02060006 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
'BUILDINOADbRESS.! .... .. PERMIT NO.
ft'Y 'HUNTERSTON PL 02060006
OWNER'S NAME: APPLICATION SUB DATE
ROBERT & MICHELINA ZALUSKY 06/03/2002
1.'��'+ ,•PHONE: SANITARY NO. CONTROL NO.
it
O O AR CHITECOENGINEER: BUILDING PERMIT INFO
ELECT PLUMB MECH
stF. ti?.
, ;'
PCENSEDONRATOSDECARATION
Al-of \ .:,Job Description
OZC the ! m
C; wthSean r7M)ofDi ison76flhCB ' sand Professions Cale,endmylicense KITCHEN REMOD (sj+B�Ts±Tr��iJCBURAL
Y.E J i (II force and effect II y S;y?I._i R ..A
Xi
se�U License Class Lm.x
Date Contactor
uaS3 is. ARCHITECT'S DECLARATION gip 0 4 2002
C�=ONS 1 undcisand my plans shall la,used as public records
yT
a,a p O Licensed Professional
'� OWNER-BUILDER DECLARATION
1 hereby a1Rrm mat 1 em exempt from the Contractor's License Law for the ��O 1"C1�vs �!'_
t < following reason.(Section]071.$.Business and Professions Code:Any city or county" `►N$70000
0 ,wh h requires a permit t construct.alter,improve,demolish, r repair my suvaum
tis e,alt requves theyhoonein for Conramitmtractors im igow(Chapticm
. a•3- (c tmbe sI' rnsdh Sectimtq Int of Division or the Ce Business and
IChapmr9
cw,,y.,apt pW�ppo- Valuation
t' ( ret ,Bamh Sento7q,0)ofhe bmi, 00fthelujod'v dPh.Any vi Cade) 3'6�LZ!G.O'Z
or that io rs exempt an,
the basis for me alleged ekemption Any l psooan j
of Section]071.3 by arty appllcans for aperminubjecu the agDlicam to v civil
nt nnt.mnre m.n nve nunarce apllaia tssoBl.
101 APN�� ATION ... a Occupancy Type
- "
,Dl,as owner of the progeny,or my employees with wages as their sole compensation.
othePiERS
will ne the work.-andsiturs .dc:smiTh snot tinentle0 or cmic eredLaw due,al, ply
In
- "-- - 103. _. "UFER "
mannas mid Profess ons Code The Cptnactor v, cense Law noes not ork hi to an _ Required Inspections ' • '
'owner of property Who builds or improves a...on,and ve docs such work himself
•t+ of through his own employees.provided that mpr improvements vrc nod intended or 104 - REBAR _
-uReiee for ielE.If;how evei:the tibilding ai improvement is edlJ within one YeaFor - '-"-- -
'Completion, 105 - ANCHOR BOLTS : - . .
p proving that he not build or
reprove forpuryottuteale.,. 106 - SEWER & WATER _ _
-- .._ - -
6�fuso ea p' peny an aRcies veiy t cr' g 'ihl n.edea naacto sio' 'ZO2 - UNDERFLOOR PLUMBING
t t the pmyecr(Sec
7037 Hashes, std P (essmn Code)The Contmati s
License Lawdoesma apply t ndiction, 203 - UNDERFLOOR MECHANICAL
::arta hu contracts for such pm,cct w m a contractonQ licensed pursaant t .m . __ .. -2'04 = UNDERFLOOR—_FRAME
-- "
R ,C u toreLielse Lv s "' -
jO I m empt and,,5 1 e - 't �! ' B&P C far histreason )
1 �pz 205 - UNDERFLOOR INSULATION
WOR SCO N DF.CL RAT N
301 - ROUGH PLUMBING
302 - TUB & OR SHOWER
± Ph<rcby affirm d pen pepuiyoue,ofinefllowmgdeclamti n.
303 - ROUGH MECHANICAL
-Z ❑ I have ad will maimain'a'aniReel�nr eunseetin sclf insure far Workers 3 04 - ROUGH ELECTRICAL
Computation.,as provided for by Section 37W of the Labor Coda, for the
performance of the work for which this pessniit is issued. 3 05 - FRAME
❑1 h and will'ma t t w'rIce- C rep i o Infamous,m readied by Sdfion 3 06 - HOLDOWNS -
3700 of the Labor Cod f r the performance of the work(r which this permd is
issued'' .My Worker's Compe s t .Ins en tamer end policy "k,are: 3 07 _- INSULATION
. ..W... _i. ....
