00100118CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
,
BuaDINCADDIxegL:1830 EATON PLACE
REDWOOD.PLUMBING CPJRMfMt
00] OLhi 18
W"ER's'NAMB: LEE, DARRYL
1590 TACOMA WAY
APPLICATION Stfh ftI'E 7/2000
1-
ONE -
(f,50)369-1%93
SANITARY NO. CONTROLNO.'
ARCHITECT/ENGINIiEIt- -
BUILDING KRMIT INFO
BLDG ELECT PLUMB MECH
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=1 Itle I=
LICENSED CONTRAC'TOR'S DECLARATION
lob Description
I hereby,tffirm that I ma becnced under provisions of Chnpm !) (commencing
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w101 section 9oanor Dmisinn3onnr Bmmesdane Professianw c,dr, enemy bund°
'•ADD ON 2 1/2 TON A/C TO EXISTING.SYST
toll force and e t
License C
us OO Contractor
.. ..
ARCHITECT'S DECLARA
1 ondemmnd to, plana shall the uueA as public rccunL
Licensed Profe,ame l
DECLARATION
OWNER-escor
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lflfrom
I hereby unn mm I um exempt t IMm the Cnnmacnn:w License, Lew for the
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rcuroa Co d,:Any city nr aunty
..
whichlre
which requires a permit ca constmct,,her, improve, detisr
permitconstruct,rte, demolish, re,adranyd
nm, file dlaicmre
prioraillcensed e,alumrehiresthe,pplicanl for suchpemrivoIliaa
'
S9, Pt, Floor Area
Valuat
,hmheleciagwilpSectio malapl the Law (Chapter
tractor vBusiness
with Section invi ion he and Professions Coo)
naw Coee)
of Division 3 of the Bas,ad rad
Rt
t$G650.
., that [in
or Shot tie ix nit w
rote dw basis for the exemption Ary violation
Ar
Curry
atom
e,'halleged
of semina 9031 s nr atny ttpplicum lace permit danieeta tee appbram to a civil pen,
31.5 blurry
ora., mom da Five hundrge dollar,, (x500). -
APN Nyg,lk j�r91
Occupancy
Occupancy Type
❑ it, mmpmy
1, is mv, of the property, or my employees with wages as their vole enxation,
f :'2` 00
e
will du the work, and the sou sure is not intended or offered for sale (Sec. 70,14,
I
KjM til
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Bmine.da and Pariesdoaw Coda: The Cenmbelm', License Law fines not apply a an
owner of property Who builds or improves thereon, and who dcas such work himself
204 — U�� nAME -
or through his own catployeas. provided that such inlprovemems are
e not Intended or
offered for sale, u', however, the building or o prowemcat is sore wlfdn one year or
' , -
3e, 1 — ROUGH PL LMB I NG
imatectoa iIleo owner -builder will have oro burden of proving mai he did not build or
mprove lot pmpadeorsde.).
303 — ROUGH _MECHANICAL .
0 ],;is owner of [he jactiany. am exclusively contracting with licensed contractors to
304 — ROUGH ELECTRICAL
L,muc, the panjmt (Sec. 7044. HudInes, and Pmfecdiens Code) -The Crmtraaor',
icense Law does am apply to an owner at property who hailds or improves bacteria,
505 - FINAL ELECTRICAL
and who contracts far such projects with a cantor tmly licensed pursuant In the
Cantracmr'd
507 — FINAL FI_LIMB I NG
License Law.
D l eon axcmp, muter Sec. ,B&PC for his mason
•.
508 — FINAL MF_CHAN.ICAL
Caner . Date
7514 — FINAL, FIUBLIC' WORKS
WORKER'S COMPENSATION DECLARATION
,
`, I hereby alined tinder penalty of perjury one of the following declaration:
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D I have and will mainmin n Certificate tilComm to selbinsme for Workeds
'r
Compensation, as provided for by Section 391111 of the Labor Code, for the
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peHonnmtea of the work ter which this perm,, is issued.
D I have anddMll mainwln Worker's Coanpen... ran Inxt.mnd, ns required by Section
3700 of the Lobar Code, for the performance of thr work for which this permit is
issued. My WnrkarSI �Com call/lJ4/{an I itmto, c,rtierra/rd Policy nw b(,e.[,:
��✓
Cm,a, V Policy No:
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CERTIFICATION OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
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0his section tired not t c congdcted If the p ora is for one hundred dolbns
($100)or less)
L certify but in the perfnrtnuam of the work for which Chiu permit Ix issued, 1
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shill not airplay any person in any manner so as m became subject ,o the Workers
Compemation latwx of Cmlfnrmia. Date"
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Appllcmnl
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NOTICE TO APPLICANT. If, after making this Cenificute of Exemption, you should
becomenuhjc,t to the Waketx CompensnlionProv n.sof the Labor Code, you count
io
fonM1wllb ,imply with such provisions Fir this permit shall be Jamul revoked.
