00060052 CITY OF CUPERTINO •=aa.n.. - •- .: r,,,n...,,.,
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:'
BUILDING ADDRI-SS'. PERMIT NO.'
DWNER'S N]®:12 C AIpL1CA'1'I B
"DUE; RIDING/DAVISON SANITARY ND.
OO A RCHHECIENGINEER; C. BUILDING PERMIT I NFO
BLDG ELt7C1' .PLUMB MECH
N- LICENSEDCONTRACfOR'SDECLARATION ,106 DOSCrlpll011
OO S I- I herehy affirm Inco 1 am licensed under provision,of Chapter 9(enmf ,,cing i '
r,m� with Section 41XX11 of DivislonJ of the Business and Professions Coee.mWmyliunv'e -in full rnrci ane effen.
c 2 is-mase class Lie, r a SFDWI_
O U ),IC CanHmctnr
a 0 fn ARCHI'I'ECI'S DECLARATION F� i
C I-`I I .I rhentsmml my Films he]]be us.J as mise accord, ,tl A L E D
se -
'apt ce p O Lmerl Pndcssional -
n om OWNER-BDILDfiR DECIAkA'1'IfIN -
Ihereby rr ,IntlContactf the nna L L for the NOVO 5 20.01
G toll g ; (5 H '1031 5 Business J Professions ra r J Any Cray re ly
Z 'prn n l i p Hl nt I II p rich 1,1 p tiy,i- f ..
y II "dicer,I 'hscroll t II g dal n
Warn I amount Il p I tl C l l f l la pt 9 S Ft. Floor AreaBUILDING(Commencing tn4en OIath rue 3.1 he B 'rte JProfession,. CW) q fry 'Valuation .
of that he a exempt Ih any
and the haus for the subjects
the exemption.Any Holman �7
of Section c d I.5 it any sold ditt for a pemlil subjects the applicam to a evil pen:dty
ar Hol mare mon nsa nund:ea muaR lssanz APN Number - O pe,
❑1 fth p pinyon lyanphy lith Cl :Ib r I p .:mon .
wild thek d the gn,care Ix all of del offered 1,.15 .911AJ .
Bus nH r: ,t,Carl,1h.Col m ,r d : H pplyto;In , 3621.7002. quiredInspections '
owner ar property Who bmldc or improves Hanson,and who Jae.such work hi Iwlf
.r through his awn employees.provided Ihet such impnnc.occur me�at in ended o.
offered for.ale.If,however,me building or improxement is sold within one emof ' 101 — FOUNDATION . ..
Completion,the maner-huileer will have the WHICH,ofproving that hi did not build or
p 'e fin,ah"wafsale-): 102 — PIERS
✓,owa;e
:Wan d,er or roe property,an.esallrsm.ly.omoaeang with uc.rlsal a�mnlnorx Ha 103 'UFER
.p.fc,t Isce.ZIDJ,B.sinass Lend Pmrassiona Calor)The Gmlrmcon'a
License Law Jaen nal 111.no nwnef of pmleny who builds or imp}ovs tbefnm. -
.,,it who.cammeHs I,),such pajeaa,nim a camriclu la licensed personal I,the t J04 — REBAR
Contractors License Law' - 105 — ANCHOR -BOLTS- '
°l; seer pt under 'ec. ,B ffi P�C�fo(r th�rtasn_n _ -
Gwner�=�snN� tvf 1 106 — SEWER &- WATER'
WONKLR'SC MI'IiNSATIONDF.CLARATItN 202 — UNDERFLOORPLUMBING
Iher.byammrark,peonyol ,a,,one a'memnowin,gcaanmmn." 203 — UNDERFLOOR 'MECHANICAL
1 lease and will maintain a Cenireate or Cansen Ho wit-nsure ror Worker's 204 — UNDERFLOOR FRAME
Compeeaidi shea, he p.rkfim mf by ,.omit nBB.nr he Lancer, coos, R.. me - 205 — UNDERFLOOR INSULATION
pcK rmm¢e of me work for which this pamil is iaxueJ.
