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02030171
CITY OF CUPERTINO BUILDING DIVISION PERMIT CO NTRA�CTOWINBORMATI©N: I1ull.P16G1A9BESisIMPERIAL AVE TAYLOR WOODROW HOMES PERMI'rNt62030171 YWR WOODROW HOMES 2300 CAMINO RAMON APPLICATI"MtTO 2002 // LL PHONE: 9___2_5T3 6 -5- 310 0 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o 0 0 LICENSED CONTRACTOR'S DECLARATION Iherebyaffirmthat1amlicensed provisions of Chapter NEW TOWNHOME Job Description Section ftheBuinssode,9dcnmmewing (ifec Division t of the Business and Professions CONI, and my license is fu of and ertee'. inand Lime 1589 SQ. FT. LIVING SPACE Class License clan Lin. N Date Contractor 492 SQ. FT. GARAGE : - ���® ARCIll DECLARATION he use 1 understand my plans shell M used as public records DEC 3 0 2003 LicensedPrommitmal OWNER -BUILDER DECLARATION I herchy affirm Nat 1 am exempt Irom the Commclm's License Law lin the following retina (Secuon 71131.5, Business and Professions Coale: Any city or county requires a permit to improve, construct, alter, demolish, or repair any structure BUILDINGwhich prior to its issuance, also requires the applicant for such permit o file a signed statement that he is licensed pursuant to the provisions of the Contractors Li me, Law(Chapter 9 Sq. Ft. Floor Area $167YObtion (commencing with Section 7110)) of Division 3 of the Business and Professions Cade) or that he is exempt therefrom and the hado for the alleged exemption. Any violation of Section 7831.5 by any applicant for a permit subjects the applicant to a civil Penalty of Occupancy Type not more than five hundred dollars ($500).e ❑ 1, ss owner of the property, or my employees with wages a their sole compensation, will do the work, and the structure is not intended or offered for sale (Sm. Business and Professions Code: The Contractor's License, Law does not apply In ea owner of TOt 102 — - P I ERS equtred Inspections property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are nn mwoded or offered for sale. If. 103 — UFER however, the building or improvement is sold within one year of completion, the owner. builder will have the hurdcn of proving that he did not build m improve fur purpose of 104 - REBAR 105 - ANCHOR BOLTS ,✓sale')' �r1,es owner of the pmpery, am exclusively contracting with licensed contractors to 106 - SEWER & WATER - construct the project (Sec. 71144, Business and Pufasiuns Code:) The Contractor's Lt censelawdoesnotappytoanownerofproperty who builds orimprovaDamon, and , 202 — UNDERFLOOR PLUMBING who comment for such projects with a contractor(s) licensed pursuant to the Contractor's License law. 203 - UNDERFLOOR MECHANICAL I an exempt under Sec. ,B&P C for this reason 204 - UNDERFLOOR FRAME n (�.^-+ Date 205 - UNDERFLOOR INSULATION WORKER'S SMP/E/N' N�$p�ADECLARATIO 301 - ROUGH PLUMBING Ihemby anon under Pcnmt4FRr q.,yonenflhe fnunwing decmralinneo 302 — TUB & OR SHOWER ❑Ihave and will main mi nection3alc of ConsenttoCodeself-insure he facoees ome,of he stolon, as pnrvitled for by Section 3]1X1 of the Labor Code, for the performance of the 303 — ROUGH MECHANICAL work for which this Permit is issued. 304 - ROUGH ELECTRICAL ❑ 1 have and will maintain Worker's Compensation Insurance, in required by Section 3 0 5 - FRAME 3701 of Nm e labor Cade, for the performance of dm work for which this Permit is issued. My Worker's Compensation Insurance carier and Policy number ase: 306 — HOLDOWNS Carnet: Policy No.: 307 - INSULATION CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 308 - SHEETROCK (Thiasection need not Mcompined if the lermitisfortme hundreddollam(SIaE 309 - EXTERIOR LATH orlas.) 310 - INTERIOR LATH 1 ccnily that in the performance of the work for which this permit is issued. 1 shall not 311 - SCRATCH COAT employ any Person in any mannersna.�nyaf,m s/IycVtstBEWorkers' Compensation V�� V- Applicant 313 501 - ROOF NAIL - FINAL ELECTRICAL ENERGY NOTICGTOAPPI.ICANT:1Laftcrmakmgthts Ccrtltcatco� mpuomynusho.N become subject the Worker's Compensation provisions of cc lallo Code, you most forthwith comply with such provisions or this Permit shall he deemed mvnked. 502 - FINAL PLUMBING ENERGY 503 - FINAL MECHANICAL ENERGY CONSTRUCTION LENDING AGENCY I hcrehyantrm for there iso consweion lending agency fnnbe perforreameof 504 - FINAL BUILDING ENERGY theUn nears Name work which this Permit is issued (Sec. 3097, Civ. CJ Lend 505 506 - FINAL ELECTRICAL - GAS TEST finder's Address certify Nat 1 have read this application and mom that the above information is 507 - FINAL PLUMBING buildingconstruction,inn,any hereby amhonp represemmiva of Nis city mcorer upon tlne building concoct comply herebyth lndat and cnumynrdlnancof and state core, upon the 5 FINAL MECHANICAL above to trygone for cs 09 FIN (We) agree (We) egmc t inemnifyan keep indemnify and keep harmless the City Cupertino against ,save, re a liabilities. judgmcnts,cns¢and expenses which may in any way accmc against sail City consequence of the granting of this Permit.APPLICANT 5 F N�tGin UNDERSTANDS AND WILT. COMPLY WITH ALL NON -POINT Issued bye 1 ORKS Date ULATIONS Re -roofs 603 - OF BATTENS Signamrc of APPlicanUConuacmr Dam HAZARDOUS MATE DISCLOSURE Type of 11644 - ROOF IN -PROGRESS Will the applicant nr future huildi tecupamstore or handle hwardous matenai as defined by the Cupertino Municipal Code, Chapter 9.13. and the Health and Safety ma Section 25532a)?/ ❑ Ycr [aSNit All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which et it hazardous air Contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. n adnn 0 W Gr./ 1 have mad Ne hWatintousmantials rnluirements under Cbapmrfi 45 of the Califor- nislicalN&Safely Cult. S.D. 355115.35533 and 35334.1 understand lhatifthe huilJing - does not currently have a mnam, that if is my resp¢i mhi1hy tootify nthe aeeupant OI Lha /^ s/ t7 !/ IllmmenLtwhie bmeslbc melt Yoe Ota Cenlficate of QCuPdrl[y � �� /� Signature of Applicant Dale , /Datte Lam- All rooferings to be Class "B" or better 0 mnrnuNnrizcJ agent --lL