02020018 CITY OF CUPERTINO - -
BUILDING DIVISION PERMIT , CONTRACTQR�I„NFORMATION: ,'
_n p
BUILDWG ADDRESS: PERMIT NO.
1670 JAMES TOWN DR 02020018
^WNER'S NAME: - -
APPLICATION SgB DATE
3LENN SERRE 02/ 06/2002 .
q -r HONE: SANITARY NO. CONTROL NO.
WOO
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
H BLDG ELECT PLUMB MECH
�Z�_ U L I
Z=v Z LICENSED CONTRACTOR'S DECLARATION escr tion FINJ �...
1 hereby cM. he,I Am licensed under provisions of Chapm,9(commencing Jab D !!P r
with Section 7000)of Division 3 o the Business and Professions Code.and my license ADDITION (963 SQ. FT. )
CAr License Lcense Cl.,,, dAffect. FEB 1 9 2003
I Liccnx lass Lic.a
C Date Contractor
c.C G ARCHITECT'S DECLARATION
g I undmmnd my plans shall be used as public dards
sac Limaxdprofessional BUILDING
R OWNER-BUILDER DECLARATION
I hereby aBinn,hat 1 Am exmnpt from the Common,',License Low for me
It:aa following reason,(Section 70313.Business and Pm&ssions Code:Any city or county $145000
2 F O which"air.,a permit ur ronstrua.alcor,improve,demolish,or rtpair wy swaurt
INA. Prior to its Issuance,also vas thea lican,for such rmiuo 0leasimed Andaman,.
rc9 PP a ....._ �. ..
'-that he iijicqsxpok6inif tothej;bvisons of the Comxms Li cense lw(Chapter 9
(commencing mSection 70W)p nthe Business and ProfessionsCode)
or that he the basis f.rdhe alI.gAda%eruponA.y io
y
~, Valuation
-o(Sectln 70715 by my applicant foropermit subjects the applicant tae civil anAl -
of dm more than a.ehundred dollars(SMay. 10 I�PN PtcLTI1134lDAT ION Occupancy Type
❑I,as owner of the propeny,ur my mnployccs xhh wages us their sole compensation, 102 - PIERS
"will',dq,tfic work,and the structure is nu(intended or offered'fdr'sale sec'7044,-' 1 O3 - UFER �t^
'Bueiness and Profcsians Code:The Contractor's License Law docs not Apply m vat Required Inspections
owner of Property Who builds or improves thereon.And who does such work himself 1_04 - REBAR _
ar through his employees prpided_Wt_such improvement,ere mimm�ded or -_^_,__
f .. ._.__'-ANCHOR-
'-,
offered n.the If Ito ser m ti avec r mpro ro�sstha tdidmebuiaraf 105 - ANCHOR BOLTS
completion.the It.
(der will have the harden of proving that he did nn build or
improve for purpose of sale.). 106 - SEWER & WATER
�j,asownep.ja,1 comp,amen,.,limicsycomraciahmACAOR I d,:)sedcomramorsm ZO2' UNDERFLOOR-PLUMBING"--
q -PLUMBING-
construct the prosect(See,70aan Business and Profession:Code:)The improves
the ors, 2 O 3 — UNDERFLOOR MECHANI CAL'"I+? -
- License Law docs not apply m an owner of propeny who builds or improves thereon,
_and who anica... r s ch.p 3 to nh a conncmgaJ Iicenred.pmmat m the ...__.._.......'-2 04'-' UNDERFLOOR-"FRAME_.' - __.:.-_ .....__. w_... ._. ....
Com an is License Le ,,..;.. -
❑I a sudA,Sec BAPCfon 'sreason 205 - UNDERFLOOR 'INSU'LATION
ser NIS 301 - ROUGH PLUMBING
RK COM ENS ON DE TON 302 - TUB & OR SHOWER
lhereby.frrin Ander penalty of P,jyrynear coq following dacl.nllons,-- 303 - ROUGH MECHANICAL
Ct 0 1 he.A And will a.idtito'a ce'nihcate of canasim to',self insure for workers 3 04 - ROUGH ELECTRICAL
7 Compensation,As'provided for by Section-3700 of me Labor Code,-far me 305 — FRAME
perform...of We work for which this permit is issued,
01 have antiwill m.hd16 Wdrker ColnpenaAr.A Imirenae,is required by
,Section 306 - HOEDOWNS
_ 37M of the labor Cade:for'Rrt perfrrmaa'of the work for which this Permit is 307 - INSULATION
s Pohcy nmbe ate
Hued My Workert Compensation 1 sumnce came M
ti ip'mmyN ,. 308 ;y \ eSI-IEETROCK
1 t CERTU7CATION OF EXEMPTION FROM.WORMRS - ;� - '309- `r' TERIOR `LATH•
COMPENSATION WSURANCE::.:�.`..a1. �INTER-IOR-LATH'- -----.-. .
