00090030 CITY OF CUPERTINO 1
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION-
BUILDING ADDRESS: PERMIT NO. -
20690 KIRWIN LA-
OWNER S
_A•OWNER'S NAME: APPLICATION SUB DATE
. WAIdGrt TERRY' its I!Oti!2000 '
} PHONE: — 8.3.0 - - SANITARY NO. CONTROL NO.
r
I
=Q zo ARCHITECnEfiGINEER: BUILDING PERMIT LYFO
x p - _ - BLDG ELECT PLUMB MECH
<
lz'U
Hz '
LICENSED CONT'RACTOR'S DECLARATION
-z5 _ - JobDescri tion
CZE+ imm700oofmm Iam.FdmBoder provisionsnr..Codrnnd mmenemg Description -
with sertion moo)or Di.ision3nrthr BmirnessaM Pimrrssmns code.anti err Beense .
xxf- ismrmlrorer Were
Lm,p 2840..LIVII,I0. SPACE, . 441 'GARAGE.
z z a Li<rn. -
ed as pumr -
- a C< % •wry ARCHITECTS DECLARATION.
)understand my Plain shall w used m public reconl� •27'2 G - � -
OWNER BUILDER DECLARATION /,.S -
uai 1 hereby
aff thin I pt(mm the Com oor V Law for the IOti -
F Z roll g ISecuov]8315 B - ess ad Rofesmm Cotle Any fry m county ®
f wh h req a permit t m.fact alter,tmpmve,demolish m rept smuemre / "
i"3 m pn� t aissuana,tits mquueb rhx applicant Rrc inch tiro,itmfileaugtmd summon[ a ._ -
tnatheisIiwwapunuouttomegrossiomisofthe commictoraueenrLaw echaplerq Sq. Ft. Floor Area -' _ Valuation
(commenting with Section 7")of Division 3 of the Business and Professions Coda) � - -
w but he is exempt therefrom anti the basis far the alleged exemption.Am violation. $285372 .
ofnor` enm� rsroniiIwb!ea w apphean[me .n amlry
ormom than collas o - APN Number - Occupancy Type -
0l,as owner or the properly*or my employees with'wage,aw their sole rnmpev.arion, 3592300F,.
will do the work.and the burtme isom mmuded or offered rm sale(see.]Illi. - -
Busim,s and Pmfesions Code:The Contmeror'.w Liorme Law does out apply to an Required Inspections - -
owner of property Who builds or improves thereon,and who does such worn himself
or through his bun'emplo-ver,.provided mat such impmvemrnts are not inmMce m 101 — FOUNDATION
. .
oBered for.sale If,however.the wading e<impa.emem is sold within one year of :1.T:I?_- — Ft.T-ERS -
iompletivn,the ner-Wilder will have the burden of proving that he did [build - --
ownoor
mprove for purpow,of sale;). . _ 7.03 .- --LIFER ,
01,as owner of the property,am exclusively a mraeung with Ece vxd ri nuactorz m 7.04. -- REBAR..
omswct the project(Sec.J811.Business and Profession.Code:)The C..,.,*, -
License Law does nor apply to en owner of pmpeny,who builds or Impmves Merton, e-
aM mmac[s who nfor such projects with a convactm(z)licensed pm;oant m.the 105 — ANCHOR. BOLTS
or
Conmaers Li.Low.
- TOG — SEWERWATER0l am exempt under Sec. ,B&P C for this mason
o R by F02 jl,IDERI I._OOR 'PLUMBINGa
WORKERS COMPENSATION DECLARATION " 'c'03 -° IJI,IDF_RFLOOR MECHANICAL
therebyanrm role a Ry ofperjmyWeofbefon gdetlamron � ?0k — ;iU
. IvIDERhL001'k, FRAME- . .
owl have and-win domymn a Cemfieate of carotin,to self-some for Workers' - 205 — ! NDERF-LOOR INSULATTCJId -
gemmiumeodeworktad for by Sectionit Sym or the tabor coat. for the. . 30 '. , ROUGH PLUMBING,
arfotmarme or the work for wmen this arms is"me]. - - .. r
I have and w ill maintain Worker's Compeausamer,Insurance.as reSuired by Section 302 — TLIB ..R OR SHOWER.
