00090033 CITY OF CUPERTINO - .BUILDING DIVISION - PERMIT CONTRACT"ANF" TRNN ING '
❑UILDINOADDRESS,,.' - - - ,514- -' FINAL PUBLoQk1W0RKS
OWNIiIt'$NAME: _ APPLICAI9UN SUIT UAI'fi -
PHONE: SANITARY NO. CONTROL No.
n n
M-O ZO ARCHII'ECTVN 'R: 41)
BLDG ELECT PLUMB MECH
Z N: LICENSED CONTRACTOR'S DECLARATION - ]Ob Description .
Z— 1 l, b)alarm tl t 1 h d t J pr I CI pt )( cncing p
F,�.�.41 wthS t 7(mrofDi 1 ftl Bsi II f.'' :CJ ylicennc "?>f
FYI= ',m fall f ernl effect
c —LillineCl J Lir p
G Dam — ted Cn .,i
3 u ARCHI'I ECT'S D6 ARATION
1-lie 1 d t d ypk .h la h rod,
CC Licensedl nal O^ HALL RtaTH 'REMODEL
°'a.W o i ON NER BUILDER DECI cNATIOON -
m—m 1 M1 by aft roe than exempt f thecontractor's t L L for the
�ZQ fdow% ga (Section 70JI.0.Busnrs, dle.demolish.
or AyclytoCnny
2 C prix i requires a permit n,consW<L alter,itnprnvc,dcmolinh,nr repair any stmnurc
3 Amort , issuance, is requires the applicant forsuchCannot u fleasigned st to tont
Nath I I, t the mo—mmoNhe Coumuclua,Lioness,Law(tJ'Im,9 Sq. Ft. Floor Area 1jua[io -
berm g with Station 7000) 1 D' t: n I f dw B nuc I I re C del Ll
or that he is exempt tharnmm and the basis for the alleged exemption.Any violation
of Section 7031.5 by any applicant for a parrea.senicels the applicant m a Civil penahy ..
If aa,more than uve humid,ed dopa sT$500l, APN'NumbeF : . Occupancy Type _
01,.,,,.act al propcn,or no,employees-w-III wages as their .IC compcmmion. -
4 will do Me.woik,and the mrunure Is not Intended or offered for sale(Sce.7044, . - -
Business and Pmresimas Code:The Contnto License Law does not apply to an T •.Required Inspections
owner of mcpso Who builds or itnpmves thereon,and Ishii ams such work himself
or through his own nmpl0yees,provided tout act haprob,reco s am not immnded or
offered96r sale.1r,hsw`ever.the building m'tmprouann nt i,cold Wrlm one youror 3264501 8: 00 -
completion,the owner-builder will have the hurden of proving that he did not build or
improve for pm m,e of sule.).
❑Las rrnneprrperty.a selunivelYmntmrtmgwinilian>eJatmramurs,o 1.01. FOUNDATION
consruct, he project(Sec.70W,Business and Prof cs,are,CAdgd The Clat menu s1 02 — PIERS, -
License Law does not apply to an owner or property woo hddds or improves theraon, - - -
and who contracts for such projects with n entim es) licensed parsaant to the 1013 — UFER
Contraceor's License law. I -
°Laa,common apCmSec. .Iifor iiefr;mix reason ."' . - 1.04 - REBRR
owner Come ' ].05 — ANCHOR 'BOLTS
WORKER'S COMPENSA'1'LON DECLARATION -
lthereby anirtn tinder penahyofperju:yone ofthe fuuu„ingdeemrations: 7.0E — 'SFIdER R• WATER "
❑ I Lave and will maiothin a CemTtaaa of Crn,ei toelf-n.,un,for wurker's 202 — UNDERFL`OOR PLUMBING.
r
•Crtopermlic . a, mi,ided or by Seedun 3700 of the Late Code, for the - 203 — UNDERFLOOR MECHANICALpemarre nm of me look for which this is mtit is issued..
