00100065 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDINGADDRESS: - - PERMIT NO.'
:74-93 RAII___ ONSTRUCTI'OI 001.00065
OWNER'S NAME: - - APPLICATION SUB DATE "
Aj
DR 10/09/^c000 6A I EL DEN
IONS - • — SANITARY NO. CONTROL NO
0,-,7.
OO ARCHI'ILCT/ENGINEBR. - BUILDING PERMIT INTO
w - - BLDCECP' PLUMB MECH
GC
I--I -
Z m -
LICENSED CONTRACI'Ok'S DECLARATION lob DOSCrI Iron
QZ__ 1h by"Irmanll I'cenred d p n.ofChapte,9(..„mendng - P '
, 70gB nrD".' 3 fthe Rn ndP densis as 'doandm hcenxe - '
a 6 5 �.
°a LL o-v S a r r •� RRTH, REMODEL !�
O ARCHITECT'S DECLAR TION 7
ser PublicJ' QOf �^`
Y
ac I = dP I : 'I ,
c°�$= OWNER BIM Ill R DECLARATION 7 /�
ail I hembyalion That I am esempt for,trip Contract v Law for,he !/
$a toll 6 wow.a
d rS , 7011.5,e, d e Profession.,h.o e y an ct re '
��CO wh ch 9 p of construct, R p eJ I':h p ya credo /
3 m In , ,. .. els q vhepapplicantiarsuchp u file signed teepee v _
thorn exlicensedpurs,4n th p nn,a rm L IT,aa ,L . L onsCod) - S Ft. Floor Area Valuation
(cool g 'p sem, oman robin tooth=le:dexemeion.Anyvi Led=) q•
or the he is exempt Therefrom nm the hauls for alleged pplmera in Any violation
ofseamc 703 n v any dmd d ll o-,r a perms subjects me applivam m a civil Imnwty APN.Number
or nn,mare man five nuam,ed souses rs5txn. .. _ Occupancy Type
❑1 a. fah t tY Y PI to g: I - .
ill do the k and
the structure- not
intended e ff d r r sale fSec.9046, + A.5 - g 2
Business z d Plate,. Code:The Contractor's License Law does ,apply to an Required Inspections
r of pmpeny Wha bu IJ.T nr'mpro,e.thennn, and who Jnes such work himself
orThroughhis own employees.provided Iha,such ithprevemmau are not intended or -
offered for sale.If,how,,,,,the building or improvement LT-Told within cane year of 1.01 — FOUNDATION ,
completion,theowoer-nadder will have the burden of proving thin he diH no,he ld or
m ]Bc — PIERS'
ip ov purpose cf sale.).
❑1,as owner of property,am exclurmelr contracting wan licensed contractors to 103 LIFER
eemtruct be Project(See 9044,Hairiness and Prorcrdmac Cada)The cnmrncam's - 1.04 - REBRR
License Law does nu,army to an owner of properly who builds or improves themon ,
and who contracts for such pmJees with i coutmelor s)rcenTed parsuce m the 1.05 .— ANCHOR BOLTS
Conaacmr's License Law.
❑Ianal=xeoapton de,sol. H&Pem,miameento 106 SEWER &T ,WATER
°cane °Dia 202 -• UNDERFLOOR 'PLUMBING
WORKER'S COMPENSATION DECLARATION
Iheren Iran"nee, aran f 203 —'-UNDERFLOOR MECHANICAL
ra rocate ifeonsnhernowingde�IforW : 204 — UNDERFLOOR FRAME
-C 1 nave and will mvidein a Certificate Sd,e of Gondol m rte Labor Code
Worker's
compensatmn. as p,obtdea far by semina v,xl nr me Labor code Tor Ilse ^e0S — UNDERFLOOR INSULATION •
pehaniance of the work for which this permit is tssa d, 301 — ROUGH PLUMBING
❑Ih' - d 'll "aim ' W ke C p :au mInsurance,a: l dbySet ,n
3710 th n Code,f we of m k fwhich This is
Isso=a k scap :-r Insurance ePaiy I ,. `302 — TUB & OR SHOWER
303
ef
— ROUGH MECHANICAL
Carr CERDFICA 10 EXF.M1IPTION hi'-t�i wo RSVG 304 — ROUGH ELECTRICALCOMPENSATION INSURANCE
305 '— FRAME
(This section real not ITT,retrofitted a'he permltisfar be,hundred doliam 'BE — HOEDOWNS
(S loo]or less) 3 J -
1 certify teal in he performance of the work fnr'wntel,this permit is cooed,1 307 — INSULATION
'hall ori employ ally parson in say cannon so ars to become super,m the Workers 308 — SHEET ROCK .
