02090024 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDINGADDRESS: PERMIT NO.
115S KENTWOOD AV CONDITIONED AIR 02090024
APPLICATION SUB DATE
Aft M'NeITINCHALI 1701 LITTLE ORCHARD ST 09/04/2002
IV PHONE: SANITARY NO. CONTROL NO.
(408) 291-2220
nacZ ARCHIFFECTIENGINEER:
aaco j BUILDING PERMIT INFO
_DG ELECT PLUMB MECH
8��2 LICENSED CONTRAC'fOR'S DECLARATION
ozi2l w I hemb, ffim that I am licensed under prqvipons of Chapter 9(commencing Job m®ri tion
r W its Section 7000)of Divimmm 3 of he Bonitos,at.,pWroffes,was Code ad na,license FURNACE CF /1CC)e GE DUCTS
< .6 in FBN.A ilecau
ad 11sicaraluil se aenSp e 10 Lie 1 .44- 11- rem
02V LE
sea,
C-MaL
ARCH1=1 DEC 146N��'�'
I understand my, a
him,in 11 b,used as public mcmd,
a4
Licerassai Proft,ii...I
x OWNER-BUILDER DECLARATION
sc, I hemb,.1find that I man a,a.pl froun the Commission's License I-Mv far the
�Z� following reason.(Section 7031.5.Business and Professions Code Any city or county
hich re,sims a eirrat to cor�tmvt.alter.improve.demolish,or repair any structure BUILDING $3875
poor to its issuance.also"ideas hou applicant for such permit to file a signed statement
h�iii:i,li��ia��s6�it6ffi'e��6onsof�ContmetarsLictn�Uw(Chapter9
(Ooarmarr�.'&with SLclocin,700D)of Division 3 of the Business ad Pomm,aiiam,Cada)
4, 3 5&13�k�QtJ29T @*a;
.1 donat he 19 cican�u danrcmain wriciffic basis for he plj�gcdl csam�wwn.Any violation a
of Section 703 1:5 by any appli...i for.permit mbjecla he applicant to.civil FcmHy
of net more In.five hundred unit.($5BID
i 30jARNk0tgtRq PLUMBIN ;tv.,i OccupancyType
0 1,as owner of the pmcry,or in.y employees a ith wages as their sole cona,mosioun, 303 - ROUGH MECI__J. ZT�
',will do the work.-and the structure is ind intended or offered for sale'sa.7�
Birshocis and Nofessions Codei The Contractor's License Low does not apply to aa� 304 - ROUGH ELIX TFa(rAbeCtiohSi,%,Lr,,,1z
Owner of pro,any Who builds or improves thereon,and who does such work hirr,,elf 505 - FINAL EnTRICAL
_:.1 Borough his own erapt.yeas,mosmead that such unpres,mmants am car intended or
1.115crod for aide If,hosusner:-da,building orhmjp�vmditinl is sold wilhirione-yea,of - ----- 5 0 7'_��'_F INAL_PLUM13 ING-, 7_7
completion,the owner-latilder will have the burden ofpmving that he did not Wild or
impon,oaforpiapanseciforle.). 508 - FINAL MECHANICAL
-................ ............. ............ -------......
n I Of s"woom of dociampary,am exclusively contracting with licensed contractors to
emespred,the pirsjon,(Sec.704�1,Business oil perfessicaus Coake)The Cardamom's
License Law does not apply to an owner of prol who builds or hoproves toacmi.
and whic,condracts-for such projecan,wita a conarracharal.iscameni sswcam,us�dhi_
7 cmdescon'sLicautual
annaman,on it Sm P C for this mason r,
a,
'L wn
0
WORKERS COMPENSATION DECLARATION
I herab, M. nd,,r penally.ofOo-do On ofth in howing declarations:
L'y 1.1e I
scif
13 1 "irld will 61 -in o2carfil Of Csm"t'�. -imuse for Worker's
Compensation. an provided for b,-Sectim. 37M Of he Labor Code for he
perfarrainceofthe work forahich this Permit isissued
. . .. . . 11.I lm -I�� I I
0 1 have and%illinummin�Vorker*s Coin,answoorrinsuranoi al malmond by Sc�,,diori
37M of he Labor Ccdk�for'he kWasol the work farr'.1hich this pi�mra�t a
isirad,My Worker's Compensation lard I ran e,c f.hoy mmffi�,am
o -143 1*11�
R
im ERS. 1V 1,f
IVN Ul�hXh ION FROM WORK
:Vi_,Uj; CERTIPICATIO, !,v
._t COMPENSATIO?if P�SURANC I, .2 1 1 1
01 ;--; ,-!- -� E, I--,-.---,_.I— ------ -----------
iflhc permit is for one hundred dollars
(SHKO M less.)
