00120022 CITY OF
PERMIT CONTRACTOR INFORMATION:
RulLnlnGnpn_cyg6 BLACK OAK. WAY' MCHENNR LANDSCAPE" + ' PERMII'N1>04�J] '
owNERN"'1jPSASNICK 15573 BENEDICT LN APPLicnnd&lua''IKrG/2000
'PHONE: SANITARY NO. CONTROL NO, '
(408) 356 .1641
OO aZ ARCHI IECTIENG]NEER` _ ,. _ BUILDINGPERMI'r INFO"
w C _ ' ' _ IILOG ELECT PLUMB MECH
H 6 c I.I =1
LICENSED CON'rRAC'I'OR'S I)' LARAI'ION
�z�' nreh rrnnma,lamhecn.cenndcr fena ,ervao,mnene;,, - • .Job Description,
.
P B
�z5 nor nxxpnrD an3anncBa' .: tip f : :c 1 ane,nyleea,e TRELLIS
r t, a �co�Oji 3
I ace
Unc
% nNCHIH:cT's us:CLAicrecod. .
t 1 understand n1Y Plana mall nc used u.Public mdaN, "
x-00 sa
as
Liereard Prule,,mooll -
o� OWNFRBUI1DIRDICIANATION
= ` ' h ly'fl [hit( pl the Counine,le, Liwasto Low for the
t•Z
follecosing remain.(Section 7031,5 Bu n J Ihof. Code:Any city panty
,S d which reclaims pe „ n w, a I¢n p demolish, p any opuc,urc
prrich - ` "
: , t I. I ' tl Irl' ,I tip it II B L,,muco - s
— man licensed p pursuant thepm -Of the c tar 1 La (Chapter9 Sq. Ft. Floor Area .Val, _ 0
(co ne,en6x'thSua•n71,IB)afD'visan Ld the Bue'ne,,.nd lydes.ners Code)
,or that he i,exempt there,'mm and the ha,,,for the olle,O]eacmpdon:Any vim,;nit ' '.. •�
of Sermon 7031.5 by any applicant fur.permn n:bjrc s the applicant,o a civilpenalry
amlm,m
t. lhantiwhandled,Inlhl,ktasaro. APN, u��h,�{le:,. Okl Occt a yType
0 L n.awaend me Property,ur my employees x ill xa,,,a,d cinole couni'ma.ion,
will do the k d the......ate is a.I lat 1 off fin (See 7044. -
Bm dl r: Codl: I he Cant,Canmi Larmu,Law dars , P,ly ons
motorcar, nl who cars rssh rkhi dl 101FOUAMIUni
w fp pe,y Who)builds '
broad,l a pIr .1 dint: h op . -
'
, ' ler 1.0� -' PIERS q
n,rc e 1 Ic If,n in building nip c , le m ) f
mp h 'II 'II th1 f "hat d bl LIFERpr, per; r I , Ta
°L ,nnhepr p ,y. ahy „
e .,eeIter Bwn l ,OI ,I amxm 1.04 — REBAR
an,wtxihe nice,(See.7044'.11mine.,aad Pool....On,Cade:):Ine Cod roi 1.05 RMCHOR BOLTS
.
i.ieensnLawdes,nn,applymm.w�e,ofpropcnywheb,dldtartam
impr..r, m ,pursuant 1.0E, -- 'SF_I+LER F. WATER.
.
and.1 mmahen for web pm,,,,,with n cmamcl u(s) Ilumral w the
ContractorsreLicense
l . e'(Zh-- UNDERFLOOR .PCLIMBING
❑ oin uelnpt,order Sce. ,RffiPC7nr lhi,re:uon
Owner nate. 203- — UNDERFLOOR MECHANICAL_
WORKER comrErvsnnnN rntcl.nftn3'1oN c04 — UNDERFLOOR FRAME
Inereby afnrm anac.pen:ely ar pe.iary,��e anne rnunwmg dcemp,tia"'
205. — UNDERFLOOR INSULATION
° 1 bull, adwill maintain lt Certificate of present a,m11-inwre for worker;• _
Compensation, as pnikloi rn, by Secdnn,3700 of the LaborC<xlq for me 301 — ROUGH PLUMPING - '
perlari„antic none work ran wnieb mi.Iwrnih is i.maa .. 302 — TU UI
B' & O R SHOWER
°I lea-and will nleinmin Worker',cnm,misation Lu _ .1 umnee.u,myuimd by Sermon
3700 of the like,Ceae.far me peltarmnace of It work fon which Ill,Penn i, - 303 — ROUGH MECHANICAL ,
iamed,M w.like.,enm,eIa.arnnln,nnmcecame'randpolicymole,are: - 3,04 _— ROUGH ELECTRT-
Gpnier �e,51�,he,'rvt,:3846alow is , _
• C 10N Oil EXl!MPTIONYHOM WORKERS', r - `:41Z�5 -j•FRAMFr ,
COMI'IiNSA'1'IONINSURANCE '' 30 — HOLDOIAINS _
This seou„..need 1, t he enmplelda itrial pI,n,is rnr ane mandrin dud''`s
307 — -INSULATION .
