02030113 OF
CInut
BUILDING DI ERTONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10533 ESQUIRE PL 02030113
OWNER'S NAME: APPLICATION SUB DATE
�TAAS CHARLES J AND ELLEN J 03/21/2002
iA HONE: SANITARY NO, CONTROL N0.
❑rc Z ARCHITECT/ENGINEER:
m O O_ BUILDING PERMIT INFO
z.
,cub BLDG ELECT PLUMB MECH
w i LICENSED CONTRACTOR'S DECLARATION Job Description
Z h C I hereby aff m
at I am licensed under provisions of Chapter 9(commencing OSC❑p
at with Section]OW)of Division 3nthe Business and PmfesmonsCode.and pay license REPLACE CONDUIT & WIRE TO POOL EQUIP
c x E-i Is in full ponce and effect.
_zea Danseaa°° Lie.# NEW POOL DECK & BONDING.
3 3 LL N o°1e Contractor
ARCHITECT'S DECLARATION
O 1 understand my plans shall be used as public records
3 d p C LcenseJ Pmlessomal
OWNER-BUILDER front
DECLARATION Y N
I hereby.(Sect,his 1 1. exempt Arum tnc Contras a License Law for the
i o following reason.(Semon 7onstr Business and professions Cosec:Any city nr coumy OCT_ 1 7 ,
z F which requires a permit m construct,Direr,improve,demolish,or repair any swemrc
i3� -pnonois issuance,also requircvM1<applicam(orsuchpermino Eleasigned smmment - _
thinrte s l q-xd pd;u ,to lho prb 'ons of me Contractors Li a se is (Chapter 9 S [ Floor Area
nn
Icor g with Section7000) fDivsion 3 of the Busmcs.and Prfess.s CON'[ (' q, . '�": Valuation
or that (axe ,m<refo d,h bass for the aIle cd cram dAn Costs) 't tA �t�+°t_asDA _.Jct �_ 'j� {(„vY-s �'
P g p y vola,on
of Section]031.5 by any applicem Turn permit subjects me apphcvnuo a civil penalty 1
a fnam..ih.nf.chuhdreddali.(55M). AP umber a:'„•,:' ,,, ecupancy Type
❑I,oso he lmrk and
testmmye is o,intended
ntenwasesaxed side
smion, _
will J”,he work;'and me'awcmrc is nuf imm�ded'or"offered for sale(Sec.]t W,"
Businas'°ne Professions Code:The Commelm's License Law docs not apply m an 102 - PIERS Required Inspections
0
wner of property Who builds or improve,thereon,and who docs such work himalf "
"rte ggIn- ply p -dmm .tIimprovements intendedor 103 - UFER
"pre df .'I Ifh ,nI ld'ny ar'u4n6virrar,is sold"-'Inn one it.,of -- ._ ..-. _. _ - . . _.____ -, .. .-.. ._._ ..._...
104 - REBAR
inmplc,iun the owner braider will have m burden of pr"nn6 that he did na,build or I, � � c+. t,.L. `•
mprove for pury"senf zine.). 105 - ANCHOR BOLTS
--- -- ' - ----- -.actors. . ..... _ .._
I:sew oi•;�er Done am =omra=nog with licensed=onaae.omm '106 --...SEWER_.&..WATER-....•.__.-.__.. __................
.. ; Pmpeny,a .i.
WATER-
tic,
,he does
(Sec,]Ori,Business andpro Proerty w ions Codc:)The Contractor's. - "
Lactose I.we«:notapply man owner nr pr"penswenbuildsser improve,..rs..redo. 202 - UNDERFLOOR PLUMBING
.ana-who cs License
for such projau.wim a conuac.ogs)IiaasM.pursuan.m,me.
