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01060118OFFICE ......__.. CITY OF CUPERTINO + - BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: I PERMIT NO, 10601 DE ANZA BLVD SOUTHBAY CONSTRUCTION 01060118 OWNER'S NAME: APPLICATION SUB DATE NOVA CARE 511 DIVISION STREET 06/20/2001 PHONE: ' I SANITARY NO. CONTROL NO. (408)379-0400 Z ARCHITECT/ENGINEER: - - 1 BUILDING PERMIT INFO O BLDG ELECT PLUMB MECH I- _J LJ I__J t=1 a LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing' With Section 7000) of Division 3 of the Business and Professions Code, a ad my license T.I . SPLIT LARGE OFFICE INTO 2. snfail ,Cass anaeffecl. ' (1) TREATMENT—CONVERT & License Class Li<.M „ D... c°"tin"°r (2) RESTRM TO H.C. A ''fECT'S DECLARATION�'�� /)fulyseis�tn s 1P a used as public records FFM Licedry'sedtPL`mf.'lona orer, E,/ Oe, -BUILDER . the C DECLARATION 1 h reby offmt ,het m exempt from the Contr"cmr's License Law for the( JUN 2 9 2001 .following mason. (Section 70315, Business and Professions Code: Any city or county which requires a Permit to construct, alma improve, demolish, or mom, any structure ,- prim ',° Its Issuance ala° noc o,ce the aPpli ar, f.nauch permit,° file a signedsmtanarl - - ie,the y) With bhitplh mf"si - fm c cm L - 1 (('hall -)' ,�' Ft l'IoOI' nmrua I ,-p-. :. �1L ,jltj�ly Oil (c n6 with5 , 90001 fDiv s' 3 fth 4 ln s eP fessrons Cml7 f;"s, .. s9. fs )m Y_pr xy{. <...r- ,'vs' i�...he .l. IjlJ llsu.V V11 or Na[ he s exempt therefrom and the basis for the allbged ci Linuhh. Any v ulct mi of Section 703 Ed by any applicant for a Permit subjects the applicant a civil penalty ' of not more than five hundred dollars (5500). 3 5 91l i1 F2'66 {'' ' - Occupancy Type O L as owner of he property, or my employees with wages us their sole comas smi.n. —will 'do'[he , work; and the structure isnot intended or offered for sale (Sec. 774; - -- - - i8miness and'Professimns Code: The Cnnuai License taw does not apply to an 101 - FOUNDAT wired Ins0ections, ' "- wner of property Who builds or improves there.., and who does such work himself 102 - PIERS ii 0 o through his f, employees. provided - that such Improve t r mended of .will LIFER... ... _.__.. .. ...� i „ B or improvcmcn y � .., comPlenon, the owner bti Ider wdl have the buNen of proving nm he did not build or ' impoeforpurpose r I t 104 — REBAR j -'q her of the propegy mend.aivdy comracnng with licensee contmaors to' lO5 -----ANCHOR BOLTS i tV. f a:r'l" - construct the project (Sec. 7044. Business and Professions Cale:) The Contractor's ( Iii. dig ri. P:' . �' V;; U,. - License ". L ace not apply to an owner of property who Wilds or improves thereon,10 6 — SEWER & WATER ,� " ., and. who Portions, for such. projects. with a coroncloas), licensed.pursuant.ro the____2 Containers License L 02 -----UNDERFLOOR PLUMBING ❑I of 'tom? rB&veto, his aog 203 — UNDERFLOOR`'''MECHANICAL 'o ,ler "D, 204 — UNDERFLOOR FRAME wo sCOMPENSATION DECLARAn° t 205 - UNDERFLOOR INSULATION ' I"''-1 ertby afOrm under pepally, 9f prcrjuryimia ofilm following declarations: 3O1 - ROUGH PLUMBING Cl I n n' n ma mu a cera t f Con ±epl'ta sur insure for Workers' 302 - TUB & OR SHOWER Compensation, as, provided for by Section 37M of the Labor Code, for rhe Petr°rmaneoufd wmkfor.Whicbthis a mi i, is issued.., 303 — ROUGH MECHANICAL ❑ I have a d m ma t w kits crntpe r o t 'ran a required by Section 3 04 — ROUGH ELECTRICAL _ 37W of the 'L 1 m'Cwl f ,h peifpfmanc f the work to, 'which dins Farm, is ed My W.'k r. C pe vuon Ic and Pol y tube i 3 05 FRAME 3 0.6 HOLDOWNS -_. �arte raj 'C .t 3.e1 PTIO -#` r..