01010076 CITY OF CUPERTINO.
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
RUH.DING ADDRESSPERMIT NO.
10394 DENISON AV LIFETIME POOLS INC 01016076
OWNER'S NAMji: PPLICATION SU U T
KUO WEN A AND NOZAWA 7 MI 910 SAN ANTONIO R aff19/2001.
1,
VIE: (408)738-1576 SANITARY NO. CONTROL NO.
g'00 zp ARCH]'I'EC"I'IIiNGINIiF,R: BUILDING PERMIT INFO
F`Wu BLDG ELECT PLUMB NEED
aI
5- LICENSED CONfRACfOR'S DECLARATION
0 S N 6 I heretw aBim,the,I am licensed ander Chapter (commencing - Job DCSL'fl II ❑
Z i,„ rmabinm%MCha , ) P
k,v_IC7 whn smtiao namnmininiw3,l nha B,I.ine..ana Pror.%dnn,e.de and mylmen,o NEW POOL & SPA
a x -� fall fn Rc A/ �J/)
w w .iccn.e Claret. )3 I,ic.N.I�LK/ �
>are Commcwr
wLL. a, ARCHII[LT'S DECLARA'HON
$ ? 1 understand my Plans,hall be used a.public recoml,
/C
,wi` p O Licensed Pofcsionul /
OW NR R-BUILDER DECLARATION
or I hereby at]!—ohm 1 no eB.,in from,he Cnmmnnr'x License haw for the 7 -
zA?M followingu, alcmitl 7omm ltu, a„JProfis ns Cade Any ca"o only
tra wiort isi'si ru re Isoacc.mnmen,pplicant fur'u,denmlin 1 or repair any p,rcu�mro '
a 3 z rdU l I ",ce l 1, acclaim.,theapplicant f ore 11 rte 1, J C nraen,
n,,,I I rap II d p nhct '(,,pore Sy. Ft. Floor Area ValU Li. a
(ran b hScn ,tANB the
7 10 l IPoll :' _GWc)
or that rte u,31.5 b,here from and(hr pe s fur Ino subjects
the
common.Any v Penalty
nl n'll mn70.1 7031.5 by any applicant foropermiuubjecn the nPPlicam a,acivil revelry
of Nat maree,aa dee I„',area aollaa($500). APN Number Occupancy Type
111.as owner of tie Pirelli or my employees wits wages as their.ale compensation. 31629070. 00
._
will ao aha sena..and the saneuw Is not intended or offered for sale(Sec.)M,,,
Bnsinros;md Professions C(Ac:Tile Conlracr°r's License Law docs in)[apply to anReqqu_ired Inspections
owner of propsr
erly Who builds or impros Barbera.and who ds such work Iii elf 103 — UPER
trough Nis own employees.provided[hat such improvement,art not intended or '
nikrtrl fat wIc.If,uowe,c,,the building m improwili ,sold,ithia one year of 104 — REBA R
completion,the owner-builder will havo,he burden of proving tum he did uaI build ar
impulse humlipnreofmle.). - - 107 — POOL/BONDING
❑La,ow'ne none property am exele,iwly corraling w ilh l wenmd eanl,ocu's to 301 — ROUGH .PLUMBING
1icn....c,therpmjee,(See:71k;_;.Bus and 1'rofus ,Calc:)The Comme,nr'. '
cow Law doe,nm apply m rte owner or liberty who nulla%or nmprews'hemon, 304 — ROUGH ELECTRICAL
and who contracts ror such project,win,a contractor(%)licensed mrsauml to the -
Comraemr'sLuensnLb... 502 — FINAL PLUMBING ENERGY
❑I sun exempt under See. ,R A P C for mismason
Owner Dane 503 — FINAL MECHANICAL” ENERGY,
WORKER'S COMPENSATION DECLARATION 506 — GAS TEST
Ihereby aff,.nmmer penalty orrejurynal following dmlannimii - 510 — FINAL PLANNING .
1 have dad win It namin u cennienno or consent m.elf-in,.m f.,Worker', 511 — FINAL POOL
enmpen.adan, a, pnwided rte by Smao.. 3700 of he Labor Crate for d,° 516 — FINAL BUILDING
ped...lantt of'he vend far which this In.oil is N,ubal.
❑I have and will maintain Worker',Compenmrion hoc unec,uv me rob J by Section
1710 of theLabor Code.for the 1pprriMarmont,or the ework for which Iii.permit i
carni ^
CE I;Oicy barrister am:
IPICATION(1F EXEMPTION FROM W ERS' -
COMPENSA'1'ION INSURANCI?
(IIn. cOxer need no'be oom,plemd if'he permit is for one hundred dolma -
(STW)or -
I cemy that in the pedannance of the work for which this perrel i.turned.I -
shall nil employ my Ixrvm in any manner so res a,become n.bjec, .,he Workers
Compensation Laws of CaliGot ria.Dmn
Applicant
NGI ICE FO APPLICANT:If,eller making this Ccnifi of Emmpnion,inn,jun,
Z Inco...nabj,,, ,, Im Wn k,,,C mynmarion provisions of the lahor Code .am.,,
Z O fonhw ,S
inh comply with,such pro inn,or this permit shall Ic deented,,liked.
F^, L CONSTRUCTION LENDINGAGENCY
a I hereby lot.ha,h this IM1.a i[:I ra„m(S a IenJing agency lin the prrfart,unce
Lethe work rm which this penin,is issued(Sec.3 W).Civ.C 1
C7. z Lender's'N.me
� L Isndcr'n Address.
U —' I ceniy(hat 1 have read this application and nate that the abwr information is
kT. t y conem I agree w comply with all city and county ordinances and%late laws winning
C U toholding convection,and hereby amhnrirr rrprc,entmi,cn of loin city ,,enter urym
} r4 the abn'cmenti.ned properly lid inspection purpose,.
F. P. (Wu)uglcc illoer.inlcuumly and keep Small...the City of Cupertino against
% lianilllies.judgnunls,cops:mA expemcv w'uu'h tray in uny way accrue against mid
U Z City in cunac ucnce ul,he gmming of shin prrmiv
LICA E 'ANDS ANO WILL COMPLY WITH ALLNON�POINT �yy
ouRNs UP�� Issued by: Dale
sigr,awre orAppdeanoeontwru'r nave Re-roofs '
Hans or imme building
ocALSDISCLOSURE
\Vitt the applicant or loom bolllAing urenpum port or handle hazardous nwmriW Type Of Of
as defined by the Caperton,Municipal Code,Chapter 9.12,and nue Health and Safety
Code,.Smlinn 25572(u)f '
Yen ElNo All roofs shall be inspected prior to any roofing material being installed.
Will due applicant or future budding occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
'mit.vend.....air cnnmmmant.a,defined by the it,Area All Quality Management g
order all new materials for inspection. Applicant understands and will comply with
�Y`r [3 No all non-point source regulations. PP
1 has"read the Safety
Cad , m.mrivls 505,25533 a under 4.1 ma 695 ol'thr
filCaleinnill,,,du,ll S I ecl Code,Sec,iale25505.r it n and 25534. it,,nr:ma,nut _
..nuc buildingdnesnm,lon,lyhavono'he ad priormyr,.sne.ilit Clanditse -
um of the nyuircmm�n,which urua M met prior to i%ruunec°Ila Ceniticvm of
or a,
FL!/GR/�4 Signature of Applicant Date''
ser ou anthnd,rd age,,' u (rte ate
All roof coverings to be Class "B"or better
OFFICE