01110061—
mal no is imeareatpursuant to I= previsions or Ne k- V Cmx5 Lyteave Ww p-lapler Y
"(!om
OF CUPERTINOPUILDINcntOtstoN
1,3f]) P$ P99r. Amgp
'J'D f�ii H,[T i
Valuation
YalnatlOn
PERMIT
CONTRACTOR INFORMATION:UILDING
fs .Lo P,_: r,- p_p''+s
”- -
Iotht
P Y onYnp on to Y ..n t beard t 1. the Worker,
[�C!TTY
ADDRESS:.'
or that he Is axe not the shma and the bass for the al IeSed e pl t. Any violation
PERMIT NO.
1'0555 -DE -ANZA'BLVD # 125
A Icum '
01110061 ..
"
WNER'S NAME r' - -
-
APPLICATION SUB DATE
r.
DON ON DEANZA_PARTNERSHIP
13/13/2001'
ONE. -
- "'
SANITARY NO. CONTROL NO.
'
"" I hereby'iiffinni that here aa em.moultionlending"agency I., thp f once°
ibdl do thework The C]o
a structure not ar', License La sid(Sea: ra,
omta
Bui nesd P of s oimas C d : in ed offered for does appe y lman
�C O O
ARCHITECTIENGINEER: -
BUILDING PERMIT INFO
Lend rs Neme n _ s s. �:.,. _:_.- ..
BLDG ELECT PLUMB MECH
F<L—
A
+'LICENSED CONTRACTORS DECLARATION .
- 'Job Description
_... ._....___.. __ _
I hereby afrm th t F t liccmed and p o f Chapter 9 ompar cmg,
completion, the comer-bui War If have the burden of proving that he did not build or
m
s7
with Sect n 7000) of Dtl ons abu dP t msC le dnd license
SIGN
I
C
a mfllfo ff t
v
'� I+I k
1 ew:t i Y : ,w ....
WK6
cCalle113G('I.
3 a vii
eai CHITECT S -DECLARATION'
.[a. decload my be
construct the a S SBusinessd f ima Code) The act s
}
pl ns shall axed as puM¢ records
looLicensed
-.
.1.
� �
5.nr
- ON NER BUILDER DECLARATION
�
Date
. _.
'- 1 h by off that 1 pt f u tM1 Contract ur s License Law for the
Convesu ',Lf,en.cL
'DI n x pt dry ..I 'rs �'o je&PC for this
l—ZQ
Illi g .(Sal 9U11SB es. ndP f i acodeAnyanyornoury'
$3000
E gal
which handrail, a Permit 1 construct, alter, p e, demolish, or repair any structure
'
—
mal no is imeareatpursuant to I= previsions or Ne k- V Cmx5 Lyteave Ww p-lapler Y
"(!om
l i' J -
1,3f]) P$ P99r. Amgp
'J'D f�ii H,[T i
Valuation
YalnatlOn
ng„th5ct ]000) of Olt 3 of the B dProf esaons Code)
.
fs .Lo P,_: r,- p_p''+s
”- -
Iotht
P Y onYnp on to Y ..n t beard t 1. the Worker,
or that he Is axe not the shma and the bass for the al IeSed e pl t. Any violation
Comps m LavreeCC 1 t nw Dal
.
�_.
A Icum '
,of5wtion]031.5 by any apelicamforipermilsubjeas theappl ..... . civil penalty-
...._ ..- - .. _.
NT after ofoh ren mnshould1
NOTICE TO more, v >m
.. ..
bfnotmole than fiv¢hundred dollars ($500).
,
Occupancy Type
it 1, is all offhep'ea'ty or my employees with altarsnslh compensation,
'.{Y'+CONSTRIIC'NON LENDING AGENCY. ,-.. :. ..'.
5 01 — FINAL ELECTRICALEll
'
"" I hereby'iiffinni that here aa em.moultionlending"agency I., thp f once°
ibdl do thework The C]o
a structure not ar', License La sid(Sea: ra,
omta
Bui nesd P of s oimas C d : in ed offered for does appe y lman
5 0 5 — FINAL EREFt9fFd8II [ions
mill pPapeny Who held, or improve theme., and who does such work himself
Lend rs Neme n _ s s. �:.,. _:_.- ..
. tintended or
A
'nl -
dg
offs - - -'and year of
mile aYItheb Ifng mP nenfivIJwithin
_... ._....___.. __ _
.
completion, the comer-bui War If have the burden of proving that he did not build or
c eyeas a
oriec4l agree t imply with aIL<ityati0 co nlysor:iinances end state laws relating
V, agree,
improve for purpose of sale.).
'
the eb t ded property f n peaion purpo
"co 1 as owner(if h property, ant IY competing with licensed contractors to
(We) egiec Id xd e, t tdemnrfy and keep harmless'the Ctly of Cupenmo agnion
construct the a S SBusinessd f ima Code) The act s
liabilities, judgments, c sa and expenses which may in any wayaveram aga;n!Ir said
F' tlALEDl
LiLaw does not Apply hian owner properly who bdimproves the
!'
!
sbuRGER IDN,
pd,wh m forlorn proltts wih a co t a s) ccnaJ puruant to.the
Date
. _.
v
Convesu ',Lf,en.cL
'DI n x pt dry ..I 'rs �'o je&PC for this
DEC'1 qq 'qI
EC O"L tLao1
f 1a
f
Owner,
jP' s ru WORKERS COMPENSATION DEC'Luk
+� RATION ..
