02010016 OF
• :'I BUILDING DIIVCrISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10704 GARDENA CT S W R, INC. 02010016
OWNER'S NAME: APPLICATION SUB DATE
SAAH ABDULLAH D AND HALA A ET 1965 CUNTNER AVE 01/03/2002
PHONE: SANITARY NO. CONTROL NO.
_ (408) 879-0408
pse i ARCHITE=NGINEER: BUILDING PERMIT INFO
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FF 10ENSED CONTRACTOR'S DECLARATION
O� I M1ercby vfErm that 1 am licensed unJer pmvisinm of Chapter 9(commencing Job Deseri lOn
vr-° with Sectian'I00f1)of❑ivision3of rhe BusinessanJ Pmreaions Cale,antl mylicense BAY WINDOW
is in full force and affect.
eat
U License Class Lie.N • �•O _`� L�"�
Date contmcmr
ARCHITECT'S DECLARATION
F-O S I understand my plant shall be used as public records
�Y
e.C<
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Licensed Professional /
c A, Oat I am eU mpa from
DECLARATION
1 hereby moto affimt o nr I vin exempt from the C onion hi License Law for the
which ire reason.(Seamon 7031.5,Business and improve,
de Professions Code:Any city or county' $4000
f%❑
which q n pennit to construct.alar,wpmve demolish,o p any structure
� _,pro to its is ce, l requires the applicant forsuchpermuo rite a signialsonement -
mthe'a1'cenuO VursummtN prvvrsions nRhe Cnmrvcto .� Lew(CM1aprer9ey,�fc�t,,cw�ppr-hrea Valuation
(c rnncg- n secofth
section of Division 3 e Business and Prfssous Code) j A;�s{ 4 -32AV;O U:/4',1VV 'F.5*s
or that he is exempt therefrom and the basis for the alleged exemption.Any violation
-of Sectors 703E5 by any applicanj for a permit subjects the applicant to a civil penalty
of not mom thann<ehundreddollars(s5wl 101APNF'V ATION i' o,fo ` Occupancy Type
❑1,as owner of Ne pmp<ny,or my employees with wages as their sole compensation, 102 PT
will doNe'work;'and the-stmcturt Is not intended or offered for sale(Sec.70,14, - - '-
Bnsinesi and Professions code:The Contractor's License Law does not apply to an 1 103 - UFER Required Inspections''` -
owner of pmperty Who builds or improves therear,and who does such work himself
or broa,h his n mpl yee. provided m"[stairs improvements are not intended m _- 104 - REBAR __, -_-_
',offBfo"sble wmort. e' thebuavet p of Prov ng
thin eyear oL 105 - ANCHOR BOLTS
cornPletmn,the ownerbu Idcr will have the burden of prov ng mot he did not build or
int Prove for Purpose nfirle.)' 1.06 - SEWER & WATER _ _
_-_- - ..._njz . -- -- ---' ----'c - -_ — — -- -------—
ri ❑Irasowrter ofrhe pmpenyum Businevelywmrofeinions Caanud comm�otsm 202 UNDERFLOOR PLUMBING
construct Lriteaw
project(Sec.]BLL Business and property
who
COJo:)The Cont camon. ." a `
' 203 - UNDERFLOOR MECHANICAL
- ---
License law a«s not apply to an owner or proPeny who builds or improves thereon,
-'
-rard.who ctors kens for such.Pmlecu with a-conuacmt{sl licensed
Contractors License Low. 204"="UNDERFLOOR-"FRAME`
❑lam e<mpt undai Sec., `;BA PC formis remo" 205 - UNDERFLOOR'"I NS UL'AT I ON
Owner
WORK COMPENSATION 301 - ROUGH PLUMBING
.. DECLARATION 302 - TUB & OR SHOWER
-1 thereby affirm under penalty ofperiory one of the following decmrmlons: 303 - ROUGH MECHANICAL
❑ 1 have sand will'ineiniain a Cenificam of Consent to self-insure for Worker's
•' Compensation, as,provided for by Section 3]00 of the Labor Cod,-for the 304 - ROUGH ELECTRICAL
Performance of the work for which this permit is issued.I 3 0 5 - FRAME
O 1 have and ill maintain Wprk<r C6onparoubm Insurance,aarqiiirad by Section 306 - HOLDOWNS
37W of the Labor Code for the perfiarmamm ofthe work for which this permit is
issued,'MyWorker,Cmpe . , Ins a moiler and Policy dbc _ 307 - INS
w ULATION
t 1„ t p _,..... .._..
