00100077 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDINGADDRESS: A A A FURNACE COMPF ii3N. MITNO' 00100077
201.31 LAS ONDAS CT
OWNHIRCS NAME: 1712 STONE AVE APPLICATION SI1UIp.'II 0/2001
DAVID CHENG
`HONE: (408)293-4717 SANITARY NO. CONTROL.NO.
O,p AkCHITECIIENGINEIik: r BUILDING PERMIT'INFO
_ BLDG 171.EC'IPLUMB MIdcH
fiC I�1 I_I 1=1 I�I
to
tF- LICENSED CON'[RACrOR'S DECLARATION Job Description
Oo t=C I thereby tiff...IIhat l am licensed under pnnismrs of Chapter 9(commencing
_`J with Section 70M)ofDivision 3oftheRu,inti.andfromessien,Code,and myl.cense ADD AIR CONDITIONER
ne Sne ts In full force
qq
s<�a Iiatcnse C/ t„l- ZU C1�ntgractt
w 3 a.t; j RC HITEM'S DECI.A A ) C
V, 5 I a.al r iind nhy Plan,shall he lost as public m,sad,
-WT-
'.z, LiccnxJ Pna@ssional
OWNER BUILDER DECLARATION
2 a I heathy affirm Lha 1 am exempt from the Contractor's I.icanse Law fm Be
t-z following recto.(Section 7031.5.Husinees and I'rvfesrimn.Cs,Je:Any city or county
- C which cortices a penult to comtmet,alter,improve,demolish,or repair any structure
atm prior to its insuloce,ul,n requires the applicant ler such pemhitit)file a signedstatement
+- mat held.censclpur,anithithe pmvdionsofthe Cet,tractor vLimtxc[.me(Chapter 9 Sq. Ft. Floor Area Valu:k�iSBL4
(..whh Section 7000)of fitkinn 3 of Ban Bi,incxs and IOmlexriem Code)
lan he is excnga thevfmm and lite basis fa the all,ld exemon.ptiAny vinlminit
of Seen 17031.5 by:thy a,plkam Brt a permit Ithern Me applleanl Io a ei"I Penalty
,if ammerethan live haadmddollars($50,)), APN NuBnbe�035. 00 Occupancy'lype
0 Las water of the p apco,or mY employee,w,ill wages s then sole compensation.
will do the work.and the stmcmre is not intended or offered for sale(See.7011,
Bu,.ne,s and Pmfe,sion,Cub,*live Contrnetur's License Use does not apply to an 303 — ROUL1 reME.l.'H�1N Y�AL
x r of am,coy Who Build,or mipmvc,thereon,and who Joe.,such work himself
or thma,h Ids own employees,pmvak,i That such impmvanments are not intended lir
ol'cred Int sale.H.hu r.Ihe mddi..g , mam,sold will......o yea lir 304 — ROUGH ELECTRICAL
im,ihhpleden,due t�wmei,�n�mr w.Iu,ane dieil. pm�irdeh„�prmnhhy d,at he did ihrn navam 505 - FINAL ELECTRICAL_
prove!a purpone nl'salcl. -
❑I.mowner of the pmpeny.ant Bic,ine,ucuntmnmions Co licensed Commnus 508 — FINAL MECF47
L
parva the pmjcn(Sm.]61J,Husincsa unit Professions Cude:)llic Contracmr's
and n law dues nut apply man owner of a commands)
who boiler ucti pmvm to
he
and who u,mrcen liar such projects with n rontmcmgs)licenud pursuant tuthe /
01am Contractor's License Lvw. 0/
❑lues cacmpt under So'. .11HII'C liar th'n Ilan {..//
Uwncf Deo ��
WORKER'S CUMI'IiNSAIIUN DECLARATION
I hereby of ran under penalty of Icrjury one same Initial,doeliu tions: O ,
] 1 have and will maintain a Ccnifc le of Consent m,elf-insure for Worker's
Cumpensahon, as provided for by Stiction 37(X1 of the Labor Cadc, for the
perf rot aree of the work lot which this permit is issued.
01 have and will nminlain Worker's Cnmpea,,,fi i In,wancc,a,refired by Section
371X1 0 me Labor Code,for the p,,f,rn,unm of Inc work for which Ibis perml is
wet.My Worrkkeer',,CCo`m�peer-own
Inmmnce Gamer and Policy mmuner_am:'
k' ...
um<r:�LF�1:7tT I1:ICA'r10:J OF E%LA IPI ION�OK :RI
COMPENSATION INSURANCE
(Thi,w,tlun Hued nm he onudc,,d If 0¢permit is far one hundred dollars
(S 100)or fetus _
1 eenHy than to the it a.....me of the work fo,which this pc.mil is issued.I
shall not employ any person in any manner so;is u,become subject to the Workers
Compenhmkm lax,el Califomm Dane
Art]Or.' .
NOTICF'r0 APPLICANT:If,after making thio Ccmifcate of Exemption,you should
Become subject to the Wormry Cuntpcationp okimas of the Larval Code.You must
0 mIUnhwllh comply x11h such p,.si,in is or Ilie not shall he deemed revoked.
CONSTRUCTION 1.I1N DI NO AGENCY
a , I hecby mtirni that tncm is a cou'am"inn lending ngei¢y for the perlinimarm
oI the weak for which this permit is issued(Sce.3(197.Co.C.)
L p Lender's Name
= 7 Lender's Addrem
C.2 0 I certify that l have mad this application and,tme that he shove information is
fm to correct.1 agree it,comply with all city and county ordinances anti state laws relating
Q (� Iu building emiwin ctinn,nnJ hercnyanthorlre repm,crnrtivc,al this city to cnteaupoll
Ice above ocililei Icity for ip 't .
C
WcOgi,c to am,andermily !kor,anotle,LhaCa, ICapin.- ono
N liab'I'fe. judgment,c t d .ps .xs which unity In any way ai-I mid
U ! City in cmmequence of the grunt ng o1 this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON pOINT Issued by: '� Dale
X SOU ER TDR._
{+vfctnl-.t_
.Si am of ApplicunVConOa<u Umc Re-roofs
IIALARDOUS M All 111 SDISCLOSURIi
Will theal,prcatn or future htfddimgoccoliant.tmm or hl...die lha.atdmnx m,atedm Type of Roof
a,dill..ed by It,Cupcniuo Mmacipal cede,Chiyne,9.12,and he Ile:ddt and Safety
Colic.Section 25532(10^ u
OYca 0N All roofs shall be inspected prior to any rooting material being installed.
Will the applicant or future Wilding occupant use equipment or device.which If a roof is installed without first obtaining an inspection. I agree to remove
emit haaandaus air ennmmmants as defined by the Bay Arca Air Quality Management
.'lash all new materials forinspection. Applicant understands and will comply with
0Yes ❑Nm all non-point source regulations.
I hnvc rand he 6amNono mnm.i:dr rcyulrcinunix i It,Cnupter 6.95 or the
Calif nm a Hcallh hSatoy CoJc.Scctiuns25505,255)9 mull 2553.1.l understand thw -
if the huilding Joie,nal curchtly have a tcnunt•that It is my ne,al sihillly to notify the
occupant of the mquir<nvnts which am,be vie prior to i,saanee ul u Cen.ficme of
°c`n r afy' / _ Signature of Applicant Date
aummaved gc C/_ /1)ae� All roof coverings to be Class "B"or better
ge..