00070175�.,.• CITY'OFCUPERTINO
nun.mnc nrylslory PERMIT CONTRACTOR:INFORMATION
BUILDING ADDRESS: -'�' a . PERMITNO.
1000"CRANBERRY•DR.' „ 000701.75
OWNER'S NAME: APPLICATION SUB DATE07/27/2000
HELLER
:PHONE:,' . - SANITARY NO. CONTROLNO. {
S
CZ ARCHI fEC'I/h NCINf Ek: are BUILDING PERMIT INFOad
-
O O y. " " n S. A - - .BLDG" ELE PLUMB MECryo
Z LICENSED CONTRACIOk S DECLARATION ARAPION v Job Description
I 1 by ❑ e than l , lie....dactI 1 I Chain 9 ( mtmcna ng
�c"F.� ithS , 70001YD n III Jp f'.I C ntluy1 ec,.c
x�� 4 R t OS �2 ADDITION 597 SO.' FT'
aoe It[ Cl,ss_ L x REMODEL 35 SO. -FT.
Dat G , ,
A eHITFcr's mo A _
1 aide,.. doi,edis shop busedDnolnew,said,1
-
wCiwr_SFa- CCw .uonIghbyIf t OIhtIDl 31 a5 ❑ -ptf 'd the r hCf .. ti v ' C J'CL A L I.,0m,
WNER BUIDLR ULCARATION
S hwhi 1 q "p mIm :I ,alI p establish, pit any 'tr ,re
Pro
u r un' red Contractor, L L (Chapter 9
Ch"pt r9
t Sq. FL Floor! Area.
Varl
uati, on(cowith Sedan 7(XAP of Division S ofteli I nfea Cade)
ortoed he is bt ,nrfan and le boas for he alleged scrition Any .n
f Section 31.5 anyint for Ipermu subjects theapplicam m u civil penal,y
n.,bar, than live hundred dooms ssa)
,
-
'
APN Number Occu he.
tj
❑I. as the
and ([a,
is
intended
mead faJn lie(S. diatomic,04-
Bwillus e m k d d o, n, ,mended .mere o f r5 7oaa _ -,3620200g . g
❑uet.: eP f: :il 1 The Contractor's License i, J l'rkh melll 7KC 'eli.InspCCtlonS
.i ownavgh his ow Wmjflcyho d'r"videdtat such,atewhol .suWwaendedelr .
or through his awn empl.ydes provided thin such impmventcnts ns not InlCaded-
ofmred un sale. IL hawevec the nodding or hnpmvnnem is said within be rear or 101 FOUNDATION ' '
completion, the owner -builder will have the burden ou
f proving that he did net hand d - - - - ,
ne,otoo mf parporo ofsale.). - _ - 102 .— RIERS - -
El 1, aftheproperty. " 1.iv1y't ting van ficenscid broularle.,1. - .103 UFER L
ora t o project (Sea 7044 B 1 Profession, L d) Th Coundwon'e
;.104 — REBAR
Lc L d d' t apply Business
p ty ItohuId p thio h "
,nilwhoC I 7' f, h projects io a , crags) licensed I p - m m the �
rollL L105 — ANCHOR BOLTS
❑ l am attempt uad,,Sa B&P CIll, this r...on -
OwnerD:,td - - - 106. — SEWER & WATER -
WORKER'SCOMPENSArtONDECLARAIION y".202 UNDERFLOOR PLUMBING
In byal d ally fpt Ill fou i ge r r 203 —' UNDERFLOOR-
MECHANICAL'' +
I have l will maintain it Codficate of Consent t, self Workers 204 — UNDERFLOOR FRAME`
accusation, as provided maty Semon 5700 of the Labor Code, for the
perf.rotance.ftneweak ba fit
silica isi..yGl. 205 — UNDERFLOOR INSULATION
'301 — ROUGH PLUMBING
Oil in... I 'IlmaintainW k p.0 ec t I arcreducedbySeuos - (� .
