02040150 CITY OF CUPERTINO
BUILDING DIVISION pERMI CONTR-kCTOR'IlVFORMATIO;
• 5
BUILDING ADDRESS: PERMIT NO.
7544 FALLENLEAF LA R A D CONSTRUCTION CO 02040150
0\\T'ER'S NwME: APPLICq]ION SyB DATE
IF
CARTY KEVIN P AND ELAYNA 4315 FILLMORE ST 04/29/2002
PHONE:
(408) 988-3690 SANITARY NO. CONTROL NO.
C c zARCHITECTMINGINEER:
{a
00 BUILDING PERMIT WFO
BLDG ELECT PLUMB MECH
y<- U CJ L."J U
LICENSED CONTRACTORS DECLARATION Job Description
r2
i= 1 neteby amrm he,1 am ranXa ander puviarons orchapter 9 apmmenaing
w $ATHRM UPGRADE
ctlont with Se ]001 Division 3 of the Burris apJ Professions Ccdc.mdm license
E_Q is in fuand<ffect Js
ti Li -X. Lloae
3 L tNJ Dav/ C vanoY�
understandy`Y
DECIA a
� 1 understand my plans zhall uARCHITECT'S beud u public ¢
rords
E O O Lmenud Prmfessional 2��2
OWNER BUILDER DECLARATION otmTION ague es
6=, 1 greasy oRsm chat 1 1. exempt from thr C ssiams o License c taw for the G
< following reason. Pani,in
1onstr Business endove,demolish.
h.or Any city or county $5400
SFO prim,'requires a permit re mnswn,alter,improve.demolish,or repair any structure
3m poor coils issmnm,also requites the applicant for such Permit o rile a signed statement
diathtgliunXd pursueN to the prsvinoothe CmvxmiLianLaw(Chner9 . tl . as Ail T# _
(rommemgwith SmlmN000)pfDivision Soft ® y.a
he Business and Pocknions Code) S8 .a
a_tio-n-- -
or then he is exempt thcrcfmm Octel the basis for the alleged camelhmn.Any violown
-of Section]OD LS by any applicant for a permit subjects the applicant ma civil Pennlry,
dfgettmtraenrivebandmdd.11r ($5W). 1014PNPftV FPIDATION Occupancy Type
❑La$owmmorthe,mpert,urmyemployees with„t,cs.stheirimeeempe....int. 102 - PIERS
will do the work,and the structure is not intended or offered for sale(Sec:]OaO;
Butmois and Professions Code:The Commnor's License Law does not apply to on 103 - UFER Required Inspections
owner or property Who bund$or improves thereon,and who ams such work himself 104 - REBAR
or through his Own employees,provided that such improvements art not intended or
{offered for file.If,how<ver,the buildingor int - -- - . .
puv<ment is sold within one year of- 10 5 ---ANCHOR BOLTS._. "- ..__. . _.._.._-... .
completion,me owner.wimer will have the widen ofpro.ing that he did Out wad or ,•�' . . .
Improve for purpose of aIrI 106 - SEWER & WATER
.. O L as owner Orme property,am aselusively Commcting with licensed eonvaemn to. .. 202 =- .UNDERFLOOR.._PLUMBING
-_ cooewn the pmjen(Sre.]OOT,Business and Professors Code:)The contractor'$ -
License taw does not apply to an oxnm of properly who wilds or improves thereon. 203 - UNDERFLOOR MECHANICAL
-: .and who emumets.for such pmjeeu.with.a-contrumr(s).lieensed.punuanuo.the
Contractors License Law. 204 —" UNDERFLOOR 'FRAME..
❑lam exempt under$tt. B III PCfm tNs teasop 205 - UNDERFLOOR' S•NSUILATION
ovine:" Dam301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
I hertby.mmm on&,Penalty of pc II ooe or mp Billowing declarations: 303 - ROUGH MECHANICAL
-5, ❑ 1 W,I and'will maintain is Ceniftcne of Consent to III.sum for Worker's 3 04 - ROUGH ELECTRICAL
Compensation:as-Provided for by Section 3]00 of me Labor Cade, for m<
Perforanni Of ate wog roc which this permit is issued.
305 - FRAME
❑I lhii.i2'will ntammm worid.$CompenXpod'Insurance,'as regoirtd by Section 306 - HOLDOWNS
3700 of the labor Coshe.fee the Performance of the work'( which thispermit is
)ruureue m pd , dense 307 - INSULATION
tssaeaM cER<, r " j' 3 01'-6,2 308 - ;SHEETROCK ...,... .,.. --
ser Policy -
PJ(EMMONFROM.woR 309 - t EkTEi21OR LATH
COMPENSATION PSURANC '
..E-., —.. _ . .....- ..3-1-0-::--;INTER'IOR—LATH. ...__ ._.... .