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CONS, RUCHON LANDING AGENCY
I thereby union 'bar rare is acunctractilm trading agency Raritan performance
of work Ib, which this permit is issued (Sec. 3099, Civ. C.)
lender's Nanta
Leader's Address
I certify that l have read this aliplic aio..,to ,a,, that the above nourrom ion is o
car ecu. I agree m comply wraith city and county ordinances and state laws relating
to building conalruetlon, and hereby authorize representatives of Cbl+city to enmr upas
the above-mentioned property far inspection pu0roces.
(We) gave save, indemnify and keep larhdrx, the City of Cupabli against
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libilifle, ju Ibm ,x, c , tJ cxpeme: hick may 'a any way arerue against said
City I co' g nun I
'• rot
APPLICANTI COMPLY WITHALL NON POINT
_
Issued by: 77
sourscF 'u
Date
/D�11L A)
Re -roofs _'
s. t Appl ant—Ilsiar
H LAR1lOUS MATERIALS DISCLOSURE
Will the applicant or furore building occapunt dale or handle hazardous material
Type of Roof
as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety
Cotte, Section 25532(x)"
r
El yes ° No
All roofs shall be,inspected prior to any roofing material' being installed.
-_ Will thea pllcant or future building aenapan, use equipment or devices which
mammon P
If a roof is installed without first obtaining inspection, I agree to remove
g an P g
ctnit Fir ennt,alJnamsmdefined by me tiny Amer Air Quality Maaaagemcm
Okiriell
ON.
all new materials for inspection. Applicant understands and will comply with
DYcs -
all non* point Source regulations. -
1 have rend the huzod,ma mntttlale m,nommems under Carrier 695 of taw
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California Health&Sm-ly Code ScI c25585. 25533"125534. I mdromndahal
fah hm1dm,dor' ren,lyh runt. thin i, ie my rexgmsibili,y la noJl'y the
occupant of Ientd ul h met prior tit lewuance of n CoriOcvtc of
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o«'spat
Signature of Applicant Date
All roof coverings to be Class "B" or Better
tam ;
OFFICE
CITY OF CUPERTINO
I 1 of 1 BUILDING PERMIT RECEIPT
Sec: Twp: Rug: Sub: Dlk: Lot:32619122.00
DATE ISSUED.......: 10/17/2000
RECEIPT 4.........: 13739
REFERENCE ID # ...: 00100118
OPERATOR: Christya
COPY # : 2
SITE ADDRESS .....:
21820 EATON PLACE
SUBDIVISION .......
CITY .............:
CUPERTINO
IMPACT AREA .......
OWNER ............:
LEE, DARRYL
ADDRESS ..........:
CITY/STATE/ZIP
...:
CUPERTINO, CA 95014
RECEIVED FROM ....:
TIM
CONTRACTOR .......:
PARCELL, ALICE V LIC # 640
COMPANY ..........:
REDWOOD PLUMBING CO INC
ADDRESS ..........:
1590 TACOMA WAY
CITY/STATE/ZIP
...:
REDWOOD CITY, CA 94063
TELEPHONE .....
...:
(650)369-1793
FEE
__________
ID UNIT QUANTITY
_____________ __________
AMOUNT PD -TO -DT THIS REC
NEW SAL
BREMAIRHAN
NO.UNITS
1.00
__________ __________ __________ __________
8.33 0.00 8.33
0.00
EP ITFEE FLAT RATE
1.00
35.52 0.00 35.52
P
TFEE FLAT RATE
1.00
0.00
TOTAL
PERMIT
---------- -------0--0-0 ______0_00 _____35.52 ______0-00
79.37 0.00 79.37
0.00
METHOD OF PAYMENT AMOUNT
NUMBER
CHECK
79.37
5204
TOTAL
RECEIPT s .s 79637
VOICE
ID DESCRIPTION
VOICE ID DESCRIPTION
2042
UNDERFLOOR FRAME
301 m ROUGH PLUMBING
303
ROUGH MECHANICAL
304 ROUGH ELECTRICAL
505
FINAL ELECTRICAL
507 FINAL PLUMBING
508
FINAL MECHANICAL
514 FINAL PUBLIC WORKS