01080118 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:'.
BUILDING ADDRESS: - PERMIT NO.
10389 BONNY DR AAA FURNACE & AIR CONDIT ONING01080118
OWNER'S NAME: APPLICATION SUB DATE
GREENIVAS GOLLAPUDI 1712 STONE AVE08/24/2001
PHONE: (408) 293-4717 SANITARY NO. CONTROL NO.
II
O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
n u BLDG ELECT PLUMB MECH
ce
�- LICENSED CONTRACTOR'S DECLARATION
Z4,; thereby affr that i am licensed under provision.of Chapter 9(commencing Job Description
° with Sen ion 7")ofDokid.Sofine Badness aoitPrefessiod,Code.and mylicense ADD A/C & CHANGEOUT FURNACE.
n fall force n
iz�a u�caaeclaa ` Lieu (48r 0.00 BTU A/C,
i°`1 G°"'`actor 10 0' 0 0 0 BTU FURNACE)
3 u.y AR ITECf'S DECLAR O r
a C; `f- /I tooli nsmand{sty plans shall he used as public records _ FI N A E D
�>
as p O Licensed Professional
o i OWNER-BUILDER DECLARATION
I hereby affirm mat 1 am exempt from the Coolowler's License Law forms,SSEP 18 2001
iQ
following 7031.5,Business and Pmressions Code:Any city or county
a ❑ which requires a perd,I.construct.clear,imp rovq demolish,or repair any structure
a, ie .pr t it 1requires- theppan
lct for such Permtu fileasgstatement.d
nam that he Rlicarsed puradow came pmvbmm of the Contractors License La (Chapter 9 a.S u $ Ft.Floor-Area Y
(commencingwm3eh ]0u0) fD' don 3 of the Bu5mas and Proficesons Cad) t` .n s, af,-e e.9 t ,+S!_ t 4.1, r,s,i ,fq,g tfile<' BuitDi ¢/ nion
or mat be n exempt therefrom and the bass for me alleged eiernPuod Any violation u•✓���{`��V�7
of Section 703 15 by any applicant for a permit subjects the applicant to a civil penalty
f not more mhn rive hundred dollars($500). 3 5 9A pl u 0 r 'v n Occupancy Type
❑I,as mwer of the property,or my employees with wages as mevsole compensation, _
will do the work,-and'the structure'is not intended or offered for sale(Sec:7044," "
Imianesstand'Professions Code.The Contractor's License Law does not apply to an 3 01 - ROUGH PIRkII3BrrWUEhspeetionsi' I
owner of property Wlm bull&or improve<thereon,and who does Bach work himself 3 0 3 - ROUGH MECHANICAL
arcthrough h' . viemployeesp d d that such pro a t. t intended or
'of(rcd To the
If h thebuilding t P t Idwithin one year of .__ --------
completion,
.__ _. .._. .._._. .. ..
arpinion,the owner WJderw 11 have the burden of proving that he did not build or 304 - ROUGH ELECTRI CAL'>�� �- �•� <'�'.rl . •
mpronfiarPurpaxeofnme.f 505 - FINAL ELECTRICAL
.. pl o asn of map perry m
es lye mmaing with licensed vaceara io507 - ..FINAL....PLUMBING•., .._ ...._..__
r
construct the project(Sec 70,y Business and Professions Code)The Contractor's 508 - FINAL MECHANI CAL ,
License Law does not apply ra an owner of pmpeny who Wilds or mproves thereon,
..and who contracts for suchprojects wild a connotations)lo:ended.pursuant-to.the. _ _ ._. .._ .,. .. ... . _ ..t
�z"' Contractors license Law ��_`.'..'.-. -
r ti ❑I e Pn �.., ('reason - I,1}.' xr
n t under S B&P C for th
Did
WORKER'S COMPENSATION DECLARATION
T hereby affr editor Peimhyof pe t ry f the following declarations:
..
t ❑ 1 lowi andwill°mamon a Ceriide t f C' .cin'm If m for Worker's
Compensaton, as'provided-for by Section 37W of the Labor'Code. for the
_ p<rmrance of the work for which this peimh is issued.,
yllh 'nd'will inzm nWorker'e Co pest elmdran srefundedI 'tion
]]00 of the Tabor Code.forthe perform ce of the work f which This N-rodat is
issued.M.y(Wo ke s,Compensation insurance awrier
and Policy n mM1am.
em er V/ChRTIF 01 r4,Na_4 k%'�6 sQ� �� r "1 . n ''L_` ' T. Y�lr•'� ' { `i 5..' i:AIT3 ( . S-,,, rJ- _ ,v
�n[z, RTIFI ATI N OF EXEMPTION FROM WOR ERS ' ..
