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CITY OF CUPERTINO
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BUILDING DIVISION PERMIT
CONTRACTOR
INFORMAT ON:`
BmEI@1(5411EEsCULBERTSON DR
ALL AMERICAN RESTORATION
PERMITN02060064
fAICKRAME:& HELEN SARLI
1080 A ELM STREET
APPLICAT9VYR1DFf 2002
PHONE:
(408)249-8500
SANITARY NO. CONTROL NO.
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACT'OR'S DECLARATION
I hereby affirm that 1 am licensed provisions of Chapter 9 (commencing
JSa Dr�sfr'ipfion
with mess my license is
Division 3of Ne BusineasanJ Professions Ctale.
ADDITION (4 9 8 1
and
infaileffect.
ilforcnndeffec
/,-.
AEDRM/LIVING RM�REROOF
License Clma X
�](Lf
Co
Oaw ComDECL
ARCHITECTS DECLARATION
I understand my plans shall he used as public records
Licensed Pro(essomol
Oat NE. DECLARATION
1 hereby affirm that 1 cat.DER
nempl tram she Contractors law for she
Any
followingreason,a. 71131.5. Business and io :
1. Code: Any tiny it roomy
c
alt
arch to after. improve. demolish, nr repair any
which requires a pours. mi improve. li t,
$60000
tnnnthn.
identr
thateislts cense pansy IC(wina the proisionanlfor ConariehpCrmlld.BICsal ga(Cmpo,CnI
shat heir licensed pursuant l.shcprovs;ou of the Curuonur'a Littrelaw(Chaperr9
Sq. Ft. Floor Area
Valuation
of Divis;nn3 ufshecged! exa and Pfalesy
seat
37536019.00
that he is comps therefrom and the basis for the alleged eumpsion. Any violation of
W is eagwithsecfrorn and violation of
APN Number
Occupancy e
P yTyp
Section 7031.5 by any applicant for a permit subjects she applicant o a civil penally of
not more than fn hundred dollars ($5m).
101 - FOUNDATION
❑ I. as carer of the propeny, or my employees with wages as their sole compensation,
i62 PiERS
Required Inspections
will do she work, and Ne awnum is not intended or offered for sale (Sec. 7014, Business
end Professions Code: The Comeaators License Law docs to
not apply an owner of
103 - UFER
propcty who buildsor improves thereon, and who doessuch work himselfor through his
own employees, provided that such;mprowments are not intended oro0ered forsale. If,
104 — REBAR
however, the building or improvement is said within one year ofcomplesion, the owner-
1OS — ANCHOR BOLTS
builder will have the burden of proving than he did not Wild or improve for purpose of
.1,a).
106 - SEWER & WATER
C.as owner of the property, am exclusively conuacung with licensed commercial to
202 - UNDERFLOOR PLUMBING
met she project (Sec. 7044, Business and Professions Code:) The Commortar's Li.
wade Taw does not apply m an owner of property who builds or improves thereon,and,
203 — UNDERFLOOR MECHANICAL
who commuters far such projects with a conuactor(s) licensed pursuant w the Contractor's
204 - UNDERFLOOR FRAME
License law.
❑,nese ps n rSec. A .B&PCarlhu;mwmm
205 - UNDERFLOOR INSULATION
Dia
301 - ROUGH PLUMBING
ICER E_ZMA OND RATION
302 - TUB & OR SHOWER
I hereby a0irm under Penaltyof neo (lowing declaration::
303 — ROUGH MECHANICAL
❑ I have and will maintain aCer ifica¢ of Conenno self human for Worker's Compcm
3 04 - ROUGH ELECTRICAL
Orion, as provided for by Section 3700 of the labor Code, for the performance of the
work far which this permit is issued.
3 05 — FRAME
❑ 1 have and will maintain Worker's Compensation Insurance, as required by Section
3 06 - HOLDOWNS
37(X1.( be talar Code, far the perlmero nw of the work for which this permit is issued.
My workers Compensation Insurance carrier and Policy number ore:
307 — INSULATION
carticr: PolicyNo.:
308 - SHEETROCK
CERTIFICATE
COMPEN ATIONIINSURANCON FROM EGRICERs'
309 - EXTERIOR LATH
(Theistical Wilma Mcompletedifthe permisinhamie amiloddillara(5100)
310 - INTERIOR LATH
ter leas.)
311 - SCRATCH COAT
I notify that in the perfo a the work for which this permit is issued. I shell non
313 - ROOF NAIL
r
employ any person ins Bran m becomcauhjnonhe Workcts'Cnt enalinn
Laws of California. Da
501 - FINAL ELECTRICAL ENERGY
AppCann
502 - FINAL PLUMBING ENERGY
kin s is c fin e EmapIi......should
NOT OAPPL ANr:Itaftc mate
born bjemtotheWorker'sCompensationprovio Labor Cr de, you must
503 - FINAL MECHANICAL ENERGY
forthwith comply with such provisions or this pcmnit a.,he dwme rev --
504 - FINAL BUILDING ENERGY
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is. emnremion lending agency I the perftannows, 01
505 - FINAL ELECTRICAL
the work for which this permit is issued (Sec. 3097. Ci, C.)
506 - GAS TEST
Lender's Name
507 - FINAL PLUMBING
Lender's Address
1 certify that I have read this application and sum that the above information is
508 - FINAL MECHANICAL
correct I agree to comply with all city and county ordinances and sate laws relaing to
Wilding construction, and thereby tantrum represenmivem i of this city enter.Mm the
5 FINAL GRADE
above foeemnifyan
lO FINWANNI(Wei
keephs.
(We) toanowri
ages to uvc, indcmmty and keep harmless nhc Cily of Cupertino againn11.1,114 es' gmens,cusuand expenses which may in anyway accrue against said City
5 NRKS
in Co.!see -c of the grsnung of this permit.
APPL111 A UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOU EG L TIONS. ^ y
?—Re -roofs
Type of Roof
gnaturc dfAilplicamUC
"AZARDO ATERI LOSURE Dxm
Will theapplicanlurfutum hot mg Occupant amrt or handle huaNuu material
as defined by the Cupertino Municipal Code, Chapter 9.12. and the Heath and Safely
Section 25532(a)1 .....���AAAA
103r, No
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
ll t
s Will the applicant or fu^wrc building occupant use equipment or devices which
crit hwardous air contaminants n defined by she Bay Arca Air Quality Management
all new materials for inspection.
Disuicfl ���///
❑Yes }y No
Ihavere the aaaMiiusmmw6alsmquimmenuundcr. Chapwr6.95ofnhe Califnr.
ria Health& IySecures253)5,25533 and 25534.1 understand Nen if the building
Joos not curt 0y a e tenant, Iha it is my respouibiliny to hei the oecupanl Of Ne
rcquircmcnts uslhcmclpt Iriaaaanwofa cacufOceypa y.
Signature of Applicant Date
( `
All roof coverings to be Class "B" or better
owne au reagent w