02050183 OF
TINO
CI BUILDI G DIIVIISIONPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT N0.
10104 CRESCENT RD LEI & SCOTT ENNIS 02050183
W NER'S NAME: APPLICATIONS T
AW LEI & SCOTT ENNIS 05 2002
PHONE: SANITARY N0. CONTROL NO.
❑re O o ARCHIT[CT?:NGINEER: BUILDING PERMIT INFO
u E BLDG r LUMB MECH
G<'ad
S w i LICENSED CONTRACTOR'S DECLARATION ]� ]��e p��Qq -'
Iherebyam,m,M1t,lam licensed and,,provisions efChamero aommeneing ADD 750 SQ. FT. W�2NllrIS'1'VRY DECK
J
with Section 70W)0fDmbmn 3 ofthe Businesvnd Pronsions Code.and my license
in full force and effect. c
z a
is in
Clan, Lir.n ��rs� p
;O'i- Dam Convanor F N t`V
13 if, ARCHITECT'S DECLARATION a
:d. 0 5 1 undemmnd on, for,shall be reed it.,,public records
i 9 0 Licensed Professional OCT 2 g 2002
. OWNER-BUILDER DECLARATION
of='w 1 hereby affirm that 1 am exempt from the Contractor's Liceme Law for The
tz'a followingma,n.ISection7031,5,Bo,ine,xandPronasion.Code,An,cityorcounty gU'�®'� $73140
cF o which require a permit m t oromm-L alter,improve,demolish,ler repair any structure
at 3 priourIo its.. alsor rcquda' ppl cam for such Permit file a signed smtement _
... __.... __ ...... ..
that he :licensed lis n thepar,a.' vion the Co Business
License' La on,Code)
Ice hJdng worm Secttherefrom
I Div'. is 3 ohne Bus rte a exemption.
corm 1'j'' 13 ®lI'P��r,.Qtj�a,� . I ,, ,, Valuation
or that he is 31.5 b any application li and me hays for the allsubjects
the
eapplicant to Any l Pennon
of genion 7031.5 by any applicant!m a permit subjau the applicant m a civil penalty
of net more than rte hundred euEar.NS500L l O JAPN ATION Occupancy Type
er or'a thereforeaw
property.or my employees with rages as their sole compensation. 102 - PIERS
a-the work. m and therefore is not intended or offeree for sale(see.l , 10 3 - UFER
Bosh;eza and Ziea:ioCode,The Comn
raor'I License Law does nm apply t.an Required Inspections'
or through
r of property Who builds or improves thenen,and xbo does such work himself 10 4 - REBAR
or'ed for Ms own employees.provided that such Improvements meold ore no;intenear or
offered fon sale.IL nowo'cr,the building of eno ,improvement n soil he
one yard ler 105 - ANCHOR 'BOLTS - -completion,nn,the owner-builder,will have the burden of proving that he did not bulla or
improve rod Parynsc of sore.)_ 106 - SEWER & WATER
C3 as mwnar of'he .exclmi"I cnnvaceng with licensed contractors,. - - - - - 202 - UNDERFLOOR -PLUMBING-._
progeny,rte vely a
PLUMBING-
constrict,he project(Sec.7(1&1.Business and Professions Coae:)The Contractors 2 03 - UNDERFLOOR MECHANICAL . —-
License Law does not apply,o an owner of progeny who builds or;mproves'ereon,
and who eommets.for such porintsah'.a conmactorts)licensed pursuant to the 2 04 UNDERFLOOR. FRAME .
.... ...... .... ......... ...
