00090057 ;B�U
TY OF CUPERTINO -
f. BUILDING DIVISION- " gERlMIT CONTRACTOR INFORMATION: '
DING AD13R�SS: - .
Piz
WAI
DR8N SONSTRUGT 1-9 1—G.PMPANY-0-71 LA
ER'SNA , — _ .� AI'PLICAI'IONS III.IIIi: _ _ - SANI'I'AItYNO., ONTItOL.9it
tp g ARCI{II'IiC'f/1iNGINEER:�, F )I Ys - - IIUILDINO PERMIT LNFO
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• Dc ELECT PLUMP¢ .. .. - �11 h1CC11
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' LICENSED COMRACn'ORS DECLARATION
,Z= Inby atht IA licenced provisions of Chapter nn 'rens
4 wII S i 0)ofD ' a Ofthe Nun. nJProt wsa'Cole,Audi my ieJ,.e• '+ Jo.1 Description
in tell forceAnd clfmr.' _
-
..
'
Lwomw Class Lic.p
Unl c INT'. RMDL,. .REMODEL,KTCH, . AND BATHS, .AD
=
' 'au ARCIIIIECT;S DPCLARATION
tO4 Zunderstand myplans shall ho,used a%public records RDA WASHER AND DRYE
6G:OF Lce dP o
ONI R BUIL DER DECLARATION - ?.
h
I rcbyby I W
ff IM1,I arn oseala[ rh L , 1 f the4 '
Iihi g .rS 7HISB ` r II I : - CI Ayaly - IY � re•-
A, wrh°1 e c pe n' , n, c, ❑ p demolish. par r,rmcwre - -
A, prima,I u' I, q Ih '1,1- ,1 hPe turn it,fl y Lrr nem
Ih:1I 1 inahadin to our proolsour,uIII Cot I Icn 9 SFt. Floor Al'ea
(aml on, 6 'rhSe, 91X10) fD "i l I'll,'last.... dfr 1 (:Code) I' &aluah n
r that he a exempt dth ha. f theallegedexemption.AyviolationV
o-Station 71115 byuny ppl If P r hl I'II rpll a Ip alby, - ' Il
n1 dol more Innn file handle d II lau>n) - APN Number Occupancy orl
T pe
❑L av o.DermmeprmP rr rNr m y:a:In pn.-, ' $3 +310
will 11 w k. Ilh I t deJ offered Jr I IS 911JJ '
Bµ'i Ill f CW Tn C r r Lc La ere. r apply R6' aired II15peCllODS•
rp Penrwn builds p In d n 1 .am workhimself' '3690',008, 11
.or lhalgbhis own e,Ilrexpmvllul,bar ' eho,"weme ..xm u l mendW or • _
off,md for sale.If,hox'eve,,,he building or improvement,is ,old within one year of
completion,the owner milder will have he burden of proving is,hedid nor build
manerrn,Irpmsemrame.L. 101 — FOUNDATION'
ne ,,flhepr,peny cl relycnr rnguith liccnsede.m,me,n r 1.02 — PIERS 1 .
Ccef theP j n(S'i 911W B. .: 1 Plait u Civil 11 C nbaemr, - -
n.'La a Ia'PI , w Ip Perry ho'holdimprove;lherc 103 — UFER .
' cnr nr 1 z Tlx:<nprojects ma nmmmm�x)licensedpursuant n m 1.04-, _. REBRR .
L1 n1 la
d n - ,� % � 105 ANCHOR BOLTS
wORKBR'S COMI'IiNSA'I IUN DECLA At " 106 — SEWER & WATER.