❑1fro,and will lrminalinWmkcraCompen,alumImmerse,',recailedbySection 204 -• UNDERFLOOR FRAME
37W of the labor Code,for the pe mm once of the work for which tb,tenni,is "' - 205 — UNDERFLOOR I NSUI_AT ION
I
„ -
acll My mp
ket Cuer.aril.Insurance Poll, 301 ' — ROUGH PLUMBING
artier: Pahcy No.: ( by 302 — TUB R., OR SHOWER ^.
Cii T lCAl10N OP IiXLMF'I'ION ' M RKERS'
COMPIiNSATION INSURANCE ... - '
'This senior need not he completed ifine t is for one hundred dollars 303 -- ROUGH MECHANICAL'
(
isloo)one,,.> _ a`mi 304 ROUGH ELECTRTCAL _ • -
1 stonily the in the performance of the work for which this permit is is,ued,I - 305 — FRAME ,
,hall not ano any Acton In any manner so as to became subject ,,Ne WrrkmY - 306 — HOI_DOWNS ' . .
.
Cormemal Lewy of California.Dam
Applicant
,
ppl ca - 307 INSULATION
: ” '
NOTICE
TDAPPLICANT 11 after @Certificate
k'ng . nf Exemption,you should "' ,
became,N)eanr tire Worker Ctuaper�maaa potwi,ion,Nme Labor Cuee ylso Com 308 — SHEETROCK' '
Z,2 I't rthwr Comply will,Inch powision,orth'perml:hall he dmmW revoked
F m CONSTRUCTION LENDING AGENCY 309 — EXTERIOR LATH
I heresy allirm Nat them is n construction leading agency for the fnnnm¢e
C4 ''tnhework frrwhmnthisPermdlsbsued(Sce,3N7,CmbC.) °" - .310 — INTERIOR LATH _
a a 1`mef''Name 311 — -SCRATCH COAT
lender's Address t
U 0 I eenfly Nat l hoo read misapplication and stmto that the above information is 313 ROOF NAIL
Cz E.. Correct I agree t Comply ll, II city nd tYordinances u d am law,relating
U mbtJd g' t toe II eby, r' P ti .ill tli:aty¢ mrupon i �\ - -
�] the abo ro t n<J pereperty f r o ryo D A l J r
(.. 0.
(We)agrc t v d ly ke hamdc,s the City f Catania.ugairot fa/��•YD _ ,
y� 47
V1 Imhiliticn,jndgmenu,eosin t exp C ouch may in any wry accnta agaimt said
U Z_ City in consequence mein I't,.permit.
APPLICA
UL 'N NDS ILLCOMPLYWITH ALL NON-POINT Issued by:
501 — FINAL ELECT RICAID&NERGY.
Signature of Applicam/Comm" Date' Re-root,;
HAZARDO 'MATERIALSDISCLOSURE � 503 — FINAL MECHANICAL ENERGY
Will the I,p0oam rf 1 a tuning«ntpant store or hnnme nmtm,
a. dor, terial Type of Roof
as defined by the Cupertino btu a'i al Cala Chapter 9.12,and the Health and Safety 504 — FINAL BUILDING ENERGY
Cele.Section 25392(a)P
eve, El No All roofs shallbr2��07tn�pecte�� ' i 4o'tdt�t3{a�rial being installed.
Will the applicant orfutare building occupant use equipment or devices which If A roof is In StalllrD'vahonGt t cTlga n an inspection, I agree to reove '
Chavardous air contamlnints a,defined by the Bny.Area Air Qunlay Mmwgenunt g p g
m
District? all new niateriaf5N inpdEtIdNRJApjRhA ffiT%Kiands and will comply with
°Yea 11 No all noirpoint sctt]@p]regul0F11lAL. MECHANICAL_
I have read the eta orae.Sections
2 rcyai25533a•ami"tor 4.1uChapter e.93 ,1fir509 — ,FINAL GRADE
California l{euhh&Safety Cnde.Sections 25505,25311 end:5574.1 understand Na
ifthe building does not C case ateran6 tont it is my responsibility to nmify'Ne
acumm A the mop,en con rase.I,c trot prmr m I,etnmee rot CemOcate art, ,n S 10 FINAL PI ANN I N ,1
'occupancy' - Signature of Applicant Date
ncrory ,ed
mmmia nt
OwDate _ All roof,coverings to be Class"V' or better
K t