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02030105 CITY OF CUPERTINO -' - '" _. - ' BUnAING DIVISION PERMIT CONTRACTOR INFORMATIO., BUILDING ADDRESS: PERMIT NO. 20091 FOREST AV NGUYEN HAI T ET AL 02030105 OWNER'S NAME: APPLICATION SUB DATE NGUYEN HAI T ET AL 03/21/2002 HONE: SANITARY NO. CONTROLNO. a ZO ARCHITEC7f/ENGINEER: BUILDING PERMIT INFO U F BLDG ELECT PLUMB MECH rice I� z H i 1 hereby effno in I i mNSED �ce sed underr Provisions of Chap er 9(commencing .lob Description 'vCLARATION Z—,�u wish Section 7000)of Division 3 close Business and Professions Code,andmylicense KITCHEN REMODEL. x 2 is in full forte and effect. License Class Lic.4 1 0>. Dem Contactor i is 5 o9�'s-B O ARCHITECT'S DECLARATION un 5 1 mukatend my plans shall be used as public records 6p�p Licensed Professior.] MAY ? 4 [UO2 u�et i OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the C Z following reason.(Section 7031.5.Business and Professions Code:Any city or county f x O which requires a permit to construct,alar,improve.demolish,or repass any swaure 1 t 1 11�p I/� $10000 3� "Prior taiuiuuanc<,alsorequirsthe applicamfor suchpemdtsoflari.grr4 statement l/ F�[i INl'A that ban licensed pursupm t.,W provisions ofine Contractor's License law fChep¢r9 ca g p Q,r@a (commencing with Section 00D of Division 3 ohne BusimessaM Professions Coda) _ r., x•r3 SO 3'. Ir.:U,1/. -'... ., .3.'S•, Valuation or that he is exempt thcmfrdm and the basis for the allegca ucimptio.Any violation - -d5mtion]031 Bby any applicvm for a permit sobjecu fie applicam to a civil penalty , :of no, me than fse hundred dollars S500). 101A'PN qyd3DATI ON h Occupancy Type 1,os owner of the pmpeny.u my employees with wages es theirmle compensation, _ will dd the work,'and the structure is not intended a offered for sale(Sec.71 . - Bhsindas'ana Profession.Coda:The Cnntamor'a License Law docs nor appy to an 103 - UFER Required Inspections' owner of progeny who builds or improves thereon,and w.W does such work himself 10 4 - REBAR or throwgh his own employees,provided that such improvements are not intended or ,,Or fol sale.IChowev<r,the Wilding ar imProvcmcnt is said'within one you of �complcson,the owner-Wilder will have the burden of proving Nm In,did nm Wild or 105 - ANCHOR BOLTS imp roveforpurposeofaale.). 106 - SEWER & WATER 61 wetimg with lcened cuntracmrs m 2UNDERFLOOR PLUMBING " -02 -- —-- ----- - - -- meteoritics that,pmjmt(Sec.704x,Business and Professions Code:)The Connor's License law does not apply to mmowner of pmpany who Wilds or Improves meraom, 203 - UNDERFLOOR MECHANICAL _and.who.contacts for.such projecra with a.conulicensedrsan actor(s) puut.to the ContrutOls License Law.. -- -- -204" =' UNDERFLOOR--FRAME- ❑l am exempt un ac. -' B&P C forthis reason r ' 205 - UNDERFLOOR INSULATION orr�r r D;te 2i' 2/�OZ '' 301 - ROUGH PLUMBING 'WORT R'S COMPENSATION ECLARATION 302 - TUB & OR SHOWER Inerbyamrm nneq penalty o(pe joy one of the mnowimg amlaason:: 303 - ROUGH MECHANICAL ❑ 1 haJe'eiid'will hainuin a C<rti0cate-of Conant to self-insar for Wmkus 304 - ROUGH ELECTRICAL . v Compensation. as provided for by Section 37W-of the Labor Code, for the performance of the work for which this permit is issued_, 305 — FRAME ❑I have and wilrmain am Worker's Compensation Insurance,as required by s«tion 306 - HOEDOWNS 3700 of the'Labor Code;for the performmce of Ne work for which this permit is issnea.My workara compcnsatiov luuama eatrierem Polley number aR:. 