01 am xe License Law. - .. .-__._ -203.__. .UNDERFLOOR-'MECHAN-ICA'L- --- -- - --
°" Olamexcmptunder Scc. " ,B&PCfonhisI .'? 204 - UNDERFLOOR'�'FRAME'"
°""" �CAI).NOV---" ° 31OZ 205 - UNDERFLOOR INSULATION
WORKER'SCOMPENSAn NDECLARATION - 301 - ROUGH PLUMBING
I hereby ehicn under Penalty of perjury one of the following declarations: 302 - TUB & OR SHOWER
e o I ho<e sena wiil'mamt id6'c nmmle nrcdneni,e seer-insnrc for workers 303 - ROUGH MECHANICAL
moo---yyy"' Cnmpensmion, as provided for by Section"37W of ,he Labor Code, for the
perrarmam«"one work Tar womb m.pe,mir1 Assam., 304 - ROUGH ELECTRICAL
O I have and will mainiain Woiter's Compvnimion Insurance,as riquimd by 5 tion 305 - FRAME
noB r he Labor code r m p<rr-m ar e'wdrk r r n=n mise perm x 306 - HOEDOWNS
suedwoxl" on1 m.c- ,WP c 4a
CainAT OF EXEcyNo. 307,* -,INSULATION-
MPENSATIONINSURANCE'/Y sIODO� 308 =JFSHE�ETROCK-1
v__ ---
s ddcanalboam'Ieleannc 309- -= 'EXTERIOR LATH.--, - -' - - --- ----
(g100)muss.7 p Permit rs far one hundred dollars
310 INTERIOR LATH- ;,;,•.^
'
3.1.1.,._—SCRATCH COAT
Ic nfyO t th p f 'fm'' kf h nm perm.'. ..0 d'I -
.�ali n PI r v x n r s to become subject t me work : 3 13 - ROOF NAIL .':> . ._....
Compe... on Laws of Calform. Date rte -
App" 501---. -FINAL -ELECTRICAL ENERGY.._ _.
- NOTICE IU It nk,ngmsovsions of t01 he eborodyoushould - -"- -.
y teeomexubjcnmmthsuch(rvoionsoruisPermiomafmdemedCocked. most 502 - FINAL PLUMBING ENERGY
Q 0 forthwi,ti comply with such Provisions or this permit shall be deemed revoked.
Ft= :rf _S _ _ N _._. ._ _..- -- -- 5.03._ -_ _F.INAL,.MECHANICAL.. ENERGY,- -. ... - ---- -
- ';coNSTaucrlGryLENomngGENcY - 504 - FINAL BUILDING ENERGY `
"h 'Ink I' which this m'erc is mired!See
lending
"J.E vageniyTorJseperrortna„=e 505 - FINAL ELECTRICAL '
of the work for which this permit is isi (See.309].Cin.C.)
W Q Linder':Name....—::...: .........:..�..._:.. -
-
�D7 Lender':Adcrcxs -- _ __ __ _
o.z 506 -" GAS TEST --
U � I«rfrym�Inaereamnappl=t Jhnmun ba ' r,mnonih 507 - FINAL PLUMBING
carrier']agree to co ply. 'th all city and county.ordinances and state las mating 508 - FINAL MECHANICAL
O.V rbabove-mentioned
bovg uvet and h by ,kneerepresentatives of th ityl merupon
t.96 meanen I dp"pnand
509 - FINAL GRADE 7
Ft ZI, (We) grc isindemnifype d k ep h may aha City f cruera o egamsl
Lt m liabilities,judgments, ohs a pose which may n any way c ge nxj said 510 - FINAL PL I NG
U 'Z City n cnhsegUNDE 9T g ro g WILL:
a S 14 � N
APpIvi UNDERSTpYD5AND0.1LLCOMPLYWFHALLNON-POINT' Issued y: WORKS
g0'I REGUL TI VS
� �b�k r�n� %Ll/oZ Date L � 0 l ,—
S,gnaum or ApphatenULOnna=tar
HAZARDOUS MATERIALS DISCLOSURE -pate Re-roofs-
'e W II do pCupear a f rare Municipal
g e.Cho t tae or handl Hislilous .enol
C def ed io Ne 3 pen M p 1 Cod Ch p, 9 Iz and me H aIm sena 1 .- Type , Roof
as
dee Section 255320 �/ } .�- c fa - .. .- _..
