00070057 CITY OF CUPERTINO T�r ���pTi nnNN.�
auu,.t3ltsl• ,st4 C 'AVERMIT CONTRALEXW 09%T'T�L-NNN CO 00070057
BUILI IING ADDRESS: PERMIT NO.
701 ALDO AVE 07/11/2000
OWNIER'S NAME: API'I.ICAI'ION SIM DATI'S
252-9252
'HONE: SANITARY NO, CON'IROIL NO,
C-YO ARCHITECTIGNGINIiER; BUILDING PENNII'IINFO
s HLDO, ELliCf PLUMB MECII
Z< CI --1 I=asi 1_1
. SNS LICENSED CONN RACPOR'S DECLARATION REPLACE 1" .{ak,QeLWPJ$ld SERV. FROM METER Ti
I herehy nriiml Thal I rain rimmed under pnoki... ul Chaper,9lennanancing
°mi_° ,cithsene.7(Xlo)nfui.'ioier3efthe lw.me„nndPrnlr„inn,Code.Imdbuy license WITH 1 ” COPPER "L"
a m E� i,in ion force and effec
a L.cerw G r_ 36
Conuacn
3+s ARCHIT w woe UECL. A'1In' s
5°—'G 5 1 ImdersmnJ mY Plan„hall he ureJ a public rcenN.c ,
Y
:+�+ p p Licensed Pr iewinnal
OK'NEN-BUILDER DECLARATION
I hi maso al Brut.hal 1. cBusin limn the C,,ion, r'n Licence Law bar mr
followwhich ing.am,n ISmtino](BLS. .alm,.c and ver daions Cmle:Any city or manly
w—p which requlrc,o promo re cunamo,cher,infer Su,denmlish,or repair any mmeturr,
�3� pammLIS i..nnnra.also ragllhen meln,hli,�Ill for sarin lmrinhit)ilea agned,lamn,rm
mal lie i,oeell od amount In the p.o,i„nl,m lee comraelor,lien,Low lCha,mr 9 Sq. Ft. Floor Area V*rl(V k*
Icnmm unci,with Section 7(Xlo)of D1vi,ion.3 of the Bmim„and P.m,A...Code) _
or that he i,exempt Iherefrnnl and the basis for the alleged exemption.Any violation
of section703 1,5 by ally a fit licart bur almond Subjects I lie up,,licunl ,a civil penally
of not mom than rive hundred dollars($500). Al'. 14049 00 Occupancy Type
❑1.a,owner o1'the pmpeny,or my employee,with wage,a,Batu sale cmnllvrul anon,
will do the work,and the orwrom i,nal intended nr offered for.sale(Sec.7194.
Business and Pmfe„inn,Code:Thr Contractor,Licence Law does nm apply to an 106 — SEW8`1quire"M dens
r of pml,ony.Who bund,or improve,thereon,and who does such work himself fT
or Ihnmgh hisown employees,pinvidcd Inas orch ilnpowearr a are ion intended of 202 — UNDERFLOOR PLUMBING
offered for Sale,If howevee the building or improvement is Sold within one year of
nnplminn.the e oner-huildcr w
dl have the lander of proving that he dm not baild car 301 — ROUGH PLUMBING
ilnproveho,mrpn,anf.ala.l. 302 — TUB & OR SHOWER
❑I,ars owner of the prnpeny,am exclusively eommeting with licemed common,to
,nmlll,'I the is...yet Nr.7044.Broiorss Ilnd Profen,{m„Code Bbe Cnmmclnr, 502 — FINAL PLUMBING ENERGY _
License Law doe,not apply to an nwner of prof srty who build,or improve,theocrat.
and who contract,for Such prn;ect,with a cnmrenor(,) licensed pommot nl the 506 — GAS TEST
Cnntramn's LiiYna Lass.
❑I ma e:onpl a title,See. .9 le P C for this reason' 507 — FINAL,„PLUMB
owner unto /
WORKER'S COMPHNSA'I'ION DECLARAIION
1 e and affiwill bander penalty nfacoperjury one of the following declarations
for I)r
7 1 have and will provided
n a Cby Sect tf Conwlo n, Labor for Workers
Comnniarenn, a, provide) for by Section, X1 of the tabor Cade, li,r the O
(n'.rfnrmunec of the work for which Iii,pnnit is Ixnned.
11eand will maintain Worker',Carman lion Insurance,as required by Section v
7011of the Labor Code,lin the Perh,nnance if the work fur which this peroln is
issued.My CW ke,n,,C'�omG,nounn Insurance carrier and Policy number ar _
C:brier:_ A_f&,1_.E policy Na: S W y00 11)10 .
CHR'FIFICA'I'ION OF IiKEMPIION FROM WORKERS'
COMPENSATION INSURANCE
.fhb Section need nor be I i'leed if the lie nnil i,for one hooded dollaw
IS 100)or hese.
1 lerill that he I'he k I 'ho'l,Ih-pronnit':koned I _
,hall".'employ any 1 Vt 1r W&1 I In W rker,
Cnmpe a ,fC I'f >t / V—
A,pliwao'
NOI
NOIICC )APPLIC NI If anon C 'I II pl y hmulst
becomeSubject
I,Iolit Such
Cm nYrtis permit rri hall be dLuhnr Code.you must
Q O hnmwim minply with.Wali provisions or thin Pem,il,M1ull be deemed«vnkeA,
Z
CO, he.is PION LENDINGAGENCYa -
a ' 1 ,k thereby offiran this therr i,s u Lied(Seen lending s.C.) for the perfnnnunee
II work div wbich this permit i, ,sued fscc.3114],Civ.C.
az Lender:Nunn
Z Lender',Address
r..) Q 1 certify that I have read this appllcall^n and%late that the above information i,
Ga. t;. correct.1 agree to comply with all city and Want,nrdinanem and,tam lax,relmiog
Iu building conurroinn,and hereby authnire repre,entxesae of this city to enter upon
the.1ove-nmiroureJ propel'Iy liaringmstlnn purp:m,.
E., a IW'e)age=morve.indemnify and keep harmless he City of Caperton agarol
m Iiabnhirs,jadgmenis en m..exp.„ex wbian slay m any way eserine against,aid ^^'��X
V Z Cil'in ron,cynanr the .Inling Lit Ihic, ttil. //_1
APPLICANT 'd S3MPLY WITH ALL NON-POINT Issued by: �"'�— Date VlJ
SOURCE
Signal ,pirbeantl unarm... Dam RE-roofs
IIAIARDOUS MATIiRLA DISCLOSURE
Will tire appliicanorfranc bandi^goeeup,n,arm or[,amlie hoormwormaenal Type of Roof
a,defined by Ise Cupertino Mu^icipul Code,Chapter 9.12,and the Hrdlh and Safety
Code,SNIum 255321:)".
oyes ❑Nn All roofs shall be inspected prior to any roofing material being installed.
Wiu the applicant or lalum building occupant use ot,opmett or drvices which If a roof is installed without first obtaining an inspection, I agree to remove
semi,hanNous air contentment,a.defined by the Bay Area Air Quality Management
Dnpi,IP all new materials for inspection. Applicant understands and will comply with
Oyes °No all non-point source regulations.
1 have eLA the hoeunlonc malarial,equireuterry under Chapter 5.95 of the
Calimenter Health,F Safely Colo Sections 255115.'_5533 and 15534.1 undewmnd that
if the building docs not currently have a tenant,that it is my responsibility to amity the
euparal of Ilia rerlunimmi which must he mel prior m issuance o1'o Certificate of
Signature of Applicant Date
ower„,ntmo....ed n't,na Dale All roof coverings to be Class 'B" or better