00060109 CITY OFCUPERTINO '' , r•. i o ,
nun.Pift iswift. - p Tr .. CONTRACTOR INFORMATION
BUILDING ADUR13S5' ;,: _ _ e, PEIIM I'I'NO,
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RTMENTS
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OWNFR S NAME', - R - „„ .. - - APPLICATI I3
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'PHONE' . -aS.' - p - SANITARY NO. CONI niOI-NO.
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O O ARCIII rCCI/ENGINCER' BUILDING PER MIT.INFO
PLUG ,CLI:C'f .PLUMB MFCH
Z Z 'L y - LICENSED CONTRACTORS DCCLAR'AI ION • - YI f
oz o In b> o that l' licensed I p fcnw 9I . g ,. "b -,REMODEL LNTEE 'I�FF4'�SpTHS ''& 'IiTTCHEN� ,NF.W 'q
FW ilhb
yy ' to
full force End NEWSTRCKTNG WASH�R✓DRYERr
C�6 Lrc C .. 1.
.S
°�$O i H Dol C n nun - - , -
3 u w \RCHITFC'I S❑LCLARAI'ION - - - S '- ''f 4 '
OQurlr I e Idturns Anr
-0 0
Lirtrs,d Pr down l ,) - f\
OWNER BUILDER DFCI ARAfION - F
u7 1 n ny ff Ih I I pi I Ih C i- n 1 L f thet f I+
II b (5
fSp whl y ' p :I'cna
dam p"nt t I. 4 'Ih FVI' ll Ip l fl 6 d.ft I
In ltn epfcnpl ') S Ft FloorA'rea V•1
(ve b lIS Q' v $�}� �i�+ .
ra 11 ' pm r de n r In ug do II nr penalty,
- .
ds mils br' r PII Ir p I li I.II nppl Y n,nc'v'In IIS - Occupancy TYPe
oro l thin
r n d a l II :15som Apt j�iy nP�'
a iddird
el k 9ppt4 r . .
Bos S an Lr- r c e TI c I t L I d t npb t • ' geft� nspections -�
woe f I I, , F bpm ,E a mewl I n iii - Ir .^1 01 — 'FOLJNUH"I 1��
rm fon: pr n 'd rill l ' n n I I' I lea
nn al 1 Bn m building ,p o 1-02"",'P1ER5
,n pl if p In ul' o north. rn gu II ae Ib m i'105 — 'LIFER' d,
i, q
'y in xurof Wi prp IY I .\ ly IrclIt Ihl dI' I I :'1:04 .REBAR .4
uh inflect(SN.90448 ldP f ' C1erTl cll. , �, L ,
Linc L d t l,r,tblunterp I ty r b_Ie 1p, r. II - 10.-I .-;ANCHOR BOLTS
and n I I I p weds will I I Is) I n d p I I e - K w * Y
Court I :I ; , SOI 1,05 "$EWER:'& WRIER",,.
01 ,e 9 B& cl ni.r 202 UNDERFLOOR PI UMRING
°w �'r� -- t, 203 UNDERFLOOR MECHANICAL '
W KLIf 5 CDMPF,NSAl10N UIII T O
I n ny n d o by I p l rr nn I u g l m oit 1f
204 — LINDERFLOOR FRAME'
" " 2�T5 UNDERFLOOR 'INSULATION .
• I M1 -J 'll t C (fr l f Consent I. II i c f -Work,, -
Co,p I p d d f by S 391X1 f to Labor C I fn il ,.301.-. — ROUGH PCUMLI ING,. a.
'P,,f fIh k1 Inch this p 1 I.
