03020085 CITY OF CUPERTINO 7777=
mg
BUILDING DIVISION PERMIT
BUILDING ADDRESS: FRABONI TERMITE CONTROL It CKMI I I'D.
19781 BIXBY DR nin2008S
R'S NAME; 876 CHESTNUT ST PERMIT ISSUE DATE
BIERMAN RONALD E AND KATHERINE 02/21/2003
PHONE: (408) 287-8111 SANITARY NO. CONTROL NO.
ARCHITEC'riTINGINESIR: BUILDINO PERMIT INFO
Do ELEC77 PLUM
LICENSED CONTRACTOR'S DECLARATI Job Description
I hereby$firm met I am licensed under provirom,of Chapter 9(commencing
with Section 7019)or Division,3 of the Began"Prolood.Coft.turad my license is
I full f on 4ffccb2 1,-P rL -7-,,,-7 1- TERMITE & FUNGUS REPAIRS
U 1:2 LW.# FINALF.0
I understood my plans"I k surell as public remmill MAR: 12 Z003
Licensed Professional OWNEIR-BUILDER DECLARA71ON
I hereby affirm that I am exempt rincor the Conumdar's License Law for the BUILDING
0 follonving nisom.(Section 7031.5,Business and Profession Code:Any city or county
RE which resuhus a permit to construct,almr.hopurve,demolists.or repair my MuChum
1 poor to its issuance,also requires man applicant forsuch Permit In tire I signed mwmni
9' that he Is Rewound pursuant to the provislons,of ft Conarmlor's Licenion Law(cloplerg Sq.Ft. Floor Area $�Y412aion
(commencing with Section TWO)of Division 3 of flat Boximuntand Pro mrs Code)or
that he Is exempt Betterment and the basis for the alleged exemption. violation of Occupancy Type
Section 7031.5 by any applicant for I Permit subjects ft MPIWlcl In-eivil Penalty Of -3 APW NVMWe 0
..I...0.fl.hundred dollars($50y.
E3 I.umwofftprop�y,�mycmploymwlthmgmuLheir�lc�PeAutim,
will do thavourk.andthe summun,t...tintanded mothered folualu(Sm.70M.Budocaut eq&Ped Inspections
and pwfundoes Cc&:The Ounhande,.Limmm Law does hot apply no an Owner of 102 - PIERS
property who belldsor Impromon,duchanne,andwhodcausuilt worse hinvulforthenoth his
mot conployces.provided dust such troperumserru,me not intended draffied me all If. 103 - UFER
however.the Wilding or Improvement Is mid within ons,year Of COMPIcumn.On owner- 104 - REBAR
Wilder will have the burden or proving that he did not build un Improve for purpose Or
ale.). 105 - ANCHOR BOLTS
Ej 1.as Owner of the property.res munjuraiwily contract with UM�sufflossUall In 106 - SEWER & WATER
comment the project(See.7044.Business and POO(Milmer Code:)The ContraCtor's U-
cendan Law does out apply he M Owner Of Property,.1vo Wild.or Wit.Issues.,Md. 202 - UNDERFLOOR PLUMBING
who common for such projects with A comomsor(s)licensed Intolunn'le the Customer'
LiccrocLai. 203 - UNDERFLOOR MECHANICAL
0 _.B&PCfoxIM1mkMm 204 — UNDERFLOOR FRAME
Dam— 205 - UNDERFLOOR INSULATION
WORKERS COMPENSKMON DECLAiATION 301 - ROUGH PLUMBING
I hereby spired under penalty of pcdury One Of dZ following d=IMOOW. 302 - TUB & OR SHOWER
1-1 1 haw and will maintain aCeNfIcals of Consent M self-Ifflauld forWarker"Chrolum
sation,as,provided for by Section 3700 of the Labor Code,W,the PcrfOm-=Of the 303 - ROUGH MECHANICAL
work for which Win permit Is issued. 304 - ROUGH ELECTRICAL
0 1 have and will maintain Worl Compeoreflon importance,u torsion!by Sedon 305 - FRAME
Code r the ef Mucafftworsforwhichddspamehishimed. 306 - HOLDOWNS
"7
.—,'Or, Pc"7 307 - INSULATION
O'g': -d
ceimPILCAftH OPaXVM
COMPENSATION INSURANCE 308 - SHEETROCK
(Thissochonmed course completed If the permit Is Amodo hundual dollars,(SIM) 309 - EXTERIOR LATH
OCICSL) 310 - INTERIOR LATH
I mrdfy Out In the Performance of the work for which this Permit Is mead,I hall not
employ any person in my minister an sa an becorm,subject to ftWorlaosComporsillon 311 - SCRATCH COAT
La.of California.Dan, 313 - ROOF NAIL
Applicant 501 - FINAL ELECTRICAL ENERGY
NOTICE TO APPLICANT.If.after making this Cemnam of Exemption.you should
become subject On the Worket's Compensation previsions of ths,Labor Chum.you must 502 - FINAL PLUMBING ENERGY
Z forthwith comply with such provisdow or this permit hill be deemed moolmd.
zo 503 - FINAL MECHANICAL ENERGY
CONSTRUCTION LENDING AGENCY
1 hereby afflum that dams is a construction lending agency for the performance of 504 - FINAL BUILDING ENERGY
the work for which this permit Is issued Sun.3097,Civ,C.) 505 ' - FINAL ELECTRICAL
Lemd.r's Name
Lender'sAddims, 506 - GAS TEST
u I certify that I how read ibis application and sum,that the Above Information IS 507 7 FINAL PLUMBING �
W E comm.I stprece to comply with all city and county Ordinances and IMM law,turning W
0 building construction,Md hereby Rumorlin representatives;or this city to enter upon me FINAL MECHANICAL
I
We)agree in low,indemnify and locep hurnoless,the City Of Cupertino'Pleal 0 FI gAnEA
.1mm-mentimixt!propeny for Insimcione purpose. TTA7r r.
,4 11.1,11filmJudgmems.cost,ad expense.which may 1.any way accrue Saint aid Oty I NG
U In consequenm of the Stirling of this Permit. Issue 5 ;/3
APPLICANT UNDERSTANDS AND WILL COMPLY WITH LL�ON-POINT d by:5 WORKS Date
so REOU
7`/05 Re-roofs (��;7
Onto
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will ft applicant urfolum building Occupant store orbandle blosedGussmaterml
firmdd by the Cupertino Municipal Code.Chapter 9.12.and the Health Md Safety
Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
[3yes 02rigo'
W1 If a roof is installedwithout first obtaining an inspection,I agree to remove
Will the MrAhnott Or future building Occupant use equipment or devices which
emit harartiours air conuminants as deflned by ft Bay Ams,Air Quality Management all new materials for inspection.
m'?
District?
rl
0 Yes
Ih vo read the monstrous MAWTiAllourlhoonC11111 underChapter6.95 orthe Califor.
11
ni&HmlthkSarelyCodc,S.-U.23505.25533.d25534.lundcnLwW�difft Wilding
does hot enormity Im..mrsant.dust It 1.my reeparolldlity lc'msd�y =.Pan Orote
m.whk us, Signature of Applicant Date
s All roof coverings to be Class"B"or better
I OwWEF`mwry1brWnd age t