01030037 4T CITYDING DIIVISIONr�O
BUILDING CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7514 HOLLANDERRY PL ALL PHASE CONSTN 8 REMODI_G01030037
OWNER'S NAMIF APPLICATION SUR DATE
BATLEY THOMAS J AND CLARE L 7373 FAL-LENLEAF LN 03/06/2001
PHONIP t SANITARY NO. CONTROL NO.
tall L (408)366-1701
ne O AR HI'1'E(T/ENGINEF. . pU1LDING PERMIT INFO
zF B ELB PLUMB ME
�-. LICE SI!D CONTRAC OR'S DECLARATION
0 h= 1 hereby a it that 1 nm licensed under provisions of amplet9(commencing Job Description
PhC wish Section]111X11 of Di nn]ol'tbu lfastness and Professions Coda and my license -
< mrauraree-dem•` 220 SO. FT. ADDITION
K O U Lia., Lic.p AiP2��—
R!
f
c.
9 Date comm1594 SO. FT. ELEC. UPGRADE.
�O ARCHITr;Cf'S DECsed as pcn
yo O Licenxal Pjoleseionnl
o,
OWNER-BUILDER DECLARATION
hereby,(hero that 1 nm exempt from the Cwoun.C's License Law for the
C3< Followwhich n,reawn.(Section 17m1.5,Businessand improve.
Cod,:Any city orr aunty
If� O which requires n permit to comtmd,alcor,impnwe,demolish,nr repair any structure
E3� minrmhs lensed alscretail esthe app...is the Cmara n Liccfile a Ltsw(smmmem
thminnera r,witpursuant mine povisum of the the Business
and Pxxvwonr(Chapter Sq. Ft. Floor Area Valuation
(,mince is c.c,u Section gat add the basis
l of the Bued co and Professions Csdd
or that he 7 31.5 tph tmy,plli soil the co for the es flat exemption..An,violation
of Section thin vanyapplicantfar apcmrit subjectsthenpplicmn macivil penalty
of not mare than ire hundred damn lSstlBl. APN Number Occupai
°1,as owner of the PuTeny,or my employees is ill wages as their sole compensation,
will do the work,and the structure Is not intended or offered for onto(Seo.7014,
Business and Professions Code:The Contractor's License Law does not apply to an 3622901, pgidreI Inspections
twos,of prv,ny Who builds or improves mcrcan,and who does such work himself
,r through his own employees.provide that tach Improvements ate not intended ar
offered for sale.11,however,the building or improvement is,old within one ywr of
completion.themorambaileerwillhavetheburdenofprovingthathedidnotWildor 101 — FOUNDATION
improve fur parpnseaGale.). 1.02 — PIERS
°1,as owner of the propedy,am exclusively contracting with licensed contractors to 103 — UFER
construct the project(Sec 7014,Business and Professions Coded The Contocmr i
License Law does not apply to an low net of propany who builds or improves thermn. 104' — REBAR
and who contracts for such projects with u contract...t0 licensed pursumm tl the
rem meexemptmc,See 105 — ANCHOR BOLTS
°1 to exempt under Sec. .B&P C for this mason
Owner Date 106 — SEWER & WATER
WORKER'S COMPENSATION DECLARATION 202 — UNDERFLOOR PLUMBING
Iherebyaffirmorder prally of,cj.rymneofine runowingdecmrutium: 203 — UNDERFLOOR MECHANICAL
° I have and will maintain a Cenilicate of Consent to self-insure for Worker's 204 — UNDERFLOOR FRAME
Compensation, as provided for by Swim 37M of the Labor Code, for the(. pebronceortn —
eworkforwhichthispermiiisissued 20S UNDERFLOOR INSULATION
°1 have and will maimain Worker's Compensation Insurance,as required by Section 301- — ROUGH PLUMBING
37M of the Ichor Cee,for th performance of the wok for which this permit is
toned. aar•.cam esti tlnwranceearrierandPolicynumherare: 302 — TUB & OR SHOWER
Came Policy Nn: 303 — ROUGH MECHANICAL
Up
CIiK 1 C ITION OF ;XEMM ION MOM
COMPENSATION IN URANCE WORKERS 304' — ROUGH ELECTRICAL
frnis section need nm be completes Friar Permit is car dna hundred dollars 305 — FRAME
(slw)mto..) 306 — HOLDOWNS
I eimify that in I •rmrmance tar ate work ler„mien this permit ix issued,I307 — INSULATION
shall not employ any per i manner as , •c 'ubje[I m the Workers'
raMI card ti wear, ih kIEDI
08 — SHEETROCK
Applicata
NOTICI I L N'I':It.. 'mnkins Ibis � ni ams Exemption, us Id
z became object o the Workers nn pro$(Pus of the LaMn Cwtq,Yama"t 09 — EXTERIOR LATH
r�00 forthwith conglywithxuchis tsps tvhot] ad.
10 1,0 — INTERIOR LATH
F ^ ya CONSTR '1lONLor ' 'lig y-- nor 11. — SCRATCH COAT
1 hereb Ilirm thus there n' en a for the"`■� re
of the work for which this 3(197,
w `p LenderoName r� 3 — ROOF NAIL
W� C Fund, Address 501 — FINAL ELECTRICAL ENERGY
I sonify that 1 have need this upplication and state that the above information is 502 — FINAL PLUMBING ENERGY
its F. correet.I agree m comply with all city and county mdin:mees and s aide lawrelating
O U
it)building rnmtruchon.and hereby au@mlzerepresentatives onhisehyinat11erupon — FINAL MECHA I
me alms-mentioned pouirmy for inspection Parpores. 503 ENERGY
a (We)agree oaave.indemnify and keep naodeasthe City orcupenionagainst - 504 — FINAL BUILD
Z liabilide udgmm�ts,coats and expenssx whrth may in it.,way necme against laid NERGY
V .za City' son name of gaming o(Ihis permit. rn�1�
AU �R UNDFt ANpSANDWILLffIMPLYWRHALI.NONPOINT Issued by: 5 TIjIC Uate
Sign r� anocmnvestor Dme Re-roofs 507 — FINAL PLUMBING
HAZARDOUS MATERIALS DISCLOSURE
Will theapplicaut or future building temper sore or handle havnrdaus material 'nope of Roof 508 — FINAL MECHANIC
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Ford+and Safety
Code.sction25532(ayr 509 — FINAL GRA4E
°YaS All roofs shall b este 1 a r a bei m Iled.�
WiII the applicant or Imme building oeenpunt use equipment nr devices which �' D
emit ha haus sir cantaminnmsa dein the Bay Areo Art Uuallty Management If a roof is insta nhou s to I C I a fee t re
�qq pp�11 RR x�
Di'1 all new materials nspectI pG lnddtrs c9ldpl tbblt�t
°Yee °No all non-point source regulations.
1 have read the haxaNaus materials requirements under Chapter fi 43 of the
California Heahh&S sty Ctde,Sections 25105.25533 and 25534.l undemmnd that p V
tribe ng Jncvn remlybnvaa mnon6 that it is my respunsilarity to notify the DJ
rc punt the rcy r nems which must be amt prior m issuance of u Cenilicute nl'
° 'ancy _ Signature of Applicant Date '
owl• amnart Dote All roof coverings to be Class `Bs' or better
OFFICE