0'Ib< n,dwu nn nl w,rker.rnnp G Insnrvnw n �I ten by sn rnet -';'302 —,.'TL1B ' 8' no ,SHOWER ' m
3900 fd"L'I
Code I n I r - n,wnnne'orkf n' Im'p ' ti, ..'303 .— 'ROUGH° MECHANICAL "t
lssu 1.My W k -,Co p t t l a d Policy
b r ,
3O4 `-•`ROUGH ELECTRICAL
/ Cur Pnli.yN .1. t ' . - G
CERIIPICYfIONOFFXEMP'IIONFROMWORKERS 305" — FRAME
COMPENSATION INSl1RAYC1 305 _ HOEDOWNS x "
I ✓
5•
Y -mplele i f ll I erl to l u deed Jhllu v I -
le. - llhl' tad tl
mom r,.L � . '.307' —_ INSULATION,
r w p 308', — SHEETROCK
I etf Ihl tl t of kl I111 'I II fi• W
hull I e pl y' ,O Y I l bcco m bl yo IM1v 0.n k
Conµ. I law,of Califiron Dow � � 309 -'-EXTERIOR, LATH. ,
Pa Applicant - -
1 . NOIICI IOAPPLICANTB 'n -k bin CII fE.emprn yousholld 310"yr INTERIOR LRTH
nen ,add tlnmLW k r.C �. t p ;Ir me labor Cnle,vrel n1s1 31 ] , — SCRATCH COAT r
Q O fnehall],comply w'Ih hp ex or th'p1 nt,.ul he awned evoked y.xi I s
(~ 4 CONSTRUCT ION LENDING AGENCY 31v�'I!—, ROOF NAT'L I'•f
Ilse ehT ff Ih nM1 e nl I lending Igen f m home t c
A > ,Its - kr nLnm pernt ,issuedfS ' 3B9 cvc)y ' F01 '— FINAL EI_ECTRIGAL ENERGY
r ° Iona N 502 .x. ,FINAL PL.IJMDING t'EM1IERGY
Lcu Add
0 503 FINAL .MECHANICAL ,ENERGY
I Iry m'n - atn' pnl I a IYI In'Io n f 'I
w H
cancer.I plv with a city t> d I I s '504 FINAL_ +EIIJILDTNG ENERGY' x
,O V to b1 Id g I I I n ny: In p I l' rin Ir I pan. r
W the h dp p yl r 505 — FINAL,,,ELECTRICAL ;
F.I0. (W) 6 t 1 fY dAph 10cryrc nn' b :I
.. m rnnilt agm t p :. n 1y nor >' 'rn 'g 'n,t 'I 505 — GAS TEST? r;.
.) eddy t I h grityyn at his II - -,
SOURICA. cBRST SNUIrCOMPLY WITFyA NON%INT ISSUCd.:bY S�I17 — FINALP LOMB INEfi pate '`I u xf
.Signal e fAhpf' JC t t I. DateRe-roofs " .� c� - _n �.:.9
HAZARDOUS MATT RIAI S DISCLOSURE 50 J j F I NqL L'I RIyDE p
Wed ppl ,nt r fiwl Ids p to 'n dl h rd uncurl Type ofRooi10 FINAL .PLANNING i
Isbelledh duC"Irro id "p lCur CIclu 9.12, nIt 11 hh and Sufly, pp 7(^ (''�p�/,
- C.d S t ssz(7 - • /, ,-- '[O� flb Yi}ale R '
❑Y ❑" ,All roofs shdll�bTc inspe�t� {or t fir n t being installed"
W 11 h P I I I b IJ' y pn I " ' t I wl
If a root is installed without first obtaining an in ectlon 1 agree,to Eemove
emhh al a t dlltdbylh Bay,Area Quality M age l g p
.Dia lOy , ON.
-all.new materials for inspection App
E, will comply with
f all non pou1C' }ource regulations 7
1
1 read II l I 'I 9 o, d Ch'pl 6.95 a11h - es
cillhourtio Hinth&EadrW Code,Sesd 5505 25593 nd 2559E d food n t 1,.
'fnen Id it t try l' tenant,thlll. IY p bl yt illd t •* , r e
up Ie m t hyo nota 11mi„ C of wl
o 'nn Y /�����✓ t ��� Signature of Apphcant Date
lA
owe�n- mnrue got wle AlFroof coverings,to be Class'B" or better.