01110011 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS PERMIT NO,
10084 CONGRESS PL BATH ROOM INC, THE 01110011
OWNER'S NAME' APPLIC TIONS B DATE
ELEANOR TURMAN 1910 W EL CAMINO REAL 11/02/2001
PHONE: (415) 968-7666 SANITARY NO. CONTROL NO.
O O ARCHITF.0 lENGINEER: BUILDING PERMIT INFO
U BLDG ELECT PLUMB MECH
5 y i LICENSED CONTRACTOR'S DECLARATION
I nercb %irmthalamliccnsea undo rens mrq(«mnmcncin Job Description
{z-C ya pmvisionso p g p
,vm�mu wim Section]gp)af D' ion3of the Buzinesse P 'essioa oee.anAmy u<enze BATHRM REMODEL.
;m E� is m inn force a eff s l/
:W..<O License C . Li,.a
Dam C nano
u O< .HITECT'S DECLq AA
1 undo rand m plans shall be used as public records
i a C O
Licensed Professional
o
OWNERBUILDER DECLARATION
I-�aNal a ' tRATION
1 hereby affirm In,1 Earn the Co
s Law he
followingmown. Section 703
1.5
.Business and sions Code:Any,cty or county
00 which q acowst,illr p ve,d,r1'ah p slwctu
a32 'Pdwha' e.alw'c9 rethe,applicantwell permit ofile gedstatement.
1'ce rd pars anti fie pmol !Ne C tracwrs L law(Chaps 9
3 fm Badhes andPmsssi.rsc a) I.'d�:' f.t3 ®'. 3;(F?1o9�49�a takI:1_i-I.0}\ • Valuation
or Thar he a"eacmpt mhercfmm and the basis for me alleged annptiod.An)violation '�
-of 5«uon]031.5 by any applicam fora pe oth subjects theapplicant toe civil penalty'
mfnatmaethanfvehundred dollars ls5W1, _. . _ 10JAPN AT ION <'l Occupancy Type
_❑Lasowner of be properly«mremploreea with wages in tneirsolecompenmtion. 102 - PIERS
will do the o.&, ad the swcmre is nm intandeJ it ii for sale(Sac:7W1
Busihm and Piofessions Code.The Convacmr's License Law does not apply to an 103 - UFER Required Inspections
owner of pmycny Win,builds or improves thereon.and who does such work himself 10 4 - REBAR
or thin gh h' employees.p did mm m<b improvements n, t intended -
offt d f I �If,h the b dd n __"'-'--"' _-
- gorimenofprotms Id 'tem not i or I05 – ANCHOR 'BOLTS
arprev mon the owner builder will have the burden of proving that he did not build or 106 - SEWER & WATER
improve far puryou of salc.2
❑1,as owner of the-.'"_._......_..chis.. .. .__-chug._it -- _.
._._......-.— _.._ .._....._... __.
p(Sec.7.am ex<wsmey«mraaingwimueen:Th Ccmmxotam -02 --UNDERFLOOR`PLUMBING._..__.•.._ :_:__I,__.,,; _.. .
r <omwn ms maim(see. .. ..44.Business,oand Professions coeeo The Comaaor'a 203 – UNDERFLOOR MECHANI CAL 1
-
License Law does nor apply to an owner of pmpcny who build,or improves I<rean,
and.wno.camaense L su h proiens.wiLa coir roar)(men a.puamm tome ..2 04 ..UNDERFLOOR–..FRAME
cootractors License Law 205 – UNDERFLOOR' INSULATION
❑1ohn i, mptundcr S,.` ,BRPcf«misreason
own r;" "' ata 301 – ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
302 - TUB & OR SHOWER
Ihereby affirm under pegaltyofperjury ol;eothe following aeelaations: 303 – ROUGH MECHANICAL
❑ 1 have and will ,nsid6iaa cenif<nte'of consent to selninmre for Worker's 304 – ROUGH ELECTRICAL
\� Compensation, or provided for by Section 37W of be labor Coda, for be
p�erronnan/<eormeworkr«wn�<gtnispe�nitisizaoed 305 - FRAME
0'T and will l6diairi Woiker'i Compensation Insurance,ea inquired by Section 306 – HOEDOWNS
]W or I labor Cade r the performance or me work for hien Its smut 3 0 7 INSULATIO.......... ........ ....--_. ._.,.......-----_1--...... __
�(/ (�Od 308 _".'SHEETROCK"..._ .. .._ ...__. _–
CamePolicy ....... •,m
,� I RTIFI (TION OF EXEMPTION FR MWOl.ii -d}". ? 73.09 _i_E�fTER�IOR M,:ktHd
coMPLNsgnorvlr+suagrvcE-. _—_--31'0-'=--.TNTERIOR'-LATH
SI W l m]less j t o need of be«mpi�ied d the perms s for ane hundred do]lots 311 1 SCRATCH COAT
m.., I cents but in Ic An, . . • ,
– I --------313– ---ROOF--NAIL---•–
m r a ane or tb rkr ni�nl M � r issues I
, - 501 – FINAL EliECTRICAL"''ENERGY
enrol e t PI Y Y feali Y robe b n me Workers
campe nt L felt of - .._5.02._- FINAL .PLUMBING .ENERGY..