<3071— �INSULATION,1 __. ( P XEMCOMPENSATION INS FROM,WORKBRSh' R. x- t COMPENSATION INSURANCE __- an `,mvn d.an _._'30$!\F."-SHE$TROCK___. _,. A iompkc¢d if the Permits for hundred dollars a$!T.;loss?t ,. t 309 — EXTERIOR LATH, 310 -- INTERIOR °LATH ° I mint nth pe f- ttminhe work for w,h h th pe tk n Ismail, a I SCRATCH 'shill Ant empl, y any p by manner so a tiec.n bycl w N'e' Wo k d 3 11 - ICOAT . 'ApplicantCoope r cm fool nm= _._3.13 —-ROOF-NAIL 501 FINAL ELECTRICAL _ _.. ;'NOTICE TO APPLICANT If aft r mak ng Ih s C ri fc t f E mpu n, you ho ld L ENERGY \ &come sub,ecvo,h Workers Cinifenst n pmvismns of the Lahr Code. you most - jform uhcomplywith coprovisions ort permithall bed mankind. - _ _ 502 -._.FINAL.... PLUMB ING._ENERGY. _....._ .' t f. x,.t,. corvsrnucrioNLENOIrycncFNCY 503 - FINAL MECHANICAL ENERGY.-(' ° 1 hereby ff n thath t tonleading oRnwo kf n ,h pmtnt isued(Si 309tc CI 504 — FINAL BUILDING ENERGY agency P smance, Lrnd Address- �-. I 505 — FINAL ELECTRICAL,. 506 — GAS TEST .. y q ri I gory that I h d this application and slam that Inc above information Is. 507 - FINAL PLUMBING w rrcct I ago- g e t a ply ,h II city and county oN n d t t las mining In buldng was- i dh byeutu erep tin [n city to me pon y beab(W) niug-e,op pu0nnmfyfor midWinh les theCty fCup'tiva g nst 508 — FINAL MECHANIC 7 liabilities, dgments Is a d expense Which m y m tiny y gain , said 509 — FINAL GRADE City oas,y ence nl t g of th Pefrtut 7 FPpf "f lE DS AM1D wB.L COMPLY WITHAL NON-OINT lO - NA ING G IssueCIR Date ' g ibpntlCon tor.'.:.=� :",i 1 tome<-:�,, Re -roofs .-HAZ DOUS MATERIALS DISCLOS ftE i W II N' applies 1 f 1 making aWorn upa t t or handle le aallo s national Type Of Roof .. _ _ .. _ 3 as f J by the Cu M p I Cod Ch pr 9 12, andum, Health and 5 fely - ' - " All roofs sh .:. a DYs 715532 3 f 'I;. PA F a+1' '„ ' ( °' I � ` x,, ;' ' „ .. _ all be mspected.pnor to.any, roofing matenaLbeing,mstalled... esti m., ppr , ,r unum building occupant _, a equipment pwhich! If a roof is installed without first obtaining awinspectioisTagree•to`remove a..l hav d o m khans a defined by ,h Bay Alma A Quality hi nagerr nl, 'District all, new materials for inspection _Applicant and d well_ comply with ❑Yee .. ::e -g . , e[S an San al] non -point source regulations 1 have and thehazardous comma, s reymrersenis under Chapter fi e,5 of umj ' ,Cal, int Health'& Safety Code; Sections 25505; 25533 and 25534. I unders,and,har ' -jflhebuilding down dyha<amtmnt;that hls my responsibility rd notify the b d y p _ fa'c d(Ipam.of� Signature of Applicant __ __ .__ Date __ __ __ _ _ UC[ a heti mu5[6 1 flat to l5 .an[ . ... _.. _..�.. _- . - ._...._. . .. - _. .....- .-.... .