00110063 CITY OF CUPERTINO - "t• : :_•'"• ,•I ,
BUILDING DIVISION • PERMIT CONTRACTOR INFORMATION:
BUILDING A DDR ESS' - PERMIT N
232, CARTA BLANCA ST - WEB CONST FdQJ].1'L?fV-16:5
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OWNER'S NAME : APYLICA'I'I51 B DATE; -
STEIN - -1080 LOVELL. -AV ��.) 137clZl00
PHONE: SANITARY NO. ,+ -CONTROL NO.
(408) 31370829 1
O!p ARCHITECTIE GINf:ER: BUILDING PERMIT INFO
FF BLDG ELECT PLUMB MECH
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LICENSED CONTRACTORS DECLARATION
-' ' I Fech,affina,lntl .'d 1 n fCn.ptu9(aame ng • Job'Description.- .
dm5r 7rnro1,6D nh . d1 f. "one cele and„yl eaa
q' a ii e alCC1 n B g L T TCHF_hJ REMODEL•�' -
iU all C elan '/tJ
p ARCHITECT he a DECLARA'I IU
l: g J 11)AI�p�J my plans shall he used tie public records ,
,,,vvvyyyrrr r G( I�—
• _p Licensed I'n,l . }I- A
OW NEl lBUILDER DECLARATION
1 hcrehy affirm that 1. .Basin form the Contme,Ce :Anyr,Law for the
?a following realm.(Section 71131.5.Intel.after and P dre ons Code:AnY city ui county
O prnch rcy e, tr ahimprove,hpermit
eI hors asigned
y.I Imre
prior r an alsorequiresrhapplicantfor.0 such nofl g J.tt mein �7
a -
iliac he is licensed lpursuant m P nn t r i r 1 1 Clamor,9 Sq. Ft. Floor Area $YS4nJ�etIS�I ...
,from li 6 'llS t 70he r❑ ft C tr J1 t : 9 - S
tribal by 1,wenn,the efn ,and(he basis fir Ills dlefiod exempla,.Any v'Nul n,
of Section 7031.5 by any apNiemn fall permit subjects dm apprevn ,e a civil penalty
of not mom than rive hundred dnuaraa500). I APNNumberoo�T /OccupancyType
0 L.,owrN;uf then,Y nnnY employees soft woes as their sole cot tion, 326 13055. 00
P P Y B pensa
weld 'heA th d m t mli I i tt red f r v l fS ly real
artierBesidn. IP f..' il qh C t t , al I w l t'rk him an _ Required Inspections
9w,
Ip In ly evil
ll: improve,ntr 1 m d 111 th' le, 101. — FOUIdDHTIOhd
infected
thea fill his awn emph yavx pros din mm sup, mpelf,is .[i ury non'ntender nr
n wle.If,however,then building e improvement n sore went one year of 102 — PIERS
completion.f me owner-bale.).will have the lwnlen of proving that he Aid not build or
hnprave roi purpus of sale.). 1.03 — LIFER
711,a.s owner of the imports,um exclusively contracting x;m licensed cammders to 104 — REBA R _
- "msh0cl the projen(Set.7W4,Businme and I'ral'cssia I,Cede:)The Cacti or'e '
- Liicen'eFewdae.Flapplymaauwrurallarenywnohaild,,, urnvcsmercan, 1-05 — ANCHOR BOLTS
and who cer m etc for such protects with a cnmmem,O)licensed pursuam an the -
Cantmmar,LiceneLaw. 106 — SEWER R- WATER -
❑Iameaen,prunJerSee ,p&PCfnrthis reason Tom 202 _ UNDERFLOOR PLUMBING '
'Owner WORKER'S COMPENSATION DECLARATION 203 — UNDERFLOOR-, MECHAN.I.CAI'_ �,
I hemby vrfrm under Fenmtyur penury aha at fWtwlog Aeellummus: 204 — UNDERFLOOR, FRAME
• ❑ 1 have and will maintain a Certificate of Consent ro self-time for wale.. 205 — UNDERFLOOR I hIGULAT I Ohl.