.Appl cat _
z N ; CANT If ft making th sC n f t f Exemption,you should
neGimesojecluo mu4, 503 – FINAL MECHANICAL''ENERGY
rmeomsuch bsorm pemitshaubeeeee rev led,2 - -- - _ - - ___
504 .- -FINAL_BUILDING ENERGY
505 - FINAL ELECTRICAL
E.4 `; rCONSTRUCTION LENDING AGENCY m
> I hereby alrsm m t I <onstm u lend g agency form'peAorrnwae -
f
ar be weak for which thisPemut is issued(See.30l civ.C.3 5 0 6 - GAS TEST '
W Q Lender's Name�w..:w s,.... _.... �.._..... �:a.. _ .. ._. _
:;):z andersAdd 507 =FINAL` PLUMBING –'—
U.,o .Ify th t l ha e I s d sine Iauhe ono I on ms
508 – FINAL MECHANICAL' '
[" coin Iagree to comply with all city.andcounty oneirmarres and sole la srelaing
509 – FINAL GRADE.
0 tobuldg Drumm d properly(onpuna for byre.pc fo p rp
ton rev tt 3ormscrytoenterupon 510 – FINAL PLANNING _
yW me abo e m t(w<)'gree 10aee.undehandify andkeep hannle s,thie Cty ofC P[rr 'dgemnst 514 – FINAL PUB 'IC WORKS
V] City tea dg an r c rs uM a t , h may any way rue gamst,mmd
U Z
City - on. dames o rth e IL
APP( I ER, q. N WIL COMPLY WITH ALL ON
SOU
-� Issued by: - - Date -
i. ,�-`iMo 1
, . .
s nt D m m Re-roofs - .
HA O MATERIALS DISCLOSURE '
will the apphe ddingocc pent mare«hxndle :raboasrmo in . .Type of Roof-_.. -..
as fi ed by,the C pen Municipal CM Chops 9:13 d I H Im d So per,
codes t 8s33a1 , .I ,'+ta.9 .- 4 t;' ' Oa1.1. 1. i`'� a.�.... .J r� m rr�\h t:•.I
❑Yu r �•
I -d 1 _All.roofs shall be inspected poor-ro_any roofing.matenal being installed._.-__-_
awnmireapplicant future wf, ng e t qupeens - device,emnt If a roof Is installed without first obtaining an inspection; I agree.to remove
mit hvard nu nu def by m B y A 'A Quill ry M agemem
°ini all,new materials for inspection. Applicant understands and will comply with
\ n' all'no In ourcWuatis. t
1 h ve ne me Safety
Coe mai pals req vein t undo Coapt 695 of the
C lifo H hh&SeBry Cad Sections 25505 25533 and 21511 1 orders,d that
f le'. le g e--m rte t1Y ve a unvmt m t ra Y rcspons bill to oafY le
atop t f me q mems c mus t poor rss tit c rag mfineate of /
e -
Signature.of Applicant . Date
o`y.or ons ageat- " ' . 7 0: :<Dan ., All roof coverings to be Class "B"or.better',
-OFFICE . . .- - - .. . . .. . .. . _.. __ . . . .... _
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All dimensions 8 slm designations T619 is an original design and must TURMAN Scale:1/4'=1Design: 10/31/10 Dwg no.
gWen are subject to"oriflcstlon on nM be released or copied unless Data : 10/31/101
job aIle and adjustment to fit jab applicable fee In.been paid or job ELEANOR TURMAN
condlr order pieced. 10084 CONGRESS PLACE Designer
CUPERTINO