LR
COMPENSATION INSURANCE t -
"" (Thine.) n stead not be'compleretl❑the permit is fa one hundred dnllais 'I j "'w '
i15100)nr lcssJ
.,' I nrfy than n thPerfo r 1 th e*f r wwhich this Permit issued I ............ .................. „.. . . ...,. t .. _._ _,_
sh II t employ y pe n m any man er o s m Wsmaric R bti n 16 the W rkers '..' 1 - ti s
-.Atopt Lwr fC IoDu,l.e
PP( ane .;
z
NOTICETO ,after making this Certificate w1i,complaw,yen should
become j nto the
Wimke Compensation p isionsof e LaborCode,,youmust
fortm ply nh h provisions'ortm p m thall b downed kedZ C - - -
Imo, W " yCONSTRUCTION LENDING AGENCY
� ' �'� Ihereby'Ifrm thanhereis onstmcu Icndmg a6 ncY for the peifolm nee I .. _ .. .. '; i,
0. Q
U+�
Lender's Add
U,C r
r, ,1e.certify thatIhave read thisityndonand scale thais b 'nlowSmountain.g
lea, �"y coirett Pugree Ip comply with all city and county mia'ardinances and site laws`eluting
�?V the ittoemernaved prialnanereisuectionuposematives bilhiscity menrerupon
the nbatwo)agree to mp,indemify adikepurp°.ses.,
•�,(y (Wejagreeto medmnifyandkeph may inimy,wCit. seup s ino agained
W liab 1 t j dgme,hs,cost d pe se. Nab y any 4,a m ag
mail said
City qu ce of the joining of this pert
APPt7QANeT4UNDERTPNDSANDWILLCOMPLYWITHALLNONPOINT' ISsuedby: Date
StlIyFCE R/U S�
r r Sib
anne urA1 canVCont a — Re-roofs
-,HAZARDOUS MATERIALS DISCLOSURE r ji .
'ati 1 willthpplic t We v b ilding oat t store rhandle ha:aia m e1 1
as defined by the Cupertino Municipal Code Chapter 9.12, d the Health and Safety
-- s - •-
Cpde Sen 25572(e7°s T x s f 't' jc". ?-r>h ! 4_Sm
Dyes 7x�N .� t1 'Fret IC 4" 3'. s >,° S: } n�
All roofs shall.be mspected.prior.to.any roofing.material being installed.-.-._
;� Niel theiiiiiie a
tor future budding occupant use equ pm nt rpt Ices hiah If a roof is insialled•'without first obtainingan ins eetiori I a ree'.to';•einove
/ Dist a by the Bay Arm Air Quality Mnagemnt P hs
emit Weapons air<onmmm n[ s.defined
all new materials for inspection Applicant understand_s and will comply with
113 yes. CIN.,1 . i 1 i„ '. ' .� .alI non-point S011LCe regUlat1011s,,r, n t ?t`.it .•.1 .-. '.-
�� 1 h
mwlabphtpzwddinoticamil,r q ire en¢under Chapte 695 of the
Cel font a Health&Safdy.Cade,Sen oto 25505.25533 and 25534..1 mou rstand that
if,ih building dye,nor a d'have asadism:ie a tismresponsibility .. -.. .. _._._ _ .. __....... ... .. _. ._.
arca nt of the re yY i°notify the .
Si nature of A licant. Dat
W 9 rcmems which .t be e p to issuance f a Cenificme of
Oe
fj�y . g. PP, e
Grrner or authonzeaaq<� -�' Date All roof coverings to be Class B or better
OFFICE . ....... . . . _