02030012 C1T:VBUILDING DIVISION.:0FjqqFrERT1N0 x't-lo_ .,. :.I
,, CONTRACTOR-INFORMATION:
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:r BUILDING ADDRESS; PER141TR0
In
OWNER'SNAME APPLICATION SUB DATE
PACIFIG-. RIM. PARK (TIN TIN) . . 126 SAN ANTONIO CIR 03/04/2002
(650) 948-4727
&PTONE ' I 1— I . 1 SANITARY NO. CONTROL NO.
11
dW- ARCHITECTIENGINEER
P.0,2 I BUILDING PERMIT INTO
I.I - I. . t BLDG ELECT PLUMB MECH
wt L—i
Z' ,:, mK".LICENSED CONTRACTOR S DECLARATION fob bescri-
tion
K.e ,hereby
mffirm'he'I.m licensed trade......visions of Chapter 9 mornavericiag p
Iso dp I Ed d by license
�,,v ad affect
-asas< se "a C""unr�;"aac. HVAC INSTALL.
<al ,,a fall
I�pcM4--
C
at ontm
S OECI:KRAUsJN
ioundsolarof ra,plans shelf be ruled as Public moulds'
tI. i
o
C Laterod!Polficsonful
OWNER BUILDER DECLARATION j s l_
M, I hereby affirm that I am exempt from the Commission's License Law for the
Whirring Mason.(Section 7031.5,Business and Pmfessions Code:Any city or county ItF r
C ohichotdifiresairrarni toconitruct.n1mr.improvC.e.demolish,or repair any sioicturre $9000
.z 9 isirmthrioissu2nolso miquirts,the applicant for such pennitto file a Vinod shamearm
aa7atha
Bso
pL
c. Cha l) S9.,Ft-,FIodEr,Al;epi
(sminnilaung with Seathn�70K)OWDIlio.in 3mPia B.siriestrandPoillessicas Code) Is Valuation.,
intimate licalmspa therefircininad the basis forthe allijed 6inirpimp Any sicilasicars n:,I1!i ..1.13 61, 3400
of Sam.70315 by mirynapficard fora pormit subjects the tnamicreman.sisil Penalty
APN Number rP!,;r.t 1,I- Occupancy
Type
0 cas ms'ner of file propI or my employees with u ages aa itheir xrle c6.gms,;m . ..... .......
-will d.,the work,and Re ansultim is a.,intended an liffecol for Vale(Set,:'Mist.. 1=,
Biomass and PmRs,rous-Ccals:The Cialm".1,1 Liormle Law does 1,-a an Required ections �r it
intrust of property WK.Wild,or impircive,riancial.mall who does monor2p himself 103 UFER Z I d Insp'
Or thmugh his man employees.provided that such improvements am not intended or
•
-sell:If,h6w&VT,ahe bmldi�j'&J.,xux,m&mFi, old within one yaw of
liff,rid S& 1.04 --REBAR------ F-INALED
compiction,the ovormobuiul will have the burden of proving that he did not build or 105 ANCHOR BOLTS
improve for Purpose of sale.)�
'D _._.10.6.'. .-SEWER..-&....WATER-------
1.as ownerrof the propinHy.all,exclusively contract,.,with licensed contractors to
construct the Project(Sm.70sbl.Business and Professions Coal The Contractor's 202 UNDERFLOOR PLUMBING r
License Law does not Ail man owner of Profanity who Wilds or ampronvos thereon,
_and who'commou.for,such funjects.wah a.combaclops).ficensed poromant ba dre. 223_,,.-__.UNDERFLO0R' MECHAN
'DING:-*,:-
Olson exempt under Sw.* &4 •
ibk
Commetuar's License Last., I B&PCIsm.this mason 2 04 - UN�FJD66R, FRAME-I.
205 - UNDERFLOOR INSULATIONam, Data!I .'
I I
WORKER'S COMPENSATION DECLARATION 301 -
ROUGH PLUMBING
I hereby .affina ancerTnIalty of perjmry one of buu firallow"ag declarations: 302 - TUB
& OR SHOWER it
ale :fConsent to selPirmax for Win 3 MECHANICAL`0 1 ll�vc and will ma ,a i�'rrific
Campam.,ont"as-psovided-for by Section,370I) of the Labor CadeI fice let s .03 ROU
Rembrobarso'c of the work for which the 304 ROUGH tLECTRiCAL'i
this pamak is issued, ...
