02080154 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMITNO.
940 HYDE AVE 02080154
SUB DATE
DUsh�1�lE & MIHWA COONEY APPLICAT08/27/2002
(_ HONE: SANITARY NO. CONTROL NO.
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ARCHITECT/ENGINEER: BUILDING PERMIT INTO
WOO BLDG ELECT PLUMB MECH'
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SRH
Z LICENSED CONTRACTOR'S DECLARATION Job Description
ZO Z= 1 hereby affirm that l am licensed under previsions fa of Chapter 9(commencing ADD 17 5 S Q. FT. /REMODEL
s-,gr wi,hh�ninioryryRgo)of Division lof Ne Bmims Pmfessions Cade,end my license
<,jE isinfullryrceenJeR ,�2° u, FINALE®
icep u°i U License C az Lic.
3 LL
Data Cammnor
CHITECI'S DEC 10 ,UN J q
C OI lead.rsmnd my plans shall be usedmpu rare Tilt DEC 0 d:,2002
C
aci o O Licensed Professional
OWNER-BUILDER DECLARATION
y 1 hereby affirm that I am exempt form the Contractor's License Law for the , '' �fa�(;_
F-Z following notion.(Section 7031.5.Business and PmfessgY
ions Coke:Any city or county I 90
f F C which re,uims o permit to construct.alter,improve,demolish,or repair any structure
p , 't issuance.al req ' the applicant for such puma fl signed summen, """-" -- --- - -- ---
P P P . , , e ... Valuation . ...
That he elgcnktl Sec in eNe rotisiosnion N,CeRosine L law(Cho mr9 3 g...Fa,.Rk... t
Or n¢c g with t Th' a ]tool f Division fir
the Rosiness d 16.Any vi Cod<) (_{-y, v-!i i... V lYL' ,E,,.,..:1,},jCx%;
of Section
c he is 31.5 b a efroni anis the basin fir the cts the.exempdo o Any violation'
I of net tome the.
v anyapplicantollforapermit mhjrab the applicant mocivil Penalty
IocnptmnmNa�r�anandrcddnllar.(sstro). 101APNNS*flATION I"-I,n,l':`"` Occupancy Type
°I,es owner mf,he property,u my employees with wages as their sole compensation,
".0l do the"work:end theTwnure'is nor intended or oBzmd7or'saI,that.]Oltj ],O3 - UFER Required Ins ectioh"sI('•>'�'"°
t Business and�Profmsi m,Code:The Contractor's License law does not apply to aa. q p
owner of property Who builds or improves thereon,and who does such work himself104__- REBAR _ _ _
or through his own employces.provided that such improvem,ms am not intended or, —____ __,_ ,_,_.__
'-bff red forsule:If,however,,he budding nmp,ovcmenr issold-within one yea?oft --""--105 - ANCHOR BOLTS "4I <O. `�'f hsL'<U_
'iomplcticm,Ne ownerbuilder will haw the burden of proving that he did not build or
improve for Purpose of sale.). 106 - SEWER & WATER
:p 1;u owner of the proper,,am exclusively contracting with licensed contractors to
----------------2'02 UNDERFLOOR'--'PLUMBING-"—
conacut,the projcet(Sce.7011,Busixss and Professions Code:)The Contractors' 2 03 - UNDERFLOOR MECHANI'CALI^'' PI `°' Vn`It
" License law dues not apply man owner of property who builds or improves Ncrcon'
PP Y P pert,w Provo
'_' _and who escontracts1or Law such Pmlects"with.¢connumrts).Bcensed.pununm m Ne: ------------...._.
e tvitrLcense sew ---'-- 2'04- --UNDERFLOOR' FRAME --- - - -- -
❑1 isundeSec. , '.I^'r' 't ' &rcf.nhi,ecoun 2'05 - UNDERFLOORI)INSULATION
o " at ' 301 - ROUGH PLUMBING
„-
" '. "WORKER'S COMPENSATION DECLARATION
-.. . 302 - TUB & OR SHOWER
I hereby affirm dnder,p any of papt tee onna ronnwing deemmdnn.:-- 303 — ROUGH MECHANICAL
° 1 hale Grid wit::un arnain'a'CeniGcam'ori:itsm a st, -mum for worYsf's 3 04 — ROUGH ELECTRICAL
- - -= Cma,arspdinn:aa-provNM-fir by Section 3700-.f-rhe Labor Code. for the
— 'performance ofNo warrfor.which this Permit a issued.i 3 05 — FRAME
°Ihave dwill ni, w k :c Pe m. li" it,.1 em,IhySetion 306 — HOLDOWNS
tato r Ne Labor Cunt,r dise punficurnmato iefte rk for n;n his permit is
307 — INSULATION
'Iss d MyWorker.C pe , I'm cu rakdPolicy b-
T O 3.Q$... ., SHEi TROCK
Carlyler�-ATE, 1N% '.'Pol¢y Nn. .ryo r
CEHTIFICATIONOFEKEMPfIQ MWORKERS Q , .s3'O� 'tj.at'EXTET2rIOR:`LATH'
COMPENSATION IN URANCE"o' r ' f
. ...-. -0..ter:m:,..".. .pav-.rv - ,n-p�.___:,a-,":.-.c-rr'. -__-__..__ ._.._
N$ERIOR LATH":-- --- :- .`,.