.Comp=nrmion Laws of Culifarnio.Dote
App'[`""' 309 — EXTERIOR LATH
NOTICE TO APPLICANT'.If.after making,his Cenificme oPEx=mp,ian,you should - '
hrthre, wounplymewochproviisionsrThisproorttshaofineLonerale.youcans' 31.0 — INTERIOR LATH
z Q fmthw'uh comply with such provisions or this permu churl he deemed revoked. _ — f+
Fy h CONSTRUCTION LF.NDINGADIiNCV. 311. SCRATCH COAT
> I nerenr selene wet there is a nmsamctlan leading agency for the twelom,ane= 313.— -ROOF NAIL
6.t of the work far which this perch is issued(Sec.3097,Civ,CJ '
, y q Leader'sdd
Leader's Adarem ss 501' — FINAL` ELECTRICAL ENERGY
E z 502 — FINAL PLUMBING ENERGY
o s Ica,doIify ncThav=medals'oydonandsm=the.,anda.emfmmaronis FINAL CHANICAI_ ENERGY
0 w fr emmad 1 agree to comply with all city and county.,itSttives trice.,and sn,e Is.,en erupon
V ,hb,dleingnmgrued.....and hereby rop,,liorr representatives of this city ma enter upon -
W ,neano(We)earonedpaope,yrerinspmronpurposex. 504 — FINAL IEDING ENERGY
y
P. (We)agree m Sava indemnify and keep hnmay in the way
al Cupertino ognlnn
.. m EamhneT.iod use,which m,nY in any way ae«oe clinics,Sam 505 I NAL LECT R I CAL '
U 'L City in co , in, of the smarm",or this permit. .
APPLIC UNDRCTnN ND WILL COMPLY WITH ALLNONPOINT St�6' — :ST
SOURC;RF.0 .TIONS. Issued by:' — ate L
sigcntum p nvn,acrac, �111RDate Re-roofs 5 8 .— 'FINRL 'MECHRNICAL
HAZ 8 US MATERI
ill the a , Road adding weJ nu,,at Type of Roof 09 — FINAL, GR
os def d Caper Municipal Cod Chapter 9.12.and the Health and Safety i
Coda f 5532 -
❑Ye EI No 510 -- FIhIAL PI_F]IVNING -
Allroofsshall b 1 geted [ �tq, n r t e installed.
Wilithea,l'antnrmutrem,nawgoeucpnnosecgwpm=ctnreebi wmm� IfaroofisinstalledwI�houtpfirs�tco6�atnin a�nems ono gee to remove
eoil hamrlous wroonauninants as defined hy,he Bay Area Air Quality Management g P
°ismea all new mater' for ins ection. Applicant understands and will comply with
ayes DNo P PP P Y
all non-poi sour a regulations.
I nave read,he hazordous materials requiropt
nacals under Chaer'h95 of the -
=California Health&Sucl,Gde;Sections 25505,25533 and 25534.1 understand that
if,hc huildi nm aurzemly huvemm�ant.the i,umy responsibllttymnotify the - a .
Dram na= a na=ms winch angst rte ra=t palm m issaacee cal a eedreee or
)ceupan y. -
:Signature ant Date
caner nod ee Da,a All roof coverings to be Class "B"or eater
FICE