03040057 CITY OF CUPERTINO ?* s�tro-r%a �%' 'ts• ;
BUILDING DIVISION PERMIT CU�N4rRACTOR I�IVUMA` .IVN ;
BUILDING ADDRESS: PERMIT N0.
21753 CASTLETON ST ROCKWOOD CONSTRUCTION CORP . 03040057
OWNER'S NAME: PERMIT LSfiUB DATE
ARAYAN & SUJATA MAKARAM 14583 BIG BASIN WAY, •STE 3-A 04/09/2003
VE: SANITARY NO. .CONTROL NO.
(408) 868-9026
ARCHITECT/ENGINEER: BUILDING PERMIT INFD
BLDG ELECT' PLUMB MECH
3 0 6 LICENSED CONTRACTORS DECLARATION O O O
L hereby amrtn that i am licensed under pmN of Chapter 9(mmmencing Job Description
with Sceti 7C90)of Division 3 of the BusinuandE ulnen Code,and myllcmnsoLL
In full foeffect.
wmnoc'iaa - g LCimc^g BATHRM REMODEL/WINDOW REPLPIC)4N1}TMI��E®
" '-f ' ARCHITECTS D
1 udermand my plans ahall he med u public mcom. NU V 2 0 2003
m� Licensed Pntfnsi...I
5 OWNER.BUILOSR DECLARATION
E 1 hereby a01rm that l am exempt from the Convectors License Law for the BUILDING
���f G �Ip1/re
O O following roman.(Scedon 7031.3,Business and Profeuem Code:Any city or county BY Yen toil
I which requires a permit to mosam Atex,improve.demmiuh."repulr any structure
;c inhum its Wwmo.aWsroquims the applicant fmsuch permitto fdeasigned auemert
FFF< that he is ficaed pursuant to the provision of the Contractor's License Law(Chapter 9 Sq.Ft.Floor AreaV$I{I tion
3^ (commencing with Section 7000)of Division 3 of IN Business and Ro(cuims,Code)" $2088V
3 Nat he Is exempt thert(ro,and the basis for the alleged exemption.Any violation or
Section 7031.5 by any applicant for a permit aubjens the applicant te•civil penalty of 3�$ U ypy�ei O O OOGD araCy�'Pe
not more than Iive hundred down 6($500). / P
1,as manner of IN property,or my employes with wages u their soleeomperndm,
will de,thework,and the suucare is notlnumded reoffered foruw(Sce.704e,Busimn
and Prelusion,Code:The Cameron License law dare not apply m an mater of 101 — FOUNDM40W Inspections
Property who build,or improves thereon,andwhodoessmh wok Mmselfor0uough his 102 — PIERS
own employes.provided that such Improvements am not Intended monered for sale.It,
however,the building or improvement w sold within one year of completion,the owner. 103 - UFER
builder will have the wrden of proving thei he did net wild m Improve for purpose or 104 - REBAR
01,u owner of the property.am exclusively communing with licensed commaman to 105 - ANCHOR BOLTS
construct the project(Sm.Tae.But=and Prm(essimm Code:)The Contractor'su. 106 - SEWER & WATER
mile Law docs not apply to an owner of property who veil"or improves thereon,and
who contracts for such projects with a mnwmor(s)licensed punuant m the Convacmra 202 - UNDERFLOOR PLUMBING
Le - - 203 - UNDERFLOOR MECHANICAL
I
aamnoexempt undo Sm. ,Bk PCfor this moon
204 - UNDERFLOOR FRAME
WORKERSCOMPENSATIONDECLA ON 205 - UNDERFLOOR INSULATION
Ihereby amre,under penalty ofNduryamofthe relieving declarations: 301 - ROUGH PLUMBING
eve and will maintain a CeNOcae of Consent to se161mure for Worker's Camper- 302 — TUB & OR SHOWER
work(orswhlded forr ich Nb permlt5ia ision sued. 303 of the Labor Crede,for the performance of the 303 - ROUGH MECHANICAL
❑I have And will maintain Workers Compensation Insurance,u required by Section 304 ROUGH ELECTRICAL
3700 of the labor Code,for de performance of the wart:few which this permit is Issued. 305 — FRAME
My rken Compematin Insurance nvlm and Policy numbor art:
Polley Nm: 306 - HOLDOWNS
CERTIFICATE OFE%EMPIIO ORKERS' 307 — INSULATION
COMPENSATION IN E
(TbLLauctlnn nevi no.berompleudlfthe pmmlthfmrone nundmd dollen(g10(p 308 — SHEETROCK
"less) 309 ' - EXTERIOR LATH
1 coolly that In the perfmma a of the work for which this permit is Need.1 awl our 310 — INTERIOR LATH
employanypassu an mannerimule me bjmtmme Workcrs'Cmvpemallon
Uw.of C,Ilfmml W-10-- T"C 311 - SCRATCH COAT
NO11
TIC APPLICANT:If, r nn thisCen ma E�TBr mption,youshould 313 - ROOF NAIL
beromCNbjen an the Worker,Compensation provisions of IN labor coda you most 501 - FINAL ELECTRICAL ENERGY -
Z forthwith comply with such provision or this permit shall be deemed revmkcd.
�0 502 - FINAL PLUMBING ENERGY
55 CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
1 hemby Alhm that then its convection lending agency for the porfmmace of
x2 the work for which this pemdtLLWad(See.3097,Ch,C.) 504 - FINAL BUILDING ENERGY
s7Q Len
der'sNatne 505. - FINAL ELECTRICAL
D Z Lender,Addreu
p0 I mnHy that l have mad this ppliwion and mm that the above Information is 506 - GAS TEST
y vt CmrreeL l agree in comply with all city and=only on inaaund awe laws rowing to 5 7 - FINAL PLUMBING
bo0dingmon,And wrens athonremoses, Ives of this city teener upon IN /
shove-mentioned(WI)ag property for inspection keep ha 0 - FIN MEC I CAC
ti (WC)agreemnutsindemnify
e, hichhayInanUteymACupenstidCity almost 9 FI
lubllities.judgmenu.coauand mpenses which very in any way accmc against aid City
J
APPLICANTIn eof the DERSTANDSthis
i WILL COMPLY WITH ALL NON-POINT Issued by: 5 NG Date
SO RCER ATIONS. -
_ Re-roofs
ignnurt ofAppli Dae
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will IN applicant or future wilding occupant awn"handle haxeNous material
As defined by the Cupertino
Municipal Code.Chapter 9.13,and the Head,and Safety
code,Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed.
Yes 6�No
bon thea Ilcent m future wildin occupant Lie ill If a roof is installed without first obtaining an inspection,I agree to remove
Ire g p+ equipment m devices which g p g
e�ramnm air comeminanu u defined by me Bay Ams Air Quality Management all new materials for inspection.
[3Ym Xj No
I have red the herardnmmamNats mquarounuader Chaperd.95of the Califor•
nelialNBSAmy Coda,Swd=25505,25533ad2553a.1under thnifthe Nil, ----
dines not currently ro•enanL mut It LL my resporWNliry m mWfY sire oceupanl Kde
mguiremenuwh moehcmetpdmr u,uce f.CcttinesemrOmuparcy. Signature of AppKdfint Date
'nerve uthodacdagent Duk All roof coverings to be Class"Bra Or better