01030155 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: 11I7RMIT NO.
7614 KIRWIN LA KITCHENS BY MEYER 01030155
OWNER'S NAME: APPLICATION SUR DATE
PHILIPHUTE JR AND VICTORIA Y 278 CASTRO ST 03/28/2001
PHONE. SANITARY NO. CONTROL NO.
) 968=8318
ANCHITECUENGINEER: BUILDING PERhrl'r INFO
BLDG ELECr PLUMB MHCH
F UUrtW I� I_1 I=I I_I
O H j LICENSED CONTRACIOR's DI!CLARArioN Job DesCI'I ptloO
O0_O 1 hereby affirm that I ant licensed under pruvisiois or Chapters)(commencing
F u,Fj with Seclion]IMMBof Division 3 of the Businessund Professions Core.and my license
< i,anlull,sCl,eanr, eI.$ 3�3Q4/ KITCHEN REMODEL
e z License Cor Lic.M 'b+�l
Dane_yr2 , Ll=i c„ntraeu,r
ABC11r1EGr'$IIIiC1,AINT.
SOyS Ianrcrsrmdmyplan,call beused nsPublic reenrit, PIIVALED
Llcenad Pmfessinvl
Her
e 2 OWNER-BUILDER DECLARATION
- I herby of ane into I am exempt Inn i the Connacmr s License Law lin the OCT 0 4 2001
F�>>' fnllowing n n.(Seen n r 911.11,5.Brsorl and 1'mfms s G,de:Any city nr county '
Dwhich unp.or,a'unset a.eoa,ln¢n,rhea ntpmve,Jemuled.. , .poor airy,,acture
ne
u.) PH,),toit,i,suunce,also terries the eppllcta lar such'conal to file a signed,taencat
d"s!2 .net ac is uc,med personal tonne pre,War,of the enmraea.,uanx law(cruiser 9 Sy. Ft. Floor Area BUILDING
Valuation
mm
(coencing mRh Section](HIB)of Oivioon 3 of the Business and Profession,Coe)
or that he is cacrept thetefmnt and the nasi,for the alleged exemption,Any,'f@ah,n
of section 70315 by any appl won for a permit wthject,the ap,l leant to a civil lnnalry
of not more Lha.,lice hundred dollars(S500). APN Number Occupancy Type
❑L as owner of the roa,ny,o ser wnpinyas with wage,as their,ole corepenwlher, e
will do the k and toe%fracture is not intended or uttered for,ale(ces.TrO.
Bus arc. d Pr r•saon. Code The Contract License Law does not apply to an Required Inspections
aware of pm,1 Who nnn
ilds ,imon
pere,Bacterin.toad an,,ds such wort,hin,wu
orthroughhis own anpinycss pnn'ided that such improvenan¢are not arrested or 101 — FOUNDATION
offered dirt,d,,If:however.Ilse hunting on'innpn'nvement i,sold woldo one year of -
mnpl,no.n,6„own„r-Wonder wiln,an,e„harden of prot;ng tato he did as boilsor 102 — PIERS
improv,for propose of safe
O1.as aw,net of the prod,ear,arnexclusively contracting with licensed contraco,rsm 103 — UFER
L,n,nael the project(see.](144.Ba,iness and Poi Code:)'rne Contractor. 104 — REBAR
icease Low doss not apply a,an own,r of properly who bei ids o,hnprov„thereon,
and whotOIraer,ser,ah projeal,, wad,a cormnno,(0 hetnsad paratanm m the 105 — ANCHOR BOLTS
commuriliaao l_,w.
106 — SEWER R WATER
❑mean, [under Sec .ENtPClur this reason
Owwr Date 202 — UNDERFLOOR PLUMBING
WORKER'S COMPENSATION DECLARATION 203 — UNDERFLOOR MECHANICAL
'.r lhmahy mann talar,pa nr11,ofperin,yo at rirme lriuowingdecmnmona: 204 — .UNDERFLOOR FRAME
O I have and will maintain it Cenaficate of Consent m.wll-insum for Worker's
Cutup wrinion, as provided for by Section TA() or the labor Code, for he 205 — UNDERFLOOR INSUI_ATION
peiromaaeorineworkforwhdcnBm,permi.kioned. 301 — ROUGH PLUMBING
❑1 hove anti will maintain Worker's Compensation Irsuca wc,as required by Section n
3]Iw al he Lal r Code,for lire pcnonr.aa:of he ok roo whrh hi,pe....it a, 302 — TUB & OR SHOWER
issued.M(y1�W(orkcr�'s Cnmyy�+^� [ton��m,urao,e eana„a ad Policy mot her are: 303 — ROUGH MECHANICAL
Cartier-]_eft(. -C1?Q PtBeyNt,:3_fi3-eo offltoou?o .
