02070143z
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CITY OF CUPERTINO
BUILDING DIVISION
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BUILDING ADDRESS:
10279 DENISON AV
SUNDANCE SKYLIGHTS
ERMRN 82070143
"'N82070143
I LV
orN 1W E:& GLADYS WONG
10585 FOOTHILL AVE
APPLICAT61 spB,DAly2002
V / / L `4 /
PHONE
(408)842-9540
"(408) 842-9540
SANfrARY NO. CONTROL NO.
C ARCHITE=ENGWEER:
BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
•
U C_I
LICENSED CONTRACTOR'S DECLARATION
u Ihertbya)ofDiatia3ofc
[1037
2 SKYLIGHT & LTI��II
eBusincrprvisionsofnsCMe.(commencing
with Beedov ]0001 of DidsionJ of Ne Businc xsions Code. and myli<enx
IS Iafull( e
p
LI'anx Cl i LIO^
_ D le C Iraclw
A DECL ON
n
/ (���
<
I ono "A', he
au d y plans shall be used as punh rtcords
D Lrcenud Prafesslowl
Oat I am eULLDE from the RATION
1 hereby .(Brio that 1 cam exempt from the Contractor's a law for the
e: Any
Professions Code: Any oily w s'oonry
following moon. (Benton 70313, Bmhcr.
4 000 O O
lend ve. d
] which requires a Dennis to c-nsmue olur, improve, demolish, or mach any usuctum
rw such file .,Au,u
g -arra- iiia
nqo ase Novisio
as d pumso
ontracmiuo
- Nm nAAmci en$d puArIi to 00 provisions 3 e Contractor License LAW (i.. Ctm 9
s o icense AW (Ch pray 9
QfDivi5ion3ofineeu5ine:5u,errgret5iol>:cnael
��- - --'-'-'" - -- -......
s' 3a Valuation
•'" '� �.
orammeeeinBwiNserlion]Bml
-nhm he is exempt ihercfrom an 4 the basis for Ne allc eil exam violation
g anion.a cY
, "' 1 Vit'' a ..1 ' l'a .n :. : '. :
`' '
-of Section ]OJ 10 by Any -panto l
a pcmdt mblms the applicant m a civil penury
carte-(m-rcN:nfiveh-ndrcae-uma(ss00).
llars
PN
1 Occupancy Type
❑1--1-watt of the propery,ver my employees with wages as theirsole eompenxtim,
-the
102 - PIERS "
will do work, and the sumhoa is not intended -w dRcrea far sale (Sec. ]044;'
-arid
_
Ur Required Inspections
Business Prorcauions Code: The Contmao,a License Law dtts rot apply m an
owner who
or property Wilds -r impmrcS lherton, and who does such work himself
104 - REBAR
or NI -ugh his own employees. provided that such improvements ere not imcnded or
w.n. d for care. If, however. the Wilding or improvement is sold within one year of
10 5 - -ANCHOR BOLTS
completion,the -water-Wilder will have the minden or proving that he did not Wild or
improveforpuryozeorsale.>.
106 - SEWER & WATER
_ ..._.af _...... .........._.._._..._ ... _ ...._..
❑ 1. u owner -f the popmy, vat exdusivelY ronlrwting with littnsetl conwnws m
_ _ __....202.._...UNDERFLOOR...PLUMBING._-..-..__... -._... . _...._..._ _.........
a --awn the project IBce. ID44, Baaimas end PmPos:ion: coee:l Tna e-mlteamr i
' L"erue law tl-ea not apply w w owner of pmpeny who Wilds w improvm Iharcon,
2 03 - UNDERFLOOR MECHANICAL :: '
_ and. zvho rmuvcu tor. wch pmjeeu.wiN a antrwtogq Barred paruunt
....2.0.4_._-_ UNDERFLOOR.. FRAME-.-_,,..._
Contmclors Licwu Low.. .,, .... ..
❑Iemeaemptundeisec. " " ggpCfwNisrtawn
_, .._....._.. ...... .....___.._.____.
205 - UNDERFLOOR, ,INSULATION
Ownar isfete "
3 01 - ROUGH PLUMBING
WORRER'SCOMPENSATIONDECLARATION
302 - TUB & OR SHOWER
IhiAffirm under penalty °fPadui)`due -rthe fallowing d«Iemtion5:
303 - ROUGH MECHANICAL
j ❑ 1 have ante Mil-maintain'A Certificate of consent to elf-inama for worker"
304 - ROUGH ELECTRICAL
c°mperoatim'ea pa°vidm rot by Section 3700 of Ne Iabw Cod, for thA
perfomuntt of the work for which this pc5mit is issued.