___ _. W All roof coverings to be Class "B" or better r n t. =ea t OFFICE ......__.. CITY OF CUPERTINO + - BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: I PERMIT NO, 10601 DE ANZA BLVD SOUTHBAY CONSTRUCTION 01060118 OWNER'S NAME: APPLICATION SUB DATE NOVA CARE 511 DIVISION STREET 06/20/2001 PHONE: ' I SANITARY NO. CONTROL NO. (408)379-0400 Z ARCHITECT/ENGINEER: - - 1 BUILDING PERMIT INFO O BLDG ELECT PLUMB MECH I- _J LJ I__J t=1 a LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing' With Section 7000) of Division 3 of the Business and Professions Code, a ad my license T.I . SPLIT LARGE OFFICE INTO 2. snfail ,Cass anaeffecl. ' (1) TREATMENT—CONVERT & License Class Li<.M „ D... c°"tin"°r (2) RESTRM TO H.C. A ''fECT'S DECLARATION�'�� /)fulyseis�tn s 1P a used as public records FFM Licedry'sedtPL`mf.'lona orer, E,/ Oe, -BUILDER . the C DECLARATION 1 h reby offmt ,het m exempt from the Contr"cmr's License Law for the( JUN 2 9 2001 .following mason. (Section 70315, Business and Professions Code: Any city or county which requires a Permit to construct, alma improve, demolish, or mom, any structure ,- prim ',° Its Issuance ala° noc o,ce the aPpli ar, f.nauch permit,° file a signedsmtanarl - - ie,the y) With bhitplh mf"si - fm c cm L - 1 (('hall -)' ,�' Ft l'IoOI' nmrua I ,-p-. :. �1L ,jltj�ly Oil (c n6 with5 , 90001 fDiv s' 3 fth 4 ln s eP fessrons Cml7 f;"s, .. s9. fs )m Y_pr xy{. <...r- ,'vs' i�...he .l. IjlJ llsu.V V11 or Na[ he s exempt therefrom and the basis for the allbged ci Linuhh. Any v ulct mi of Section 703 Ed by any applicant for a Permit subjects the applicant a civil penalty ' of not more than five hundred dollars (5500). 3 5 91l i1 F2'66 {'' ' - Occupancy Type O L as owner of he property, or my employees with wages us their sole comas smi.n. —will 'do'[he , work; and the structure isnot intended or offered for sale (Sec. 774; - -- - - i8miness and'Professimns Code: The Cnnuai License taw does not apply to an 101 - FOUNDAT wired Ins0ections, ' "- wner of property Who builds or improves there.., and who does such work himself 102 - PIERS ii 0 o through his f, employees. provided - that such Improve t r mended of .will LIFER... ... _.__.. .. ...� i „ B or improvcmcn y � .., comPlenon, the owner bti Ider wdl have the buNen of proving nm he did not build or ' impoeforpurpose r I t 104 — REBAR j -'q her of the propegy mend.aivdy comracnng with licensee contmaors to' lO5 -----ANCHOR BOLTS i tV. f a:r'l" - construct the project (Sec. 7044. Business and Professions Cale:) The Contractor's ( Iii. dig ri. P:' . �' V;; U,. - License ". L ace not apply to an owner of property who Wilds or improves thereon,10 6 — SEWER & WATER ,� " ., and. who Portions, for such. projects. with a coroncloas), licensed.pursuant.ro the____2 Containers License L 02 -----UNDERFLOOR PLUMBING ❑I of 'tom? rB&veto, his aog 203 — UNDERFLOOR`'''MECHANICAL 'o ,ler "D, 204 — UNDERFLOOR FRAME wo sCOMPENSATION DECLARAn° t 205 - UNDERFLOOR INSULATION ' I"''-1 ertby afOrm under pepally, 9f prcrjuryimia ofilm following declarations: 3O1 - ROUGH PLUMBING Cl I n n' n ma mu a cera t f Con ±epl'ta sur insure for Workers' 302 - TUB & OR SHOWER Compensation, as, provided for by Section 37M of the Labor Code, for rhe Petr°rmaneoufd wmkfor.Whicbthis a mi i, is issued.., 303 — ROUGH MECHANICAL ❑ I have a d m ma t w kits crntpe r o t 'ran a required by Section 3 04 — ROUGH ELECTRICAL _ 37W of the 'L 1 m'Cwl f ,h peifpfmanc f the work to, 'which dins Farm, is ed My W.'k r. C pe vuon Ic and Pol y tube i 3 05 FRAME 3 0.6 HOLDOWNS -_. �arte raj 'C .t 3.e1 PTIO -#` r..