02030119 CITY OF CUPERTINO
BUILDING DIVISION PERMIT I,�(.`ON�'Y'R CT-MAN,
'' RMA Mrd 4•
Bill PERIAL AVE . TAYLOR WOODROW HOMES PERMIT No.02030119
ks'BO WOODROW HOMES 2300 CAMINO •RAMON FEwMIT11"THAt29/2003
IIWE: (92,5065-3100 SANITARY NO. G CONTROL NO.
ARCHITECTIENGINEER: BUILDINO PERMIT INFO
BLDG ELECT PLUMB MECH
D O
l; ofmiik
; LICENSED CON RAC GR'S DECLARATION Job Description
fd' I bemby M m that I am licensed under pmvitlom of Chapter Y(commencing p
with Section 7IXg))ofDivlalanSof due Busnuamd Profselnna Code.md my 11.,.x1.
a11 mfull fame and errcc NEW TOWNHOME APR 1 6 q
j�jS License Class Lee. l 2004
Dau Comntur LIVING AREA 1649 SQ. FT.
ARCHr 8Ci S DECLARATION GARAGE AREA 4 3 0 S FT. 12 619 . 8 0 R�o+ p�j�
�i Iundcrsund my plans ahstlbousedee public records Q. $ LS9 CaPYLDIIb VI
® e
iLicensed Pmfutional
Oat I am exempt
from
DEC Conti ON
+� 1 naso.(Sere that 1 I.S.exempt from sw Conramao Code:
nae Lew co the
i o following meson.Permit
171G LBusiness and Improve.
deioli Cade:Any oily Or county
$ which Or Issuance,
a permit m thiconstruct,thealar.Improve,de ermit t m mast any awmum
pdaruitslrumce,aluantto the previsions or for such Commuter's le a
Law(Chapter
h�Q
that noucttnwit pursuant cosh)or
Divionn3 of t eBuloom nd Proflaw(Chapter9 Sq.FL Floor Area VaIUal100
(crenouncingexewith Section7000)m)th basis for
mthcBed exemption.
iCmu)of
� that he Is exempt Ncmfmm and the buts for the alleged eumption.Any violation of ?1a qa�,..w�
Section 7031.3 by any applicant for a permit objects the appncaI)m*
m to a civil penalty of APN Number $ 28y Type
m
not methan five hundred dollars($810). / DOO
❑1,u ower of the pmpcny,or my employcu with wagu u theirmle wmpenutlnn,
wllldo the work and the strucwre le not Intended oraRered foruk(Sec.70M.Budnua
and ProfetiOns Code:The Communes Liccme law done Out apply r an owner of Required Inspections
property who wiles or improves themon,and whe doth ouch weak hlmulf or througb his
own employees.provided that two Improvements an not intended moRered for sale.If, 101 — FOUNDATION
however,the building or Improvement iamld within one year of completion,the owner.
Wilder will be"the burden of pmving that be did nm wild or improve for purloe.of 102 — PIERS
rte') 103 - UFER
11 ga owner of the property,am exclusively contracting with Intoned eonuacron to
construct the project(Sec.70N,Business and Profusions Code)The Contssemr'a LI. 104 — REBAR
cove law does not apply w an owner of propeny who wilds Or improve themon,and. 105 — ANCHOR BOLTS
who contracts for and projects with a contracurB)licensed pursuant to the Comneoe,
License law. 106 - SEWER & WATER
Vh!by�drpcmd
er se .BdvPCfm Lhls moon 202 - UNDERFLOOR PLUMBING
Dau 203 - UNDERFLOOR MECHANICAL
ORK ER'SC PENSAT DEC ON
'Jury ore.slim In lowing eeelmtmna: 204 — UNDERFLOOR FRAME
^ ❑1hawandwill malnulnaCerdOcamofComentuulf-imumtwWorter'sCompen- 205 — UNDERFLOOR INSULATION
cation,as provlded for by Section 3700 of ue labor Code,for she performance of the 301 - ROUGH PLUMBING
wmkforwhichthlapermhitirnctl' 302 - TUB & OR SHOWER
❑I have arm will maintain Workers Compensation Insurance,as required by Section
37W of the laborcoul fee the performance of the work for which this permit Is issued. 303 - ROUGH MECHANICAL
My Workee.Compensation lnrrsnce carier and Policy number am: 304 — ROUGH ELECTRICAL
Caries Policy No.: 305 - FRAME
CERTIFICATE OF EXEMrnON FROM WORKERS'
COMPENSATION INSURANCE 306 — HOLDOWNS
(rule Lt.need notweompuualrthePermit urnmehundred dolar(Sim) 307 - .INSULATION
art"`) ' - 308 - SHEETROCK
1 certify that In the performance of the work for which this permit is issued.I.hall not
emplo non ineny macro anrbbecomeanbJes �h re' motion 309 — EXTERIOR LATH
ewe act . r 310 - INTERIOR LATH -
Applic. •
NGrI AP CANP.If,efmrmaking sCcntfin¢ ^uempdon,youshoulJ 311 - SCRATCH COAT
be object to the Worker's Comp nurad previa. bop Cnde.you muse
.,SL fa with comply with each pmvbinm eathlaR beeamcd recited. 313 — ROOF NAIL
z CONSTRUCTION LENDING AGENCY 501 - FINAL ELECTRICAL ENERGY
[+ Ibercby affirm that them its construction lending agency for the performance of
502 - FINAL PLUMBING ENERGY
(Y.7 seor which this permit bissued(Stt.7097.Civ.C.)
Lender's
Namc 503 - FINAL MECHANICAL ENERGY
W
= z Lender's Address 504 FINAL BUILDING ENERGY
U O 1 cenify that 1 have mad this application and state that the above information is 505 - FINALELECTRICAL
LL coaceL.I agree to comply with all city and county ordinances and auto laws relating u
0 U wilding construction,and hereby aushodm mpremnuedws of this city on enter upon the &—Tabove-men0omtlpropenY fm lmpeNon purpmea.(We)agree to gave,indemnify and trey harmless the City of Cupertino against 0 7
r:.i r�jl ahove-mentioned
tend expenses which may in any way acarus against mid City 5 ICAL
U In come m ce of Bre granting of this perm6.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON.POINT Issued by:5 Date
CE UL _
Re-roofs
um orApp Ica an ear abate 5 4 - INAL PUBLIC WORKS
HAZARDOUS IAIS DISCLOSURE Type o_f Rj 2 - ROOF PLYWOOD NAIL
Will the applicant or fus mg occupant sort or handle hnardoe materiel
u dcflood by the Cupenln un eficil Code,Chapter 9.17,and the Health and Safety 603 - ROOF BATTENS
cote.SCNon8s3:(.)7= All roofs s jig4beins prkiNWla j'p?gglaterial being installed.
V ❑yea I
Will the applicant at future wilding Occupant um equipment Or devices which If a roof is installed without first obtaining an inspection,I agree to remove
,haurdnu..1,oentsminsnts as defined by the Bay Area Air Quality Management all new materials for inspection.
Olen,cIT
❑Ycs rims a
It, maul the harardnusmturlalsmqulmm Z5u4.l rCcnmd.93ofthe Calif. f
des not aSntlyCode,Becdomh38t36 myr and23334,1 undenunde occur wiltliny a J
tires not currently have a extent,Nn h u my responsibility r notify IM occupms lir the
welch ruuuaarlrsniruateafOccupany- Sig nature of Applicant Date
Owner uremhorbcd agent Date All roof coverings to be Class"B"or better