Is 305 FRAME
amor Worker's Comp] ton Insure I
0 1 have arldwill moi since,is raquired Ili Section
37W of be Libur'Cods,far he pr1rimnarmicI,of he 1 306 HOEDOWNS
�m;which this rentral is
lazneeom compsan.im.In'. V train Poli,y.uTba,
INSULATION-__l,
n- ?ex)
In
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—CE—R%1I CATION A..1 I kliv 1 ..'ri-3 b&s' -,SHEJETROCKd,Fq�,,I
S -30,9_�=EXTERICR_LATH
FROM 's'
..,,.,C,OM� ATIONINSURANCE"` I
..............
if the irernij is foe handled dollars 310 INTERIOR11ATH' .
-SCRATCH-COAT-
I innify that id the pearfinin d.I 31'3z' -:Rob
,In price atm a work far which'his pentrat is issue I
.11 mit employ an,Forstral in a,..Kim,so a,u,baocapas Its cat to she Workers' - F NAILil
Ciampen,atimaleaws.fc.liformirs D V tj 501 - FINAL ELECTRICAL ENERGY
r- Applicant
I. I . �h a -ENERGY
11-maclar...gou"Itinfunimoth,temptio you. .0 id DU2 - 'FINAL 'PLUMBING
Z me object 1.the No kis Cape sat gnvililisri of the Labor Ccx�' .you must
0 forthwith CilinardY ar itli such ponsisions or this permit shall be deemed Mr.ked. 503 - FINAL MECHANICAL ENERGY
4z5511 , . ..
`I` tt" i't'I�I`ICONSTRU 504- FINAL 'BUILDING ENERGI,-,;
CTIONLENDENGAGENCY, I I
I hVmbj ifil the,thate is-.Emilunction lending agency for the'performance 505 FINAL ELECTRICAL-'�
of'the work for as hiVh his peon is il�rmd Plat Cl,C.,
Leaders Naide,-
;D-z baffler's Addre 506--- -GAS -TEST-
507 - FINAL PLUMB-ING,
I ci�ni IF is application and state that the above informaration is
ari�iiet�I alone I-Comply with all city and county ordinances and suite laws matirst 508 - FINAL MECHANICAL
ry
ono 6g
CtU tabilding consamilausand hereby animal representatives admis city to entertains. 509 - FINAL GRADE
510 - FINAL .PLANNING
CO) liabilities.pid,manda.Maus and expenses which may in any way accom gyn
Uz Or it .ad
City in consexpence Sun
514 - F NA �PM
5A,
sPARI7fI!IUNDE 'D WI petro
WITH MORKS ,
Sol _R S A
T, L1.NON POINT
IDEA Issued by:. Date,
i I go I.,a I a mfApplitrr Cox Date
�RDG MATERI DISCLOSURE us" .1 Re-roofs
I:Wial the pplaram a hanne store or ranee .mr;haamad-1
its claimed!by the Cupertino Muchiptil Cars. 9.12;. -Type of
Clsl�'&Mficb'25532(01 Cininef.... 'he .11,and Safe,, A
URE
ancl Womand
ad H
t
Pi
"o.. 0 Ya"V No
-&ted pri6r,to any roofing matellial'being installed.
hejn�p
4 -roofing
L I i e lippla,V I or future building occupant use equiparient an devices which i�llc without first obtaining art'insplEction,"pagre6t6 remove
comt fn�omsair contaminants as defined by the Say Arta Air Quality Mariagerrant If a roof is ins
Distinct?
'Yee
I I I �� , ., I,' I i - -�, 4 .11 1 all new materials for insre pection: Aahons pplicant under stands'and 11 comply,with---
Y.,., r ands III wi
_Soinrc
t:RN
ilill noli-licrint III
I base read.the liaArdafs bx;mn.1s anquiramorms under Cbsrpm,6.9�of be
lu Clilifoinous Health&Safe,,Code,Semi...25505.25533 old 25531,1 and...and that
if the 66 ilding does off currently have a tenant,that itis
my responsibility to rend
the I .. .....
oedu immummustli(c Met phor to issuance of a can
�Vy , I. ificaut,of
!t q.
4
3 VZ Signature of Applicant Date�
FJ It.IQ& All roof,coverings to be Class "B"or b6tter
OFFICE