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03070205 CITY OF CUPEW11NO BUILDING DIVISION PERMIT ACON9 RAC'COR INFOIZMA PION_r. BUILDINGADUREIS: WALLACE CONSTRUCTION INC, F39"NO03070205 1 9631 T.A MAR CT (01 ^'4ILS NAME: 7050 SAN FELIPE ROAD PERMO'ISSUE DATE JOE YEUN 07/28/2003 PHONE: (831) 637-8888 SANITARY NO. CONTROL NO. ARCIII ;C /ENGINEER: BU ILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 +oo LICEfmthaSED ficonscil undONDRAM 1r'S DECLARATION Job Description £Z�w 1 mi 7 affirm wisi 1 am limnsed under provisions of Chapter 9(commencing is p withllto= ndCf.l Divisi.nJ.f he Business Intl Professions Cndc.and myliccnm is +« mmBeClaanderre['' KITCHEN REMODEL/WINDOW UPGRA License Class Lic.Y IJ Lks'9sr.68\ a E K) [Fp Dal[ Cun"aetnr INSULATION @AFFECT AREA + ARCHITECTS DECLARATION f U I understand on,plans shall W used as public records MAR 162004 ea t- Licensed I) fesoonal u p vn I OWNER BUILDER DECLARATION <S I toothy affirm that 1 am exempt Gum the Contractor's License Law for the p o following reason.(Section 7031.5,Business and Professions Code:Any elty or county O U LL�J� u�'f tVy <m which requires a Iwnnh to eco suuct,alter improve,demolish,or repair any mmctum JZi priorin its humance.ehm requires theapplieant forsuch permi0a lilcasignetl.varrmrd < that he is licensed pursuant to the provisions of the Contmctnri License,Law(Chapter 9 Sq. FL Floor Area valgtipll OOO u�$ (commencing with Section 70000ofDivision]of me Business and Professions CrNe).r a - that he is exempt therefrom and out basis for me alleged exemption.Any violation of Section]031.5 by any applicant for a permit subjects the applicant W a civil Penalty of 3 gP NN QdlBerO 0 Occupancy C not more than me humored do] ane lots D500f P y- yPe ❑1,as owner of the pmpcny,or my employees with wages as their.mle compensation, will do Nc work,and Ne vdcum is not intended or offered for sale(See.]014,Business RRe�i� and Pra ionui,J000k;The Contractors License Law docs not apply to an owner of 101 - FOUNDATY�Yk�d Inspections property`"ho proves thereon,and who dues such work himselfor through his own employees,provided that such improvements are not intended or offered for saie.It, 102 - PIERS however,me building or improvement is sold within one yeu or completion,be owner- Im after will have the burden ofproving that he did not Wild or improve for purpose of 103 - UFER 104 - REBAR 1,as owner of me propcny,em esclusivdy cnmmcting with IiccnseJ cantreaors m onnmm the project(Sec.30x4,Business and Professions Code:)no Contractor's Li. 105 - ANCHOR BOLTS ceruetaw dmsnmapplytoan owner ofpropeny who Wilds of improves Merton.and 106 — SEWER & WATER who cono., for so projcds with a contracmr(s)licensed pmwam to the Contractor's License Law. 202 — UNDERFLOOR PLUMBING ❑ Iam exempt un se[. ,B&PC to,this reason 203 - UNDERFLOOR MECHANICAL " & x 204 - UNDERFLOOR FRAME 1 ORKER'S OMP SATION GOON I hereby affnd underienaltydfperjury .f the following de[Iara.runs: 205 — UNDERFLOOR INSULATION ❑ O.aeand will maintain acenihcamofCon nttoWK-msamforWorkcrsCompcn. 301 — ROUGH PLUMBING cation,as provided for by Section 37W of me Labor Code.for me performance of the 3 02 — TUB & OR SHOWER work for which This permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3 03 — ROUGH MECHANICAL 3]W of Ne labor Code,fpr Ne Performance or me work fur which this permit is issued, - 304 — ROUGH ELECTRICAL MY Workers Compensation Insurance artier and Policy num Wr art: 305 - FRAME carder: Policy NO: 306 — HOEDOWNS CERI BeicATE Oil EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 307 - INSULATION (Thisareino need not Wcnmpletcd Rahe lrrmitisforomhundad dmlars(slap 308 — SHEETROCK or Ices.) I certify mut in the performance of the work for which this permit is issued,I shall not 309 - EXTERIOR LATH employany person in any manner to as to becam[subject to tire Workers'Comp[nssfion 310 — INTERIOR LATH Lawsof California,Date, Appliam 311 — SCRATCH COAT NOTICE TO APPLICANT:If,after making this Conifcmc of Eacmptinn,you should 313 - ROOF NAIL become subject to Inc Workers Compensation provisions of the Labor Cndcyou must �z forthwith comply with such provislnnsorthis permit shall kdeemed rwroQ. 501 - FINAL ELECTRICAL ENERGY ?O CONSTRUCTION LENDING AGENCY 502 — FINAL PLUMBING ENERGY Iherchy affirm Nat mere isacnnslruninn lcnding agency lm@e performance of 503 — FINAL MECHANICAL ENERGY z > Nework mrwmmthtmapmdBissued(Site Jfn].Civ.c.) nLender's Name, 504 — FINAL BUILDING ENERGY . Lenderi Address �\ Z)z 505 — FINAL ELECTRICAL -- J C) I certify Nat 1 have read this applionon and stere tom Ibe above inLrtmatiun is 506 — GAS TEST correct,l agree m comply with all city and county ordinances and stere laws relating m j V building conslmction.and hereby oumorire mpmscnuGves of Nis city to smcr.pm me - F I NAL PLUMVIN G } a above.mentioned property for inspection purposes, O8 FI L (We)agree to save,indemnify and keep harmless the City of Cupcnina against N liabilities,jutlgmcnu,costs anti expenses which may in any way accrue ag;Iinstsaid City / J z APPLICANT[Uppff.De granting STANDS AND WILL COMPLY WITH ALL NON-POINT Issued b 5 G Date 5 URCE REG% IONS. 'y� 07 �� Re-roofs Sipmm, ApphamsCmnmmo, arc HAZARDOUS MATERIALS SCLOSURE Type of Roof Will he applicant.,future building oc[uP' t sm,c nr handle hamardom mmedal az defined by the Cupertino Municipal Code.C ter 9.13,and the Health and Safety `'0 Section 25532h)? n All roofs shall he inspected prior to any roofing material being installed. Yes No Will me a li[ant or tumre building occupant use equipment or devices whim If a roof is installed without first obtaining an inspection,I agree to remove pp s panitQu emuic17 sairennmmmant{azdefneJstytheBayArcaAirQualityManagcmcm all new materials for inspection. Dlntrict] \�rl/a`,v, ❑Ycs have read the humorous materials requ immmu,under Chapter 6.95 of the Cali for Die Hcahh&Balmy CWc,mounm Sat it myrand35534.1 to nobly teoccup Wilding dtti not artemly nem a"nam,mm it is my rnaryinsind'ny u,notiry me Ireapen N he mquireromf,which mu Ie,met pour of Bance nfa Cerifi,mmof Occup y. Signature of Applicant Date Dw .rautn.rrzedag[nt , All roof coverings to be Class "B" or better