I cernly that in tole PMI arm,nr t.;wok Lot whadh lbi,permit laeumdrl - 308 — SHF,ETROCK _ -
shall not etpluy any person in any Inanner,n as 1n bdeama enables 1.Inc Wnrke, 309 E X TER I 0 R LATH
Calnhcn,tlml Laws of California."a,, '
Applicant - `310 — INTERIOR LATH .
,Z
NOTICE
cate,mOAPOdh,W.lir' hrmaking
an Cenf t fl p1 you u st 311 — SCRATCH- COAT
'
ace hal tt OCA kr C p iI : fm LI Code,y t ,% -
0 Ihnl ''Ill ,plv 'it such : this p ,:ball rte created k 1.
O313 — ROOF h1AIL
coNsu(us1,oNUNnIN< ia, lar 501 — FINAL ELECTRICAL ENERGY.
> I h toy Binh II d,Ih mue , 1 J'ag g rey for Inc perfnmu ce
If Ino work for which tors pemw is issued(sed.31✓l,,civ.C.1
a 'p, Lemli„Na1.c '. 50,_ — FINf-11_ PLUMBING ENERGY .
] z Lender:sAddress 503 — FINAL MECHANICAL ENERGY .'.
OO Icewythat Iheve ,ad thi,appho,inoand.hormatmcabmeoloona,"'..ia' 504 — FIhIAI_ IIIaILDIPIG` ENEROY
Fib Fy coma.I agree m comply with all city and county nnli,mna,and'ane law,miming - ,
OU ten,Iddingrm,.o-ne�i�n,m,demenya,Idlnd.empmsem:ai...armi.eityn,enlernpnn 505 — FINAL ELECTRICAL
'„ me xMrve-n¢nlio„eJ pmperty rill in.penien purpose...
a es pul.rceu,.ave,ami'"a's hi,ir mile,..to City of Cupertino ag:,inr1
`U m Iianunie.,imlglm•In,,tin,,,and expense,whirl,Im1y in:any way add�aa:Igai,la,wd '.. 506 . GAS TEST
.0 zinCCA,bt ence of TAgDSing of oris Pett;,. c
APPLICANT U')IiRSTA�J05. I.L OMPLY WITH ALL NON-POINT X07 — FINAL PLUMBING
SOURCE RI a �r _� s Issued by: - - n Dale
S,g.mumnl'A,owamfCnmram"' nine Re-roofs ` 509 — FINAL GRADE
HAZARDOUS MATERIALS DISCLOSURE -
Will tile appficamorfuture building occapam,mmorhanm,lutorean,mmcrial •Type of Roof' 51.0 ._, FINAL_ PLANNING
ua defined by the Cnpenim,. ;pal Cloth,Cita ter 9.1.,and the Health and Safety -
CWe,Semion25532(al! 54 — FINAL PUBLIC WORK
71 Y., �Nn I so _ `I. All roofs shall bel,nspected prlor,to any too mg material eing installed.'
Will the an"mia or mart nodding oee,IpaM Are,
Afir Qu my MI ax6Pen: 11'a roof is installed without first obtaining an inspection, I agree to remove
' mill 1 :' - oat Ldl Ib)Ih ❑'y AmnA Quality ncnt
Dint t all new materials for inspection. Applicant understands and will comply with
°Y' Not all non-point source regulations.
I lure read,he bvurd m,manorial y eemem,under Chapter 6,95 of me'
Coliform,Ileahh N Safely(tale,Semi on,25505,25533;...125531 1 unden,mu,that `
U nchuildingdo,,nol cumenlly4uveatcnun6lli,'umy}e,ponalhill,y no na,ilyte
ovny,am of me rcyuirem tots'which mud be nte1 prior to ismance of a Cenific:to of r
o`cn ne;'/J � 2= Signature of Applicant Date
r'
Ownc,nr mnhmvd a,e.I .nate - .AIL roof coverings to be Class "B" or better
OFFICE'