01030052 clTUloF cureH�NNo CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRF.SS: PERMIT NO. y
21446 HOLLY OAK DR SHOWCASE KITCHENS 01030052
OWNER'S NAME: APPLICATION SUB OAT '
FLEER RICHARD P AND NR MI H 12333 SARATOGA—SUN YVALE RD03/09/2001.
I'iIONG: - SANITARY NO. CONTROL NO.
(408) 253-0412
ARCHITECT/ENGINIiER: BUILDING PERMITINFO
u{- BLDG ELECT PLUMB MECa
I_ u'S 1=J r=l Cl CI
yj LICENSED CONTRACTOR'S DECLARATION
I herrn oro,that lain licensed ander provisions of GIa , 9 Job Description
o z— Y a p ovLviu e P Icunavencing
GrnC wllhIII]force and of Olv6inn3nfthu Businasxu 'n,laxinnv C41dray liccmc -
atre''� is ve full lose one effect 1^ (_)L
at re Bull,, clay, n lie.. KITCHEN REMODEL
Dom Cn,
ARCIIn'RCI"1 n.mmDIiCL I
C='O g 1 understand my pions shall be used as public don a
y i O
fO BmnneJ Ihnfessional
^� de",OWNER-BUILDER DECLARATION JUL' 2 7 2001
I M1crahy.afilnn that I on ex,ro ,fmtn the Camuerda'x Bccnw Law for the
C z a following reason(Section 7131.5,Business and Pr.fensinae Gale:Any city or county
$E M which Int permit consumer, he i demolish. p ystructure
ce
i 3$ Pm I ,: also y theapplicant I such Permit flsignedstatement
Nal I : Inn n II p of Itl t nusinr I onsCer9 Sq. Pt. Floor Area lelAll ® B� ion
fico g with Section,,line Too,
of the Business s.nese lesionspter 9 ISL/ I{� �ro
or that he is exempt therefrom and the hi for the alleged exemption.Any violation
of Sectino 70331.5 by any nppllCme for a permit subjects the upPlieant I„a civil penalty
of no,mare than rye hundred dollars(1500). APN Number Occupancy Type
°I,as owner of the prnpen,,or Illy employecv with wages as their sole ennperuation, ^^,
will do,Ire woe.and the someone is not intended or nffTred dor.ale(Sec.711,14. Required Inspections
Business ami Professions Cede:The Contractor's License Law does not apply to an
r of property Who hookk or inyvovcs tn.
he .,and who tines such walk himself
or 1hmugl,bl.down employee,.Provided that such imlmovemcule am not intended or 101 — FOUNDATION '
offered fur sale.If,mwercr,the building or imp mvcareer I,slid within one year of
completion,the owner-balther will have the human of proving that he did not build or 102 — PIERS
to forms...armlet.
01.as owner of the pmpeny,don exclusively contracting with licensed commemosm 103 — LIFER I _
commoe the project(Sec.714,L Business and Profession,Cod,:)The.Com uchr'a 104 — REBAR
Llcresa Low does neo apply b,an owner of prnpeny,who builds or improves thereon, '
and who comma for such projects with a commcmas)licensed pursuant in the 105 — ANCHOR BOLTS
Cables or'x License Law.
°I our exempt under Sec. ,D Re P C for this reason 106 — SEWER & WATER
Owner Date 202 — UNDERFLOOR PLUMBING
WORKER'S COMMUNISM ION DECLARATION 203 — UNDERFLOOR MECHANICAL
1 Ihereby amnncode, .anyofp pryotoatthefogowi.gdegam,mnar 204 — UNDERFLOOR FRAME
131 have and will maintain a Certificate of Cause.,m offinsme for Worker'.
- Cmnp mzatlon, as provided for by Section nein of he Labor Code, far he 205 — UNDERFLOOR INSULATION
pear^comm)nheworkR,rwbmhthis perndtisissued.
