00100087 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO, 00100087
H PI_ l�t�
Oil N'AMF: APPLICAI'I(1N SUIT[)At If
10/11 /2000
HONE: SANITARY NO. CONTROI,NO.
� Z0 CIABIDEC-PIINGINEER: BUILDING PF.Rb11"r INFO
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U If LUG FI"LCI' PLUMB M17 11
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z6 z mon;huSIIDCOcensed under
DECLARATION Job Description
mon;hum i am oftheeB undo Pmv pron+sions C a,a(am,menci se
xw f-x with fill force add of Division losthe Business and professions Ctwe,mW mylimnne
x=- ismrwlrome,mderrr" REMODEL
%2 Licen,c Claw Lieft
w 3 u y Gree Cultural
Ism",fl'IiCI"ti I117CLARATI(N
C 1 andewmnJ my plan,droll Ire recd an puhllc lwlaly
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cco Lirenaed Pmrenvinnal
OWNER-0UILOI[It DECLAINTION
u= I hl motionmm I at.cornpl from tIm Conweml,Liad.e law for he
following mmosecond econd]011.5.Basi told Profusion,Cnm:Any rily or candy
Lo
$F O which requires a permit m construct.alcor,impmro,demolish,or repair on,slrvcmre
ad
a3= Pnt t,i........,alku ar,ture,fluepplload fr such mariou,tile it vitriolamemm
o
(huh I,Sv II II P . f'I C t ,m. L (Chapter 9 Sq. Pt. I'loorArea Valuation
or ' s h see, 9onm .Davi, 3 III l fine n ,marl $G5000j
or tem hr Is 0x1.!101 luvoil and[he Iauiv I'm ubj alleged uomptl Ill Any t.croon
of Scrtio!,mai S s any dura ann for n Icnnh anhj¢"the nPPliuw''o n civil Pennl'y
l,r mm mare them ave lloodme dollar,Ixs(en. APN Number Occupancy Type
❑I,ns awger nl the pmpcay,or my vnpingec,wish wages ns their solo cn"Womalion. Z31 FIR 1068. 00
al do the work,and the structure is not inlcadal or offered for sale(Sec.96N,
Business and Prnrersions Cole The Cnmrucmr's Livers,Low docs non apply no an Required Inspections
,Itr nfpmral Who builds or improve,Iter....,and who aces such wmk himelr
bond,hi+own cmplol prnnidwi Iron Inch imp....meal,:,m an uncalled o, 101 — FOUNDATION
onbme oa+ale.IL howaset,roe hooding o Immo se cult n sola w illill o e year mf G'T E P.S
mvupfetion,700 nwlm-builder will MIc the�holdrn allpmving'hal ho fill Dat balldor 102 —
pmve for Pnmo,e ror ame.l.
1.03 — UFER
?-11of prnlw•rly,am exclusively conlmcting with rcea.nl contractor,to 104 — REBRR
asmoract file Fallon.ser.70.14,Business and Professions Coup matnr's
rhe Conl
Licrnsel.awdiscs all apply a am,nor ofpmpeny„Its build,nriaris ,lherean. 1.05 — ANCHOR DOLTS
and who connotes 4a,itch projects with a control licensed full m the
co1ado.-f Ll e, elnw. 106 — SEhIF_R - WATER
oN 7`e,o�" naso sn:./ a Bxrrcl„Deaf rrtaol,
L( 20'r_' — UNDERFLOOR PLUMBING
rot 'SAuoNDECLARTION 203 — 1_INDF_Rf-I_OOR MECHANICAL_
I hmchy aifim,order smahy of porins one nohe following derwaa'ions: 204 — UNDERFLOOR FRAME
I have.mad ,ill all a Cedircmq of Current m self-insl're for wnrl.els 2115 — I-INDERFL OOR INSULATION
Cnmpet,mion, as loo l for by Scam! 3700 or the (alae Cndc, for the
partum,aaa�nfd,eworlrorwmehmi,p1.r,alisl.octi. 301. — ROUGH PLUMBING
olhall,and will lna'hlminWmrkol+Co..,,,sou iaalmnrancr,afrnlnheahyxrrnml 302 -- TUR R. OR SHOWER