CENTIFICA'1'ION OI'E%F,MI'nON FROM WORKERS304 — ROUGH ELECTRICAL_
COMPENSAf1ON INSURANCE 305 — FRAME -
(Thi,Bearoo necal ntI he oorgle.rd ll'dm Per I i,rnr one hundred downs 306 H01_DOWNS
(SIgB ar less.)
1 certify that an mi
the peruainrrce of the work for which this pert is isw d,1 307_ - INSULATION
shall not nnple,any person in any Banner so as et become subject to the workers 308 — SHEETROCK
Cor i'a'aion laws I Gdlfoitim Date
Apriez 1 ,309 — EXTERIOR LATH
NOT CH 10 I APPLICANT'.If.al,,making this Ccrtidicna of Esen,ption,you nl Id
z heomec0h,olollot Weake.',,Comp,m:mo.rprri.....o,,I lie l,alorCod”yonr,art 310 — INTERIOR LATH
O forthwith aontply with such poor,ior,or3hi,wont shall be Jccmcd tevoked.
F 14 CONSTRUCTION LEND]NG AGENCY
311 — SCRATCH COAT
y r any atom,mat he,is a construction lending agency for the pemmoance 31.3 — ROOF NAIL
of ho work for which Ihi,Innuit IS.,sued fgec.Ar)].Civ.CJ ,
y o 1'rol"�Na c 501 — FINAL ELECTRICAL ENERGY
UO 1cenifythlhareadthisapplicationandstatethattheabsornfunnationis 502 — FINAL PLUMBING ENERGY
am
4r. I.. costar l agree m comply with Al city and county ordinance,and state law,mw,ing 503 — FINAL MECHANICAL ENERGY
O U rebuilding con„wtaoa,and herchy tamod.etepteeenaraves ofthis city to enter uqm
y w mean.., eolaoredhtopilymtie,,,lior,..tpo,es. 504 — FINAL BUILDING ENERGY
E'+ C (We)agree or saves indcnmly toad keel,h ood"s the City of C'upcnino against
gzll
(n honilmc,.judgaem,.co,s tow eapenw„wI,i,h airy in any way acme against,aid 505 — FINAL ELECTRICAL
U G City in trnseyuance of the grarringof this permit.
Sol CI''NGo ATI N'NUSA 'l1.LCOMPLY WITFIAL�NON-J'OII 'Issued by: 506 — GAS TEST Date 7;K r,
Signuunrc . plin1,.n`RDOUSMn AUSDISCLOSURI? e(,�f>6/]t` Re-roofs 508 — FINAL MECHANICAL
Will heappacamo,I tis lid .neupanr,toreorhandle narardou,n,ruriw Type of Root' 509 — FINAL GRADE
a,refined by the Cupertino M1 pal Cole.Chapter 9.12 and the Health and Safely
Code,Section'-5532nd.,
rive, No All roofs shall bl%pectefl i 4o Jnyt V1ai 1 i't al being installed.
Wild.,..pplaeaa o.nit a htrddiog.allooLtt t,,,.lolpae.n o,aetaee,whiz,, It'a roof is ins(ailCd-wiiho i IW6lif?, o BA s r,,el agree to remove
emit harunl.ma ao,emmnninn dclined by the Buy Area Air Quality Maret,mm�t
Di„toe^ all new materials for inspection. Applicant understands and will comply with
[I ye, No all non-point source regulations.
I have rend the hazardous maeriak,naluirtmenn under Chapter 6.95 of the
CWali,miu licula&solely Cole Sections 25505,25533 and 25534,1 trrdersbo d In:n
it the h:ddiag Joe,Bol enneoly have a tenant.that it h try remponsibilhy It notary the
enpanl of Inc ttgai .teals w,t,n a,l ire n.et pdtn m a„a.mcc or a cenmeala rix Oe
ru,an`y' / d Signature of Applicant Date
0. tt - o17 ;„ `--�� Dole All roof coverings to be Class 'B” or better
VVV OFFICE