01090048 r CITY OF CUPERTINO '
BUILDING DlvtsloN PERMIT CONTRACTOR INFORMATION:
Y
BUIfDINGADDRESS: PERMIT NO.
10235 DE ANZA BLVD ALOTTA' S DELI 01090048
OWNER'S NAME: APPLICATION SUB DATE
ALOTTA' S DELI 09/13/2001
HONE: SANITARY NO. CONTROL NO. r
l
C m Z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
O O BLDG ELECT PLUMB MECH
HirJ L=1 1 1 I-.-
y= LICENSED CONTRACTOR'S DECLARATION - ]Ob Description
I hereby. irm that lam licensed under provisions of Chapter 9 lcomncering p
m_'w is inflliereta0)ofect. on3oftheBusinessandPmfewionsCotln,andmylicentt ADD EXIT DOOR. n �
n full tome and effect.
1 0 E 6 License Class Contractor
o p
Oa. Date GmnracA _ C3
!a LLO m ARCHITECT'S DECLARATI *r,�
1 understand my plans shall be used is public records T
it
1 p O Licensed Professional APR 7
(19
x,n.
OWNER-BUILDER DECLARATION VL
m='w I hereby affirm thm 1 am exempt froad the C t t rs License law fur the
EF O 611 g (S uon 7031 5,Busine s and P t - C�:j�Any city or county $3000
wh h q Permit t c tun alter mP a t I h �rr$IaB�Q$tu�ry(I
n3� 'prim tote issuance,al. eq rem ppl' tt hperniu lW{'i$9�p9LLhfhtr _.. _._. - - ... _. __ . _._._,.-.._ __.._ - ...__-__.. .,. .. ...._._,_ -...
t¢atad tl dp nglnt thp on fm C t ctol L Law fChapt 9 Valuation
(co :ng.wi�h Sect n]0o0)or Divis 3orsh Business dPrMessiansCd) ffj'q kf3' y;[t6.0 CY® .";Viy psa;y°ora!�i rn��'1�f
or that he rs exempi therifmm and the baso for the allege.elwnpt Any vi.rtimi r
of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty"
j rnfnot amthan five hundred dollars(S50T, 10I``PNN*5t5DATION 1"'''o°' Occupancy Type
01,res owner ofthe nd the stor ructure
is not intended
swim wages offeMeirsolecompensation,'�, !
' Ba;mmitne 'Pird,,im,e ode The
Cam Immnd Lice eLawred forsno applyer. 1.44;
-Business nnd•Pry Who
Code:The oaae,,,here License Lew east naw apply m en• 103 - UFER Required Inspections"'" -11-11;
aw f p perry Who b 'Id p at d who does smeh weak himself
arm for
his'l mpl y p a pm uehimprovements a tintended 1,04 - REBAR
ter ... .._._-.. - . . .. ....- - --- .. - )T qil
.:par le f of If,ha t, li Icing b t 'la' - d o t r 105 - ANCHOR BOLTS p ". - :r, ... - .0 xo
iompletion me owner builder w 11 have be burden of proving that he dice not build or
mpraref«parposeofamo.). 106 - SEWER & WATER
.; Ia.awner ofine property,44,Business
isadProfiGvi withlicensedTJcammnmm - 202 - UNDERFLOOR PLUMBING
License the pmjeat(Sec.Oto a owner t mM property
who
Code:)The improves
thereo s
iod,.hLawarwtnot.f ,such
man awnerth a mailywho naildaorimprovex thereon, 203 - UNDERFLOOR MECHAN'I CAL'`:.""
...aw.who-comrase La ch.p oiata.with a ntraanr") Benwd purmant to the. .,. . . ... 2 04.__..-. UNDERFLOOR 'FRAME: -._. ._...
El I a ears License Law. ... -"- - -
❑lam pt"ade a Oulu, q B&per thsmaaod' 205 - UNDERFLOOrR'' 'INSULATION
bw r NO ERSCOMPENSAn�NDEC�LRATION 301 - ROUGH PLUMBING -
302 - TUB & OR SHOWER
(hereby affirm ander prenal]y of perjury one of following declarations:' 303 - ROUGH MECHANICAL
❑ 1 have a will maindetiIii'Cdnain f Consent io selbirnme lar worker's 304 - ROUGH ELECTRICAL
Compcnem -as,provided for by Borden 37W of tM Labor Code: for the
perfovnahce,a(l)as work tor.wuicIt ml:permit is lssma.,,..,,, 305 _ FRAME
111 have ha willmeim w kur's Comp"ematiodlnsurenc q dbysedisn 306 - HOLDOWNS
3700 of the lmboi Code fifF the performance of the work forwhich this"mor it
307 - INSULATION
issued,My Wrk
oercarrier C mpensat in Insum em afd Pot y n labs a
308 : SHEETROCK,, ,q
t +7 CERTIPICAnONIOF EXEMPTION FROM WORKERS ' Y, j' 1h F 3.09d'" II EXTERIOR"LATH V t
on Jnmhe msP a finepermit iara o hundred _ 310-1= ZNT„FR'IOR__LATH -
_ INSURANCE _
aluo)Hit iot' oar' 311 - SCRATCH COAT ; Er", -..,�: ui , f.,Ol* _. _—._...