1700 of ror lana.Code,for me Pnronnam<.rthe work ram which his lwnnn i,w — ROUGH MECHANICAL
If,My Woke, mmotional',Cnimadmioa Intimcarie,and Policy muml,er are 00�,�
carie,: PouryN'o, 304 — ROUGH EI_ECTRICAI
CER I'IPICAC[ON OF MPF.NS TIIONIION FROM INSURANCE ORKIi Rs' 305 — FRAME
(This„ulionaccamon beednpfennir[tie pemdrylot ono,handled dollars 306 — 1-101-DOWNS
(x amt a.fcw.l
307 — INSULATION
I ceaify mat in d,e performance of the work for which teas pet art is i.+ucd,l 3018 — SHEF_TROCK
slothful oy ally rynoa in any maaacr,o as m beemor snhjeat n,O,e Workers
cmnpcnfaialt law,v of California,
Da11Applic31x9 — EXTERIOR LATH
Compensation
NOTICE TO ApPLICAN 1:a;after dialing dm%CeAfirde of E.sca l'')on should 310 — INTERIOR I-ATI•I
h ,mc sahjcc,Ill tie W..kars Competuntlnn pnwifions ethic m
Labor Cuda,you mn
Ozoa
0 fonnwiIll cranially with,nrnpm,Isom.o 'his Peru,,,'hall the d...lord mv"kef' 311 — SCRATCH COAT
FCf1NS'IIdUCrII1NLENIIINGAGFNCY 313 — ROOF NAII-
I herchy!thin,Ihm there Iss c,a,d s e. lending agency sot the pedmmenea
w nameworkfor whmll,I,iapa.n,r,Isrnm(ser.lnq .Ci,c.)
Le,wa+,Name 501 — FINAL ELECTRICAL ENERGY
y p
-r IxmdalsAddms 502 — FINAL_ PLUMBING ENERGY
U 0 Irenhy that ihave real]this application Dad stmt atm u,c uN,.a inra,mtdon i, 503 — FINAL MECHANICAL_ ENERGY
�• (r correct 1 agree II rolnply with all city and n�unny nrdmanecs and stme laws reeling
O UttIbuildiagcoodranimt,amdherehyamho'a,arepre�enatee,ofmi+eityloc,tcrupon 504 — FINAL_ RUII DING ENERGY
>, W to abovcannitinuc I pmpvny for ia+pcown Patpo.us,
H d (Wo)mgreto„nw.amdalnI ,,
,Eyik,, ,umlcoin,Chy or anhlo
C agaimt 505 — FINAL_ ELECTRICAL
w li bihdef,jodgmcal..ra,i.do expen—mhi,h o r,in mar,way a...me againo taw 506 — GAS TEST
U Z Chy,{mmnsequelre of Ire granting nrthi+Fermin. /
AP�)�(,ANT UNDEI STANUSAND WILLCGMPLY WITH ALL.NON-POINT �� O�( l •D
ss REGL+illjxi�/J Issued bY, SLrl7 — liz NAI PI I]MR INGDate
I .
pt,e cru n Art nhe Acro!'actur Ude Re-roofs 508 — _ -
IIAZARDOUS MA"f FR ALS DISCLOSURE
winme U"llllnrrlitmmmwlCode..Chille 9.12, ollillh.laa'don,mwedal Type ofRoof 509 — FINAL GRADE
as de,sec by the Cupcnlnu Mm,icipul Coda Chiller a.l2.Dud ter IIc:JIe unJ Surc,y 1
cn,le se<roa 255321ar+ 510 -- FINAL PLANNING
❑Yea 0N All roofs shall be 0.jActed lit iPts6ftlan}P1UII11nflinntW10RHdrog installed.
Will do applelun or future building,ccupm to,cauipamnt nr de,xas w lech If a roof is installed without first obtaining an inspection, I agree to remove
emit hamrdaas air com uninanls as defined by the Bay'Area Air Qlmlhy Alanagnnem
Roma? all new materials for inspection. Applicant Understands and will comply with
°Yef °No all non-point source regulations.
I nave tela f c Iluninloa.'nmc.i f,mqutcmell,tinder Chapmt ass of floc
Califomia I ICIIIIII k Stfuty Cnde,senior,25$05,25533 and 25534 1 ands„Ind tem
If the bole' g uc,n reu,re ly htce unvnun6 tent it is mY mspnn.lhili,ymnnti[Y the
,caryvn I'I•ngoirengnl. which n 1 mct prior m i....are of t Cenificmr or
occupant
y. n
t„'I Signature of Applicant Date
Iff"jItatiatilmoilad amad Dane All roof coverings to be Class "B"or better
OFFICE