❑Ye I )eN 1 1 I,,' A ti
All.roofs,shall be Inspected prior to any roofing materia grlled.--
wn r aper t Four,building Y iy n,� I a n m If a roof Is installed without first obtaining an insgecnori I agree[o remove
n't h d e ram , d f ca b (he B se A, Q I y eManagement'
"i" IN. _ _ all new materials for inspection Applicant understands and will comply with
Califo I b r,read he hat inlod m,dns 2555255J3 an0 " all non point$OUCCe regUlatlOn$ - --
1
lth
. I ha a read m<6avardous mamnaB r....
here under Ch plc 695 of,he -
irihe budding docs not currently have a tenor,that i.ism 2553i 1 understand that
occupam o!me requirements which mus, he
be mei poor m issuannce of C e ifidto n 1Of
,/ Signature of Appl'
`-Y'. " o f'n rl• 8�,�IVI .- Date _—
All roof coverings to be Class "B" or better
„a s.
CITY OF CUPERTINO "- - -
BUILDING DIVISION PERM ,-Q0NTR'ACT0R INFORMAT N:
BUILDING ADDRESS: PERMIT NO.
10533 ESQUIRE PL 02030113
OWNER'S NAME: APPLICATION SUB DATE
HAAS CHARLES J AND ELLEN J 03/21/2002
PHONE: SANITARY NO. CONTROL NO.
O O ARCNITECT/ENGINEER: BUILDING PERMIT INFO
,u-i BLDG ELECT PLUMB MECH
azm
i LICENSED CONTRACTOR'S DECLARATION Job De$CCI [lOn
5 z_0 1 hereby �that 1 am licensed under provisions of Chapter 9(commencing p
w t-m with Section 7000)of Division 3 of the Business and Professions Cade.aMm Rani REPLACE CONDUIT & WIRE TO POOL EQUIP
X0.6 itmrmlrameanaeffa` NEW POOL DECK & BONDING.
=c w a License Class Lic.«
7 3 t6r.G Date Contmnor
ARCHITECT'S DECLARATION
:0.01 1 understand my plans shall be used as public records
a�
7 m p C L¢enscd Pmfessionol ��I J{I ams
n IYc OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am1. exempt s an the Contractor's Co License law for the.?< rauawung teaaan.(Section Tons,eutmeaa moa Proreatmnt code:Any dry or roa
ttperma� CT 17 Z�02
p F which requires a it to construct.alter,improve,demolish,or mr anysuuctu
i3� prior to its issuan ,also"u;tes the applicant for such pemdt to file a signed sizmmem
that he islicened puremot to that,provisions of rhe Contmam's License Law(chapter 9 S Ft. FIOOr Area.:
(Commencing with Section 7")of Division Sof the Business and Professions Code) � j'yk9\,'�'{;^k.q�', � 1-. ,,, ,,; ; 'i �-, Valuation
or that he is exempt themirom and the basis for the alleged ascription.My violation �'''I g U�o v `V''1' -
-of'Samon 703 IS by any applicant for a pcmh subjects the applicam to s civil penehy
of not mom him fvehundred doBara(SSW). APN Occupancy Type
❑I,as owner of the property,or my employees with wages as Nair sale compensation, _
will do the work,and the swauta is not intended or offered for snle(Sec.7066,
FOUNDATION
Business and Profession Code:Tho Conuactor's License law does not apply to an 102 - PIERS Required Inspections
owner of property Who builds or improves themnn.and who does such work himself 103 - UFER
or through his own employees.provided that such improvements are not intended or
'offered for sale.If,however,the building or improvement is sold within ooc year of ' ' .. "' - ' ' R- ---- .- . -.-. . . . - . . -" . _ ..
comcompletion.n,the owner-Wilder will have the burden of proving Na104 - REBA
not or t he did b . ••
Improve for purpose of sale.), 105 - ANCHOR BOLTS
I,as owner rr the m.am�.cw,md 106 - SEWER- & WATER._ .. " . .-._.... _. .- .. _ .
pmpey and Professions Core:)The Contractor's,awn the project(Sec,7060,Business and Professions ids or mpr Contmmor's
License Law tractnot apply manowner of property who bsliceseimproves thereon. 202 - UNDERFLOOR PLUMBING
and.who contract for such pmjttt with a contnctorts)licensed pursuant to the
Comm r,mrnpt License Low. 203 - UNDERFLOOR MECHANICAL - -
_... ..-.
