02030164 CITY OF CUPEWI'INO 3 -ate ra, .pae� >a • --- ".
BUILDING DIVISION PERMIT A.CONTRACTOR INFORMATION .,
BUDP@IAP12F:ssIMPERIAL AVE TAYLOR WOODROW HOMES PERMITN(0203A0�1�64
W YWR WOODROW HOMES 2300 CAMINO RAMON APPI'ICATVJ/ cpc'/ 2 O O2
PHONE: (925) 365-3100 SANITARY NO. CONI'ROLNO.
ARCHITECfIENOINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
.�uOO
LICENSED CONIIIACTOR'$UF.CLARATION Jp6� `p
GU p I hereby of irm that I am licensed under provisions of Chapter 9(cnmmereins NEW TOWNHOME CUNS`$ff�pIt lAI ON
S4 with Section last)ar Division J or the Business and Professions Code,and my license
0gZin full force and effect. 1456 SQ. FT. LIVING SPACE
Lice.Class Lic.M
o Dare Contramor 469 SQ. FT. GARAGE : 2029 . 85
ARCIII'ne use DECLARATION
,ordsxu' ImulcrsmnA my plans shallMuseJ as public rttvnJs
sow4 a. Licensed P..m,linnal
�— OWNER-BUILDER DECLARATION I
{
•7
wJ o 3 900•]
z < rc
7 1 hchy off.that I am exempt from the Contractor's License Law our the L
a a 00 following reason.(Section 7031.5.Business and Professions Code:Any city or county
w$[1! which mquires a permit m cnnstruc,alter,improve,demolish,or repair any structure
fZi poor et its issuance.also mquims theapplicant forsuch permit o file asignodstatement
qqxx� that he is licensed pursuant othe provisions of the Contractor's License Law(Chapmr9 Sq. Ft.Floor Area
CF (commencing with Sermon70(y))of Division 3ofthe Businasand ProfessionsCndc)or
a $ that he u exempt therefrom and Ne Iasi for the alleged exemption.Any violation of
Section 7071.5 by any applicant for a permit subjects the applicant to a civil penalty of
not mine then five handRd dollars($Sa). -3 51kIW1QNRFeV0 Occupancy Type
❑ I,as owner Of the proper,or my employees with wages as their sole compensation,
will do the work,and the suuclure is not intended or offered for sale(Sec.IRx4.Business —
and Professions Code:The Conuacmea License Law does not apply to an owner of 10 2 - P I ERS equired Inspections
property who buildsor improves thereon,and who doessuch work himselfor through his
Own employees,provided mat such Improvements art not intended or offered for We.If, 103 — UFER
however,the building or improvement is sold within one year of completion,Ne owner-
bmlder ,will have the burden of proving that he did not Wild or improve fon purpose of 104 - REBAR
le) 105 - ANCHOR BOLTS
L_1,es owner or the property,am exclusively contracting with licensed contractors Its 10 6 - SEWER & WATER
Construct the limper(Sea 70J ,Business and Professions Cade:)The Contractor's Li-
censeLawdoesnotapplytoanownerofpropenywhoWildsorimprovesCommi.and 202 - UNDERFLOOR PLUMBING
who conoacu for such pmject;with a conoamor(s)licensed pursuant to the Contractor's
License Law. 203 - UNDERFLOOR MECHANICAL
lam exempt under Sec. ,B&PC for this reason 204 - UNDERFLOOR FRAME
woe` \ OR 'SCO (PENS OECLARADTION�!�`� 205 - UNDERFLOOR INSULATION
Iher�hy eRitm under penaltyn ,jury one of the following dcdarnions:
301 - ROUGH PLUMBING
❑ I base and will maintain a CCnlBcate ofCoesem tO self-nsure for Worker's Compem 302 — TUB tic OR SHOWER
sation,as provided for by Section 39110 of the Latin,Code,(in the performance of the 3 03 - ROUGH MECHANICAL
work for whim this permit is issued. 304 - ROUGH ELECTRICAL
❑1 have and will maintain Worker's Compensation Insurance,m required by Section 3 0 5 - FRAME
3700 croon Labor Code,for me performance of tbe work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy,number ase: 306 — HOLDOWNS
Carrier: Policy No.: 307 - INSULATION
CERTIFICATE O17 EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE, 308 - SHEETROCK
Trios rection need antbenonoidewd lithe rc.,I is foroue hundred dollars Hlo) 309 - EXTERIOR LATH
or.less.) 310 - INTERIOR LATH
1 cenry tht in the performance or me work rn hich this permit is tamed.I shell not 311 - SCRATCH COAT
emplo say nypetrsnnmanymannery r c t rw tm@c Workcrs'Compcnsation —
Law,o \ms��• —. { 313 ROOF NAIL
NOTICE To P- 17- B,after�g this Cenineam o�r �s ' �yoa s cold 501 - FINAL ELECTRICAL ENERGY
OObecome auejwuo me worker',Compensation pmvisionatWhlk�Ir CtJe.you must 502 - FINAL PLUMBING ENERGY
forthwith comply with such provisions or this remahehall deemed revoked.