Carrera .' ''t? Policy NA `308` , SHEETROCK.�." ..
( i -
CERTIFICATIONOFEXEMPTION FROM WORKERS �'t 3 ' 3 0'9' '-�'EXTERIORt LATH"'
COMPENSATIONINSURANCE '� S
;rrna e,c hm,nCIed not be ebmpletm d me pertna is for one hundred dollars
.. 311 - SCRATCH COAT f .
------
-
"^ lcenrfy Nodi m,p<t_ '<e tm ' osk for wh hm Pc 'ulissueal ..313.-.='..ROOF`NA'I�L`�� ,.n•.t,,i
A l e t mg y'ahy K y��,,s�f°�r s as m n e s b,ct to the,Work '
cpmge tpnLn e fcarrnmiDdur- ? n,T - 501 - FINAL ELECTRICAL ENERGY
C lin to
Tlcrronppuc NTRacrm t tni motExempionyoush la ..._........... .503.. _.FINA.F-INAL....MECPLUMBING HANICALNERGY
ENER . .. ... ... ....
Z c e b,ect to the Workers C pe u n pr ill s of theLebo Code,you most GY
O O fonhwonComplywithsuchProvson,orthiapermi sha0bedcemedrevukm. FINAL BUILDING ENERGY.....--
;I s
504._.-_-. _ - -
"z" h • f'a CONSTRUCTION LENDING AGENCY - f � '
F� + Ihrenyyl'Enatn lm retse<pnswmm�3097.Cig n<y r�r me p<irdi.daek 505 - FINAL ELECTRICAL
.6f6kr! n<nm
it
Le.ds,Iceoty th�IM1a ertaJ his application andtmeVC) .• •.... .._.. -5_07 GiMkI., ST,__..,._
� z ode d eH 507 - FINAL PLUMBING
U Cmattho W,emtomahuais 508 - FINAL MECHANICALI
cortect:(agree to cotpply with all cil,and county ordinances vad sate laws relating 509 - FINAL GRADE
I.
Id gconsi-C'mi anJh byamn ip emalw fthscitymenrcrupon
s7 m ab em mion,p psa.)for imteal nprpo.es. S10 - FINAL PLANNING
.¢ (W) 6 em tdcramfy and k phaiIa'lne City 'f Cup Ftinoagainst
V1 li b I t judgment s, nand a gens which may in any y « against— 514 - FINAL UB C WORKS ,. 1
C.)'� C ty Consequence f the granting of this pe n 11 /✓/1V/
APPEIC\\TVVDERSTAVDSAVD WILL COMPLY WITH\CLNON.POtCT'"
SOURCE_Reauen lost i. - Issued by: Date
ignat of ApplicartIC nor 2, "I. Re-roofs
p .HA OUS' A IAL.S DISC40$URP ,
Will th'applicam r f turc bu' ng occupant i re or handle haxaNbus mutcrial Type OERDOf -
'u defined by lne C perup MLi9a1"ICCdC,Ch.pICr9.I2.musithisHealth ndSiffely ,s - - "':• '"-' - ` " , Pt
Cade (]Y s�2353 {a, „ 1 N i...- rt' ts> " t1. 1 11 a' s -,t. J. �l• .1(t`;• „a
( ' t All roofsshall be respected pr r%any.roofing material being installed, „ , , __
W II m<pppl cam future,b Wilding aura use equipmentope t<e m<n If a roof is installed ai[houI first obtaining an'inspection;'I agree'to remove
'emth rdu arCottonmouth, .defied by the Bay Area A Qua]ty Management
pit all new materials for inspection Applicant understa_nds and will comply with
-r ySection,
p .-.._-
ltfurri.•He:Rn&SafettyCode S io elissos.issi3 ad25534. understand all hon-point source regulations'
ca
❑Yes N =
s the
not
if me building
ones norcurrently t nant that it is my responsibility y the
oCculpart ofaurcquiremol,which'must be mei prior tot t of o C!'HiFite
of 's
Signature of Applicant Date
o -erorterhoavedagem All roof coverings to be Class "B" or better "