02080166 OF
CI BUILD NG DIIVIISIONNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7535 HOLLANDERRY PL CUPERTINO PLUMBING 02080166
S N ME: APPLICATION SUB DATE
W
N:� GARY L AND REBECCA C 10297 S DE ANZA BLV 08/29/2002
PHONE: SANITARY NO. CONTROL NO.
fffjjj (408) 253-0618
O O ARCHITECT/ENGINEER: g BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
6mw
z LICENSED CON'TRACTOR'S DECLARATION Job Description
oEi"o Section
affirm Natlam oftheBscoundi aide provisions olfasionsCde,and(commencing
nse REPIPE/WATER SERVICE p
F=C. with fall
of Division of the Business and Rofessions Code,and my license
It full force end ellen.
E�a Ijsta Class Lic.N Z L/ f �
au G.mncro(
ARCHITECT'S DECLARAT N
�'= g I undersand my plans shall be mud ns public rtcnNs
YJi
uaml a p 0 Licensed Professional
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Commemr's License Law for she
t 3< fallowing mason.(Section 7031.5.Business and Professions Code:Any city or county $5000
E F who h requires pem t as t t.alter,improve.demnusn or mpab any..lure
C
3 pre s n. 1 nq ' pr appl ons for such pemt t w flan s ow(Chapterf the 9 , .KxnmiEFt��+IffOrr ',ea' y 1 ,y k.I, Valuation
or n acasi4hS idiom fID)ofhe vision isor the
achidiron.Any vi Code) t;{} i i 36 tl ✓QL1`!'`L 'i Fi:i.f ,I,,.,`s,
or Sectionhalos exempt thercGom and the bons for the ss the
applicant
Any violation
,of not mom than
5 by any dred doll for a Permit suhjttts the aPPlicam to a civil penalry-
lo(not m.rt tlwn Bm natured dollars(s5001. 202APN tk0tqkFLOOR PL BI'NG`O. Occupancy Type
°I,as owner ofshero,g.or employees with woes as their sole armpenes cion,
P P Y Yemp y g
'will do the'womfa,,and'the ode:T situation Is nor intended Li or a eredLaw for sot.not apply
an an: 5 0 2 — FINAL PLBMBii< GnsPd6tRCY'-
owner of ondBrty Who
Code:The roves tcwr's License Low docs not apply m an ''' '``'
owner of property Who builds or improves at such,and who dos such work intended
507 - FINAL PLUMBING
or through his own employees,provided Nm such improvements art not imended or +
completion,the
M1dwuildewibuildinge Widen
proving,
rove wlat within one Year of .fl;;d"<:, C'[.T!'O:.SU
imp....for Ne plumose
of owner-builder will have the buNcn of proving that he did nm build or
improrc for purpose of xoleJ.
tr owner of the pmpenY am eadm m a d Prue ng wah I cenxTi Contract to 1 t
Licetmesthe awdoes n(Sec" too Business and Professions Code:)Tim improves
Contractor's
License U noes not apply t owner f property who Wilds d.p mun the n
_and who.consmcu for such ProJttts roue a omrector(s)1 cud pursuant m.Ne Ftl��A r1= 0
Contractor's License Law. tttt [6s �a9
1 ❑1 wore mPt made Sefll i I"' sBf&P C for this rearm
o
net P Data SEP 3 0 2002
WORKER'S COMPENSATION DECLARATION
(' I hereby option under pro.hY f pepury e f the f fowin,d clamtimm: �j
° I h '.oil will ma ret C n a rife taf Co.enirc tb self for Worker's BUILDING
Compensation, m,provided! f by-Sen n 3700 of the Labor Code, far the
_ �perfonnance of the'work for which this permi Lis issued 1..
_ -
01 have urid will mainidin Workers Comjiniasiori Iniunnce.-es¢quimli by Sktion
37 flhe'Labor C6de;fur the ix'rfomana of she"work'foi which Nii perntH is
]I d My W rk 'i C open anon .uran ant r rid I li y n mher,urc, t
, rfB<liyl7ti;:SP beyrv.`l/:3dlU/U%TGbOOG (p,:
Came2 T 30
- ^''CEHTIFICAT(ON OkE%EMPTION FROM WORKERS"" " -' 1 • ' -1
`' ' -COMPENSATION INSURANCES. " '"
"' 1• (Thu section neiiii be comiW d
plethe permit is for one hundred dollars
(SLOTH or 10 7 -
_ 'fl. cnifY,ihaimthe Performance beet"ort far which ub perms aissued.1. _ �2 .il
"hall riot emyloy'any peron in tiny manner so as so become sub3ect m the Well
Compenzmtah Laws.(Golf a.Dam - "
NOTICF.TOAPPLICANTIf alter mek gi hCnlhcam tExabor Co you should'
becomeh comfy with;6,h ismy fors or this shall be deemed revoked.
you must ,
I. nsnuon rovui.niaf the Lobar Crede.
Q 0 fnnhwiN comply-' s p pe N. -
.. __ __... . .
b.t -�[CONSTRUC TON LENDING AGENCY ' � ' "° "'
+a
la
1 he by M thathe s re t n I d n8 8 n Y f the pert rte ace tl t 1C'I ' N.
,W ad w if wlicl ih pe t e d(Se 3097,C' C7 u'.c,.. C:. .. ,.,...__. _.._.. . .__.._ ....._ _. __ __. _ ..-_.....__. _._... . . ..... _..
P,
D" 'Lend IrrsAdd s :: . It
I certify that 1 h d his application red',,.in thole above information is
�GL E.r U.tool l g cwrs taco ply th II city end county ordinances red state t lows elating
.V l tob 'Id nBco umci'n dhertbybuth i 'peunon iv s,Tth' tyro corer upon
theh e n f 5 d p pent'fi r reopen @@ rpm'a'
_
(� W (We)ageo'tgR f lfy Bike pharmles tti Cry IC penin.against
Lr rn liabilities, yl�is c n d h may in any y accme ag?inst said CA
'V Z CtY Q9 t![e fth r n of h mill. l G,
jAP IC )ET ST it cT sz'ITHALL\ON-POINT" D d Y
$ URCf P �0 5 j PJ� ,, u ♦ /r� Issued by; Date
Sign a fA IiantlCont 'or- ' •"f ',Date Re-roofs
'vHAZA OUS 1A IALS DISCLOSUREr
I Ne appbant or oMm Wlh'ing accupat&Nrt or handle harallous mete al _Typo Of.ROOF - --- -- ---
as defined by th Cufard o M sopa)Cale Chapter 9 13 and the Health and Safety , - •: -
Code Semm� t�a I lvf19 V >>.'; rt ' r s J m-��,is +r,
w ❑Y r s. -i.1 } I ,4:. ,,. i . t.:.
I All roofs shall be mspected,prior to any roofing,material.being.installed...._....._
WII the t ftrebuldn oc t tent or e h h '
-•, pa g P a P If a roof is ihstalle8 vithout first obtaining an inspectwn ''I'agree'to remove
cmth b conmasunards as definculbyN BayArea Air Qalny Management
District? e - all new materials for.inspection. Applicant understands and will comply with _
+ '—a11 non-point source regulations.
J I baso read the h zadoas materials regmrcmeins Inch Chapter 6.95 of she
California Health& tety.Code:!ec'on. 5 25533 and 25534.1 understand that
-ofshe building nae. scu sly ha 'mn tshm it ism ponsibiliry to notify the , ri
` oc p n fthp trtm Ms m etpn is, of C'nif am of
.'' of Applicant_., .,- _ .. _., Date-,. -
All roof coverings to be.Class B o better ' 'i'
_. ..OFFICE--