02090150 CITY
BUILDI G DIVISION O PERMIT CONTRACTOR INFORMATION:
gubgl3DTXN1,ON VISTA DR MAGGI CONSTRUCTION " 'Mr`bN01090150
o` TM's nA OUT 1457 DONOHUE DR. APP`IF`"N/`TV�1 002
PHONE: (408) 251-3078 SANITARY NO. CONTROL N0,
Q ZO ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Z O y Z LICENSED CONTRACTOR'S DECLARATION Ot}, Pun
O Z_ I hereby afOrm that 1 am licensed under provisions of Chapter 9(commencing BATHRM & KI TCHEI 1C�ft &
F9 '9' with Section 100(d)of Division 3 of Ne Businessfesnions de, ylicense
<m F ix in fail In
an 4 ADD CAN GHTS
jOM Leen Iaa Lt.Jr
FINALE
Dem Commnor
too ARCHITECT'S DECLAR TIObf
I un rsmnd my plans shall be used u Public records FEB 19 2003
a.O O Licensee Professional
OWNER-BUILDER DECLARATION
1 hereby affirm that I sum exempt from the Commences License Low for the p�
t?a following reason.(Section 7031.5.Business and Professions Code:My city or county BU I LDI I V G
F C which requires a Permit m construct.altar,improve,demolish,or repair any&=turn
prior to its issuance,alsorepd.the applicanrfor such permi,to R]...limed snnment - -- - ___$10 0 0 O 0-
thSt l,e,iliaipzd puisulr,l tdthp pToNsinns of Ne comractoe,License law chager9 S [ 00 A e , ' Valuation
(cdmmeMing with Secugn 7000)pf Division 3nf Ne Bulim,Jimp Prpfialons Cnde) g�✓i)E-{'t?a 9� '�(F7 S rS ..tN-,N-I,;C)
or that he is esenipi Nenfiom and the basis for the allegetl a cropiba.Any violation 35'd d 2 ab 1'O'i 0 o
-of Section 7031-.5 byanyapplicaut fora pemm subjects be applirnm m a civil penalty
,of not more than five hundred dngam(S501)), APN Number Occupancy Type
❑I,as nwncr nftx property,orm'y employees with wages as their sole compensation, 101 - FOUNDATION
-will-do"NCwoK,"aM'the'11.1tre Isnot Intended oy offered for'sale"(SCC.VBYIf
'Buiinesi nod'Professions Code:The Contractor's License law does not apply to an Required Inspections
owner of property Who builds or improves Herron,and who does such work himself 103 - UFER ,
or thrwgh his awn employees.provided Not such improvemenu um not intended or
'completion,
the.ILhowever; wibuildingor improvement proving
nsthat he
one Wild
of
1-04--- -REBAR' -
'iamplceion,N<owner-builder will have Ne burden of proving Nm he did not Wild or 105_1 - ANCHOR BOLTS I -`
improve for purpose of Sala.).
_ 174asownaotNe property, contracting WER--&—WA--T-ER-------------,-,------�;-
p i PrSPt y Business gwrNht:enkhe mrancara 202 - UNDERFLOOR PLUMBING .. •.r:.• r.;:i�tl••o -n
wmwm the mea(Sec.Wit,ow and ctry who Code:)The Cos Chemo v t.
License Law macs not apply men owner th property who builds or improver Nerton, '
'>= Causer eamroe ,rat auto poar .wim..enanano x).lieen d puauanrm.Ne_ .___.__....2.0.3_._-.__UNDERFLOOR._MECHANI,CAL...._.__________.—___.___—_
- = CnnwaofaLeemLaw.,, 204 - UNDERFLOORt, F
❑1 am<temt d S t•' " ;'B&P C for this ream. . l •`:'?!'th'i:J❑
.p pis er ecr_, 205 - UNDERFLOOR INSULATION
- Owner �'d•M . ..:t Dam ,....
WORRER'SCOMPENSATION DECLARATION _ 301 - ROUGH PLUMBING
hereby ofOrm under penalty of perjdryone of the following declarations:- 302 - TUB & OR SHOWER
{r Cl I have end'will''mointSin'o''Cenificate of'Coment to sCl6imurc for Worker's 303 - ROUGH MECHANICAL
- Compensation, no provided dor by Section 37M of the-Labor Code, for the 304 - ROUGH ELECTRICAL
perfonnonce f the w rk for wh'ch Nis permit¢issued i.,r 3 O 5 - FRAME
❑1 have and ill'me.min Work s Comps ti h mance m required by Senior 306 - HOEDOWNS
