02020063 CITY OF CUPERTINO -
BUILDING DIVISION PERMIT' . CON'T'RACTOR INFORMATION: ,
BUILDING ADDRESS: PERMIT NO.
20910 ELENDA DR CTM CONSTRUCTION 02020063
M\'NER'S NAME: APPLIC niON SUB DATE
WALLY J. MONROE 2308 WALNUT GROVE AVE 02,19/ 2002
HONE:
(408) 554-0198 SANITARY NO. CONTROL NO,
C ARCHITECT/ENGINEER:
FOO❑ BUILDING PERMIT INTO
L U BLDG ELECT PLUMB MECH
In a c L_J E I L.'I IJ
�2LICENSED CONTRACTOR'S DECLARATION
0 n C Y a pravisians of Chapter 9lcommcncing lob `ate
a= 1 hcrzb (firm that 1 am ofdbc d ural lT u.41
yt; with Section )ofDivision3ofineBus'tny(sandProtessiltnzCade.and mylicense
ADDITION
m a 1te1 7 2 2003
�c, b� Lion 19 JAN 2'
0 6 U Con
C / "� `"TRCHITECr 5 DELL 1
`, 1 undnsuntl my plans shall be uua es pub ie mems s g^
00 Llcenud Nofe::ir.nal a nuDING
K.E OWNER-BUILDER DECLARATION ®`/
1 hereby affirm that Thal 1 am cumpt from the Committal's Licensc law for the
t 3 a following reason,(Section 10313.Business and Pmfeoions Code:Any city or county l $125000
Y�p which requires a permit to conswm,alter,improve,demolish.or repair any structure
n3� pati oiuivadPOsotequireslhev'ilonanlf«welt pcoisLilnsig«d
(c.i he i ted pu ba no the 0f v sof the Contracmrs Llcenx law l ns Cold 9 _ _ -
ci,ms's, }.� �.a� .. ..--...._
.1 that eneg with anon"Iriand the sisoof the Bul«ssantl Prof Any violation � ', ! 13 0•JU(�S'L'r,'lY�'-` ( + � , Valuation
or ch1 he r exempt Iany amp and the basis for the alleged dempt on.Any.penalty
-of Senior 10J L5 byany applicant for a papa(subjau the applicant RA carat penalry-
IaraotimarethanB.eWnareaeltnlsasode.
10 1APN NNOLYNDATION Occupancy Type
❑I,as owner ofthe propany,to my employees x ith wages as their sole compcnsmioo, 1 02 - PIERS
will'do the work,and the suucure is not intended or off<red'for"tree"(Seem 0014,-
•Bminaand PraressionsCame:Th.Contractor sLicense Law does no,.,IVtoan 103 - UFER Required Inspectidhs^^
owner of progeny Who Wilds or improves therrnn,and who d«s such work himself
or th h his own pl)a provided that suchimprovementsa d intended 104 - REBAR
off.o f r kele tr n me Witting oimprovement s told -m o= .__...._. _. _ _ - - -- --_.
Year of1-05----
..._.... .. .,_-._.
completion.the owner Wltlar will have tW Woken of prosmg that hcd Enot bads or 105 - ANCHOR BOLTS ... ..
impr..emrparpalearsale.). t 106 - SEWER & WATER
._ --"- a -- "--- --- _... - it-
❑l.nawneronna r,am Business
= - propar reontrae,mgwhnR«mxdemymalanro 202...----UNDERFLOOR.. PliUMBING m-__;":;�_ ..�;•,:n -
conswl the w does
(Sec.IDM,Business andpoa oly who
Cade:)The Con,rareon,
< - = u=emleLawa«altla 1 t 203 UNDERFLOOR MECHANICAL=-' r ' "•'t.
_ PP Y a an owner of property who builds or improvn(Wanton, - r ..
--1 and.wW c«vacu.fom such.prejecu.wil.a.con4aclWfQ licensed.pamount.lo-the_ _
2'04--- UNDERF-LOOR--FRAME
--------- -=-=-------..:"__.
- P Contractor's License Law., „ ..___..___...
- � ❑lam exam (antler Sec. ' B&PCfor this rcawn 205 - UNDERFLOOR'• INSULATION
G
amoat= 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION f ,302 - TUB & OR SHOWER
I hereby affirm under pawlly of pe'ja;ya,c Mfiner.1Iowm,d.I.rmimn,:'- 303 - ROUGH MECHANICAL
{{i, ❑ 1 had=mid will malalma�a'Cemicitte of Come., 10.1f ime.far Workar's
'It C 3 04 - ROUGH ELECTRICAL
peas
atii providad-for by Section 3100 of Mthe"Labor Code:for'IW
_ Performance of the work for,which this Permit is issued, 3 05 - FRAME
0 hi w still mai.iin won - CmpommmaIsmice,.s required by 5ecfioa 306 - HOLDOWNS
311p of the Labor
E T CATIO OF E%EM ION FROM WORKERS thismunce of dic"imck'fiar which INSULATION
far the
issued.My Wok C pensau 1 Tone e d Is umbo are -
x .., p u9f 11' u f__ 308 SHEETROCK ..".. , _.:..