307 - INSULATION cad I a 'ka< r Policy Nor , 3s08 :;SHEETROCK 7 :CERTIFICATION OF EXEMPTION FROM WORKERS - - " •• , `it ...,mMPENgnnaN INsuRANCE"- . .. ' ..., " ''309• =` 'EXTERIOR�LATH• -,-..- ,- -.- ,...r-_,_,-..-__.....__.... �::• - -,:, 3"10-,"-_-'-.INTERIOR"'OATH-_-...__:::,:: ._.....(rni:uniddxd[aKbrl><edmplamHtnepemdtisfor one Wnardaon,a 311 - SCRATCH COAT (sIW)or less.) . . . ,„T fcriyfl mine performanceof bewrk for' h'ch thio permn res r'smua1 ' �'3T3 -ROOF NAIL' '. ”" " : •• . . _.-., _, mhaB t ploy nypersom try anmy:ro ggqbbbmmm esublestrotnework 501 - FINAL ELECTRICAL"ENERGY Compc I. V's o Cel f rya Date 1 fG 2 AOTIC �s '_ f M_arc i �� iffy_ _.. 502 -- "FINAL PLUMBING ENERGY NOTICB'TPAPPL 1/,aftermakmginsc ionsofi 'th xabor ode,Y byre 503 - FINAL MECHANICAL 'ENERGY Z become auomply it cl,prCompeuNon Permit thd erred Code,you must 0 � foMwith comply with sucfi provisions or this permit shell be deemed rvokW. y� _---. .._. "_-..S.._-.-__..__. .._.. . GE ...... . . .. .. ..._ ._... 504. ,- .FINAL_BUILDING. ENERGY't- .._ ..-- a „y CONSTRUCTION LENDINGAGENCY.f "" -- --- — .� •f`^n rhfior'which this there conswniori lensing agency for the perfoimindc — ELECTRICAL hay of th'e work for'which this is issued(Sec.309],Civ.CJ EL 505 FINALE CAL wt _. .... a... .... .....:.. .... . GAS TEST p:y It(rm'anparesm -" 507 - FINAL PLUMBING ._.. . ._. .. _._. -. .. __ - . U-P ,.,- :,Icesufy'that l line read'tlsx application Ina stare that theibove Informatioo lis 508 — FINAL MECHANICAL P w'F coil I agree to m-Ply.with aallcicityand county Ordinances and sure laws.].,at, 509 - FINAL GRADEii[) to Wilding consuuaion,end hereby euthodu representatives Of this city to enter upon pattheaWve-mmtmn aed,properymrinspection pnpore L..9 ty.t (W)agree m sae mm nd if}•arra hNi k ep arthe City of Ctipem o against 510 - FINAL PLANNING Lh rA liabil u 3udg °u,come sod peau wn h may n any way true as nst aced 514 - FINAL P I C WORKS UZ City sequence of the graining of ij,pc as"7 APPLICANT UNDERSTANDSAND WILL COMPLY WrrH Aft,NON PO NT /G � so C'ERE n 3 t/a Issued by: Date / _ - rgnaweofnppfe Contanor .: Re-roofs D ..... f`„a `,'.NAL.RDOUS MATERIALS DISCLOSURE- - - ° wdI tlrc Is It niorfutvre duldrng'occnpant same or hm dl<hemdoas material . ..Type of Roof. . _ u defined by,the CLpenice Municipal Code,Chapter 9,12.and the Health and Safery - — - - - Cbde Smt v yM Y.:: 1 f771'Pq'0.t ` .e r ' All roofs shall be inspected-poo;to any roof ng material being tnstalled. IW)1 theapp!not !urn mbuilding fend oc pant use equipmentsAo devices which If a roof is installed without fust obtaining an inspectiori;'I'agree to remove t as"air join ants u defend by the Bay Arse Air Outlay Mmegement' i. es all new materials.for inspection. Applicant understands and will comply with all'id -point source regulations. ' n 1 Mvadad the'h d 'meu,reqs me a under Chaptei'695 of the ' Cllifwnn Health&Safety Code.S(ectipon�s 25505,8533 and 25534 1 ondersend Net sb 1 y to °ti(Y the W din dose nm cu ntly h vat a tenant that t 33 and 2 upant of the requ rtme e h h m v be mat Prior w usuance r a C n ate f' upon ,� y „p . .. L Signature of Applicant Dale Own Non de ant _._ .. .._. : s l s DGt-- All roof coverings to be Class "B"or better .r. 1..R ". .. . ... OFFICE... . . _. .. . ". ... . _.. . m y m k ee k O C n ON dtA.+ 8 ' Pk ' �' k c'fCo Y r U o� k S q N Y U Y m W O Y C m k °o A y n 0 � n e o s e a G �^ �• m es k rtmj ? 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