02030198 LT
CITY OF CUPER'1'INO
+-BUILDING DIVISION PERMIT CONTRACTOR INFORMAT_IONa;!
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BUIL Es MPERIAL AVE TAYLOR ~WOODROW HOMES PERMIT1,102030198
q)AYhQR WOODROW HOMES 2300 CAMINO RAMON APPLICATIprgsyaPBg2002
PIIONIa: " 9 2 5 3 6 5-310 0 SANITARY NO, CONTROL NO.
ARCHI'IECf/ENGINEIiR: BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
: 11 0 0 l=
m00 LICENSED CONTRACTOR'S DECLARATION l
eguF : Iherbyeffrmthat Iamlicensed under provisions ofChapter vmommeneing TOWNHOME LIVI& 9Vseripiithl 172707 .
<z with Section 7(")).f Division 3of the Basi.a,..d Pro(essions Cule,and my licenseia
to fmlfomehod effect. GARAGE SP'. 498 GAiRA/,p �pg3T� p���Ii{2.10
20YA2 -License Class' Ling �• p6=1
O0 p LDateice C(mtrMlnr 4 tP'�
ARCHITEC`rS DECLARA'ION
i O W U ._1 andttalanJ my plans shall W aseJ as public records
vs3tar,l- LicensedPns(cssimmii, `�� 0 2UO3
F LL0g - OWNER.BUILDER DECLARATION "
n0 - •� I hereby hffrm on 1 1. .Barons from the ComractC's License law for the
�X p 0 which
followingmason.a Permit
it)
7113L5.BLLal@ad and vs.derllns Gene:Any city s county
1-$ whieti reyuirea'a perosit re mm�rue applic improsa.Jcmmah,no repair ed worms
Prior ar s l issuance:also requires the applicam tier Coli Permit file signed snsmem
at1- that he(commislieenseJpursuatubnhepmvisndon3of ContrateBusinessanicemelswlCode)o Sq. Ft.Floor Area Valuation
zt-� (commcnci sompth Section9lad of basis froflWBuainssvnJPr.fissionsatum.r 35717018 . 00
y $ Natio u es1:5 b any applicant
li and Ne basis for the alleged ae applicant
t.Any violation of
Section the.five
any applicant fora permit subjects the applicant m e civil penalty of AIBN Number Occupancy e
oat rodeo thhn five Wnama Jmhir,fswB>. 101 - FOUNDATION p yTyp
❑I,as owner of the property,or my candoyeas with wages as their sole compensation.
will do the..,it:and the structure is not intended or offered for sale IS=704,1,Business 3:62 Pi 1IRS
and Professions Coble The Committers License Law does not apply to an owner of 103 - UFER Required Inspections
piupcny who Wilds or improves thereon,and who drnsmain work himself or through his -
owncmPlnyeas,provided that such improvements arc not intended or offered for at If. 104 - REBAR
however,the building or improvement is mid within one year of completion,the owner- 1OS - ANCHOR BOLTS
builder will have the burden of proving thin he did not Wild m improve,for purpose of
ash, 106 - SEWER .& WATER
12-171e owner of the propcny,am exclusively contracting with licensed contractors to 202 - UNDERFLOOR PLUMBING
construct the project(Sec T a4,Business and Pro(essiona Code:)The Contractor's Li.
cense Law does not apply to an owner of property who hullds or improves thereon, ad 203 - UNDERFLOOR MECHANICAL
who
Lice Law.
contracts for such projects with a contractor(s)licensed pursuant to the Contractor's 204 - UNDERFLOOR FRAME
License
I not exempt under Sec. , B&P C for this reason 205 - UNDERFLOOR INSULATION
rte s/0'l� 301 - ROUGH PLUMBING
WORKER'S COMPGNSATI ECLARATIOND3O2 - TUB & OR SHOWER
'd herchy e(finn under penalty of ury We of the fallowing declarations:
❑1haveandwill maintain aCcndicateo(ConsenttosmrnsumfmwmkersCompm 303 - ROUGH MECHANICAL
ration:ua'provided fur by Section 371X1 of the Lshor CnJe.for tim performance of the 3 04 - ROUGH ELECTRICAL
work for which this permit is issued. 305 - FRAME
❑1 have adiwill maintain Workers Compensation Insurance,as required by Section 3 0 6 - HOEDOWNS
371X1 of the Luber Code,for the Performance of the work for which this permit is issued.
My Worker's Compensation lnsumna carrier and Policy number art: 307 - INSULATION
Carver: Policy N., 308 - SHEETROCK
.. 'CERTIFICATE
COMPENSATONIINSURAANON CCORKERS' 309 - EXTERIOR LATH
(This xctiounced nothecompletedifthe Tennitisforonc hundred dollars a10X) 310 - INTERIOR LATH
""ers) 311 - SCRATCH COAT
1 certify that in the performance of the work for which this Permit is ismed.I shall not 313 - ROOF NAIL
employ any person in any manner m s ecomc, hjeam rkers'Compensation
Laws of 501 - FINAL ELECTRICAL ENERGY
Applicint
NOTICE TOAP (CANT:II,alsr makmg this Ccnimate of Esc. . Wshould 502 - FINAL PLUMBING ENERGY
Waome subject m the Worker's Compensation provisions oylr tar nc,you must 503 - FINAL MECHANICAL ENERGY
OO forth with comply with such provisions or this permit shall W deemed revoked.
z CONSTRUCTION LENDING AGENCY 504 - FINAL BUILDING ENERGY
[- I herchy afford that there is a combination lending agency for the performance of 505 - FINAL ELECTRICAL
Qi �: Wasmor fnrwhichthispermitisissueJ(SecJIXp,Civ.C.) 506 - GAS TEST
W Q Lender's Name Lenders Adtlress 507 - FINAL PLUMBING
U O ` I certify that I hale read this application and sus that the above information is 508 - F I NAL MECHANICAL
f•' comet.Iagree tocomply with all city and county ordinances and shimlaws field ingw 5 FINAL GRADE
building construction.and hereby aothnrine mpmxnhitives of Nm is city enter ulcera the
U, building
atxwcmentionedmortify for inspectionpurposes. lO FIN ANNI G
(We)agree to save,midemni fy and keep harmless the City of Cupertino against
rjj liebilitics.judgmcnls,costs and cspcnscs which may in any way gimme against said City 5 �] U LI WC
in eu care,m nee of the granting of this permit, v v
U z APPLICANT UNDERSTANDS AND WILL COMPLY WITIf ALL NON.POINT Issued by60 NAIL Date
CE REG ULATIONS.
T2 Re-roofs 604 - 0F IN-PROGRESS
Signature of Appla,monC"on" Date,
HAZARDOUS MATER ISCLOSURE Type of Roof _
Will the applicant or future buildingr'cupamstore tar handle hamrdous prose l
as Jeftied by the Cupenino Municipal CnJe,Chapter 9.12,and the health and Safety '
section 255320)? / All roofs shall be inspected prior to any roofing material being installed.
❑res E fir
Will the applicant or future building occupant use equipment tar devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
District'/
OVcs �sr '
I have mad the momokius mmerials rc:luirumcnts under Chapter 6 95 of'the Califon
nice Heahh&SafctyGate, n2S"NIS,355JJund255J4.IrmMrswnd ohmifthebonding
does not curtently have v count,Nal it is my res(xrmihility m omit)the occupant of the • a
swhichmnst met anceofacemaeasofacepaney. Signature of pplicant ate
���� All roof c Ings to be Class "B"or better
Owner or outhorimd agent Dat,