K,attuae need n or be completed the e perms is for one hundred dollars `I - •0 I0. C.t'I r
311 - SCRATCH COAT e
;bull
A PLICAm If,samak -�- '3-13- _'•--FINALNEtEC -- -- _
7 r ass)
pe of me k f h ch tot perm t n nsued 1
II me ploy any person rile! ' nnrs as to ec esub)ecttetheWorkrs 501 - FINAL ELECTRICAL("ENERGY
Compo �t o Cel e '
App°'nt�`''9`fY'gt ,sanlrc —T- .FINAL .PLUMBING ENERGY _...... _
pion y should 1
Z bedomesubjecnomeWorkeuCompensation"provisions ofm LaborCe,you must
503 - FINAL MECHANICAL ENERGY
00 forthwith comply with suchPro sonormap mbb shall be created revokedFINAL BUILDING_ EN_ ERGS . , _
V1 CONSTRUcnoNLENDING AGENCY" 505 — FINAL ELECTRICAL '
Tr' 1 h nby aRsm mitt them is a co suuct on lend g agency f r the Perf rma e rls
of the okfor' h hth panni ssuedf5 7097 C C) _ 506 - GAS TEST '
n,.0 'Lone ra Na -_.._. ... - _
p.Z L0derinea _ .._.-507. -....FINAli...PLUMBING.-- -._. . _..__ .. ....--- ._ _.- ..
V�Q Icemfy,that l have madmfs application d state that above information is 508 - FINAL MECHANICAL"!
0:�fit: roricn 1 gm to comply th.Il city God co ly ordinances and nate law.rcleung 509 - FINAL GRADE
toZibl"Scomoructi6n,and hembyem brizerepresentativesofmiacitytoenterupon 510 - FINAL PLANNING
the above-mentioned Property for inspection purposes,,, „
[.f L IWe)agree to leve.indemnify end keep harinlesi the Cii`y of Cupertino against
r,y liabilities,judgments,costs And A.peases.which may in any way Acrma against said 514 - FINAL- PUBLIC WORKS
t> City in consequence o(the gmpung of thlapertnn V V
APPLICF5 IT t ER$IANT9 q1D\\7LL COM Ye ALLNONPObff 602(^- O NAIL
g�p'ptxAZARDous ATE ��T� \ Issuedbffi Date
_':nn aIlby �a�nt o�Nft��b rite Re-roofs — ROOF IN—PROGRESS
CF L ons
mea ofA I car/C mars —'m- e 4
Cod} RIALS DISCLDSURE 7 t`
s 'PO g bccupam antro d haM1e bazSNous material 'Type of Roof .. _
As d , a p ode Chapter 9 I2 end the Heahh end Safety <
e Seeuon 25532fa17 I t g}},,,
.` ❑Yes ,lr'i.. r'ap 5 7".Li. l`?i -
P P y g. g installed.,
All roofs shall.be inspected nor to.an roofing material bent
Will the applicantor out building Occupant useequipmenturd ,c.wmch If a roof is installed'without first obtaining an'ins ectlon',I agree to�remove
�n hazard s air c mamma is el Action, by thBey A A r Q mdy Ma.gement g P g
°isna all new materials for inspection. Applicant understands_and will comply with
all non-point source regulations it - - ~- �-
1 hove reed me.hazallous materiels requirements under Chapter 6.95'or me
Califomia Health&Safety Code,Sections 25505.-23533 and 25534.1 understand the,
'if n
the bar ld,g doer rm
not cumly have 4 whist that it Amy recpons b lily td notify the . ._... . .. ..... - _.... ... .. .-. .-_ ___. .-. . .
occupat a the requirements m tell molt be mat In -
0. pe. Pn ksu rice of a CeniOatc'of
. .Signature of Applicant .._...._ ._ .. ......_. .. .__ .._... Date--.
- neo Ihorizlung
at „.'•ts , ,' e,e All roof coverings to be Class "B"'orbetter
_OFFICE'-