02040105 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR,IIVF,ORMAITON ��'
BUILDING ADDRESS: - PERMIT NO.
10491 QLENVIEW AV ATLAS HEATING 02040105
OHW'ER'S NAME:
APPLICATION SUB DATE
HOWELLS DONALD F AND ALANA M T 155 SAN LAZARO AVE 04/19/2002 .
PHONE (408) 739-0516 SMTTARY NO. CONTROL NO.
ARCHITECTIENGINEER:
CO BUILDING PERMIT INFO
L Z BLDG ELECT PLUMB MECH
1,<y LJ CJ C.'d U
C v z LICENSED CONTRACTOR'S DECLARATION Job De$CTIpCIOn
Z.❑ Ihembyaffirm that I am 0).fDM,ion3oftheBcensed undvpmvisionsa1.mCd..tt.o license REPLACE FURNACE/ADD A/C
=C
with Sec,ion7000)of Division)of the Busincsa andP fessions Code.end my license
is in full force ond'eRe 1
s < License CI s Lic.N l
O O DateComrator
LLO�, ARCHITECT'S DECURATIO
S 1 understand my plzm shall be used as public records
s<E
Licensed Profcxx,onal
6❑O
R OWNER-BUILDER DECLARATION
1 hereby aRmt that 1.m exempt from he Connor's License Law for the
t Z_ following reason.(Section 7031},Business and Professions Code:Any city or county 5 O 0 0
❑ which requires a permit,o Cons ,otter,impmve,demolish,or repair any structure
6 $ -prior..its i....oce,ahn.,Oauim Ne epppplicem forsuch pcmduo fikui{nM suremem.
N4,he.ulieiosed pursuhnini ti,milt nsofthe Contmnoh License lawlChapterg .,., - ---- ---- -_ - _--
(commencin{wiNSeeti.7000)gfDivision3 ofthe Builncssand Prufnaiou Cod)eV1:'�,' g'E3.�,�`1Ff? I PCoA t - — Valuation
or than he ii iaefn'it6i¢from and the basis for Ne all"ed eke "u }'-1.` '
P G scant u,Mry 1penity
Of SaOon]031:3 by my applicant for a permit wbjttu the applicant m arnll pmnlry'
mr n.rmdR than five ngmrea dauda(ssw). 301'PN 1" Occupancy Type
13 1.as Owner of the property.or my employees with wvges u their sole Compensation, _
,vill N'e wiirk;mJ the urtbiiurt a not inundid orOffered'foi vle(Sea-7044,'.
'Im :ineand Aofacd...Cade:The Conwnofs License Law don.qlot apply to an 304 - ROUGH Ell?��tlt$ICI@3pY.ctioiis'Jy�'"='r"=
owner of propcny Who Wilds or improve Merton.and who that such work himulf
or
Nroueh his own employees.P.Aricd.that such improvement.ere qm intended of_-_-,_,___- S_OS 7.-FINAL ELECTRICAL
;offered for sa)e.11•however,the building of improvement is sold within one year of _ ----'- _""N-' - ' -'-_ "-"'-"- --' ----- ---
Completion,the owner Wilder will have the When of proving the,he did not Wild or 507 - FINAL PLUMBING
imm--ef puryom otsal.... .508 - FINAL MECHANICAL
._,,. _._._ . _ , contractors _. ._ ... -...._-.-- -__._. ._ _ _.
col acether mjeCf the pmperty.am excBusiness
dratinglicensed Contnnon,° :3_ILl>. Ilconstru ' :.
Licomectthe does
no(Sec.71344.Business endetywo Professions Cada:)The Contreron, d!.,' •'Ll ., `:CI(
License law has nm apply loan owner of Progeny who builds ou seimprove thereon,
' ....ntrace,Liccse.or Lawah Pm)acts.witl.a.comracwr(s).licenaed punuau.t°.he. _. _ ...._---_..._-.._._.__,-.__::
CIIam hptu :Law 0 1. aC I td • '. _.-
❑loot cmPl under Sao.' "B pp C for
r . . v . .th.is.: .:.o,n
" : APR 2 5 Xl2l
.,
Ota
",_. WORKER'S COMPENSATION DECUBATION
Ihe.e . m��eu - - - BUILDING
- by pemiry,ofperjury;oneo(the(ollowingdMandom:--
❑ 1 hive
sod"'I"nuinlain Cinifiete of CoiuenYla'self-imum for W.rkn's
ComPntation;as-Provided-f.r'by•Section'3700'of.the'lab°rCode;for-Ne
performance or the'weak•fm which,his permit u iuued..