(This'ieciibn need not be completed H the permit is forum,hundmd dollen ! `1'_`
(SID10mrleto.) , 311,` SCRATCH COAT
313 -- '•ROOF NAIL._.., __::-.
1 cenly iMn in the pe rf mii_tce f the wo k f wh h th peon ns d it ',
ihv11 nm employ'uny pawn,n any manner so ax to become subject m the Workers'i 501 - FINAL ELECTRI CAL' 'ENERGY
' Compcnvt on Laws of Cebfom;Dam ""'
Applicant ' 502_-- ..E.INAL..-PLUMBING..ENERGY--" - ----"-.
pNOTICETOAPPLICANT Iferter making tri,CeriRcam ofEzemptim you should 503 — FINAL MECHANICAL ENERGY
y h Work r C mpensat Pru Is ons ofN lobo Code.yoJ ust
O O of Ne work fo 1 'iN npro th pe t nau bee d ked 504_ - _ FINAL BUILDING_ ENERGY
{zr^ s jceuo t
.,W PY — _ — _ ..
v� ''f " corvsTRucnONLENDmcnGENCY ' 505 FINAL ELECTRICAL, ' �
e' nn then t the on tr dd n IbnNng agency for the Per f nn ncel
which thispcmtd it ssed(sec 3097 c' c) ., 506 GAS TEST
F, Z d Ada .. 507 - FINAL PLUMBING
v"O50 FINAL MECHANICAL"
.c I rt fy Nat 1 h readdin,application al t t d t dv bo formation rs
�T" Teat I agree to comply,with all eqy and cotim,onfinamoca ad ,t 1 . relining 5 9 — I NAL G DE
,,o bis ld g , , dhercby N u prcsett' fN aryl em upon
N ba up a- c aunt rrpm 5 0 — INAL NG
'�`" y (We) S ,o o e demo yang keep harm(i it City of C.Krt noagSast, 5 - INAL RKS
L Vi liab lines Judgmems s lid e h may y y c against said
V Crylnc seg ere f@ g t' f,hkp t
NT UNOER$'1• qRS' yw6 coMPLYwiTH ALL ' '` INT Issued 6602 IL Date (••C/
_ A IDN tl
r• `. 04 - 00 IN
pamreo Appllmhr/Comrxme' Dae , Issued
t5 't HAlEARDOUSMATERIALSDISCLOSUREt ° i -
will the aPPlicallo r f mrt bwldi cupmt port or handle IiosiNous material -Type of Roof.
�sa dcra dby.N C pc i hMu Ch pt r912 and the Health and Safety - -
Code Yon u253�2(q)t c Nod i .� �. ( wirj ,'3 �l` t t 1'.`y
tYI
All roofs shall be inspected prior.to.any roofing material being installed
Wll,h pplc litor utmewad ,opantoee,equpmen,orae,aea m,n If a roof is ih'stalled'without first obtaining awmspecnon-4 agree'to'remove
mut hazardous c maml ants as d ed by th B y Arc A Q I t Mo agement
District „: , " all new materials for ins echo Applicant understands and will comply with.,
all non`- oinf'soUecer6g6lat'U have reed Safety Code, rruucri 505,M53tiis'under Chapter 6.95 of NeantId th`h&S f, Code Senium 15505 25513 and 234 I dem d t , _®ere urcmesxhes m shot t tory apo sbinymnou(y N - -" -- 8
C I f m,a Heal y
fib e buddm does mlcu lid ha - - 'L
y rte m t p ,ml suan a of o Cenif¢ate of
r Signat re of Applicant_" Date_
B 2T oZ'
All roof coverings to be Class 13"i orbetter ,__.I(
s ...(a'. . ..OFFICE
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