G�Tie 3 E u Polre ?A/ b.� l
�• .. COMPENSATIONINSURA,hi 310 INTERIOR LATH
I 309 EXTE
&I OR—LATH
fIh s u1eed n e campl<tcd f the pemul is Tar one hundred aiders ( 1 .•..-... .-.-_•_'
sloo7ar!<s>.) . t b 311 - SCRATCH COAT
-.1..'.r14<mrymtin' m=arronnac r1a arm which this 1 '__._.'-'31-3--_._ROOF--•NAI•L-- ._
a saedl. 501 - FINAL ELECTRICAL -ENERGY _
_..-_.
h ll act ply ypa on y an iso as t be omgr.6311 to 1fie W n
Comps t o la f C l fo D I
NOTI°' - --- -502.-- _FINAL_ PLUMBING ENERGY...,. __.
NOTICE TOAPo the Work If aft Making this C mfc I the rapt y he Id - - - -
bcdomasublctrotheW here 503 - FINAL MECHANICAL ENERGY -'-
Z pe t o provisions ns of the Labor Cotle you must
z p mrnwm a ply m rpm arm permit snuxa a kd 504 -.----FINAL-BUILDING. EN_ERGXI
'- 'CONSTRUCTION LENDING ADEN CY 505 - FINAL ELECTRICAL
a y 1 hereby aR. that d rt u i co swat t Ind g v6 cy fo the perfltrnw ce' - _ - -
onnb orkf hdhchisparmt s uuLicce(S c 3091 c V,c) 506 - GAS TEST '
p ,Z Laver Andre - -- -507 -`FINAL; -PLUMBING
Up 1Ij l rifyft,lh artdthis vppl chi and 11.1111 he uW info to is 508 - FINAL MECHANICAL '"
orre'1 1 tilloce m ma ply Oilh 111ty.end....ly o d nc as and state Iowa relating 509 - FINAL GRADE
to building consau<1pn.anl hereby amhonie mptesantaures of this city to enurupon
>a.w he iropori,far Imperil On lemse a 510 - FINAL PLANNING
E~ G (W)agrtdlo.cra nandee oty andp,r., hihamayinanCay way id aiunst 514 - FINAL PUB IC WORKS
h City in cams cl nu,f the ran opus which may a y way ace again1 said
V Z City in conse_quenee of the granting alis palma '-• ".�.. C+
APPLICA, USD RSTA4D5'AND R'ILL CO\IPLIY\�ITN'gLL\0\pljL�'r o' 1
5
CE Gi n ef. -c.,t Issued by: Dale
Sc pelican on mr
+ ' HAZARDOUS MATERIAL$DISCLOBVRE ii„' Re-roofs
;!pall the'is 11 ail1 ar flicami bedding occupant store or handl hauNltm material . Type Of ROOF;
ss daft d by the C pemno Municipal Code.Chap, 9 12 and the Health and Safety - — -'
CodeSllon8332(e) y•c .. v ,1. :
Oyes ti,:
..All roofs.shall.be inspected poor to.any..roofing.material.bemg.mstalled._..___.
I, III the� 1canto , w Wddn ac ant x '
1� Pp _8 D i. pine 1 Tae.les which If a roof is installed without fust obtaining an inspecnoni-I agree--.t&remove _
mi hawdous a co,em tins defined b5 l B y A qtr Qual ty Managamcnt
( `tri,"oY 5'�N - - .-all new.materials for inspection. Applicant-understands and will comply with,
all non-point source regulations
;_1 M1 c read the hanrdo t materials requirements 6dei Ch ple 6 95 of Ne -
California Health&Safety Code:Seedons 25505.15533 and 25534.1 undersand that
:r Ott W Id g don-m WrtentlY he e e tenant chat a MY m1po Ib I ty 10 ow,f he
fihe
Da - u h ch u t be ran p ,o suers of C n f<at'or
of th i qu
T
Y A ..
Signature of Applicant - Date
o,n<ra t r„ agent I a
Data All roof coverings to be Class "B"or better
i� - - - -..:..,- ---'OFFICE - .. ..-. ._. "....
r .