01020067 CITY OF CUPERTINO - .. ' h' +" -.k. ' _
BUILDING DrviStoN PERM'IT,- - CONTRACT,OR INFORMATION:- •• - ,
HUI IDI NG AILD RE.SS - • _ - PERMIT NO.
01,020067 0
OWNER'S NAME; - " • � •, APPLICATION SUB DATE
•. PHONE. " - y SANITARY NO. , - CONTROL NO
BUILDING PERMITINPO-
• yaOO ARCHITF.CTIF:NGINEER: BLal UO ELECT, PLUMB ME,CH
Gro=I� LICENSED CONTRACTORS DECLARATION 'B Job,Description !
OZ the by. fr tha I n I' J I 1 .. fChn '9( y � . iy T
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F' m fJS I 9000) fDv,tr3n1theBl.' IP f ' 'C 1 lad ,
a II f II i of rr c, - 3
g5g z'a
Uteri,Cors. ' Tie « - INTERIOR,:REMODEL, .
p'3Lf Dm e ,' ,
se ARCHITECTS DECLARATION , pJ/-�� os
I d � d ypr naB n,.,sw phrCwcora, - r� ' ' - r,
LiceasedP f
OWNER BUIL DI R DPCI ARATION
a a, I h by. IE Ik 11 pl fr J C , , L L 1 II -
6 (S I' '1(131 5 fle and Pn r C J Any IY ly
hh y p I, I , 'lir p J I'1 p- y. I' , ' �S .r. ,,�� w
If a fl .'y d.l, r
d .main 1 :dp d p f he Cinnerew,License o- (cnw '9 Sq. Ft. Floor Area` - _ Valuation,
(,n 6 will,Sul ]11(111) f IJ' f,h ❑ I I :" C It) n
,, her her,ese In 11b,orfroin maids,best,for the a ,sal exc,tp,...,'Ary v'ulm se - p
nr Section 9031.5 by say c,laral far.pe 'I fhi,,1. Its c,+,cm, a ivil penallyf -
ill let lnon cinto hot brindled allara(ssan APN Number ,a•; Occupancy Type! .
❑1 o o f the proper) 1 my c'npk y with wages„d i r n pen,arena
will I thic work, I the arn.ine k,nor intended of fr d fol sale(See.70c,L -
Bn, d Professions Cade The Connector's L i does not apply,o an - ' Required'lnspecttons . _ . ..
- ow p 11 IyWI h IJ p ,h Il 'h J kl' IE - , r
r,ih...uUt his yl y provided loa arelf anpro's'n,in, r'arreldi _ 101 ,�— FOUNDATION
abroad fl .lrla6wever.the'1 sang or riallfrosenint.: IJ w'anif oney -.'I,
......lr fi b 'IJ ,ll Wrote doyg lhIid, Ir . . IIERS
nl r pmpn,cal,3a). 'i.01-4 .
.1 .1 Ian p p ly ' '1 : IY b hl J , , - I n
'103 '— UFER
In pr) t 9M4B :' dl re:' cJ )T c I Ir.' T04, = REBAR ' - 1
❑c L 'd , pplyi r ry Pc IY 1 h ld "p :,h - , -
a�I T contracts forn projects with I l,n,) hearses!y n e 105 —ANCHOR BOLTS
❑la np I,.rs ., - - .B cl,r ,I,r , 1.06 SEWER R WATER
Owner na, 202.'—' u
NDERFLOOR FLUNKING
r ' S C l If DI CLARA ON
203 : UNDERFLOOR,; MECHANICAL_
Itherebyiff I p 'Sly II ) Y 'n1 rail y 1 Prl
• • 204' _ .UNDERFLOOR•' FRAME
❑ Ila I 'II nanolaile a Croffi,me ,I Consent Ir ,If insole or W k
CoY p ,aIm, a, pawdea mr h,-Scat ” 3900 of the Tell, Code.,lar the - 205 UNDERf UOORY INSUL.AT.ION. 7
v=,harrance-0 he wok for Inch this pe I I,ie,n&L' ,., on, ,
•• 301,= ROUGHPLUMBING":.r It
011 'll C' I ' Worker:C p la t e y l 'li bySteelton a 302 ' ,TL1B" R OR SHOWER
39r10 f Ine labor Code,( n 1 1 of work I.,wh eh lbl,per I A -.� r , qk
issued MyWorke ,C mp -r I1s,m and Polmy lwnbe'I - ' "
30 '.- ,ROUGH MECHANICAL ,
•Carrier. , Pot,Ne, •' 304 '---'ROUGH ELECTRICAL.,.. • •
,CERTIFICATION Olr EXEMPT ION FRONT WORKERS; ,
COMPENSATION INSURANCE
305 t- 'FRAME...