z' ^ CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
I hereby a that there is a coegruction lcrear tent forme lorrom.ol 504 — FINAL BUILDING' ENERGY
[-` Yu'irm GE y per
P4 ti the work for which this permit is issued Sec.dun,Civ,C.) 505 - FINAL ELECTRICAL
{✓a Lender's Name
Z Lende,'sAddress 506 - GAS TEST
U O 1 cenry Nat 1 have read this application and score that the above information is 507 - FINAL PLUMBING
U coding lagrccIo Comply and with allcity and county ordinances and smut lawsrelating a
�U shrovengcnlioned construction,and herebpectitn n,core.scnmtivesof his City mcntcrupon the 5 FINAL MECHANICAL
W those-mcntinncU property for inspeclinn purposes. 0 9 FIN
0. (We)agree to save,indemnify and keep harmless the City or Cupertino against
h liabilides,judgmenq costs and expenses which may in any way accrue against said City 5 N G
U in consequence of the granting of this permit. —
as APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON POINT Issued by5 1 WORKS Date
wa E Fjt.GULATIONS.
Re-roofs 603 - OF BATTENS
Signatureof ApplicanUContmaor )ate
HAZARDOUS MATF.RI ISCLosURE Type of p0011I - ROOF IN-PROGRESS
Will the applicant urfumrebuilding Cupant store or handle hamdous mamnal
m defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code.Semon 25532(a)? � - All roofs shall be inspected prior to any roofing material being installed.
❑Yrs
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
emit hanedous air cunreminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
Distract?
❑Yes Lrsvrt
1havemad thehaaallous,25513lsre33 and 35 understand
95dWe build,
diesr I not"orently an 2 tenanns211itis. 533atpurea574.l in
to occupanaff the t
oil ng �-- //'t s/•D
does not currently hove n tenant,that it is my resryrmihility m nodly the acupant of the (//
monks whichmuv he lound...facCrtif¢amoroccupancy.
�0 Signature of Applicant Date
Owneror aetherl]ed agent Dam All r verings to be Class"B" or better
CITY OF CUPEWI'INO 3 -ate ra, .pae� >a • --- ".
BUILDING DIVISION PERMIT A.CONTRACTOR INFORMATION .,
BUDP@IAP12F:ssIMPERIAL AVE TAYLOR WOODROW HOMES PERMITN(0203A0�1�64
W YWR WOODROW HOMES 2300 CAMINO RAMON APPI'ICATVJ/ cpc'/ 2 O O2
PHONE: (925) 365-3100 SANITARY NO. CONI'ROLNO.
ARCHITECfIENOINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
.�uOO
LICENSED CONIIIACTOR'$UF.CLARATION Jp6� `p
GU p I hereby of irm that I am licensed under provisions of Chapter 9(cnmmereins NEW TOWNHOME CUNS`$ff�pIt lAI ON
S4 with Section last)ar Division J or the Business and Professions Code,and my license
0gZin full force and effect. 1456 SQ. FT. LIVING SPACE
Lice.Class Lic.M
o Dare Contramor 469 SQ. FT. GARAGE : 2029 . 85
ARCIII'ne use DECLARATION
,ordsxu' ImulcrsmnA my plans shallMuseJ as public rttvnJs
sow4 a. Licensed P..m,linnal
�— OWNER-BUILDER DECLARATION I
{
•7
wJ o 3 900•]
z < rc
7 1 hchy off.that I am exempt from the Contractor's License Law our the L
a a 00 following reason.(Section 7031.5.Business and Professions Code:Any city or county
w$[1! which mquires a permit m cnnstruc,alter,improve,demolish,or repair any structure
fZi poor et its issuance.also mquims theapplicant forsuch permit o file asignodstatement
qqxx� that he is licensed pursuant othe provisions of the Contractor's License Law(Chapmr9 Sq. Ft.Floor Area
CF (commencing with Sermon70(y))of Division 3ofthe Businasand ProfessionsCndc)or
a $ that he u exempt therefrom and Ne Iasi for the alleged exemption.Any violation of
Section 7071.5 by any applicant for a permit subjects the applicant to a civil penalty of
not mine then five handRd dollars($Sa). -3 51kIW1QNRFeV0 Occupancy Type
❑ I,as owner Of the proper,or my employees with wages as their sole compensation,
will do the work,and the suuclure is not intended or offered for sale(Sec.IRx4.Business —
and Professions Code:The Conuacmea License Law does not apply to an owner of 10 2 - P I ERS equired Inspections
property who buildsor improves thereon,and who doessuch work himselfor through his
Own employees,provided mat such Improvements art not intended or offered for We.If, 103 — UFER
