02030173 Liii
BUILDING DIVISION PERMITCUNT,RACTOR T1V1F'ORMA15WDR ERIAL AVE. TAYLOR WOODROW HOMES PERMIT NO.
02030173
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WOODROW HOMES 2300 CAMINO RAMON "'N'729/2003NE7:: :: (925) 365-3100 SANITARY NO. CONTROL N0.
ARCHI7EC°ENOINEERo BUILDING PERMIT INFO
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A0Z, LICENSED CONTRACTOR'S DECLARATION Job Description
1 hereby affirm Net 1 Am licensed under provisions of Chapter 9(commencing
with Section 70(S @
APR 0 U
B of Division S of the Business end prufc tions Code,end my license is 2004
:7'�R G mRforceandeffect NEW TOWNHOME
;'(�Z LiceDow ase u°g LIVING AREA 1649 SQ. FT.
Date CamraclL ���0 p�yB��
As shop he nee DECLARATION `69
I underwnd my ptsm shall W used u public records GARAGE AREA 430 SQ. FT. $12 619
C
Licensed Pmfcssimnsi
OWNEm exempt
DECLARATION
R 0 i 1 hereby A(Sect that 1 1. exempt from the Cosions C,License Lew for the
S.02 which requires,
e reunn.(Section 7031.5.1.5,Busl lm. end improve,
demolish,
Code:Any city m county
$1 which its Issas ported to construct,alteA improve,h Permit t fie a sig any tatudun
F�92 prior In its Issuance,pursuant
n:to the lW applicant o for sucCon Permit m Ne s signed(Chapter
6 that Inc(comma cingwitpursuantmtbeofDiviouofthe eButi Connector's ndLIvProi alonC Code)or Sq.Ft.Floor Area Valuation
,SpI (cat he
xempthhomfrn70ndthe baiisfrthe ai Business and Pro AssinneCMo)car
3.- Uw he 6 exempt U¢rcfrom end Uw burs for the silegrA exemption.Any violation of
Section 7031.5 by any Applicant for a permit subjects the Applicant to•civil penalty of APN Number $DMip2sy Type
not more Nan for hundred dollars($500),
❑1,u owner of tire property,ar my employees with vnges u their sole campetwUon,
will do the work and theswctom is amimended oroReted for .I.(Sm.7061,Business Required Inspections
and Professions Code:The Conuamees lJcense law dues ml apply in an owner Of q p
property who bu I Ids m tan proves thermn,a nd who does such work himul f or Uuough hie
own employees.provided[but Such Improvements are not intended eroQend for We.If. 101 — FOUNDATION
however.the building 0r improvement is mid within One you of mmPICUon.the owner
builder will have the burden of proving that be did not Wild or improve fm purpose of 102 - PIERS
"lo.). 103 - UFER
see owner of the property,em exclusively contracting with licensed eon"clon to
mulmct[be Project(So"70",Business a Ad PfoWsious Code:)The Committee.LT. 104 ,- REBAR '
muse Lew does not apply to an owms of propeny who Wild,or Improves thereon,and, 105 — ANCHOR BOLTS
who Contracts for such projects with a eonmcwr(O licensed pursuant to the Contractor's
License Law. 106 - SEWER & WATER
exempt under Se .B&P C for this mason
�.�� 202 - UNDERFLOOR PLUMBING
°"` 203 - UNDERFLOOR MECHANICAL
WO R'SC MP DECLARATION
Iherebyam.underpeNlI uryoroofthefollowing declandoK 204 - UNDERFLOOR FRAME
0 l bow And will malnWnaCenificamof Consent to sel6lnsum forworke's Compete 205 — UNDERFLOOR INSULATION
sation,As provided for by Section 3700 of the Iabm Code,for the performance of ft3 01 - ROUGH PLUMBING
work for which thisPermweissued. 302 - TUB & OR SHOWER
❑1 have end will maimm Workers Compcnsatlun Inmrmm,As requited by Section
3700 of the labor code,for the performance of the work for which this permit Is issued. 303 — ROUGH MECHANICAL
My Worker,Compensation Tnsumme comer and Policy number art: .304 — ROUGH ELECTRICAL
Cartier. Policy Nu,: 305 - FRAME
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 306 - HOLDOWNS
anis section need not Wmmpleted lftllc permit is forone hundred dollars(SIM 307 - INSULATION
mm") 308 - SHEETROCK
1 molly that In the performance of the work for which this permit Is issued,l Shall nm
emphrym paten In any mmnet �u til de Workers'Compeneatien 309 — EXTERIOR LATH
Laws ar Da 310 - INTERIOR LATH
ApplkW
NOrICETOA PLICAN7:If,aftermakingthis enlrmm mption,you should 311 - SCRATCH COAT
become subject to the Workers Compensation provision c labor Code,you most
.,7. forthwith comply with such provisions or this permit Wdmmed rooked. 313 — ROOF NAIL
z0 CONSIRUCTIONLENDING AGENCY 501 - FINAL ELECTRICAL ENERGY
1 hereby Arlon 1su them Is A construction lending Agency for the performance of 502 - FINAL PLUMBING ENERGY
thcwork for which this pastels is issued(Sm.3097.CIv.CJ cr'e
Iand503 - FINAL MECHANICAL ENERGY
�W Q Namc
DZ
Len aor,Add.. 504 - FINAL BUILDING ENERGY
V O Ittnify that l have reed this Application and sure that the AWw Information is 505 - FINAL ELECTRICAL
Iy coned.la&=to comply wltb all city and county ordinances andetste law misting to
C rV' building covwetloo and hereby outhodm minamadves ofthis city to enter upon the GAS EST
W above-mentioned property for inspection purposes. O 7 F I
gy (We)agree m ssw,indemnify and jeess ftp harmleCity of Cupertino against
ww to liabilities,judgments,costs and expenses which may in my myamuo
ragainstsaidCity 5 ICAL
IVA
V Z Inco mqucnm of tiro grmting of Nis pmmll.
APPLICANT UNDERSTANDS AND WILL COMPLY Win ALL NON-POINT Issued by:5 Date
Re-roofs
Si etureofApplicar antncmr Dale 5}4 INAL PUBLIC WORKS
HAZARDOUS MAT CLOSURE Type of RW02 - ROOF PLYWOOD NAIL
WIII the applies m or future bar mupmumrc or handle huudous materul
As dented by the Cupertino Municl Code.Chapter 9.13,and the Health and Safely 603 - ROOF BATTENS
do.Section 35533(&)7 yyy'''''' All roofs sb4l4be insp prtoNtopl�j�gq&�aterial being installed.
CYet �o
Will the epplicmt or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haurdnus air contaminants As derined by the Bay Awa Air Quality Management all new materials for inspection.
District(7 ,(
❑Yes
11%
read the huardousmaterish rtquiremenuun,kr Chapter A.95 ofUre Celifory
nlaHulthd<SerolyCoao,Sm90 nM5.35533ar n5M.1uMcretsnd UWiftic Wilding
dmf rot mmomty new a rot.Nal II ts my ruponslMlily m nMfy lh occupml of Ne
ce of ccelrmm,or OceunanS ignature of Applicant Date
wne,m.thudmlApa d Do a All roof coverings to be Class"B"or better
r