37M of the labor Code,for the Performance
rymv.me a me work for which thi.permit u -
mumiLMyWmueaSumpe�Z l 11>Mer d Policy moron are: 303- --�ROUGH .MECHAN I CAL - -
c 304 —- R01.10-1 E,I_EXT:R.T.CAL
N OP EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 305 +FRAME,
(phis seeuonweed not Wcompleted ifthe'Iermhisfor onehumteddollars 30F, - . HOL:DOWhfS' ..
Islm>oness.) + 307.--,:.,IhISULATICTN: '
leenifythminthcarfomr of ork f ni<h m. Perrot[ . sure.i '0!3
shall SHEETROCK,
a ply any Pr. y . [ become - b) t t th Workers: "•r '
Compensation Law.°rCalifornia.Date
Apphcam 307 — EXTERIOR, LATH
NOnCETOAPPLICANTif ft makigthis CemreamofE.emptode.younmdd - 310- — ILITERIOR, LATH
bet b)reuo theta k Co a a p -' sof the lawrCNe.you must
Z C forthwith tomplywithsuch prowt or this permit shall WdeemMmoked 311 —' SCRATCH -COAT
E•a WCONSTRUCTION LENDING AGENCY ,,,13 '— ROOF .NAIL
• > I I hereby affirm b.them is a cvnswction fibbing agency for the performance
of the work for which this permit is issued(Ser.3097,Civ.C.) - p
Lemkr,Nam X01 - 'F :GMAC hT_EC'CK:I:CAL F_hlEfiGY
iter taarrdvar,Add 502 :- ,i`INAL-.F`i_UI'IE;IiIG•-ENERG,
I certify that I have read this aplAw.uon and ser.that the aws.Infomuriou is
- } F a
enmer.I agree m eomly with all ery ad roomy mdaand •e Ism,raltivg 503 F I NAL MECI-li,lq l:CAL ENER
GY
C :a Wildingconstmeuon.amherebytramoru ofthiscirymenter upon 504 F1NAL BUILDING ENERGY6
--- -
the above-menuoved Proanyifor imaerion purpose, _
F•, C. (We)agree to save,indemnify and keep hamdess the City of Cupertino again.
.r 2 Iiubiliues,judgments.ca.s and exames which may in any way name again.said --
C'7 Z City in evmryue a of the grenting of this smut
APPLIC NDERSTSNDS AND LCOMPLYWpn ALLN '-POINT TSSnEd by: l� �' Date L--"-'�/� •
AL
— —D
s' on err Dane Re-roofs - -
HA]ARDOUS MATERIA ISCLOSURE
waI the appwant m m[ure wilding t snae er nampe wammus tmte>;aI Type of Roof -
as defied the Cuartino Municipal Cafe.Chapter 9.12,avd the Health aM safery
Cada Setting 353^_W)'t '
°YG9 - Ali roofs shall be inspected prior to any roofing
material
being installed.
-
or
Will meson rvmuota ommusasbuilding lbybeStyAeaAir mlityMinagemch If a roof is installed without first obtainingan inspection, I a fee to remove
emir nararduus air conmminanrs m defend by the Bay Area Air Qualiry Management
P g -
lDistna" all new materials for ins -ection. Applicant understands and will coin 1 'with
Yew P - P Y
• all non-point source regulations.
-
Po g
1 aHe red the hty Cok,kum materials 2 migi505. mcnts under .1 un 695 dl the ..
ifbe roil Health&safery Cde,sttuom'_5.drat 5533 nM sp53a,I ily m rimrtd dad
if be Wilding does nm rnrrevaY have renant.muis mj"minue bifiry m notify of
occupant of rhe req 'rcnrnrs which mmcr w e.......isuaime of a Certifirnm of
PeSignat of Applicant - • Date '
ner orim ad gent . All to coverin to be Class "B"or better _ -
OFFICE -