02040145 CITY OF CUPERTINO '
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
�LDING ADDRESS: PERMIT NO.
10237 CRESTON DR ROBERTSON DONALD M AND B NNIE 02040145
OWNER'S NAME: APPLICA�TrION SyyB D
ROBERTSON DONALD M AND BONNI 04/ 26/ 2T62
Adh
PHONE: SANITARY NO. CONTROL NO.
E O O ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR rd... DECLARATION Job Description
z
K.O I hereby Cron that I am licensed under provisions of Chapter 9(commencing p
wl-a withfullfoncandefect, on3oflheBusinessandProresxionsCodeandmyliccnu KITCHEN/BATH REMODEL
y ce< Is fe toll lIto and[R[CI,
era Date Class Lick Dit Ply��r� �
O U Dae Conus'or a`fitEF
G ARCHITECT 5 DECLARATION
a1 understand my Plans shall be used as public records Ol, I 2002
a 8 O Ltecnua Profcsemnal
u N OWNER-BUILDER DECLARATION
I hereby Cron that 1 am<xunpt from the Contractor's License law fur the
Z a following reason.(Section 70313.Business and Pro&a ioas Code:A.,city m county BUILDING $25000
tom O which requires a Permit m eormotei,alter.impmm,demolish.or mpair tiny structure
�3m P req reuhce licant for such .... ____._....._ ____.__.__.-.._ _
nonmts issuance,also, ui pp pcnniuo Dleaxigrcdstnrcmem•
(coI he -----
(commencing
with
Sectioitli)(plLnuonsof the the
urines Licrnutaw IChapler9
Ic duct he is c Huns«gona0o0)orhe baron 3°t ee naalMsa aria Pili.Any vi lotion L�� 9;( P9T: Te9-; 5 '; Valuation
or Inas io is caempt any applicant for
Inc basis for the cts th de plicanbn.Any violation "' '
"of Smion TDJ I'.3 by any apPlieam for a permit mhlens IhrapPlicam too civil penahy'
fofnol morelnan Bvehundroa dollars(SSW). 10 IAPN rftftDATION -Ep:it-"n Occupancy Type
1 owneroftnepropertY.ormyemploytts;with ,�agesatheirsace°mpens,rs°n, :102 - PIERS
II Cd the Pro ssi I,Codunbm is not iO,cm,',Li or oreaw Yoi.]I(Sec.to an
Bnxm If gee PTY Who
Cod<:The comma°rx I and
w Law does now apply to an 103 - UFER Required Inspections°%` =1i'''r E
owneI of properly Who Wilds.p improves at such,and who does such work intended
or
throughorhso employees.provided np„tin_ t t ingeaar 104 - REBAR
:offered f r rale If.h Ih building o p m I is sola -tti o year of _ _. .. _—
'complaion.the owner WdEerwal have the Wrden orplosiag that head not build or 105 - ANCHOR- BOLTS -- -,: --- -
impra,•efarp°rpnxeofxale.). 106 - SEWER & WATER
-- - ' -
q::.,� ❑I;as owner of ee properly,omeumsivdy ommaing wiihlicenseJ comranors_o_____.._.._..202 -...=.-UNDERFI'.i00R.'..”PLUMBING
_._.�7.:`-,�._......__.._.___._.__..__._._.
�e°nsWel the project(See Toa+ Business and Profen.oas code)The Cammacl°rx 2.03 - UNDERFLOOR MECHAN•I CAL r
cenu Law does not apply to an act h coo who Wilds or mPrmex thcmon.
e h Imeo fur such poj t .with a c Irxtor(s).hcensed pu am I°Ne _ _ 2.0
aI a<I sucnttla 4. .---UNDERFLOOR FRAME—.
I ❑,1 mplunder S ,9&PCT thisrcasun 205 - UNDERFLOOR': 1I'NSULATION
z = 01 - ROUGH PLUMBING
- "'WORKERSCOMPENSATI DECLARATION 302 - TUB & OR SHOWER
Ihereby salaam under penallyafp<,l°;y.;neafmgfollowing decimations:-- 303 - ROUGH MECHANICAL
}•�0 1 ha,I ane will rrmmiin''a cerieb;le of Cunanl io self-insure far walkers 3 04 - ROUGH ELECTRICAL
Campelaaaon, as Provide far by Sttlm, 3100 of the LOW, Cade. fare° -
peif.im mee of the work far which This Permit is issued 305 FRAME+
01 ha had will'main0 Wrker'a Coinpc tool lana,as rcquirea byctttion 306 - HOLDOWNS
37po of the UWr Cone far he perro7ma c f the work for which this permit 1' 3 0 7 - INSULATION
s tied My work r cc pc.6,I I m«e< rid Policy nu be tie
k. I -+ ;1,, - 30.8..;._.. .SHEETROCK _
Carrier'- EzEMvnolvFROMwoRKERs - -' ' ` 309 •- `-E TE�RIOR •I]ATH: " -
-'. coMr�NsnnoNwsuRANc2:,, '- - . _,,.,,_,_, _.__._..3-1-0- INT-ERIOR---LATH---' - '
(lT s section need hat be completed dee amit Is for one hundred dollars3 11`` SCRATCH COAT + `
1x1007 less).. .. ' • •_:..