"
Contractor License w
❑I vis exempt aide See' ' &P c far this macho 205 - UNDERFLOOR INSULATION
oxn2r On 7 3�?� 301 - ROUGH PLUMBING
WOR S ENSATION CLARATION 302 - TUB & OR SHOWER
I•he,eby am,m under Penalty a!perjury one of following deelamtions: 303 - ROUGH MECHANICAL
❑ 1 have and wu1'maintain a Cenirca,a of content m sell for worker, 304 - ROUGH ELECTRICAL
Compensation. as provided for by Section 37W of the Labor Code, for ,he
performance or me work for whichthis Permit is issued. 305 - FRAME
C 1 have and will maintain Workzr,compensation].,.,amid..1 m1rin:d by Section 3 06 - HOLDOWNS
3700 of the Labor Code,for the parmmaamce of d e wmk'to,which this permit is 3 0 7 - INSULATION
nsu J My W ker's Compensation Insurance c -
- SHEET
CERTIFICATION OF TION MSURAI°vice°"RERs ,369,a
EXTERROCK- — --
d l s t y
ca 'Policy N I OR -LATH
310.- INTERIOR' LATH - ---
Ito.acct onnna not be comple,ea nhe perm,,,s rorome naneree aouare 311• - SCRATCH COAT
($IN) less.) .
I cell fy that to irfornme,ooh" k for which his Feet is 6suea,1 — 313 - ROOF- NAIL
shot]not employ anyFiner,int anyarbecome subject othe Workit 501 - FINAL ELECTRICALiENERGY
comicant nnyxsorelrma.Date 502 - FINAL PLUMBING ENERGY _
NOTICE TO APPLICANT:If ager mxkmgthis Centficam of Emoipdon.you should 503 - FINAL MECHANICAL ENERGY
Z become subject to the Worker's Compensation Provl�ionx of the Labor Code.you must
C) Forthwith comply with such pro.;,;nmorfail p—it,'all xdeemeere,okea. FINAL BUILDING ENERGY
CONSTRUCTION LENDING AGENCY' ""' 505 - FINAL ELECTRICAL
I hereby arum'm mem i,a construction lending agency for penrotmance
y:p ofcheworkfar o97.CieC.)' 506 - GAS TEST
Under''NJor1'`e�mis „s.eafsn.3 507 - FINAL PLUMBING
Permit .: . ...
.,:z 508 - FINAL MECHANICAL
C.7 .I cenify'at l have reed this applim,imi end stall that the abuse information is
�' F gin comply with all city and county ordm:maa and.smm laws relating 509 - FINAL GRADE
V to building construction,and hereby aottaimm sentaivesofthis city to enter upon
�., W the above-meptioredp.olany for inspection purposes. 510 - FINAL PLANNING
0. (W it agrn to save,meemn' anJ kc2P hamdess the City of Cupertino against
V]' liab"les�judgmank,mnsandfmpemon b;eft ay in a ay way,verme gains,aoid 514 - FINAL PUBLIC WORKS-
U ► C' iaconsequenc2oftnegre gbh tsp earn 7 `!/1
PPLICA, UNDERSTA,' SA.A➢\ L -0% CV WITHAI.LSOy/
SOU RCE REGUTATIO.' p / Issued by: Date
Signature of APPlicanUCommnmr-r /' ate, _..—...
/ - HAZARDOUSMATERI LSD LOS Re-roofs
FWill the appEcint or future buil .pant sto urn ile hazridous macnai . Type.of Roof
// us defined by the CuMnia.Municipal e,Chapter 9.12.and the Health and Safety --
Cide Section 2551 (al
OYes Oster
_ All roofs shall be.inspected prior to,any roofing material being.installed.
Will(he PPI t f build g p t eymp to J e v.'n�n If a roof is installed without first obtaining an inspection, ] agree to remove
em t h d uta t d fn d by in Bay Area A Quality Macagemrnt -
Di""' all new materials for inspection. Applicant understands and will comply with
❑Ye � ❑N -
all non-point source regulations, - -1,Er moa Ne haase" serials rcgmmmea¢under Chapter 6.95 of the '-
CalifomiaHeal'&Saltorf Codas nio 505.255337 25534.,?,undcmand that
if'e building da,no,cuneney , lea ,situ ieir responsiiit full ,ify the
occypam of the re9uircmcns w nth ttlys Ix mchpno issuance of Cell term of -
O c `alley, .
/ Q 2 Signature of Applicant Date
ned or authorized agent .. De All roof coverings to be Class "B"or better
:: . , .. . . .... .. OFFICE