- 'C into CERTIFICATION OF EXEMI'r10N FROM 30Q,-, $HEETROCK
1 ( .. ., M WORKERS,'„ L,at .. . Y s . ,A
COMPENSATIONI.NSURANCEr. 3O'9' •EXTERIOR"LATH
_.•- TOtii'nion need nm be comPletW if the permit ix for one -__:.., - _
-- 10,',r. IN,TERIOR--LATH 'lo"', , ,.c . .., :A r,;c.
hundrWdollars -t r-• ' .
,1 • 311 - SCRATCH COAT '
`T l a riir�to+un tn< roe,n<p or to k rorwman to 31 - = -ROOF'NFIIIL - .. ---
-3 - ---
..� Y pe pem it t iss ed"1 - -r 1
shall of employ any n in ony man so t b onto bion to the W h n _ c L
mpensato Itm D« 501 FINAL ELECTRICAL ENERGY
DDlieanr ��_ 502 ---FINAL- PLUMBING ENERGY'
"J NO ICE IS PE N P II t r aking t s C pt m 1 E nna n you should
z bcwmesbjectrothwrk< ctpenatdprv( n..fd Lb,Cco.y , 503 - FINAL MECHANICAL ENERGY `
Z� loon m<omplywins enp ons m pe ,dhoti bed -mW.-.ked - ._ 504.--.-FI NAL BUILDING ENERGY- ,- - ; -"--- --
;-'CONSTRUC'NON LENDING AGENCY. - -
"-
Iherebyaffirmthat thereka convection landingagency tonne performance 505 - FINAL ELECTRICAL
Q
� � 'armwkr ngnmsprtn, :: da 3o9yci<cl 506 - GAS TEST ._-.- _._ — '-- --_._...----
07 -Lenders Name
= Z L e ,Aad 507 - FINAL PLUMBING;- .
_ U o rt ma inane aamr;aPPhcarnn"a a:tar mat meow inro�information in 508 - FINAL MECHANICAL
v04� F caned l agree to comply with all city,ond county ordinances and sane rows relating 509 - FINAL GRADE
(, t building Brun , "tlhereby authorizep senmtive ofthiscity m enterupan
"r r� th, b mianeJp petyrt.msp<r npurp,ra, 510 _ FINAL PLANNIN
F,.y, (We)agree io sae mdemnifyand k ph mlesi theCity of Cupertino gams,
h liabilities.judgments,costs and peps which may in any y cane ago n t saitl 514 FINAL U WORI
V,z C ty m q o f thegranting of thisPanama.
mo %Apl \\ U ' ERSTANDSANDRILLCOMPLYWITHALL ON-PINT" ISSuedb r Dat '/ - 3^O
SC eATlp\S _ 6 y: O'
S w pPllcam/Comrnnor,• r ... : ,Data.
P-, Re-roofs
HALARDOfIS MATERIALS DISCLOSURE Typ
Wit me Pplca„rNt to Wila Of . .. -......,. . , W =c-. ,.., .-..... ..._
,a J
fined by theCorrosion My pal Code.Chapter 9 12 and the Health and Safety
p 4 p y ' '.
" C Je S f 25532(m? p a t -
g«c pa r tort or handle harard us in t I e 0 . O
❑v4s " ONa �, � r t1{ � .(',rrldj,ir
1 All roofs shall be ms ected no[[p.an roofing material being installed. •"__
W'll he ppl m future builtl g« p u 'equipment devices which If a roof is ilistalied'without first obtammg an inspectwn Pagree to'remove
'emit hz-d- contaminants sdef dbythBYAre AiQuality Mnagement
Dao all new materials for inspection.:Applica_nt understands and will comply,with. "
ova; 1)No. - -- allnon-non -re Mations.. _ - -
�� jLhave read the hazordova materials requirements under Chapter 6.95 of the
Coliforms Health&Safety Cede,Sections 25505,25533 and 25534.1 understand that _
"ifm riding duel currently hmcamnant.met
tolouomi.f. tett .,the
f
' pa q p n wit (v fcurc of
s �o nc o u`he re remem hrch"m 4th met matt Da� 5`IgnahlCe Of Applicant Date
t _ erti
P
rzed ag agent , e All roof coverings to be Class B" orbetter
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,ET: ADDITION OF A BAY WINDOW .,
1L. 10704 GARDENA DR CUPERTINO,CA A
ADDITION AREA: 13 SQ.Fr.
DATE: 112/02
I
Structural Floor and Joists I 2'k 6n@18"Centers,Double at Corners,Tie to 4"x 6"Girder I
Cover with 13/4-Plywood Sub-flooring
4"x 6"@ 4'Girders Typical
j !
Remove one 2"x 6' Girde
, 1
IR IsSIONq
No. 2A02
ATF OF CFL'i��` v JAN 3 2002-'
By
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