00070165 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERM11 NO.
OWNER'S NAME: APPLICATION SUIT PAI 17.
• 20212 JOSEPH CL CRAFTSMENS BUILD INC 00070165
PHONE: SANT CARY NO. CONTROL NO.
2t O'/O ARCHITECrlIEROINEITIR IUILUIN(3 PIiItMII INFO
w❑ BLDG 1?I.1!CI' PLUMB MI CH
uU — 1=l C.-P I=I I-I
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N j LICENSED coNTRACIOR'S DECLARAr1ON Job Description
1 hurcby affirm that I am made,der motioof
ns Cl aur,9 lcommencing
r_Cat with Section 7000)of Division 3ohe Hmine„and Professions Code.and my liceme
in full Inues ter •ct
and cl . Lias
m z Liccmr Clp -
% ):Tic Conlydd (�� [.� (�
F LL O lin p0MRCHHEC-I'S DECLARAI'I(NNl F, I&tN- ILtJ (�✓�
and r, m )hy Plan,shill be,used as public accord, REMODEL, E. ECT AND PLBG
Licensed Prefeoionm
OWNER-BUILDER DECLARATION
1 hereby mnthat I o exempt from the Contractor s License Law for the
C 7< mr following«:oar.l Senior 703L5I mums and Pnde„ion,Code:Any city nr county
Z O which rcgrl;'c,a be it m cons;mn,alar....mod.d,..... h,.r;upset tiny strnnmc .
d3� Pjet oim,mnne.nNo nynar,he oPlifcant forwch pcntdno file a,ignedamemem
thin he is hurt,]Puouanl m The prnvksio;tn at the Cournwh lis Liccroe Uve WIT 9 Sy. Ft. Floor Area Valuation
(ca,am...in,with Section 7000 of Division 3 of the Hu,ines and Profo,bn,Code)
or that he is exempt therefrom and the bask for the alleged exemption.Any violation
of Section 7031.5 by any applicant lis a Permit subjects the applicant to a Civil penal y
of not mere than five hundred dollar,($500). APN Number Occupancy Type
❑I.a,owner of the properly.or It,enp,loyce,.fill wages as B;eh sole c»m ax,eadou,
will on f t J 0 structure s, t I J r h rJ : (`, 7
(tilnmre. t1 hellion,cm v Contractor',Lid La J t PPI .;u - Required Inspections
ow t p pony Who h IJ humors,;1 J h,A -- cM1 :icll
or through h npl l .p J d that h P ser t t t Tided t 31624050. 00
o@rcd for sule.R:M1awevice the building or improvement a sold within one yrar of
c.mpleiom the nwne>beilder will have the harden of proving that he did not build
improve for purp lie of wle.).
❑Lovoforrrofmrcf,<�ny.a;nex�n,maycmu;roe;i.gwiurnce;r,rde.rnr;;cu,r,., 1.01 — FOUNDATION
n;,met the project ISO:.7044.Hoarse„;sed l..,mn,Code:)The Co.ru'la, 1.02 — PIERS
.Licen a Law doe,not al to air oprove,aw Tier of property who he lld,or imihei cut. ! V
and who contracts
atora for such projects with a comm tort,)licensed paRoant m the 1.03 — UFER ^
c,mrLicer m Law. /
O l optemmpt.under Sec. .H K PC fonhisssoon 104 — REBAR
Dwdrr Dare 105 — ANCHOR BOLTS
WORKERS COMPIP'SNI ION DECLARAHON 106 — SEWER d• WATER
• Iarmbyauirbemdrrinnaltyorperjet,uncut mrfill how iIt,dedaraBorr,: 202 _ UNDERFLOOR PLUMBING
El hevr.aod will maintain a Cern&me.f Consent ,,,elf-in,are for Wicker',
Compen,otiem. as provided for by Section 3700 of the Labor Code, for the 203 UNDERFLOOR MECHANICAL
pert.mmrceonbcworkfar which this pbear isi,tuhL 204 — UNDERFLOOR FRAME
❑I haveand will incaution worker's Camper,„door[counter,as required by Section 205 — UNDERFLOOR INSULATION
3700 of the Labor Cede,for thr perform v of the work fur which this permit i,
orrd.Mywor mpcn,a y ucyNrn•2'd9�m��G (Q �Jv7(f t 301 — ROUGH PLUMBING
CERHII ATIONOFI?%IiI IONPROandMWORKERS' 302 — TUB &' OR SHOWER
COMPENSATION INSURANCE 303 — ROUGH MECHANICAL
fId,wid a oem nor be completed it he wmrt I,nature hundred dollar. 304 — ROUGH ELECTRICAL
(S 10p ns'Ices,i
Iruddy land inthe p,,Ibnnn
asereohrk
ewolbtr,Idohthisprnri isissued,l 305 — FRAME
,hall not eotploy any person in any summer s,a,t.We...1.,am"I to the workers' 306 — HOLDOWNS
Compensation Law,of Clihi la.Dote
Applicant 307 — INSULATION
NOTICE.TO APPLICANT If,after making this Cenific u,of Exemption.y..should
Mcome.subjecnn the Worker's Contpe %ation provision,of the Labor Cook,you must 308 — SHEETROCK
O forhwah comply with such provisions or this permit,hall lw deemed revoked.