3.1.3_..,_^- ROOF NAIL .._ _
rem y tht it
n the performance rk fo hich th p is tssund l' - t;.,L
.'balldtemlo a arCal tomde tp to bat the Weakens':; 503 FINAL MECMHANI CALY)L'•'NERGY
P Y yips n Y 1501 - FINAL
I _A
NERDY
Comped t L
NG
NOTICE TOcta6me Wm If aft making ime C n6 a ofE peon , should `ENERGY
Z Cnecomesubectt wi W rkersC io resat n ram son ofthe Labo t J oum t
roan m ply lh sueh pdivisions arm p t nen nets m Lea. . _ _ -, 504:..,-_.FINAL...BUILDING.-.ENERGY ;..-.
F ""coNsnxucrloryLErvDngcnGEwcY
f th 505 - FINAL ELECTRICAL.,.,
C 1 heretiy farm that mere i s .Iran n 1 d ng uge cy pert' cards ,;r 1
.. im mkr n I m pcmtt maalsec 3og7 erne) h _ _ 506 GAS TEST
Lend Nan .. .._ --__ .. _._. ._ ,.--_ .._ ). -.. . .
s 507 _ FINAL PLUMBING
z ]end . I', I
V-� bl Ices fy thm(have read the application and.tate that the above mfrarma dist 508 FINAL MECHANICAL "
cormct 1 sre to. mply th all city and co my of cea and state laws relating. 509 - FINAL GRADE
building c atm uon and, byauthanzerepresentatives (tht cry toe ter Pon -
>, taj he aboeme gree Rtihade aspen pip _ ., SIO - FINAL PLANNING
E.t py eW)agree m', mdemmper n whikeepch
h may in the C ty fC pert ai agamd
y Cityi consegments,costs expenses h hmy ,any yaccmeagainst said, 514 - FINAL PUBLIC WORKS
V City c asequence of the g m s f this perm l.
,APPLICANT UNt3EST DS AN WILL COMPLY WITH ALL NON-POINT
S011RCE REGULI.n ' � 1�U1 Issued by: 'Date
58 atm fAPPI c!!la.., mra t t Dacer—+
AZARDOU�RIALS DISCL0.SURE ' , Re-roots
wn me apps dam r t bre la g dee Pam t rc h nJle hauaNa s mete rel' .'Type of Roof_:
d fn d by the Cupen o M n c p 1 Code Ch pt 9 IL d the Health and Safety
CJJ s OcYes 25532(a)aN r t ' i _? t I r a 76Cil�E y I• , ±t,a Lih i.
Jr All roofs shall.be mspected,pnor,to any roofing.matenal being installed-- .
w u m app)^ t cit b Id ng oc p t e equ p t d e which- If a roof IS mst'alled'Without first obtain an Ins eCClon 13 fee IO remove
"th b t ants def ed by th ByAreaA Q IryMngem r; tg P g
e1 /MYJv all new materials for inspection, A Meant understands and will comply with
F� ❑Ye P Pp P.X
all non-point SOUrCO Rglllah011s t fn
1 ha tad thi hazallous m tedals regmrctnenls under Llsapter 69t 6f thea
I ,Cal( H ahh&Safety Cade Sections ,I 25533 arM 25A4 L understand that r
do e 6 Itl g d c not c R nJy have e tenant that i s ntY rtspon rbd ty t tify the,:
I &d p t of th re irrmdata,
ch maxi be m t p r 'iss antt fi Cen fiat f-
"' o" p _ '' r-
a Signature of Applicant Date _
yvce All roof coverin s to be Class B"oi,better `
Owner r h d r nate„- g
OFFICE..
i.�
ryR .
AIR
1
APPROVeo
. IN ACCORDANCE WITH THE CITY Ot
CUPERTINO CODES AND ORDINANCES OffiCE Copy SEP 13200
D
)ATE
moo / 1
31CNEG �" iEsy
This set of pians .,
16
be kept or. the io^a_ ��ecitications MUST
lawful to make an,. "I times and it is Un
on same Ali. :vii , 19—S or alterations
'-.-c.Hzcey-.... t�+ .jam Y
he buildi ns ;ept `., permssion from �t�c rvht uw\ ""``/�
The stain n 4, of Cupertino. -.._ — --- — .:.— - -- — ---- ----— `
p g r this clan and
SHALL A'Oi be herd Pec'rermit
approval o. the ,o or to be an =
Of vroia,t n of any provisi
any City Ordinance or StateLaw.
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