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00080043BUILDING DIVISION PERMIT PHONZ. FABR_IZ'IO TANI nwz N 07wa— z O LfCENSP.D CONTRACTOR'S DECLARATION O Z40 — 0 p I henbY aRem Net I and licensed undue provisions of Chapter 9 (rommercing F:C J with Secdion ]000)ofD' ion3ofthe Bu.inmsaM Profmioas Cox,Wmy lieenseis YZ� in fullforceesdeff od U Limn ate N IDu Con is F a O 3 ARCHITECTS DE E y I understand my plans shall W need u public racci eUcmaed Rofeadmul — _ OWNER -BUILDER DECLARATION G 1 hereby etlmd Nal 1 me .hemp- from the Comz me. Liceme Lew fm NG ❑ following mason. (Sectio 7031.5, eusimae and I'milmimu Code: Any city or county a 3 $ which requires •permit so comtrou" slur, improve, demolim. re repair any eb#.me prior to its issuance, sho requires, the applicant fm such permit in file a signed suumant that he is licensed pununn. Ne provisions of the Cim,mor. Lkanm law (center, 9 (mmmencing withSecilm li-") of Division 3 of the Buddhist and I'mfe siom Cade) m tMmp t he is mu d therefrom end the basis for dhe'alkped exemption. Any violation a Section 7031.5 by my applicant For a permit subjects the applicant to s civil pmeby of not mon Nm five hundred dollars (#500). I, as owsnr of tW irmp usy, m mY nmployms with wages u th.ir sole compereatim, will doth.wmk, ands: abrCmuatroti Licame owdofm apply an Business and ert,Riowho Code1 The Contac rso License Lew does not apply to lf owner h 'property wM10 Wilde or impmvm thereon. and who dues such wntk himself or through his own eme,ar the provided Uro such mens It said w em nm inurhd m oRend for tram.If, however,dm Wil the burimRovement Is sold withina bywofmmple for the pows.f ilxr will have the When d proving Nat W did nm Wild m improve for pro- poseofmle.l ❑ e m owner of ct property, am chdueivoil convecting CwithW :)tensed contractors m centvum dproject(Sec.o an Businessandrty who oro Codas)pri Con evade, red cense law docs but apple je an with a or property who builds or itttprovm thereon, and wmcontracts fm such pr.lecu with acontnetoAs)licensed punuantm Ne Convecmrs .Limnlaw. ❑Ism esemptonder See. ,B&PCferNittessim owner Date WORKER'S COMPENSATION DECLARATION 1 nearby M. under penally of perjury We of has following decimations ❑ I have and will neeinuin a Cediificair ofCumehnoselginsumfor WodersCompen- sidion'as provided for by Section 37W of the UW, Code, for the performance of the for which this permit is issued. I have Lnd will maintain Writer's Compensation Insurance. a requited by Section ] fth9[Abor Cndn,for theperformence of Nc weak for which Nis permit.).sued. My Wohy's Compensation InAratce carrier and Pnlicvmumb#r, (Thissection timed not be corepleted ifthe pc.I is for hundred cadbrs n; 100) Or tetra.) 1sonify that in Ne performance ofted work for which this amoit is issued, ldWI out employ any person In my maomr so ns to become subject to she WOM1en' compen- sation Laws of Cdifomie. Dau Applicant NOTICE TG APPUCANT: If, afar meting Nis Cad ificste of Evemptibn, you should hecom, subject to the Worker. Compensation provisions of the Labor Cade, you must foMwith comply with such provisions or this permit heil be deemed rooked. CONSTRUCTION LENDING AGENCY t I hereby uffiim Nat N.m is a construction lending agency for the perfomtance of r•n the wmk for which this pmnit is issued (Sec. 3097: Civ. C.) E., tin Lender. Name a > lander" Address W Q 1 certify thin I hews reed Nis application end sum Nm she above information is 0+ correct. l agree to comply with all city and county mdimnces and sum laws mbting do U Obuilding com ucdon. and hereby authorize npresenmtives ofthis city to enter upon Ne above-mentioned property for inspection purport. - W F (We) agree on save, indemnify and keep humleas the City of Cupertino against C.) IishiliIns' jW nm.