iso ftl Lh 100*
, a cc fIh workforh h it pert lIs 2 '
nna ti' Policy n 30c — :TUB OR SHOWER, ..
carriar.. e i U ( - 303 — ROUGH MECHANICAL �ROFF.XEMPI'IONFROh1WOkKERS'304% ROUGH ELECTRICAi, OF EXEON INSURANCE. _
ern' [m,nrecdra,neu,ntpinernh prnt,aror.rehrra2adall .. 305 — FRAME
'306 — HOLDQWNS
` l ee,iry bar in the pein . ... amed ofu k for whichthis prfr,issued, l.307.— INSULATION.. .
shall t ply y p y of as ,, become .object to the We,kers' . "
Cat i f LawsmCalifornia, Date 306 — SHEETROCK
t. .
Applicant
NUI [CE TO APPLICANT It, It atingahi, cIbwidearF m you should 309 EXTERIOR LATH
becomer a d' W rk r Compensation -p f theLabor Code, e
) nst
OCfourflow daomprywith such,p „sfrJ permit allbel udncked .310 — INTERIOR LATH
„FI CONSTRUCTIONiFNDINGAGENCY 31`1 — SCRATCH 'COAT '
I hereby mount that there is a [ .. action imman,00ns, f.. the perry craned
.r the work for which ibis ,Feanl a sueo(Sen 3097 Cis.e) 313 - .ROOF
"NAIL +"-
a Q .Lender's Name
p Z Larder•, Address, .501 — FINAL ELECTRICAL' ENERGY.,
U 0 1[ IlythtI 1pf t statethat the l is 502 FINAL PLUMBING ENERGY '
Grp [r
'correct, 6 t ply 'o all ",y- J p 1 JstateI joining
-
Ov tan Id gectstndi.r, Jlermty.aho erpeentarve.,nnset>taettcrnpo,t 503 — FINAL -,MECHANICAL 'ENERGY.
.,-
the n f ns 1 rtyrrnpaf npurposes.
504 — FINAL BUILDING ENERGY
t�. CA esjud, agree in indemnity lk pharmless theCityICprt"g'a
_Z liabilities t' t J as,now, Ira mY in any Y tuy.its,:'J ^..�
v . City 9 once of NDSANDWIL int �p505 — FINAL ELECTRICAL 2 P
APPLE] DG STANDS AND WILL COMPLY WITH ALL NON -POINT
r rfioes Issued by: 50E- _ GAS TEST.., Date
ga -O' - Re -roofs '
. gm, r IAppll anuCnnlnnor. D'Ic
507
HAZARDOUS MATERIALSDISCLOSURE"50B FINAL' MECHANICRL ,
Will r aper w e
arl r future re Idng necvpam Sm or n l by de s mater a 'Type of Roof . .
as claimed by the Cap,nicat Mnepal Coda Charter 9,12, and the Health ,dSafetr -
Code Section 25532 509 —',.FINAL GRRDE -
- - 1n)'.
°Y- . El No ' All roofs shall be fiMpacted fFi1i51flhnyGhcM9shbhtErial being installed.
wu th tppli"nl rat building real m,ne eqa l , rd n. wmah If a roof is installeg 1vllthoutl j4YqtlVtj(aintA¢Il1ry}��egtj�RRtT;�rI to,remove
emilM1 dm,id,nall anl. u, detrain by theSt, Area Air Quality Ish ugmearl t
District N all new materials for inspection. Applicant understands and will "comply with
urns 11 No all non -point source, regulations:
I h" d We Imandem, andenally a n t: under Chapter 695 of the r-
'
Ca ifinnim Health is, Safety Code Sections 25505 25533 tied 25534. 1 arderstand that
. Ifihn building does nal cuavnoy have a tenant, Ihat itis niy re,ommility to notify lno
occupant or the rN.iremmns which mot be net prior I. issuance of a Cenilieae of -
% Signature'of Applicant. -� 'Date -
ra�nar xdd again z �Da,o , i
AllTocoverings to be Class , B:: or belts_ r -
OFFICE
... .. - •,.. � lar .