3 05 - FRAME '
❑ I hav<A win"mamilla w;akor•a Compensation'Insunruc, as riquirM bin Bastion
306 - HOEDOWNS
n0o of me Iabw case rw vela perfo mance of tha work r r Which this Q<,!mh is
307 - INSULATION
.sued Myw kat tom save Insmnce euner nd Po,! ,aey
PoIgN
308-_- SHEETROCK _..
'CERTIFl TION OF IXFMPf10 OM
_
3.09i`;'.EXTERIOR'.LATH -
COMPENSATION INSURANCE",_,; _
310._ -_ INTERIOR..LATH_...----_..____._.._....._
..'..tali.�tio'nl�eeaA.,W�amplatadinhePermitisrwon,hundreddoe.rte
.._...
311•. i'- SCRATCH COAT
(SloO)or less.)
....: •_.:.' , '_ . .._ ,
...I that in Na pr drc work for whirh NIS p[m1111515aYtd, I
..• ..
313-_=.ROOF•,NAIL "...".' - •._• .. -... -_..._ ..-__.
5
shell nor employ
employ in Any ma n
person in any manner w ss m become subject m Ne Workm'
t to
01 - FINAL ELECTRICAL ENERGY'
W,
Appicn5aiod LAW, of California: Date
Applicant' " '
502 - FINAL PLUMBING ENERGY
503" - FINAL MECHANICAL�ENERGY -'
NO]TCETOAPPL1CANf.If. after making this CrniHeamof Exemption Y--ahomd
P Labor mull
became subject eWorker's Com nsmionProvisionsn8+g�nrY
foMwith toter N such permit shall be deemed rev -e ' you
comply with provisions or this
_ ked.
504 - FINAL BUILDING ENERG?t'
' CONSTRUCr10N LENDING AGENCY ��
5'05'= FINAL ELECTRICAL
for the peg
0 1 hereby affirm Net then Is a construction lending rfomuine
fNe woh'fw which Nis It i5 i5anm ser. >,o9,]_civ. C. � � -�
( )
506 - GAS TEST
�"
_... ..... .. :.:.
nag4rndprdss., •
.. . .507-- FINAL PLUMBING - - -
""
I certify that I have mW this application veld more Nat Ne above information is
508 - FINAL MECHANICAL"-
mince I Agree to comply with All city end I...11 ordinances and sure law, rtl. ing
509 - FINAL GRADE
to Wilding c-nstrunion. un
and hereby 3mre rtpnsenudw oftles city to enter upon
Ne above-mcntionW pmperry for inspecdoq puryous.
510 - FINAL PLANNING
M'e)agmetb cast, ammmifyendkeepharmisstheCityefCupeninoigainu
esu
• liabilities, judgmenu, mtl .,cA which may is any way accme against said
514 - FINAL PUBLIC WORKS
city int eomuguena or Ina grail .'Ir'gf inn pamliL - •. -
APPLICANT 'DE $A,\D C L IMPLY UT ,ALLNOti-PQf,NT "
SO D
ISSUCd
C/
2
by:
Date
hare of App cav uutor :' .•' ,. .. .r. Dau; -
RD6U5 MATERIALS DISCL SURE " ""^
Re -roofs
son me,pp
^-M�- WC occ pwtstave rhendle harurbus mumu
as definM by Nn pe pal �pde Chepl 9 12 and the Health end Sarcry
.Type of Roof
C.d.Smtlom 25532(.).
r
❑Yes 6M-'l�..r
«
:. .. r'. ..'
All roofs shall.be.inspecte'd.prior...t,o any, roofing material being installed...__
I Wi11N Aparcwtorfuun W Idm pat sea Air Quality
ten hazardous ver contaminants u define by the Hay Arca A it QuaiuY Mwayement
..
If a roof is installed without first obtaining an inspection,, I' agree. to remove
District^ ll1C _
oras',
all new materials for inspection. pplicant understands_ and will tom I with
p y
•
"I have ad Nd heaudou5 materials rtquiaeimmj Chapter
all non -point source iegulat1 S. '- "
wider 6.95 of Ne
California Health A Safes Code, Sections 25505.25533 and 25534. 1 undersund Net
y
If Oe building does as c.renlly have• sol. in it is my rtspomsibilily to Amity Ne
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9Zcupam of e rc hit m mel prior io issuance of a amficau of
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g ature of A I nt ate
All roof coverings to be Class "B" or better
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