02020012 :CITY+OF�CUPERTINO !. '.;, , } . s' ,. . ' .. ... . - .._ _
emnb�rcuiVtstov CONTRACTOR INFORMATION: - - --- --
PERMIT ..
F BUILDINGADDRESS Y... t 7•t, .i ._ _ _ ._ ._._ PBRMIT AOjr
.
,.... OWNER S NAML:r .. ,..-_. e....: .. ..... .__.. ... .... ..APPLICATIONS B DATE _
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TAYLOR WOODROW HOMES 02/05/2002
(„ PRONE _ ,I, SANITARY NO. CONTROL NO.
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OO ARCHITECT/ENGINEER:. - , 1, _ BUILDING PERMIT INFO
w " ..: .�-?:.:• :.: ;, .rrr' r BLDG ELECT PLUMB MECH
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5" LICENSED CONTRACTOR'S DECLARATION
�� I n by,dffim that 1 am licensed ee p f Cti pi v(=omm n=ng ' , � �Job Descnp[ion
t wims t 70oo)nrD nJonnee sass aProfexa caa.nnemyu=enx DEMO.
6xf is filf - endcRa 3SZo4� .
tot � Di ICmmnor . ��,.1 SINGLE STORY DEWLLING.
u�u to ARCHITECTS DECLARATION -' - i.;
4 - I derslend my pl h 11 h used as puhbc rtcords - -� ---
+ �R L censed Pfess OWNERBUILD:E"RDECLARATION r . " A .rp'l
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m 1 hereby nlBnn ihm I am exempt from the Commnor's Licenxe!aw for the
Z G following mason (Semon 7031 5,Bumness antl Professions Code:Any ciry or,counly
Y F O uh h r q e n Pemvl to slriin site pr 'demolish or rtpe r any swcwrt
,a.3$ .pno to ussuarmuolm requ res Ne dpplicw fw such prmdu flalHnWsutemem _
Nal he ssl ecdsed puisusM iq @G p visions of the Cb irecme Li IISe law IQhaMer9 _ - a
(co nnng Ih SC4gn"(f100)uf DivivonJof ih asineu and fGmiovi Code) (J�t1y ) ttp4 4$Cf.Ft(FIOOr ACea, (Lill
.�'rrr?. _ at10❑
nh t he s exempt ihertf7om end the tins fo th IltgeJ eAemph II A y v of t on Y, ,, ,r v� ,11, i f - t -
n. ofS t 70115 by.0 Y PPI ori Pora pemnl 'bl uthe'uPplc n cIfs
try
I r olni rc.lwnrven maredamlaa(s5fN1) ..._ f. R� at. OccupancyType
OI r fNe P P ny rmyempl y nh wog sas ih .. I -petommir.
y ',will do the work nna N 'mm� 'S n i Nmnded. 'of dS .sal (Sec.7(W
BusmeSs a d P ofess ns Code Th Commclo s L rise la arcs n 1 apply wan
•� F, owns f p pony Who bu Id mproves th nand who does s ch ork himself 9 t p
• .� of through his own employees.provided Nal such im rovenams arc not intended or
building imp Y
completion,arc orue. owuildethell havn mvf piovia cold he did nor dr of i;,,•; P -::.,❑L:'•'•,.: - _- -
iprthe pose of s lel).will have the burden of proving that he aid not build or
improve for purpose of ante:).-
t
(� '�3-7as fN'property,-m Btica,i.+ and
1 ingm,ihlicensed e von m
,^•x, Li tract(o pooled(Sec 7toa owners uJe lessons Code)The ves lrador's
Lice h ,c a nor apply t n wrier of property h who builds or improves mcreon '
..and.who o s io h p taco w N lines ns)i cenxd Pursuem a the
Co i ea e License Law.