<3071— �INSULATION,1 __. ( P XEMCOMPENSATION INS FROM,WORKBRSh' R. x- t COMPENSATION INSURANCE __- an `,mvn d.an _._'30$!\F."-SHE$TROCK___. _,. A iompkc¢d if the Permits for hundred dollars a$!T.;loss?t ,. t 309 — EXTERIOR LATH, 310 -- INTERIOR °LATH ° I mint nth pe f- ttminhe work for w,h h th pe tk n Ismail, a I SCRATCH 'shill Ant empl, y any p by manner so a tiec.n bycl w N'e' Wo k d 3 11 - ICOAT . 'ApplicantCoope r cm fool nm= _._3.13 —-ROOF-NAIL 501 FINAL ELECTRICAL _ _.. ;'NOTICE TO APPLICANT If aft r mak ng Ih s C ri fc t f E mpu n, you ho ld L ENERGY \ &come sub,ecvo,h Workers Cinifenst n pmvismns of the Lahr Code. you most - jform uhcomplywith coprovisions ort permithall bed mankind. - _ _ 502 -._.FINAL.... PLUMB ING._ENERGY. _....._ .' t f. x,.t,. corvsrnucrioNLENOIrycncFNCY 503 - FINAL MECHANICAL ENERGY.-(' ° 1 hereby ff n thath t tonleading oRnwo kf n ,h pmtnt isued(Si 309tc CI 504 — FINAL BUILDING ENERGY agency P smance, Lrnd Address- �-. I 505 — FINAL ELECTRICAL,. 506 — GAS TEST .. y q ri I gory that I h d this application and slam that Inc above information Is. 507 - FINAL PLUMBING w rrcct I ago- g e t a ply ,h II city and county oN n d t t las mining In buldng was- i dh byeutu erep tin [n city to me pon y beab(W) niug-e,op pu0nnmfyfor midWinh les theCty fCup'tiva g nst 508 — FINAL MECHANIC 7 liabilities, dgments Is a d expense Which m y m tiny y gain , said 509 — FINAL GRADE City oas,y ence nl t g of th Pefrtut 7 FPpf "f lE DS AM1D wB.L COMPLY WITHAL NON-OINT lO - NA ING G IssueCIR Date ' g ibpntlCon tor.'.:.=� :",i 1 tome<-:�,, Re -roofs .-HAZ DOUS MATERIALS DISCLOS ftE i W II N' applies 1 f 1 making aWorn upa t t or handle le aallo s national Type Of Roof .. _ _ .. _ 3 as f J by the Cu M p I Cod Ch pr 9 12, andum, Health and 5 fely - ' - " All roofs sh .:. a DYs 715532 3 f 'I;. PA F a+1' '„ ' ( °' I � ` x,, ;' ' „ .. _ all be mspected.pnor to.any, roofing matenaLbeing,mstalled... esti m., ppr , ,r unum building occupant _, a equipment pwhich! If a roof is installed without first obtaining awinspectioisTagree•to`remove a..l hav d o m khans a defined by ,h Bay Alma A Quality hi nagerr nl, 'District all, new materials for inspection _Applicant and d well_ comply with ❑Yee .. ::e -g . , e[S an San al] non -point source regulations 1 have and thehazardous comma, s reymrersenis under Chapter fi e,5 of umj ' ,Cal, int Health'& Safety Code; Sections 25505; 25533 and 25534. I unders,and,har ' -jflhebuilding down dyha<amtmnt;that hls my responsibility rd notify the b d y p _ fa'c d(Ipam.of� Signature of Applicant __ __ .__ Date __ __ __ _ _ UC[ a heti mu5[6 1 flat to l5 .an[ . ... _.. _..�.. _- . - ._...._. . .. - _. .....- .-.... .___ _. W