00090180 CITY OF CUPERTINO
nun.olNC.DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS PERMIT NO.
Ooc)90/sr-j
OWNER'SNAME APPLICAIION SUIT DAYU
JOHN DR AAAA—DRAIN PATROL 00090180
ONE: SANITARY NO. CONI ROL NO.
1p PFUND 0 RAD AND HILDEG RD TRIJ. 1701 S 7TH ST 09/28/2000
Q z z ARCIIITECrYENGINEE R: - BUILDING PCRMI'1'INILO
BLDG ELECT PLUMIt ECfI
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(408) 989-600 5 =1 I=l 1=, r 71
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kVj LIctiNspi)coN'rRACIOR'S DECLARATION Job Description
L✓ I hemby o1Rrm that 1 am licensed under prioraons of chapter 9(commencing .
to f-u1 wish Section Warl Division 3atma Rusin—sal Promotions Codeand an,manse
5 Y J is in full force and treat.
Y co¢ Lamio,a Clan Lic,e
K p ii'c Date cnmrmmr
w 3 u.H Ali' I"S uCCLARATIO.N
t Na /dernen,yp all bi,.axeJasp,mhnmrnda REPLACE SEWER FRONT OF HOUSE TO PROPEI
Re i - i
LI ,na1 LINE
DWNIIR-BUILIER DECLARABION
I hareby dii,nl that I m eupl Pram the Commanr'n Bova,,Law o"he
_
1". S following a ,.(Smoo.910 L5 uBrni and prolesslool Cud,Any it,laclonly
Q which 11 t 1 It p J 1':h Pan, , thre
i3m prort t I. 1 ,h ppl tl hp t1 n g I f,mem
that he licensed purstt to file P , to,. I'he COnartwome,L eeLaw(Chapter9 Sq, Ft. Floor Area Valuatiolic
ot,n mmamng with Seeuan 7101))of I nsision lot,he Business and Prolissinns Code) `C/
,,,,[,a,he is exempt,therefrom mJ the basis or the alleged exemption.Any violation OOJ
of Section 7131.5 hy'an)'applicant Ibr a permit subjects the applicant to a civil readily
oto„,momthan five hundred dollar, SNXB. APN Number/ Occupancy Type
❑Lannwne,nnhe Pmpeny.to my employees with wages a,mmir.sale oompcn,amn. O 3y a 2'6
Will do the work,and,he amnum is not intended or offered far sale(see 71YL1,
Business and P omWom Code:'rhe Cnntramor's License Law does not apply m an # Required Inspections
owner or progeny Who builds or improves thereon.and who does such work himself
or through his own employees.provided that such improvements are not intended or
offered for sale If,however.,he building or improvement is sold within one year of 36934026. 00
inmpletion,the w ner.buildcr will have the burden of proving that he did no,build or
io
mprove for purse of ink,). _
01.as owner of the prnpany,mnexclusively contracting with licensed eoamemmto 106 — SEWER H WATER
wonslrvn the projm,baa.nay Business and Professions Coc The contractors
een.eLawdoe,notapply,nanLownernfproNotywhobuildsorimpmvestmemen. 202 — UNDERFLOOR PLUMBING
and who contracts it),soon majors wane a matriculants)licensed pursuant to the
Coamctors License law. 301 — ROUGH PLUMBING
OILm cx Sec. B R P C for this reason
Lod {� 302 — TUB R OR SFIOIJEP.
Ow-°- woRKl:R ssurdan
To .c1,�Rnno:u 502 — FINAL PLUMBING ENERGY
I hemhy:nEnn under readily of picrury one of the lounw;ng declaramis: 506 — GAS TEST
1 have and will ct , c .1 , rc or B r w k . 7 — FINRL PLUMBING
Con 1 ( P , J I by S d 3700 f 0 Labor Code, f the
perforniance alth rk tor%nich his PCFL14 Is ciLacd.-
,3711 II IlAillanin Worivel'.-C L,o,iflon.Jose-oxic.a,coloind
o, c i
issuenl 110 Lot (talc,for the . do ,1',hcwork ifitcy vdith this(krnt is
ioueJ.M c wupunvuti mucocuriaa 3 norther are
/
Garro RO p
CERI'IPICA'I'II1N COMPENSATION
INN FROM WORKERS' 0
COMI'[iNSA'rION INSURANCE
('Ihi.v scctloo need not he cmnpleted If,he permit is for one hundred dollars
($1011)or lea.)
1 realty that in thepcolonnaince of the work for Which this Penni,is issued.I
shall not employ any pass n any manse,sn as,o become subject m me Workers'
Compensmion Lows at Califomio.Dam
Applicant
NOTICE TO APPLICANT:It.after making this CCaificae of Exemption.You should
bsub)cet m m
the Worker's Compeatinn provisions of the labor Craze.You must
O Qecome Ponhwi,b comply with such pravisionv or this permit shall be deemed revoked.
z
E' Z CONST RUCTION LEN DING AGENCY
> I hereby affirm that inert is a construction emling agency for the pafommnre
m be wink for which this Penni,is issued(Sm.3097.Co.C.)
L Q LenJcr's Naas
Z) z Lender's Address
V 1 minify that l have rend this application and state that the ansae information is
k:, F n nett 1 agree Ir um,ply sv'ith u11 city and county ordinances and state laws¢Icing
O C.7 m,huildingcanomninn,and herchy anthema reprcwtionses of this city to enter orat®r
y the move-nsntioacd properly far inspection parpnves.
(We)ag000-vn,laden oily Load keep lnmalass the Ca,of Cupenmo against
rn liabilities,ludgomnh,mw'and expenses Winch may In any wtry accrue against said
U z City in nimelncncc ul 16c gmmin. ods pern,i,. pi.a
APPLICANT UNDERS'rASNN, ILLC WITH ALL NON-POINT Issued bY: c 7,00' y'N'� Date
SOURCE REGULATIONf..
Slgnth,mol Applinlnt)Cmtlrocm, Into - Re-roofs
IIALARI AJS NAI IKIALS DISCLOSURE _
Will theapplienmLorfntmemindingoseupanacone...handle ha>anmaalnaedzil Type of Roof
as didimd by ma Can"'im,M,miciryd Craft,Chap,ere.12,zinc]the Ilcallh and Safety
Code,Section 25532187
Cl Yes All roofs Shall be inspected prior to any roofing material being installed.
Will,he."Ibemn Lor Ban huilding rscupam use equipment or devices which Ilia roof is installed without first obtaining an inspection, 1 agree to remove
,i,h ramAoun air cnm:nninan,.s/m dclined by the Bay Area Air Quality'Managemen,
,mato vex SCI No all new materials for inspection. Applicant understands and will comply with
ail non-point Source regulations.
1 have Lead,he bmerdous actuarial,mgwmmmnta under Chapter 695 of,he ,
Califnmia IIcu1,h ce Safety Cade.Sections 25505.25533 and 25534.1 understand that
E
mx urn cunenJv tenunt,M1a i,is my res..ca&lhymnmlarethe
ofrequiren IOr mus,be met prior m issuance of a Cenificac ofSignature of Applicant Date
ri.ed a Dae - All roof coverings to be Class "B”or better
OFFICE