<mm ap sand enms whian ch may in y wrymmmi aeagl mid City ;a,L in conuqu cof Ne gmnring of Nis permid. UZ SPI LIP RfGI11dIt 9TANDSANDWI .I•Co PLYWfD1A1.1.NON-PGINf ' - SANITARY NO, APPLICATION SUB: ROYAL POOLS INC 0 SANTA CL RA00080 N/C CONTROL# 2258 CAMDEN AVE_ E] 08/07/2000 4083718000 _ ` .......... Job Description INS ROUND POOL AND,, PA Sq. FL Floor Area Viluation 356150*5LulZV inspections 103 — LIFER 1.04 — REBAR 107 — POOL/BONDING 301 — ROUGH PLUMBING 304 — ROUGH ELECTRICAL 502 — FINAL PLUMBING ENERGY 503 — FINAL MECHANICAL,ENERGY 506 — GAS TEST 510 - FINAL PLANNING 514 — FINAL POOL 516 — FINAL BUILDING - HAZAKI39111MATERIAISDISCLOSURE. - WilltheapplicanwrfuturebuildingmcupemsdMeorhandle hazard... materiel. Re -roofs w as defined by the Cupertino Municipal Code. Chapter 9.12, and the Hem b and Safety Code, Section 25532(a)7 Yue QNo Type of Roof ❑ Will the hothead or future building occupied use equipment or devices which All roofs shall be -inspected prior to any roofing, material being .mit hawdoo, air comemimme as defined by the Bay Arch Air Quality Management installed. If a roof is installed without I-irst obtaming,an inspection District? I a ree to remove all new materials for inspection. Applicant Ym ] N. g IM1. ,<„�e,n,,,,ro„cater;,,,mgrs;m,,,e„dan,,,e,�Trhpm,b.,SofN.e.li- understands and will comply with all non point source regulations. fo�in x&^afety cox, Sada. 25505. 25513 hod 2553#. I undendand that if Ne - anthoria ge — e-'�� I Signature of Applicant _ Date All roof coverings to be Class "B'4 or better OFFICE go CITY OF CUPERTINO BUILDING PERMIT APPLICATION FORM Building Address: ?J Owner's Name:Phone f -A7 No:� 77--?-? Contractor: License No: Contact:. q � 'Phone No: Architec /Engineer License No: &06 Applican ntractor Energy Add Mialti Building ermitInfo: (circle .on e) Bldg celPlumb Mech ascription: Residential Commercial: q. Ft. Flo4r ArdA: �.. $/Sq. Ft.:-: APN # (Must provide): /s-^_��--- Valuation.® Type of Construction: Occupancy Group: Qty. if Fee 1D Applicable Fee Description Fee Group BTEMPPERM Temporary Bldg Permit BUILDING BCONSTAX Construction Tax BUILDING - BENERGY Energy BUILDING BENERGYADD Energy Add Mialti BUILDING BOVERTIME Inspection Overtime BUILDING BPERMFEE Bldg Permit Fees BUILDING BMITIGAT Housing Mitigation Fee BUILDING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee' BUILDING BREINSPECT Reinspection Fee BUILDING BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING ZADDCHG Address Change IBUILDING . doL EPERMITFEE Elec Permit Issuance ELECTRICAL BELEC1000 Elec 600V <=1000A ELECTRICAL BELEC1001 Elec 600V >1000A ELECTRICAL BELEC200 Elect Svcs 600V <=200A ELECTRICAL BNEWMULTI Multifamily Res ELECTRICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL - BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rcptl, Switch &Outlets ELECTRICAL BRENIRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lghtng Fix ELECTRICAL BSF&2FAM Single & 2 Family ELECTRICAL BTEMP Temporary Power ELECTRICAL BTEMPSVCS Temp Dist Svcs ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL BAPPLOTHER Other Appliances MECHANICAL BBOILER1 Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler >100Kto500K Btu MECHANICAL BBOI.LER3 Boiler >500K To W Btu MECHANICAL BBOILER4 Boiler>1 M To 1.75M Btu MECHANICAL BBOILER5 Boiler > 1".75M Btu MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BMNEWMULTI New Multi -Family Res . MECHANICAL BNINEWSF&2F New Sf&2F Res Bldgs MECHANICAL BREMACOVER Ac Unit >10000C -fm, MECHANICAL BREMAIRHAN A/C Units <= 10,000C -fm MECHANICAL BREMFURN Relocation Of Furnace MECHANICAL BREMFURNOV Relo Furnace > 1 OK Btu MECHANICAL BREMINHOOD Installation Of Hood MECHANICAL BREMRELOCA - Relocation Of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL PPERMITFEE Plumbng Permit Issue PLUMBING BNUMULTI New Mulifamily Res PLUMBING BNUSFD New Singlefamily Res. PLUMBING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool- PLUMBING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPREPIPE Repipe Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRIN.K Lawn Sprinkler/Back-110 PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt Of Drain & Vent PLUMBING BPWATER . Install/Alter Waterpip PLUMBING . BPWHEATER Water Heater/Vent PLUMBING BPWS.VCS IMain Water Service IPLUMBING