❑I,.me[e'em(p�andUts . BaPefor Niaxaon 204 - UNDERFLOOR` FRAME '''
owner Cglm NO!+>— Date .j�� OZ 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING
hembyaffmund pnatyatptu ogatN tonowngd lmtiana: 302 - TUB & OR SHOWER
❑ I have and will mountain.Cmificma of'Cansem m orf-inure far Worker's\_ 303 — ROUGH MECHANICAL Compensation, m provided for by Section 37W of the Labor Code, for th<
perfmansoce of the work for which this pemN is Ixued. 304 - ROUGH ELECTRICAL
.. ❑I nava and will maintain Worker.Compensation inumme.as oapt, by S tion 305 — FRAME
3700 of the Labor Codo,for the performance of a work for which this perm is
issued. war sCo 'anlnumttceca ttdP 'ey a roc 306 - HOEDOWNS
catrieF - ' Policy No- _ 307.E
C T A'[{pm OF EXEMPTION FROM
/J F /gQbMPEUSATIONINSURANCE /000/ o/ ' ' '308 _= -SHEETROCKI
un 3091 -: EXTERIOR- LATH.._. - -'
erne xmico'trcm not be completed inns permit it lar one hundred dollars 310 - INTERIOR LATH
1E100)or less) •
I certify that in the Performance of the work for which this perrnii rs issued,1 311 — SCRATCH COAT •- - - -
shall not employ any person in any manner so as to become subject to the Workers' 313 - ROOF NAIL' '
Compensation Laws of California.Date ,
Appl1cant501 - FINAL ELECTRICAL. ENERGY
NOTICE TO APPLICAM:B,after mating this Cemfimx of Exemption,you should
.Q Z becomesubjectmNewmersCampcn.donmoitionsofthe LaborCode.youmust 502 - FINAL PLUMBING ENERGY
fomhwith romply wit such previsions or Nis pcmit shall be dttmcd mrokcd.
� 503 -. FINAL .MECHANICAL ENERGY
F., y CONSTRUCTION LENDING AGENCY 504 - FINAL BUILDING ENERGY
> I hereby affirm Nit then,is.romouction lending agency for the performane,
:fig; t..i of the work for which this permit isissued(Sea.301Civ.CJ
Lender's Name 505 - FINAL ELECTRICAL
y Q
p z leader'sAadxss -- 506 - GAS TEST -
fUAs O 1 ramify that I have rend Natis application and .Is ththe above information is 507 - FINAL PLUMBING
1. comet I agree to comply with all city and county ordinances and state laws relating 508 - FINAL MECHANICAL
0 U to building constmcron.and homby authorize mp¢sentatives of this city to enter upon
r'W the above-memionedpropemy for inspection purposes, 509 - FINAL GRADE
tG (WOigme to rove.indemnify and keep harmless the City of Cupenino againat
h' liabilities,judgment.costs and expenxs which my in any way accrue against said510 - FINAL P ING
U z City in consequencePettit,of the granting of this pe
APPLICANT UNDERSTANDS AND WILL COMPLY Wfm ALL NO.Y-POINT S14 N [•+IORKS'
so�' RIS", n�a. Z/L Issued Dy: Date L� ^0 1,—
Sig i,
&gnamrc of Apph oAZARDOU .Date- Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will the applicam m rums building e.c haps slam or anode hazardous Safety Type of Roof
as defined io Ne Cupertino Municipal Code.Chapter 9.12,and Ne HcilN and Safety
Code,Semon 25332(gl
❑Yes
_ All roofs shall be.inspected prior to any.roofing rnaterial�i>fg stalled.
W;II Ne applicam or fumrt building occupant tax equipment Cr devices which If a roof is installed without first obtaining an inspection, I agree to remove
emit h Will d s air lic m Or Pica es defined by Nc Bay Axa Air Quality Management
°lath"" all new materials for inspection. Applicant tlndSrstands and will comply with
1, OYcs XNo
all non-point source regulations.
- I have read the hazardous materials requitement under Chapter&95 of the
Califomm Health&Safety Code,Sections 25505,25533 and 25536,1 understand that
s irlhe building does not currently have a tenant,that it is my msporribihty to notify the
occupant of Ne requirement which must be niter prior m issuance or a Certificate of
Occup �`�y(1 I' '
UQO' ` A� �aI �n? Signature of App-' Date
OwneronuNonze.agent Dare All roof coverings to be Class`B"or better
...- FFICE
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