Compenwtien,—vs provided far by Saban INS) of the LaMn Cade. for the
performance(if wart for which this permit is isxned. . - 301 — ROUGH PLUMBING -
6
LUMBI NG _
' IbSegan' 7,02 -- TUB 8 OR. SHOW
EP,t I 'll ,eide. W n C Lnl I . IER. -
iliu f A a, cm r n I of e In n this,. hilt is 30 3 - ROUGH MECHANICAL
.ucJ My W eters Compens.mmd Insuran a sanicr.,,it Fahey numher arc - - , '
Paley No,: '304 — ROUGH ELECTRICAL
L'ERTIFICA!(ON OF EXEMPT ION FROM WORKERS' - "u05 — FRAME.
COMPENSATION INSURANCE
(This.,•,ljuaaeedmilbeeua,Fief,ifI,ner,lnl1,In"naatmdiedeanam 306 -^ HOL.DOWNS _ -
'(SHg)mless') ' 307 — INSULATION- - -
I certify that in the per balance ar me wort fur which this pem,it i,issued,1 308 — SHEETP.00K
anau nm en,plyyanr�y many mannar� �e}pbjgr to me warkcn' - 309 '— EXTERIOP. LATH" - r
Compens tiu�J M,Cy ll tram.nine VU
L,:g Yi
NrnleL ro IL ut.kingd LII to al Exenpin, yen'bawd 310 INTERIOR I-ATFI
Zpeen I tr,mew x r l et p nndednmtled. mua
fn311 — SCRATCH COAT _
O is
O nh 'Ill n i ly with n p i. n.,nh .III[shall be deemed Cunt.
CONSTRUCT ION LENDINGA617NCY - 313 — ROOF hlAll_
•aiI hcrehy affirm that there is v emr,b crion lending agency far the pe fmmaral
alto int nrnm Fe t : .-w(s 3097,Civ.c) 501 — FINAL ELECTRICAL ENERGY
rid Q
Leader's Nine,
77 lend 'Adl , 502 FIQIAI_. F'I_UIyIBIhIG ENERGY
U O 11 that I hathis upplicanumt role daidt,allorwe mr mr n is 503 — FINAL MECHANICAL ENERGY=
W. E, cone t I alter,i limply t1 -11 lily d ry 11 d d :ml ung
O U orb lag tr n by m rm lye t lam 504 — FINAL BUII_DIlxIG ENERGY,
me lb elpndr .pernpha 5¢15 — FINAL ELECTRICAL
.�H. a i Iw> l textile.indemnifya dkeepn (lie City rept lama • 506 — GAS TEST
V1 CryI l formals r I nsuswh h ,ty', u,yxry - ry:nst said
C:1 City' qt n h b t g DIMS L I. ..
APP ANTU STANDS AND WILL COMPLY WITHALl Nl3NPOINT
- so rcuL s —� ossuedby: 507 - FINAL PLUMPING Date ,
Si t oT)tpp — s N n
Date' Re- ofs
AZAkDOUSMATERIALS
cuplat DISCLOSURE 509 — , FINAL GRADE .
Will lbs npplimm or tiruvc huilJing acenptm nmrc nr hnnAlc hunmlaus mmerial Type Of ROOF 1— G .
as defined by the Clpcnino Municipal Code,Chnpler 9.12,and the Ilwhh and Safety
510 -• FINAL PLANNING,
Code,Section 255321e)P -
❑Y" 0No, All roofs shalltb4nspecfadbeing installed.
Wit l the applicant or future building necupant use equipment or devices which If a roof is installed without first obtaining an inspection, I a ree to remove
emir heranhlusvieeuimminent,as defined,by the Bay Area Air Carl icy Management P g
Di,trimoY es ❑N .all new materials for inspection. Applicant understands and will comply with
all non-point source regulations. .
1 have read the hamrdous inaterials reyuimmems under Chapter 6,95 of the
' California Health&Safety Cale,Sations 25505,25533 and 25534.1 understand that
W.Ledues not mly have a tenant that it buoy responsibility m nmifr the is which must be Filer prier e,issuance of a Certificate of11 Signature of Applicant , Date
ON= .Fimw� ��_I All roofcoveringsto be Class "B" or better
'sN Ilam
OFFICE