O 1 ha ..d willmai um WorkerCompenu+gn butii8rra u riquirtd by Section
3700 of,he Lebo Cpde (a Ne perforinvntt of,lie ark/or h h Nn pervut u
,uue4 M Worke Gompe upon Insurance cameunA Potiry umber art
"Zi
t re CPRTI67CATION FJ(EINPnON M' 0 1 t �✓'97a �. �, !+s.t ni� K
•1 I._i:\. t t 'L.Lij.P vV. 1,
(ihh eecuon neednoO bye EomAe7 ,.. .. , ..r•.'t...:",•L.Hm _..a...,. . ..,.......,... ._...... ]... _....
a.
?4'3 ''`F ted tithe pemdl is for°rte hundred dollar ,• togs : •a•••�,� ��•+
100)or less � Pe 1 '
Irnnl
i � ..; -.. ..._..- ...._
)
C art c NfY Ihat n Ne perform.tt f the sY d f titch NO rmnln toyed 1
Wor1 �'"
N all 01 empioY any Person n vny ma rte w to become aubJen to,he ker
dln anon V of Ctll fo Dne.
pp ......._. _. .,.,.-....
of
Q pY P °king.tips CemOntath'LAboronyou should AN i_,', . , rI„ t
APPLICANT.it 10 nwhan pro+Cobbs bf the LeWr Code you mon
z berome wb«i to Ne Norkeh Com a ooh c perm t shell be deemed rtvok d.
ler m
1 a
zfenhw,N tarot -- - _
)
E+'� ant rci t "'CONSTBUC710N LENDINOAG¢NCY a' •, __ _ _
CL,� 1 hereby eairm Nn N<rt+s•e nsyvct do le do V ncY!a Ota per(omuni'e' f� 'I I r -,
W bfNe .rr far filth N s perm,ta. ., d(sec 3097iv C) ` " 34�C C
D z
1 ten fy that i have ❑Nu appl Cot on Cod su. Un N hove ml Torreon is
W t,,,, tuirect 1 a{rec m wmply w,N all c tY and amy oN n Cocas and.nn law'all..I,
Q.(J m W ld {Con witlon and hereby auNoriae reprtsenuuva.(Bass my to mar upon
�„ Ld the aW x mems Coed property for smpeclion p rposey
�:G I IVJe)agm to uva'.ndunh+fy end Peep harmleai Ne C+ty of Cupria almost
�, liab 1 t u ludgmenu,cow and expenses 0+qh maY n enY wy accrye:tains.+Wd
(J ti Ciry m coneqqumce of the ymnlm{of permu /
1rppF,iCA�TCA'DERSTA�'�ys A�'D 4,�OMPLY NTItJ L 10YP LVTs•° I'
sDLmcpBEGh:ifb.s Issued by: Date
Sli namr9 f ppl canucc Iree Re-roofs
Nii
MATERIALS DISCLOSURE
❑ ' {et Prnl rS.12,unci t harardanm a. Type of RGOf .
i Wt1i Nea RAW
urt
No
jn k t and Befery - ..'
�I dta'll Bu a Iidant a Lure Id n
as delved b the Cu moo un
Code Section 251132(a)?,, P r +_I°[. : + , s. . . I a t i r ) t +,t
Y Pe P rode.ChaFur 9 12 wd the Health
g P
� _, All.roofs shall,be mspected,pnor to any roofing.matenal being Installed..
t Pp (h gacu ant use eq-pmrnl or de¢as whi h If a roof is installed without first obtaining an Ins ecuon;'I'a ree.to'ieinove
ems hatardopa tar co temmams u d ed by Nc Bey Aree Art ent or eAci ant g
Duron+ :t 11
all ne .,materials,for,inspection.,Applicant understands and_will comply with
[3y a No .._..__..
all non-point source regulations., _
i;' C nave retdthe hazardous mntmils rtgv+rtmenu"under Chephr 6.95 of the
p g
Cabfann HeilN k Safely Coder Se Ideas 25505.'23333 and 23334:1 understand that
ebull {dasrotemrtn0
ocCoprnl the n, inenvemil. ch mut be m t odd,to I.. of•C/or�i nu of 5
/ GQ
...Signature,of Applicant Date _.
All roof coverings to be Class,-B'or btafer
+