thereby arm,under Pewhy If Perjurroneofthe fmlmvingdeelamenos: .202 —• UNDERFLOOR' PLUMBING -
0 1 have and will naml,iil, a cenincme mf consent In self-inenre ulr wnrl.er4 "20'3 —' UNDERFLOOR MECHANIG•'AI_.-
Cnmpcnserinn, a pnrvideA for by Senior 3710 of he tame Code.'tor me 204' — UNDERFLOOR FRAME
conte ,fine 'rd,f hih Ill Per J - - - - •'
111 now, d II Gino Worker Cou,sumedino la,marre, uI I
aegmmabyS ,on 205 — UNDERFLOOR ' INSI_ATION
370 f theLabor Cale.f rh perf rma f N work fir which this Per l I is °
isxnafMywrule1,cmn,al,eal'mnlnsllmauc,ImmrAndPoncymlmhmnrc" - ti 307. -'- ROUGH .PLUMBING ,
n;
Carrier: Policy Nor: 302- — TUB 'R• ,OR SHOWER
CERTIPICACOMPENSZON NSURAfNCE•OR6LNS -303 ROUGHh.MECHANICAL
This
30 — ROUGH ELECTRICAL '
( section nceJ not h°co nplcmd Lh p rmir Ix far hundred A dollurnt 4, � -
'305 — FRAME
Icemfythat in the perinnnauce or the k to,whichf Per it is issued
.,1' 306 — H01_DOWNS
[I'll o1 011111111o ry Ili ,any n
l „nrt :r 1 omc n h)e r, tire Wmacrs '
coiNimabnnlaw,ofCalifornia,Date
Applicant 307 — INSULATION
•
NoICE.'ronl rl.IcnNTb hark enc .I moll , .'308 SHEETROCK' ',{
Z balm" beam w:,heA C pe. ri p : ,f thel del borC you I'*lust
OO rmnnwn comply with such provisions nm pe„nr.nnbed eeke:,,_ EXTER,IOR LATH -
CONSIRUCTION LENDING AGENCY 310 — INTERIOR LATH
ai 1 hereby All that them I A constructionleading agency fur the Penhmuam
W
of walkfor wbe[,I pn,t.isissued(See301CrvC) 311 -.SCRATCH COAT', •
L Q I-ender',Name
Z fcnde Address313 — ROOF �NAII_
O Irun nyIhr11' his ,l AndalIhiin, n `501 - FINAI_ ,ELECTRICAL ENERGY
O F ton 11ct.!"�:Buntato l,andhnrL a'thouri county .d and " r :mining 502^-. — FINAL- PLUMBING ENE
U s r r w Ial�Cv nnhfery m enand,on r' :
�+ W ma anmre men „e,l Pa pe lrl -' :p 'I aA'r I - •a '
d fy dkupI I' In ury repo maga 503 = FINRL ,MECHANIGAL.,.ENERGY
Zi babiline 'til! , _c , dPe.- n n yixnywayac gnsrx e, 504,= FINRL- BUILDING ENFP,GY4 IIh r g P r 1 D RSTAND W COMPLV WITJd A1,LJdfJN PI�I[JT Issuedby '- 505 — FINAL' EI_ECTRICAbate
Sgnal m of A,ple"nlCmdraca IY '.tale " "` 'f
HAZARDOUS MATF.RIAIS DISCLOSURF RC-rOOtS , ' 507 — FINAL! PLUMBING i'
the Applicant or future building°ccuparr store or handle l,aons aunedType of Roof al
As leanWill ed by nm CapmnnnM,mh;Pal Cmda Chrnrnr 6.l 2.and the Uculn,and9Jbly 508 — FINAL MErHANICAI_',. -+
Code Sli 255321x1:'
0Y - �" All roofs shall beSfPs ecTedFpji�i9P1 Ri ifr
.r r 'rp (�� IT[���` 1\tQ, material being,installed.
w,n lh irc ntal future building rb a e ay use q Ipr, I d ice: nfnti If it roof 1S IDS[ulle� nboul fllti�'dl9ta min�sr1'1'l rl t�tlon, I agree to remove
emrhua 1 it contaminants defined by Day AirQuality Al nagen,em
°a'fe' all new materialL.9*$4ins ed idil .IPA �a�tul comply El Yet - 0No' ul pP ars t .�r't''U will con I with
all non point regulations.
1 have mad rhe ha. Jo renals rcq,'remenL.uMu CI Pr b.95 d the
Cnllfnr ` H 'III Suferr C d S I ins 25511$25531 a W 2551J' nJerxrerid Ib.l '
flhe held JI rot cumenrly haseu m,un, tl t f ) sry .'b llyl orifyrhA -
occupan, ,h m rs ch m,sr be ,.P t un f Certificate of '
Oce:p y. t. . -
��� -_�j � �y� Signature ofApphcant Dale '
0,ner d ,' ta,en -• .� 1' - Oa,cn. - 'All roof coverings to he Class,"B" or better .
OFFICE r .