°1 have and wilt ad, a Work.rs cam nsana hopmncc.as....inch by Secao.t 30]. — ROUGH .PLUMBING
3'100 ar the Luba,Cam,for tire purran fence ar th.wore on which his pennies is
i....J.MyWarkef',eampcasaaoninslrrlrnc.caarioondPolicy,��.oherare: 302 — TI_IS .& OR SH014ER, ,
Carrier: ParcyNo.: 303 — ROUGH MECHANICAL•
CCRI'IFIGCOMPENSATIOON INSURANCE°RKLks _ 304 — ROUGH ELECTRICAL:.
'
OIL s.ceaLaced Cut becampleedithe p.it isfor anehunereedollar, 305 — FRAME
I ' .306 HOLDOWNS
I certify(the in the perfanmmac of the and,far which this t is issued,I -
shallHolemIn Ill - subject 307 ' — INSULATION '
employ Y Pelson in any manner so as m 1.•mmc auhj.m w the Wndem'
romant nlawsarcalironia.DaHe 300 — SHEETROCK
NOLCApplicant
become sTjecttohelVar,IL lifternCompeakmgnprvisCertinsofcate arliamption,you should
ride.yuroof 309 — EXTERIOR LATH
become,Injectm theaCash 'n Compensation provisions the Lather Cade,you must '
O' r.nnwhh.atnply win.s.eh prosi,nms m his mi span n deemed;Cooked. 310 — I NTE R I OR LATH '
'F �1 CONSTRUCI'IONLEN DING AGENCY 311' SCRATCH—COAT
a rSr^ 1 hereby unit a that Hher,is a canswnion lending agency for the perfnrmmncu '
work la,which his pefine,is issued(Sec.3'O'l Us.C.) 313 — ROOF NAII_
1 Q Ink,",Name ..
,e= C LenderaAddress 501 — FINAL ELECTRICAL. ENERGY
I certify that l have read this applicatom and state that the above information is 502 — FINAL PLUMBING ENERGY
coned.1 awes m comply with all city and county ardhwnacs anal state laws rclnHing
O V Ice hmlJing Clothstion,uad hnehy ourhoflee remesenHadvsof:his City to an.r,span — ENERGY.'.
tneahova.m.a finned n rarios t 503 FINAL MECHANI.CAL-
W nape v ha'face purnoses. 1.
,o, (We).,,Ccloave.ademmly:mdkeep nam,le,heCity ofC.peninaagcon,' 504 — FINAL BUI'LD,ING ENERGY
UV1 linbllides,j.dgrnems,con,and ClErnoos which may in any why,acerae lignitol said
Z city in.o wyucncc of the gmming of illi nail. 505�� ELECTRICAL "/
r APPLI Nf UNDER. ,NDS AND -COMPLY WITH AI -NON INT y, 506' —ICA TFCT Date ( t_2- DLJ.
50' 'it F t,gTION A once Issued b
si ' 'appha, on"Werth to Re-roofs . 507 — FINAL. PLUMBING
IIAZ-ARDOUS I'IiliIALS IIISCLOSIIItIi
Will he apphcaal al from nodding-...Pact store or lam he na.am,osenat.dal Type of Roof 506 — FINAL MF_CHANICAL '
.s defined by Bm Caps"in-M.niclpal Caee,Chapter 9.12.and the nemfn nal Safely 509 - 'FINAL GRADE
Cale,Section 25532(x)?
CI ye, °No All roofs shall cct
w,u mea oath ar future building �510iP pt+l�lLo 3n0.6YlQfItl!]5lhlxerial being installed:
pp s p I . r t I d : nr.n If a roof is insta#fE4withopt1fI b ipj p(.r PE9FR�(15 agree'to remove
With I : d t II refined by theHas A A U altyM agement - a ns 1
all new ma[erials,J;gy' in�pgg it ApF1yftt�leggpAs and will comply with'
°Y °N
all non-point so regal l
DnauJ men sous ct this q nl:radio Chapter 695 of the .603 —•'R C�fr -BATTENS -
if
BATTENS - _
California 11"hh A seder Cal S nmol 255(15 25533 Id 255341 malsntand thin '
arae hu lhage Balcurrently ham arelianl that itit rary raNso.hhty to notify he - , :604 — ROOF IN—PROGRESS
occupant Eta requirements which naval na poor m issuance 2f.MMifcam of
Occu y. '
(O 7EyOZ Signature of Applicant - Date
Owpe aall,miaar agent Date " All roof coverings to be Class "B"or better'
{ — OFFICE .