.. ._... .e s... , .... ..
BUILDING I
herby afCrpn.under penally of pearl yone ofihe following declamtom,
I hoe and'will m tan a Cenificule fC ani to self-insom for Wnrka's,
0mpens5tion,. gas; provided .fonby,.5eaion 3000[of, the Labor Code, for the
.. -
_
_
peiformance of the work for which this penal is issued. .
❑ 1ld will maintain W k s Ccimperactionl stirance as required by Section
-, rf
37W of the L bo'Cod , for the perform of the workfor which this permit is
rI
-
issued My Wok : Co p . i Insurance carrier o momentum -
., .: d P?_Y_....
Came }-".,.r1 M1-':,XEiyTO. ..,: ., r.
4
"'4,o-
cEOF
•'`r, :.t: '. RTIFICATION
b
"Ir COMPENSATION INSURANCE` V17„,”
ENE TION INSURANCE
ITh actionane d not be emorphend if the perm) is for one hundxd fibers
't
l i' J -
($100)orless.)
dial
his lialmai'j, ism
of thha
,.�.
..
Iotht
P Y onYnp on to Y ..n t beard t 1. the Worker,
.. ,..
Comps m LavreeCC 1 t nw Dal
.
�_.
A Icum '
.. .. - ..
...._ ..- - .. _.
NT after ofoh ren mnshould1
NOTICE TO more, v >m
.. ..
eM1eg
beEomc subject to the Wo ke .Ccinp t pvafnns of the LaborCWc; you oust
'forthwith comply with such provi,ions or this permit snail be deemed revoked.
-
.
'.{Y'+CONSTRIIC'NON LENDING AGENCY. ,-.. :. ..'.
.._..__-.,.-
"" I hereby'iiffinni that here aa em.moultionlending"agency I., thp f once°
_t
of theoleworthth pc t "'s11d 3097 Cie .,J
Lend rs Neme n _ s s. �:.,. _:_.- ..
Len
A
n thisabove information eion is
1 have read this application and macthat
to application
c eyeas a
oriec4l agree t imply with aIL<ityati0 co nlysor:iinances end state laws relating
V, agree,
Ito build@c irucuon and hereby' out opal representatives of this cityt enter upon
'
the eb t ded property f n peaion purpo
(We) egiec Id xd e, t tdemnrfy and keep harmless'the Ctly of Cupenmo agnion
-
liabilities, judgments, c sa and expenses which may in any wayaveram aga;n!Ir said
City l seq nce of the granting of this p t ' -
AppLiCA UNDERSTAND ND WILL C( P 'lITHA POINT3i
!'
!
-
sbuRGER IDN,
Issued by:
Date
❑Y i.:'
0 can
—
ru
'u
r
own,
RI D t .', Re -roofs
ALS DISCLOSURE
mg occupant store or handle hairandina, mat al . Type of Roof...
Code Chapter 9.12. and the Health and Safety
_ All roofs shall _ ed. t
- . be.mspected.prior to any.roofing.material being installed.,_ ...... _..
ding accup'ent use equipment or devices which If a roof is installedWithout first obtaining an inspection;' I'agrec'to remove
mad by the Bay Are, At, Quality Management
all new materials for insPection. Applicant understands and will comply with -.1,11
all non point source regulations. -.
a
,' l25505:25533taunder. Chapterromed that - - -
am2550535533 and25534. epmusilundersand that -
.ten Ith tl'- Y. P 'ti lly in ratifythe
Ern .R�n .., r r r a.�'laro ,.r
val
Signature_ofApplicant I _- - -- _ Date, All roof coverings to be Class B" or better
OFFICE..
YL(TT PLADfJ
CEMCKED BY
DATE�'3
,q 77. 7`0 C4 7.YERfnrE CtfF-'V
RMMMUAL C>Ii&NML LEi' =s AND IX*%BffEM0R
RIJJ +IkNAYIIDVYPTH 30IdA NEDN 7'OHING,
LWTERS 00UM AM WD,W00 COLOR IS WMM
SURFACE W1TH RED IETTMM, ALL TRIM CAPS ARE
GOLD,HRONM CAN.AILLMMM MO MM ON's` W
FRONT WALL
CU ERTINO CODES AND
A
roc
jbe'
e.etof pans end spe fcatwnsun
of on the jobanes andit i ion°
to man W9 ,,,. ;.
me withoutwriicen permission torr
r ertino.
u.
The stamping of this pian and specs i
Yt 3s m o he to Dermit or t0 an
approval of the violation of any provision
of eny City Ordinance or State Lew• (!e f
•f W,
1[ 8.
�$TiGiu1G HIIIIDiiSG PiLS6A
HIM UM TOM
MM PAM 9178 IRD! W
am RW YIMM
M CANE MM SWIM OAP
V2 PJXMM EIRMIE wMT
6'm LRITM BODY
3SR95POR8M
am 3 Sffi um A=w 7M
in snmm �iyn ro sM.n.
rM RIM AND31�a]QF 1nim u
wr to
NOV 13 2001
I
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ACCO r 5717E "R." ]p SUr24NC
,OCAnON loSSS,geys S.OE ANzq Dlua
„"°.
MAKER HENRY'S D£31GN&SIGN SO.
Y
!;
DA -M 01/3 —of
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