301 — ROUGH PLUMBING
0 l have and will maintain Worker's Compensadun lnwmnm,as rtquiled by Scene. 302 — TUB d• OR SHOWER
3700 of the Labor Code,Tow the performance of the work for which this permit is
issued., W^aku, nne,x:Ianmin<aranmmn(ran porcyyyl 303 — ROUGH MECHANICAL
C°`"`° ��� Po°`yNo.:M4 t 304 — ROUGH ELECTRICAL
CERT(IICATION Or EXEMPT ION FR(3M WORKERS'
C1lMPENSX11ON INSURANCE 305 — FRAME '
(This sector need ran beampm,nrftnep count l,btronahtllli1rcedollars
306 — HOLDOWNS
al00).r leer.)
I cenif that in Ino performance of doe work for which this 307 — INSULATION I
Y per permit a issued,1
,ctrl nm emgtoy any person in any Itlanner so as m become xmbjen m ma..otic 308 — SHEET ROCK
Comscnsminn Laws of California.Doe
Applicant 309 — EXTERIOR LATH
NO DUE.TO to the AN Workefl,r
aloe,makingthis previsions
at of Exmnprodyou should
0 bruwilhcoamththsuch[.avampensationpmvisions.I deemedCNe,ynumo.° 310 — INTERIOR LATH
Z
0 forthwith comply with men Provisions or this Pstm,it shall M deemed revoked, s
CONthemis RUCTION LENDING AGENCY
311 — SCRATCH COAT
Iherehy which that ohesisacoosbunion lending agency for the performance 31.3 — ROOF NAIL
of the work for watch(his Iv+mi,Is isxuud(Secs 3097,Co.C.1 '
y p Lender',Name 501 FINAL. ELECTRICAL ENERGY
yLeader's
1mt,h 502 — FINAL PLUMBING ENERGY
I wnlee Oast base need Ibis it yang co and nude ante ted d above stor lawsatian is -
OL. r nen.lagreeme6comply with all cmumIunpeerecivicevondslaml°wol, Penn 503 — FINAL' MECHANICAL ENERGY
V mhuimmgconvwctinn,malherebyamction repssentatme.nfthis cioYmen¢r upon
A. d,eanoOve)gieeedpm.indemityadkepbearle,aupsera. 504 — FINAL BUILDING ENERGY
Fa M'ejagmets.tiits ed,andnifyanJkeephmayin ywayaof Corengainstaid l 505 — FINAL ELECTRICAL
st
VJ liabilities,,Nhc
rrrcms,ants and expense i which rm dory in my way acerae against said
C7 z
City f the ming of this Panni).
PSl' N SA U WILL COMPLY WI'rli LLN NPN-POINT Issued b 506 — GAS TEST Date
S( ION . ,.,� y
go3 ARDOUS MATERIALS DISCLOSURE Data
Re-roofs 508 — FINAL MECHANICAL
Willm or hums building a:ar,mal shim o handle haaarall material Type of Roof 509 — FINAL "GRADE
as defined by the Lowman,Municipal Code,Client,9.12,and the Brdlh and Solely
CoJq Section 25532(x)'! 'n p ",S� ��,.,"N �_ L
❑Ye, °No All roofs shall be 51 @gcoedFF�1 o x n r ** a noxi being installed.
Will the applicamor fumy hadiding occupant use equipment or Jevicu..which Ifaroof is installed�v`tthou[ tirtt�lain�nyifisrpe�'l �i,�cxt'gree to remove
emit hazallous air ummminan¢as define)by the Bay Area Air Quality Management
Diar " all new materials for inspection. Applicant understands and will comply with
°Y"' °N" all non-point source regulations.
I hove nod the he ntmeriaN requirements under Chapter 69 of the
Collfnmia lleuhh&Safety Curies Sections^_55,5,25531 and 25534.1 underswnd ohm
Bit,huildingdocs not curtcrod ave tenant,that it is my responsibility,.nmif fir,
au'nlpam of the re uimmenth n us,be met prior m issuance of a Cenificme of
G"°p°°`r. 3"q-'01 Signature of Applicant Date
D a Ig, r ell agent "co, I All roof coverings to be Class"B" or better
OFFICE