility to nitrify the
occupam o he A' mu m pr
iremprior
met to issuance of a Cenifcme of
Occupdnc - " '
r
'
,
1 .. _ !- lJ _ .
_ Signatur1.e of Applicant _ . Date
All roof coverings to be Class B or better
or ami: roa- Date...
_OFFICE .