(I ,rearre l ,he cen,pined'I be ncenl is h„dred doir , "07=
($1(1(l „le—) _ ' 306 HOEDOWNS _.a • .
I2r'n ly',ha,an dr, T are of i amwI.At This pca,'I , „aeJ,1 - '307 — INSULATION,
,hdl nol' i ,yy y_' ,,,astohecamc. h)=n,lndeWaker,' 308 SHEE'TROCIL - - -
Ctnar,ro,ation Laos I C I I Dra, -
App' 309. — EXTERIOR; LATH
zNOT ICE TOAPIIICAN P If. 11 'k' g(M1 C ,I 'I 1I y, y h Id U' ` -
nec bI II J w k c p , p rB LI c 1 y , a'=' . - 31.0 I NT-ERIOR LATH d
O' Inrdn ,ply w'd, 1 p „nn,nrJ y ,n sh:u ncd drc,okca. v
311 —. SCRATCH COAT
F'� ,CONSTRUCTION LENDING AGENCY , y
a > n= 3 lr file
,f 3 adagakn yr n pillsn,rris l :313 ROOF •NAII.-
.
of kl 'b,l nri„sl,e .
d(S 3099,Ci¢C)
i o L=,I N,,, . 501 —rFLNAL .ELECTRICAL ENERGY ” . is
Lcnd r A l I c.
'a z SIZE r FINAI:;'F'I_IJMATNG ENERGY
V I certify III read this city
applicationand stake d nl h T - r 3
w H
correct. agree, ro Ina Iv v a ry d II 1 a 503 — FINRL. MECHANICAL ENERGY
O U Ion I y 3 r 1 nin In p I I n Iva , upon
y A4 man dp e. Syr 1 1 p 504 ,— -FINAL. BIJILDINGIEhIERGY
� W fW.d, , J N dk pl "In Cly. fCP l 6 t'
y Ian 1, , Jk I 2,rd 505 -- FINRL ELECTRICAL
'V 7i AP TU as of lh g yof MW IvrO - c, Z f
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: •`-'�6 —' GAS ,TEST ` r�ate
.SOURCE REGULATIONS. > (• y• R'
Sae of AFi,,rVC r.,ar, - DI„e - Re-roofs ' ih C' q + .
_ HAZARDOUS MATERIALS DISCLOSURE W19I — F.1 NAL MECHANI ICAL, '
-
Will the ppl c: , r I - harm,,, l I.I h d l m ,rial I',(Type of Roof- . ,
dr dbyln.cpn M APIC 1 CnLI 9,12, w H-hn and Safety
-1 51b9 FINAL GRADE '
Cnd S 255320 - T
Or 71 No All roofs shall be Irics�C'Cted LoP�[A LAt NI[eFGI installed.
d 8'111 pff k 1 J t`.1 2 �thS 'a
wnm 11franc traten dd s p I :- I l ' n l If a roof is installe 1 out Is 16 c Tee to remove
linizareans air cortenninnotta,nf d hy�the Bay Area Air QralityM b nen,
• DI„ I all new materials for.inspectlon Applicant Applicaunderstands and will comply with
❑r nN all non-point source regulations. ».
Ih ad fit
eThe,arrlin, II:oa,anernneb,l Clenia-69 ofine ,
Caltionda H .I n&Sacayi S I 5505 25533 d 25534 I J3a' id[flat « _
nl n ld g1 , neo- I In
rm , n hna,lh I ,r if ill.
r cII wlc r L -
o � y
. � �. r/„�� • SlgnatureofApphcant,••_ .Date
'-' All-roof coverings to be.Class `B'”or better
.
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OFFICE a'
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