El tor aticialln order Seca ' i^.` 1. .;1 :B&PC for lhsmason Pat .1
Own F .s✓ 1 6m;:, t /1
t i WORKERS COMPENSATION DECLARAI ON MAR O 6 10 9 -
plh by
iffirmirad,penally ofpeluryne ofthe fdlowirltdcinmucin G
❑ I have d'' illfmo nla C nif2tte of C meni tri self mre for Worker's
'Com
o pc alt n;-m provdea+for ny sect n.3700 of'ihe'Labor Code, for the
'performance of the work fur wh ch Nis peemu is issued.. r -_:,
❑1 haJe•and will mainima ivAir s Compensation Insmadce,as hyuimd by Section - r 1
3ID0 of fl e'labor Code;for the performance of the work,for which this permit is
'la'M MysW k es Compo ton Insumrice ca and Poly mbc a ,., _
ori Itc.ae(!a'tA'g'4a<d 'f u-C"tl'CrilSOCGI_�
,r nti r CFRTIPICATI NOF XEM IONIROM WpRKERSSr Q Y}1°e 1 t # F k.1.:$]2aYn/`i 1'l f:.f. r
ICOMPENSATI INSURANCE "I I < ' 1 �ill:;lw I f', la 13{ ••
.r wt'i •,,i -.T
' , S (Thiashcl bP needn Theo pindfNe parand I,far'ime hundred d 11
wf ilcemfyther in lhe,perf ce of the ork'f+r.whiM ihspermisi sued, -- -s - - — - � - - -- --
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shall note ply any peri n I y nae sem to becom bje t o the'Woken _ ••t(,tlT A 1-. 1,_:-+(db i
Compeneat o Laws of California,Data '
Q forth Ncomplywith,suchprovisionso ih{ tyalls
A6pp1 ant�� i cS
NWICETOAPPLICANT If fl d ihnC dicta,of Exemplo 'y Would. \: Ili
�i Becomesubject INc W k e
Coal
prov t ns of th riam i d 'y 'mu 1
Pe bed ed revoked.
2 ..
F aCONSTRUCnON LENDINGAGENCY I .- t': ',11\:N, r(.
1 hereby (firm that the nswnon
a coled g agency for the perfarmnntt
- ,i •i_(p
-f:a•1
of the k(,r -hch Nn permit si ed(Sac."3097 C'v.C)
Loen +
.�.Q YLrider Name- ...r• ,. .a...' aw u_ .+..u.. _^ ..._ - _. -_ ' "�. _• __ - _ —.
yfictive
r i PP
de sAddrtaa
eon( N t 1 havt d Iht9 ap plication and state that the above Inflammation IS
frL t y crines 1 agree m comply ah all coy and county ordinances and stare laws relating
01U to budding conauunimrand hereby nullmiie represenntivds of Nis city lm enter upon '
W the above-mentioned property for inspcnion purposes.,
'pKa)'egree m'save;indemnify emd keep herirleas the Cry of Copaninoeieima i q
LL V1 limb 1 rico,judgmenu,costs mid up rtes which may m any way accrue against said `
U Z Ci1P; consequenceofT ggmDN' of Nis penny I t-, t r r
'APPLiCANP.U{JDER$T/WDS AN WILL COMPLY q'fTH LNON-POINT" .I D8[O r,,,•
( S r C GULATIGNB 1$$Ued b
�� y t
t Brat ofAPPlicnnVC m n - t I !+ Data
. 1 Re-IOOf$
W II the eppIHAZARtold itDOUS Md ng o<cupim Iltrc mhnndEl hvardws mom d e Of_ROOf
m dcrr�W by ih C peN Mun Pal Cade he Pi 9 13 and the Health and Safety
' TyP
CiidlpcYecar
s 255331ae 1M7f4f s- Y 2 C it^a'. f y t , c.<��� 1r
(i l' a+le µ _All roofs shall;be Ints'pected pr or to any roofing material beigg-installed.-_
Will the appli<apta (t bu ialog oe a it equ I, it de ices wm<n [f a roof is installed;without fiist;obtaining an'inspectidni,11I gree:to remove
mithazmdus mr<omamtwnumdfned byN ByAre ArQ al ly Management - -
m<n , i -.al4new materials for-inspection; Applicant understands and will comply with---_
ems.ander Che ur 6:9 _ _
pYcs i t a i �No Ili v n Y' TP all non- oint Source re ulatlOnS
e9 lnT I " P g -
1 hev , Ihq haze a c. mammals 505 rc p Sof the
Cahfom Hgdoesn arrelnot currently
Coac sen v25505 titism d2553a il rid .teed that'
i(dtebudNngd. niece a whihave aie t that l myssuanceof to bricia NeU�tzp ----
oemi t of N requirem ms hi h m'st be mei On.,to Issuance of C n Scale o('
Signature of Aicant. Da e
.. .. . . ...
1 Owne o emh nzedageml i , 1 a,..,, All roof coverings to be Class "B" orlbetfer
.... F.FIC 'r
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