con 313....-....ROOF...NAI.L___.
ahI n fY'Ih I arc performancef thek f which thispc t rs ssued,l -•.- _ ....-..v.r,...- .
oll 1 employ y,piison in any verso tobttomc bj«I totheKWorkers 501 - FINAL EL'ECTI ICAL�`IENERGY'
Com pc ,to la f C l f rata D I
Appl t 502.__._FINAL-.PLUMBING.., ENERGY
NOTICE TOAPPLICANP If afI ki,g Ih Cert fora Of txcmPtiOn.you should ,v - -- -- -
Z heed bJemt thaworke C 'pens it pro :tons brine labor code yoinhol 503 - FINAL MECHANICAL ENERGY '•
F00 forthwith coply withilach Provisionsorthispernitshallbcdttmdrcokd 504_. - FINAL _BUILDING ENERG
'Zt ''• "' - :'CONSTI4UCT1O,NI.ENDINGAGENCY 505 - FINAL ELECTRICAL
h rcby ar that there is C.Olon.11irm leading agency Tor the pertormance'
09Y Civ C) _
of the w work for which thisPermit i issued(Sec J _ 5(]6 GAS TEST
L.Q --l:cdd rsN me' .._ . .... ___._ .._.
O Lelia rxAddrt s
507 'FINAL` PLUMBING"___- -- _
� 0 508 - FINAL GRADE ICAli" /fin
I i fy that l have red this application o d state that bo< f ton a
m F to Wil 1 three t comply N all city d comfy ordinances f d slaw l relating 509 - FINAL GRADE
O W to a,e e-m I'm ,and fi rcby echo pre iat vols of thisny to ler upon
pr W ran eW a Itie t tied p opens r ni inspection purposes.ep Karam510 - FINAL PLANNING
Y"mesjudgmets.emit mad ea,and whihar I)to the Cay C, pcnino aga, 514 - FINAL PUB IC WORKS
-y' liabilities,judgments,costs end expenses which may in any way accrve against tile
C,)'.Z AP LI AN'T U MI of Ind cmmmc of this permit.;,"" ' `• ^• A-'V
_ P0`
.N w Lcomp�.,Y,uT}HANbN: 'Wr Issued APPI:ICA\7 U]DERSTAKD$'A, r
54 EGUL "'NS: L 12 Date
I ofAppI,an ntia ..1., rc.... /
,=-HAlARDOU$MATERIALS DISCLOSURE - Re-roofs
. ..,,-1.
W II Ne apphcam m,future building«c pant store or handle hazalddus material _'Type Of.Roof--
az defned by the C pertirw M mnpal Codc Chapter 9 13 end the He IN d Safety
Code.Sect on 23S321e1^ ```���t - '... '•' . .� Lh - � I�u t ) .. .:- ..
All.roofs sball.be inspected,prior.to.any roofing material being installed.,.
)��. Wdl the pph em ret W Idmg«cupam ux equipment role as which If a roof is installed without firs[obtaining an inspection,I'agiee to'Peinove�
1 hailrd us eu a summa is as eefnetl by the Bey Aad Air Qualuy M gem til
all new materials for inspection, Applicant.understands and.will comply with
11 T Ohaee eeod'thc h z Nout malenms P•, ._ . . •._ - -.__...
_.
all non-point source regulations '
rtgwrtme is undir Chapmr,69lo of the
C5lifom a He Ith k'sday Code,Sections]5305.25333 end 25534 1 undemend that
1(caparm dngdoei nuhcmIn . haveatrnaht thei it is my resp°xibility to not ify the - '" ""' -"" " '
_
'occupant of Ihp rcgwamenu xhich must be t p or tosuue« of Cemfcete of - •• " .
�. _ Signature of Applicant.. ..._.. . .----- --. ... ... .__. . Date
_..
Color . All roof coverings to be Class"B" or better
: .._-. .--OFFICE.. .