however,the building or improvement is sold within one year of completion,Ne owner-
bmlder ,will have the burden of proving that he did not Wild or improve fon purpose of 104 - REBAR
le) 105 - ANCHOR BOLTS
L_1,es owner or the property,am exclusively contracting with licensed contractors Its 10 6 - SEWER & WATER
Construct the limper(Sea 70J ,Business and Professions Cade:)The Contractor's Li-
censeLawdoesnotapplytoanownerofpropenywhoWildsorimprovesCommi.and 202 - UNDERFLOOR PLUMBING
who conoacu for such pmject;with a conoamor(s)licensed pursuant to the Contractor's
License Law. 203 - UNDERFLOOR MECHANICAL
lam exempt under Sec. ,B&PC for this reason 204 - UNDERFLOOR FRAME
woe` \ OR 'SCO (PENS OECLARADTION�!�`� 205 - UNDERFLOOR INSULATION
Iher�hy eRitm under penaltyn ,jury one of the following dcdarnions:
301 - ROUGH PLUMBING
❑ I base and will maintain a CCnlBcate ofCoesem tO self-nsure for Worker's Compem 302 — TUB tic OR SHOWER
sation,as provided for by Section 39110 of the Latin,Code,(in the performance of the 3 03 - ROUGH MECHANICAL
work for whim this permit is issued. 304 - ROUGH ELECTRICAL
❑1 have and will maintain Worker's Compensation Insurance,m required by Section 3 0 5 - FRAME
3700 croon Labor Code,for me performance of tbe work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy,number ase: 306 — HOLDOWNS
Carrier: Policy No.: 307 - INSULATION
CERTIFICATE O17 EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE, 308 - SHEETROCK
Trios rection need antbenonoidewd lithe rc.,I is foroue hundred dollars Hlo) 309 - EXTERIOR LATH
or.less.) 310 - INTERIOR LATH
1 cenry tht in the performance or me work rn hich this permit is tamed.I shell not 311 - SCRATCH COAT
emplo say nypetrsnnmanymannery r c t rw tm@c Workcrs'Compcnsation —
Law,o \ms��• —. { 313 ROOF NAIL
NOTICE To P- 17- B,after�g this Cenineam o�r �s ' �yoa s cold 501 - FINAL ELECTRICAL ENERGY
OObecome auejwuo me worker',Compensation pmvisionatWhlk�Ir CtJe.you must 502 - FINAL PLUMBING ENERGY
forthwith comply with such provisions or this remahehall deemed revoked.
z' ^ CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
I hereby a that there is a coegruction lcrear tent forme lorrom.ol 504 — FINAL BUILDING' ENERGY
[-` Yu'irm GE y per
P4 ti the work for which this permit is issued Sec.dun,Civ,C.) 505 - FINAL ELECTRICAL
{✓a Lender's Name
Z Lende,'sAddress 506 - GAS TEST
U O 1 cenry Nat 1 have read this application and score that the above information is 507 - FINAL PLUMBING
U coding lagrccIo Comply and with allcity and county ordinances and smut lawsrelating a
�U shrovengcnlioned construction,and herebpectitn n,core.scnmtivesof his City mcntcrupon the 5 FINAL MECHANICAL
W those-mcntinncU property for inspeclinn purposes. 0 9 FIN
0. (We)agree to save,indemnify and keep harmless the City or Cupertino against
h liabilides,judgmenq costs and expenses which may in any way accrue against said City 5 N G
U in consequence of the granting of this permit. —
as APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON POINT Issued by5 1 WORKS Date
wa E Fjt.GULATIONS.
Re-roofs 603 - OF BATTENS
Signatureof ApplicanUContmaor )ate
HAZARDOUS MATF.RI ISCLosURE Type of p0011I - ROOF IN-PROGRESS
Will the applicant urfumrebuilding Cupant store or handle hamdous mamnal
m defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code.Semon 25532(a)? � - All roofs shall be inspected prior to any roofing material being installed.
❑Yrs
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
emit hanedous air cunreminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
Distract?
❑Yes Lrsvrt
1havemad thehaaallous,25513lsre33 and 35 understand
95dWe build,
diesr I not"orently an 2 tenanns211itis. 533atpurea574.l in
to occupanaff the t
oil ng �-- //'t s/•D
does not currently hove n tenant,that it is my resryrmihility m nodly the acupant of the (//
monks whichmuv he lound...facCrtif¢amoroccupancy.
�0 Signature of Applicant Date
Owneror aetherl]ed agent Dam All r verings to be Class"B" or better