I .. I . �, I ."h '11, ,". 'o,",
o.
,,f ;a�_f mlll;;m�for wl�mb tit;,kronil7is i....di�I
bal in con, y an, .a an any net, co to_came,�ubj��,1. he Warkers'
i conly that in the,narsonan, be, U i:
,amp�madira.Laws mfC.1ifin rm. Da m'
-'Appican"
NOTICE TO APPLICANT If.Offer onalkiii, --fic-le of�E-pl )no should
Z heomic iubipect t6 the Warkers Ctimponsiflion Pius smas of the"u Code ydainusi "it I
foinhuid,couilrij widt such provisions or this permit shall ha,deemed O,Zod.
z - -------
CONSTRUCTION LENDING'AGENCY ......
I tomb'y urrim,that there is a construction lead
of ang agency Bar the pj��`ormjnam it E
Me work forailuch this permit i"itiltical sce.30l Cis.C.)
W�Q 1;�nde?,Name o —1,-
Ltmof Address
have Madmi,application add muc,
hot'he.1m,information is
with
I a.—in comply'him'
v 'r pl,.w,lh.11 city and county ordinances andstate ta%s mining
on 'r
1.Zilciial r.Ufion:and hereby authentic reprimma6cs Of this City to enter upon
ban d. c M i
'he idso'e-ommmined-
en p p 'peny for anspOstma Purpose,
drd
(we)agree 1.saslei'rityd,I'?'nify and keep harnaliO,Bic Cj�of cd,,�um ain't
and'x
iA liabilkim�j.durims.costs and es,insics wh h
Ui ..e IC May in any ,a 1.
Z City in consequence of the granting at this permit 'a c �Tast said
L ON E S
�NPPLI(!ANT UNDERSTANDS AND WI
LL COMPLY WiTH ALL _P
It k I, I ..[ .,� .
SOURCirl-o"I ATPblF/ YN, Issued by;i Date
OUS
n a., pp"ca 0
,ature,of Applies uVontration, Da :w Re-roofs
, BAZAR
l�,HAZARDOUS MATERIALS DISCLOSURE
she uplift
Will and Or of 7 W
Will the applicant or futaine Wilding ocimupself'sture or harnaft,hationjudis phaterind
aselefinedbyrmCfentimoMunicipi Code.Chapmr9.[2,andthe Health and Safety Type of-Roof-----..
. . . , " - , -A, � 1 fil"D
Code.Sicilian 25532A)l �6' j-1
. , �I, '. . ( ,?'..�I�'1� ;�,
Oyes........I, 1, 1 1
, 0
I a�.X_I f,r. All ro4s s
Adaki, I;i;�' 'z 44-- .", - ----- h 1.6edn;pected.priorro.any.roofing material.being instal led.-,,--,-,
Or ionne building Occupant Me of tornam or device,which Ifaroof s in"11�d'skithout first obtaining an inspectifin',Tagree�tdi&hiove
emit haearibous air coniamition anderinedby the B3yAic.uAi1Quolii,fsI.Mi,mrm, sta
D,mic? :* ,�. . ; I In I 1 1. 1 1
-0y, : 1 41, - - I ' all new materials for inspection. Applicant understands.and will,comply.,with
.� � - ,1. - C,I- -: T 11 non-poiht so - -----
if P, a
urce regulations:
hasemadthe himandous Eel I maimmoread,more,Ch.pm,6.65V thim
California Hi,alth&Safety Code.Secti...25505;25533=it 25534.1 understand thin
ifffie Pudding does not currently have.amount.'be'it is mylelfor,ibilim,it rofif,dic
which must W men prior to is.,mucc orn Codifies,of
Occulasam
66C.Moo of ffio,�M,Mrsmcr, ;7
Aw --igmture of.ApM.icant
Date'
ner or authorincal a
Z.. � . . , I I
All roof coverings to be Class "B" or better
---OFFICE-