00060032 CITY OF CUPERTINO -
sun.mnc mvistoiv PERMIT CONTRACTOR INFORMATION
BUILDING ADDRESS:' ' '^ - •' PERMII'NO. .. -
.,
.OWNER'S NAME ' ry' " APPLICATION SUB DATE
10500 N.-DE' ANZA/3RD ' FL SOUTHBAY CONSTRUCTIO 00060032
ION STREET ..
PIIONE. - �' SANITAkV,NO CONTROL NO. ,
DE- ANZA BOULEVARD ,INVESTM NTS.' 511 DIVI9 06/06/2000
n ARCHI EEC I/ENGINEER + - 'i ! ' BUILDING PERMIT INFO
•." °u- F , 'y 1 (408)377--` BLDG,0400 .e -IiLEcr,. - PLUMB- MECH
aza
LICI SSED CONTRACTORS DECLARATION
-
z 1 hereby of im tht I I I d p I Ch pi o( era train :, Job Description .
° [_ai w'ths t 9000) fD' oaIoftheH and tris Code and onset s9 ,
fall f dr r - tl -
L K K
Licrow,Class L .d 1 '
6°LF Dole .' _C tcallr t - : i r
w 3 m RC .T'S DFCI ARATION
pumb l,ra. 1586 SQ..FT.' ,TI
wCce 'La IP �' .,
�j�j OWNL ILDER DECLARATION
�f+i=� n, by (s ih l l a t 0 at Im l 1 ty the
" • 'tie�
toll 8 : fS t "IIY1 9 B d P :Code 1nY tY re 7
tt r l
aCam , lla I I :amce r 4 'thapplicantf hp n fl L signedstatement -
dath i :tip tt m I of the t Contractors L L (cl Code) ,Sq.Ft. Floor Area .. Valuation. +a`
(a B IlScl nn"1 in and he
he vi.' 3 oftheIl dP t Code)
d
utl dust
pt tl C aroh f -th ll,d ai Any total t
of
Section e than'by y ppd tins[ permit subjects 11 , PPI ,I 'I parody
-
nr I m l a Ian - f$5on) r APN Number
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ancy
✓' -Occult
000T
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e
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a'l1 d d he v i, a I roffered r al (Seo 9044.d Profession,C d .Th C t t ,Li t 1 I e: t Itit l to Required Inspections'..
owner atpeny WhobuildsP thar h d h k h :clr 31E2O0J.7. 00
rthrough n coalve:.p datum, n p- t tintendednr
offered for side If o [Ile haildialI or improomend sold within o m year of
completion,[lie ow mrh Id will have theburden f pro Jlg
'
,
•1,
that he da nnl bt lor
J
improvesal').) „ 101' _ FOUNDATION
of as ownerof[lie property, s ly. l' ting with licensed contractors to I: 1.02 — PIERS I - ..
ona t the protect(Se OI1f4 N : d Pot: .Cook,'.I ThCompacttr's
construct
ic La d t artily t - . f propwIt.bu Id p :m -u� 103 UFE R -and who contract,f ch projects 00 11 , ma,orls)1 pursuant 1 the
ContractorsLifenvel w. 04 REBRR. -
❑Iamnxcnpttnnde,5ec ,B&Pert„rthis rd:tn 'RNCHOR BOLTS, .
Ovine; Data 10F� — SEWER. R• WATER '
WORKER'S COMPENSATION DECL;AkATION -
'Iherebyarm„tnnderautllhy of pa;ittry ananrme mlmwi 1. v�.,itI ''202'-.- UNDERFLOOR 'PLUMBING - ; -
• ° I b' a ll Certificate fConsent to If kers 203 — •UNDERFLOOR., MECHANICAL
Cat p so Provided' r by Semen 3900 of ,b Laid codL °ir '2@4 ,UNDERFLOOR' FRAME
pert of the work for I'hli: fa t :-d.- •4
olhave and will malt waken Compensation In „
race as;rlpu rm by SacB„n X205 - UNDERFLOOR INSULATION -
391pnrthe Labor-Co1 r P p r Cm weak for hal. permit is 301' — 'ROUGH PLUMBING
^h.wd.Myw k sc, pasartn hs'at r told Policy nambu are: 302 —• TLIB'&A OR SHOWER
Ca 'e - Policy Pm.i '
^ CERTIFICAT[ON OrEXEMPTION FROM WORKERS' 303 ROUGH MECHANICAL '
.. COMPENSATION INSURANCE
304 ROUGH
nh l nee - bnH tl � ELECTRIrCA _ ,
(5m0mlesa.) 305
.