770( of tbe'LaW Cole f thepe'rl6hnance of the o'rk for which this permit s
usu d My W rkeri tatiii Insurance conic nd Policy number arc
307 INSULATION--. — .........
C..at ATIDN OF EXEMPTION PRO 1 1 "'vQ,�3aO'B� ui'jSHEE�PROCK 'e a j(s( sF ll f l
O 14SATIGNINSG ce a 3.09._.- EXTERIOR_LATH
"' IThi .Fn nn d fixe in
if Ne p,rui n,f h hundred dollars 31O '�- INTERIOR LATH J' "` " f�r,t ,
slay le ) „311 . - S,CRAT-CH CQAT j
_ =
ante my'shill in rhe peH nd nee ohhe wr k•fur Itch thispe tsboard l' 313 - ROOF:' NAIL..J'Illtllh,'A
Eh"Il
rim,b nPY pe n a o,y:n+nn r to tiecnn a M1len to iHc'W rkcrY '
'A lite t tawnll1tlhr 'pater ' ' 501 - FINAL ELECTRICAL ENERGY
�APPI ant . . .. .. .._ _..._. .. - . .._ ._.____ .._.. __
,NOTICETO APPL ANT lfmtrmk gtm Coultcum of Exe, ptio,you ahold' 502 - FINAL PLUMBING ENERGY.,
be me suhject Ir the Worker C pe x s pr nntins of th L M1m CnJc,yd must
�O p fonhwuh comply with such prov s ons or this permit shall be deemed reuked 503 - FINAL MECHANICAL ENERGY
` CONSTRUCTIO d9g y - P.. - - -"-504" FINAL`BUILDING--ENERGY r
V:
'ItCONSTRUCTION LENDING AGENCY '
; Ihercby ffmt thanherc, oust cunnlnd'n enc frthe edoMr n2 ' 505 - FINAL ELECTRICAL n �'
ri huh this perm i 'issued ISec 3097 Cis.C 1
ue�r:rimew..w. 1 .:;,....U�. ._. _:. . . ' ___... . -506- -- GAS..TEST--- _------
Lender's ----.... __._. .. ..,Ynaares' - 507 - FINAL PLUMBING
. .7„'� .rp_,
1 emf thm,l have reed this application and stole that the above information is
:g+>'O Eoritttrl•agrte m complywith all,city and coumy.oroinances and nam laws relating 50 - INAL MECHANICAL
tobuilding cons mclion:ondherebyauthorlutcpresemuti✓esoflhigcitytoenter upon
5 9 - INAL G DE
,7.]W the above niched p,openyf inspeatonpuryoses. „
.67 (VJe) g e}o sae mdemNfy o,m keep hurmlci}"Ne C'iy of dupenfn6 ogeinst 51 - INAL
=tis IiebJnies 1 dg ms,cosi d expenses which may to my ny acme against Said 514 I AL I RKS
V y City,n co eq nce of the g ni'g of this peruin -
APPLIGA, UND h5`I'rkVDS kN WILL COMPL)'WITHALL NONPOINT
sous GUL: Ns ll ' `� ?U Issued by; Date
age pp canuCort t D' ,C„ r' Re-roofs
ATERIALS DISCLOSURE .. ,
'WII Ne appl¢ant m futorc bu'Id ng accuP:mt nae m handle hormdw metenol
Type_ e - - - -.
S as'dReed by theCupertino Mu icipal Code.Chapter 9 12 sod the Health and Safety 1
Cadef Section 2553}(a)cri111 t7 No .v A r l" i t. f s t' i.`'� Is ' Is1 i •yl t.Aa.:3 Jf. i. 1
_-All roofs shall.be.mspected prior.to any roofmg.matenal-being installed.. _-. __..
WIIN pplleanla fumnbuildingoccupant useegtopr oto devices which If a roof is installe'd•without first obtaining an inspection}-Pagree:to'iemove
cmm h"4s mr conmm rums hk definedby the Bay Area Mr Qoahly Management
District?•; - all new materials for inspection. Applicant understands and•will_com_ ply with
❑r - , , . o-No'. n - r all non-point source regulations;�_y
,I have hnromous matedeH rcgmremebu�.under CTepmr 6.93 of.}he
Calif.rhin Health k safety Code,Sections 25505:25533 and 25534.,1 understand that
"iflhe build,gdoes not currently haves mnont that u m my nsponsibiliry mnouyrlie - - - - --.. __. ._. _ - -
odcupam of N nquirtmenu which into,x ruct poor m nsumue of o Cenificeu of '
Oicupamy lr
Signature of Applicant Date
o ernr m d egen a All roof coverings to be Class"B”or better
yfi
t j- P. t -.--OFFICE.