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use[ PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
22047 CLEARCREEK CT
CUPERTINO PLUMBING
PERMIT NO.
02010125
FAIRCHILD RONALD S AND PATRICI
10297 S DE ANZA BLV
UQLICyAj187yjBsn
L U
PHONE:
(408)253-0618
SANITARY NO//.
CONTROL NO.
• ARCHITECT/ENGINEER:
J
BUILDING PERMIT INFO
-
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
v wile Sermon ]OW)ofDivisionJof me Business and Professions Code, and my license
1tion7 affirmthat InmoftheBunder previsions ornsCode9ndmmenense
Job Description
REPIPE. �'B
is in full force and eft
� LED
f License Class (—� Lic. M ZL "1 O
Date ?1 �� `°nrmtaf `�
a be
5 1 Pfidfrsi ndwy is
FEB 2 6 2002
plans shall used abIJs public ono
j Licenxd Profexaawl
i OWNERBUILDERRATION
BUILDING
1 hereby alum Na, 1 romdr,
exempt from Ne Contractor's License Law for the
1.
( 7031.5. Business and Professions Code Any tiny or county
$5000
r requires v
whichinguiresa craltt construct. improve, demolish, fi repair any svdernam
prior t e, idsoac aalter.pplicant
"e pdonoirsismaaeaalsicidto slneapionso for such filea Casement.
Contractors Law
,mancgri.g,1edpurfuanLm,,na provisi°nsorthe Comracmr's License Law Chapter
(commcvcinB,wiN Sas!Pn]WO)of Division J of the BusimaIland Profeeimas Coda)
f, 3'2 '�U 144r( gets T, .r.., ti Valuation -
ra\Nt.
or thmi'he i4 exemit dhimfrom and the basis for the alleged co mpnod. Any violation
`�()'V R s.lde ? \i l: ti s �y Jn7J
I
of Section 70315 by any applicant for a permit subjects the applicant a civil pmshy
of no, mom B
than.ehundreddoll.(s5W).
202ARNIIMIDIERFLOOR PL4M3ING`r Occupancy Type
❑ 1, owner of the nr my employee with wages asedtheir sole union,
301 - ROUGH PLUMBINCI
ll d adtheproperty,
le (Sea
'Buss a therid Prk;ewien, Cose: Tanchor, is not amended or foes rad apply to0y-
'owner of and Professions Code: The Contmnoeo License Taw does no, apply tom
—'--'-'-" --- -- ---- - - _.-,
502 - FINAL PL� Q�s �;Y.-'-
of property who build., or improves thereon, and who encs such work himself
507 - FINAL PLU I NG
.1
.1 the
or through his own employees. that such improvements ate not intended a
1
ended
offered.f- Ie. ICn thebu ld'n g or improvement is ;.I one year.,
c a, dau h. din
oprove on the own builJcr will have rte burden of pmv ng thvt he J d not Wild.,
- _
improve for purpose of sale.l.
nt....._.._...._._,..._—.._______—_._._..—_....._...___.._._...____.__.___.
_ _.__._.._.___._. .......... ...._____.—.. hit -w-
none p(Sec. yam
nLNct
Cher
CoeI The CmapmRb
construct @e project (Sec. ]OIJ. Business and Pmfcssions code:) The Commgor's
Businlv=I and Professions
License Law docs not apply m an owner of property who builds ar improves Hereon,
. -
r -- - - `
:._Communes projects wiN.a,conhaemr(s7 licenutl.pursuam vo.tho..____.....__...____.____._.__
License
Communes License Lvw. -
a_
...................._....__._..._.__. _.�'__ __._.._......_—_.__.___..
❑1 am=xcmpt under Scc. ''•"`'•'"` ;B'& P C for this reason
,
!1!1
Owner'In .,a n..l•,. .•',c: •.,-. :. ns.
" ""' WORKER'S COMPENSATION DECLARATION
I hembyalfinn undcgpenals;_°f ti 01 'he following declarations: -
Y perj ryone.°,,.. g
❑ 1 have' and skCinaimein' h'Ccnidcam of Consent to self-insurt for Worker's
Compensation: as provided for by Section-37w-ofthe Labor Co1e,-for-the
performance of the work for which tris permit is issued.