'.fii,I:.udfan nae dot le cath Inca tone � .. . , .. . .:. .. .......-..--' ..
p permit is for one hundred dollars
(s1aDJmk$s.) 311" - SCRATCH COAT
1 cdnpl that in men in any ma n mi work for which this permit is issued.i ...
3' ._-"-ROOF,'NAIL'^••. ._.. .
shall not employ any person in any manner so as to become fubjm
Compenset Laws of California.Data in sea Workers' 501 - FINAL ELECTRI CAL' ENERGY
"�' 'i . 502. .-. . FINAL PLUMBING ENERGY.....
NOTICETO APPLICANT If aha making the CertificateofE pt y should - -
Z becomes bJ ttomeW rLerSCompinson i ' nsofth labmCode.youmust 503 - FINAL MECHANICAL ENERGY
O O forthwith comply m uchp Worm permit shall I nevoked. 504 - -FINAL BUILDING ENERGY'.
b - _
Of CONSTRUCTION LENDING AGENCY
505 - FINAL ELECTRICAL
H...t •' e•'lhirt'"a1Tii4ti that inert is'a conswction lcnain ---
_
61'. .-.....g agency for die performance .. .: ..,
LIOINrprwmchnisPi hvsLsurdcs«.3o9y,ci..c.)a ' 506 - GAS TEST
ame
taoders Address ._ ....Y...._.. _ .. .. - .. .. .... ... . .... ....
507 FINAL PLUMBING
gat �I certify that l have read this application and nam ma,me ad,.I infmma,mt is 508 - FINAL MECHANICAL'
O,tri t obuii I ague mono with ebyrur and county ordinancas and State laws reining 509 FINAL GRADE
O.LQ to budding emioneion)antl h for fir thoni<rtprtuntadves of tNycitY m enter upon
d;y me.w.r.m��aenea Prop<ry rorin.p«tienpmpo$es., 510 - FINAL PLANNING
IWi)egrtesosave,imdeMeilyandCeephariNcslAeGiyorcuperiiooal;ilnn 514 - FINAL PUB IC WORKS
ChY iaq judgmenu,emu ran r,ofdr which they in any way ucrue againn uid
U.Z Ciry.in PonTUND ohhe gmnGng of mis pensdC'
Z" AP 1T IJ.v'D K WILL CO\ y,15'jTH ALL'\ N'.POINT
so s M U tor r�-0 Issued by: Date
y B1C Re-roofs
ZARDOUS MATE LS DISC101URE " '
Nrt 0 '
A
Will me applicant or future wading pent Hort m handle haaaNws mnr'al Type of Roof..
as def d b the C rano M Code Chapter 9 13 utd the Health and Safely - - - -- - ---
Codi Section unt hawdous au$o cn tv, i
❑Yes - No
}
All roofs shall be ins acted '
p pnorto.any,mofing material being installed..._.
:. t fvt, building ocapant u as cpm t,i de ms which
Dyes- urnmanueia nMbS m BayArfeAi QualryMinagcmem If a roof is installed without first obtaining an inspecttori;I'agree to remove
DismaP
.' No all non-point P Y
a 1 new materials for inspection.. Applicant understands and will cold 1 with
" ' sassier regulations.
" 1 hnx read meety Code. me onals rtgmtemenu d 255 C.1 do 6.95 of id
Celifoiuil ing dofth s Safety currently
have
it ua ent. t it tip and 25530.1 understand mat
if the building deed not emremnY bre a scnuq,tjln is tip my mponsibairy m reiify the -' -
a Of m(" int' List h pnm to iuumea'of of.Certificate of
pa'w"Y -
7.
ignature of Applicant
2SDate
D e o twrizad age t - ode
. .All roof coverings to be Class"B"or better
OFFICE ._...
7S<tFi4-t-t-a-Aj �
f:ITY OF CUPERTINU OFRCE CON
SUBMITTAL
#1
CIO K4�( �
C,r,l 'PROVEd
IN ACCORDANCE WITH THE CITY.UE
CUPERTINO DES AND 0 DIES
PATE
SIPED __. APR 2 9 2002
nd specifications MUST,
This set nl P a I times and itis urt
be kept on the ice-
a By
lawful to make any c',ar,;es or alterations
• on same w.thcut V) '-n Cup,no.
dpe ;nssion from
the bu ,n� Ue. t'..;
The stamp•ng'it ,t. specifications
or to be ar,
SHALL NO'.
;nproval of t'. :
zny Prors ar
vnv City q.d.nznce or State I,au