FRAME '
I at mad i.the Em fill,manne oftha workr h l, hisIm6mitis iillLsed,l 346 — HOLDOWNS .
shall not employ any person in any 7n n ar a:t,become stblect to Hai Workers
CompensationLawsofclf Date . 307 INSULATION,
' ,NOTICE TO APPLICANT It fl akin,lb:Certificate fL pi y h Id 308 —e:,SHEETROCK - {
become hJ t I m Worker m
C 't p of theLabor Code,y must
O D furtn id ',fly wntn top u.i the tshall n daauadre,nked. 309.. . EXTERIOR LATH”
FLn f CONSTRUCTION LENDINCACENCY 310 — INTERIOR ,LATH an
I hereby affirm that there is a conislituation lending agency for lhe'imrinrnonce
'a
of tire work for which tn m t is issued(See.3097.Cil.C,) 311 — SCRATCH COAT
W (] Lenae :Na -
�a.Z I.ande Aeries,
31.3 ROOF NAIL '
UOQ of,(hot ln dd application and ml'@itn n ;mots 501 — FINAL 'ELECTRPCAL ENERGY
W. lar„lt1a, to comply fill heebctyana trowall es Lstate law,remdno 502' — FINAL 'PLUMBING- ENERGY.
O p ton mt t ty hereby m n l l rm ,y, t .,no - 503 — F,INRL d
} W theabove-mentioned p P ,y I. . :p t Purposes,
r '
w esj g am ft' ak pn y. a cly 1cI l s sl MECHRNICAL LENERGY
(rz rani s nes. a rthu n 'y ,ty ay alue_a 504 —. FINAL'': BUILDING ENERGY”
U Z cirr w n dot not,permit. _ - "��.. ., • � -
^ APP Nc' f WILL COMPLY WITHALL NO IN a
s F •.I Issued by: 505 FINAL ELECTRICAL Date.
ig t Pr atticnnln r a. ' q+ Re roofs 07 FINAL PLUMBING
Fa
HAZARD S MATERIALS DISCI OSURL -
- nm mi I r b 'ming pa Imnen l dl a, dRd,m nidal Type of Roo}�- - -
a4dlmdbyp Cped Municipal cud co-p,rslz t itn Plead,anesmglr 508 FINAL ,MECHANICAL .
Code.Section 25532U)lh
' - .' .
o Yea '•All roofs shell I'be inspected prior to any roofing material being installed.' f r
Will the pIf I orBaltic n 'ld g occupant use equipment t de,iceswhich If a roof is.in'sfalled without first bb,tainmg an. inspechon;•Iagree to remove
arm,hazNu ',,unionnount,ascementbyth Bay Are,A Q It N go t
.;
Dopler I , all new materials for inspection...Applfcant'understarids and will'comply with
°Ys n all"non-'o' Sc a MKL. GRADE
1 h d❑m ha 1 materials re,l t d r Chapte 695 f the - t�,
.Calf t. Health&Sarty Cale Sei s 2550525593 and 15534.1 andand lthat '� NAL PLANNING
if bu'Idtng dol not end to l ,hal usury pnnfryt tnif the t
t aupant H me mol b and pc ar m".yuan a C, C ditic c of - -
oula - - � a r of Apph tot,,; -.<. "' Date
o awa,eni,,. - t - ,.,; n Allro'of'coverings'tobe'Class a'B"'orbetter,