01 have ond'vldi'mainizin W°rk=r's Compensation Immance, in dquireA by SedirG
37W of the La arm Cale, for the Peffonna°ce of me ask far which this pernil is
is ed. My W kels C p f Insu add lsl y be - e:' ' -
.,, .- .,.
_ �YRcGfI 1A1-(Oa'76A:
- 5NOF FXI YN
,., M 11 �-
'' -0.'i
CATI
( CERTI CATI NOF EXEMPTION FROM,WORKERS
ROMW
"'•-
(-" J C * r f �,;1 its t 'y4A7 10 k,
COhIPENSATION INSURANCE-
• ...r.; _.; -�.:..
.. ..................�.,....�_ ...
(Th ect on needot be completed if the permit is for one hundred dollars
' to v -' • F • (. t
(Sim) or In,,.)
-
t lcnfyrht'nthe peform rkfrahihth rmr'
- - - - -
shall not rploy my p=non In any nature, P a,nt become ad,pot to the work=rt
-'(i! i• < - n -C +')t
Comic, tion'faws' California,ae "'' - "'- -•
_ .C,, ,..
hitt AMICI
NOTICE IOAP6
10 after IhlsC,m me of —Exemption.
P ho should
.,. -
the WaTIL
become xuhyn ,o the WorkcfsCompenxduon' -
Compensation pros you moa
t.T,. , i\.
forthwith comply with mefi provisions ."his .it W dLabor attacked,
shall be deemed revoked.
-permit
_
- CONSTRUCTION LENDING AGENCY
1h eby airrm the ,hert const , led g'agency fo the peKorma-
.___ __ ... . .. ........_..-._ ._hitt ...
-
of th ork far tich this'-'
pc 'C s ssu d (S c 309] Cv. C )
.. i
is d rs Name '— -
-
mud this ity'anadon and same dina that drhollstat inaws cion is
. I amity the Anitacomply
t. b.il: I agree to camply.wi!h all city gird county oNinances and vent laws relining
to and hereby dusn°}im u posenlasivu of this'cisy r° enmr upon
ahcorc- reatiwciion;
the d t atoI p=aY,, i.pct np pots -
I (Wb)ugrec wxase, dhmn fy. anti keep by ❑essihc city o(Ctipdrtino against
l i l t dg mss,am
expenses which y; any y cc eine said
Cary oll
Ape CAV U DE comPLY IYITHALL NO\:'POisrb`
S �,
!/
Issued by:
tiZ.!g
Dale
r r f Ap 'canr Dat "
H ALS DISCLOSURE "'
`L lW-Il
Re -roofs
theapplicant Pont Wildingoccupantsor, or handlehvrallou mt,;,l
defined
-__,Type.of.Roof..
as n by the Cup Municipal Code. Chapter 9,13 d theHealth and Safety
.,.tt
.,.,hi._. -
\ tI4 l
Cade 50 wn 25?J_l l "°
t' i Fl,': ti t�F,t ':'Yi
V,
.:
All roofs shall be inspected.pnor rotary
venin applicant mi building capuse equipment o a gip,.,which
m t h do ren 1 n r. J find b) theBay Are,A Quality M ag sot
roofing material being installed
If a roof is installed without firs[ obtaining an
g inspection; I agree to�temove
D its "° _ '.,
all new materials for inspection._ Applicant understands and will co_m_ ply with
PP
ti s,
all'non point source regulation - '-
1 In ad th mei la rcyu Chapter 6.95 of the
•'
f sits Hmbh sly Co
grisly Cale. Section 25333 a d 25
and sponi, aM the
f
f rhe buI9ftldoesnm cu
s son tra, that
h t itis ity to notify
ean
I
rowhL h'mve
I Pf the rcyuirc ems,wti h'm,ia be met prior to issmnce'of. d Cenificam of
timet pr,ismyresponsihillgmcian
a PancY .. .,
hitt..- ....._.. .. _. ..
.. , '
Lowarar
Signature____of Applicant ---- .PP.---"- - - --- -- - Date
_
1 •., . ..
� Al] roof coverings to be Class "B" or better
-
authorize a r t �
. g=n :,' Dare .
..:'
..-OFFICE.. ..._ ...hitt _....... _._. _ .. - --- - - - -- -