z 309 = EXTERIOR LATH
V�J CONS]RUOI'I ON LENDING Af 1:sl
a > I hereby afloat that them .
is a con, uchod leading agcrcy far the p,,fm;ounce 310 — INTERIOR LATH
Til the work for which this permit i,issued ser.NN7.Civ.C.)
i Le.&C,Name 311 — SCRATCH COAT
D Z Leade"Address 313 — ROOF NAIL
UO 1 certify thin I have read this application and state Thai the uses,information is 501 — FINAL ELECTRICAL ENERGY
I,. ;: "redd.I ugmr ,,comply with all city and county ordinances;laid,talc laws relrting
O U I.Kidding const,ulion,andlandyatmmri,rrepor,rnho'wrsolink coy tocurve ru v502 — FINAL PLUMBING ENERGY
the;moo-memi.md properly Ib;imp«con purpoa,w.
E� y Iwelagr.rpt,aseindemnify:r;rd keepInrmlc„ beCiryofCopcdin.ag;hmt 503 — FINAL MECHANICAL ENERGY
lin randaie,,judgment,,cos,and ex a nw,which may in any way accme against smd
v z City 1n conveRnence of the gmaing.fit it. 504 — FINAL BUILDING E�E
APPLICANT UNDERSTAND. )MPLY WITH ALL NON-POINT Issued by: UtRGY
SOURCE REGO .7 f—� y'
Signamr o ica; .Oto s I:nc Re-roofs 506 — GAS TEST .
IIA DUs building
bel ,NJ ERIALS leave,URE
'
wiuyteppheamrMuniHauling«Cham,mm2,andehyarl.n,nSafet1 Type of Roof 507 — FINAL PLUMBING
as antnsm by me cahedm.Municipal cove,charter 9.r,and me Hemet are safety
Code Section 1i532(m., 08 — F NAL MECH ICA
❑Ye, 0N All roofs shat` tis ec p�J{� to �Y mg ma erial being installed.
Will The applicant or future her lJimg,rcopam u,e eyuipme badly Management
If a roof is ins Ik with , tFl Fi ob 5}I .n in�ection, I agree to remove
caths,;...on,ai,xica;me.ms'lodcthtedbytheRayArtAirOmaityM'n:;grn'cn' �1,(` AM Pstands and will comply with
• Dillnhr all new materW%r TnsFe�tfA �—A h p y
El ye, 0N all non-point t!6drk regdfahNAL UBLIC WORKS
I have mad the hl,aNau,mmeriulx re,ti mmeno under Core,6.95 of the
California Health k Safety Circle.Section,25505,25533 and 255311 understand that
if the building doss not currently have a tenant,that it is my responsibility.)notify the
occupant of the behimmcnts which must be met prior.,issuance of a Certificate of
Occupancy. Signature of Applicant Date -
ownet.r;untn.d>w •e;ut [),In All roof coverings to be Class`B"or better