00090152 CITY OF CUPERTINO -
r BUILDING DIVISION .'PERMIT CONTRACTOR INFORMATION: .
BUILDING A DDRESS'. e < bf - PERMITNO. '
OWNER'S NAME: est`' •. r APPLICATION STIR DATE
1.031.8 BRITTANY CT ' SOLITH"BAY REFRIGE'R TION . , 000901.52 =
'I IONR:. SANITARY NO. CONTROL NO,Av -
MANOUKIAN NUBAR .S .AND CAROL -M 481 - PERRYMONT, 09/25/2000
OO ARCHITECT/ENGINEER: '}; „ - - BUILDING FERMI r INFO
(408)'279-191'1 -+ a DG ELECT PLII
PLUMB MEC
a
LICENSED CONTRACTOR S UFCLARAI ION -
C
_Z 5 v' I l fT n tl ,1 a I' .N d t .1. . Job DOST tion .
rpco eq Y V fCh ode,anonu license p -
F'3C"t nuns t 7(q0) CD' 3 rune Ba dP'f imrs Code,ane ny
nI fn u tr, ` .
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ARL hell b led a1CLAR/AT*#-rf� • .,Jq t _ .
NEW FURNAC3E
ed Lecrocid From,donal
c. I OWNER BUILDER DECLARATION ,
W 1 b hy offirm that I am excuipt froun the C I I License Law for the _
Elfva.,wa,mo Section 7DIA.B it Prohr-on,Cd Ar,,ay or County
S2p
which roilones apermit I .t t hw,,ine,ow,don f:hrepairy tractimr,
Cho
,,at...t I. re,eure,ih pPl' tl h paird,toII 'g d.tt n
thud licensed Pollutant th p fth C t t t L Law 9
S F[. Floor Area /! a ion
(ut g r Section plllN) f U l llw Il J]'.,I C I) - q'
nr thin he s exempt th Frn t and the hn.'. r -tl II g J e Vt AY v t tf ation
- ofSection 70315bynyapplicant f aFerric: bl ur ppl nu atied penalty r cyType
of not more time r.e n a d dollars($Shun. APN Number
°1„e owner of the t Y
pr p r y ort ner,11 n v,intended
in s l .. sr at,(S e 7 a,, t 2699
wild N k dd t t tit dtl B ' lf I (S 7MJ
mowBusinessd e r. Code,Th c t , , e d not k hit Required lnspec[ions '
w rp V w Whob ec l e e Ih J 'h e h k himself
of e tabu his own a however,
Prov den In,,(such nI rave t hart to year or !. 36930022.' 00
num le for.ale.If,however,tee bedding or ire en or Prov n sole within one year of
omurefor the owner-builder will enee ata burden of Proving Inas he ala ern buil]or
- •. .'
ilnl r Pam I
I ) is ' `204 — 'UNDERFLOOR FRA
ME.
°la, ,- fEe nout' t s Id to
mthe pej (See 7WJ,BtSno ofesoas Code oThe Coalntna301 — ROUGH PLUMBINGLicensewwdneshatapplytamto.timolpmped, -
-
in.bulld,oi-Rephtpesmercan: 303 — ROUGH MECHANICAL
and who collects an such projects with a comtruct ,ed pumuam bt the rnrel Ileen - ..
Coucannrs License Law' 1, 304 . — ROUGH ELECTRICA1
❑I am exempt coder Sec. ” ,B&P C for mivrenson
Owner' . Data ,I, - 5095 — FINAL ELECTRICAL . . .
t WORKER'S COMPENSATION DECLARATION_ -507 FINAL PLUMBING
Inereby affirm under penally of perimy'onom he hopoving decorations: ,r'508,`- "FINAL'`MECHANICAL -
o Iha' as will trairtain a CerfifitainearConsentto Ir: v for w k,- 51,4- — FINAL 'PORLI'C WORKS
cot p t olion as prt 'd d for by Seed 370) of the Labor Code, in, the '_"-+•
,erfomtna c of the we k finnovinlami,darmit' Inured.
e,
❑1 have ond,will mainmin Worker':Corn,s dian Inmm e,,,as reyuired by Section x"r
3)011 f 1 [..her Ctul 1 th p f run' fth work r which thispemm i,'
k
issued My We rke C t p t '1 r,, u r nd policy be :
Carrier./�k�XEMPI '. C MW1R/RS' I—
���—CENrIFICATIONO CXEMPIION F- SM`N''O`R-KL—RS i• 5
COMPL SATION INSURANCE c ,
'(This section need not be tomplemd it aw permit Is for one hundred dellin, 1
($100)ar less.)
r
1 n'f)tl't tl p f Irl k1 h htl p tit' d I,
shall not employ' y person in any manner so as to become subjeen to lee Wotken -
Compensation Law,or Cal Tor ft.Date
NOTICE rOAPPLICANT It. B k g this Curdificate of Exemption,you should , -
Z loceirre,ubjeatt Ih W k,,',Cdarps3roafirup t. tf the l,ahor Code you it -
Q 0 fonhw'th comply with such provisions a'this per tit Shull he deemed revoked,
CONSTRUCTION LENDING AGENCY
l hereby ar n that lhere is a co vitacftin lending agency forthe perrtrnxnce e4
-� of the work for which tl permit I,Issued(Seo 3097,CieC) ,
[� Lender's Name .. ,
VZ y Lend Address -
wy 1 nlretEllh sethis p,an I' Iatthnh b Information r ,
torr t Ig c e tr mnpl}w'Ilt all cit)and unry o nl i.tees and note lows relating
O (, .the abaringmnseactinn,;md heaby mnhoriie rcPrexcnlnlivesof ties city to enteruWn
,fir r� the ab t n' J p pc ty f p ft
L L - (We)'b -t n'IY CJk �h I..de City I'C I t' g ' a t. r
LLLL, hil t „ oilg t t d ex s h nay bt any )decline vga to 1 -
V
City nvc u” enR g tun fth'. •CO - ��t�'/� l�
APPLI DER. AND D L COMPLY WITH ALL N N-
LA Ns. ? tr u Issued by: Date
Signature ar Appetanticantreeter e - Re-roofs, -
` HAZARDOUS MATERIALS S DISCI OSURE -
Will the aftame buildingo,capart stoic orlardleh'>' smatedm Type of,Robf,
as derncd by the Cmpei o Municipal Cole Chaplet9,12,and the He'Ile and Safety " - -
Code,Section'25532(a)'! - - - - n • .
D Yr, °" All roofs shall be.inspected,prior to any roofing material being,installed.
- Will the appl t idiom Is'Ids p : valg nI devices which If a roof is installed without first obtaining an inspection;I agree to remove _
emit
It 1 nationals.,dermad by the Be,Area An,Quality Mmayvmen
time^ all new materials for inspection. Applicant understands and will Complywith
'orfs" :❑No all non-point source regulation's..' PP
1 have read the h u d mrialr '
1 us un Ju q695 mince
Cnlirman'alhlun&, ftyC I S Orr,,2550525533 and 25534.1 tnncrelatd that
ifthebuildingdos of currently en4cnam,tlot ilis my responslbiliry I,,amifythe - ..
occupant ofthc Giremems no mall he at prior 1.issuance of a Cmd1w,te of '
Occupto
- ;i• Signature of Applicant Date
Owner or amm�r:ea,gam lad, .. 'All roof coverings to be Class-"B"-or better -