02060139 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10863 LEAVESLEY PL 02060139
OWNER'S NAME: APPLICATION SUB DATE
•WILSON ERIC K AND SUSAN C 06/21/2002
I PHONE: SANITARY NO. CONTROL N0,
FO O ARCHITECTIENGINEER: BUILDING PERMIT INFO
w C BLDG ELECT PLUMB MECH
,< I_] f— I L 7 LJ
LICENSED CONTRACTOR'S DECLARATION
Q S I herebyaf➢rm that 1 am licensed under p g Job Description
previsions Professions
Chapter an ommencin
F=� wimsecdo��9p�W00)of Division the Businy5e�nd Professions Code.and my license SOLAR PHOTOVOLTAIC.
<mmI is in fuse fom]kana of ea' 7sf s (aj 2��
K m a license CI Lic.
Com ao �e e C
sississaill
XARCha I'be use as ATION _ FIYvA stl�
1 understand my plans shall be used as h c rcmrJs
ec.ui 6�O Licensed Professional
Oat I.. smpil DECLARATION CiMTION
-w 1 hereby reason.(Gmr that 11. exempt from the Convenor's License Law for the
followtis whichinguiresa(Section WJLS.Businusandmpr Professions Co dc:Any city or county
E�D which requires a permit ro construct,aha,improve,demolish,or repair my structure.
urej 3 -.'norto ehemance.aLw requires she applieans forsuch penrdt to file asigrcd sutmnent. _..__..
tha1A<islieen9ed Ph Mm" Ne pNnsiomof Ne Conuadoh Lianu lawfChaptn9 qtr F[ pIQor,(pp, �y,, fll Valuation
(�omnienciog with Section,]IXlfl)pr Divinon Jof the eatineapnd prpfwinns Code) �;t�l'�[3'S`5641.5'O 2�f.'0a��3'i23[.A.�i'j'Vi
o that he Is even"d from and the Wsis for the allpgeq ezemptina Any violation
-rf Section""5 by any applicant for a permit aabjects the othureumtoa civil penary- ]N�]p�br�
iofnotmMethanfiveWhdreddollarsIS...). 101APNFUUNllATION 't ' ^" Occupancy Type
❑1,ns owner ofine property,or my employees with wages as theinole cammo,hoon,
will do the work,and the structure,is not intended or offered for We(Sec:7Y ; - Required Inspections:*,':
'Business and Professions Cole:The Cammew,'s License Law does not apply to an 103 - UFER
owner of property Who builds or improves thereon,and who does such work himself
or through his own employees,provided that such improvements are not intended or 104 .---_REBAR__.
offered for sale.If,however,the Wilding or improvement is iold'whibut one yeu of '-
completion,the ownerbuildee will have the burden of proving that he did not build or 105 - ANCHOR BOLTS
improve for purpose of sole.).
, usi .__.. 10.6- =-SEWER_&_WATER--L-._
_ __-- _ _. .._-- .nt. .._ __.-
mior
nar
ng
__ ❑Lpuctthepmjecpropooy,amadusissandnwetisions Code:)
ra 202 - UNDERFLOOR PLUMBING
-
construct the project(Sec.]BMI,Business and Professions CodeO The Contracttons or � t
License Law does not apply m an owner of property who builds or improves thereon _ _2 03 - UNDERFLOOR MECHANICAL
. „anJ who.emvmets fo ch.projects_with a contmetor(s) licensed pursuant, .the.. ......__,
C nvactols L cense L - - -
204 - UNDERFLOOR,FRAME
1 .,,prances ,j. ` ' %" '/e&(Pcrnrmraraapn 205 - UNDERFLOOR`INSULATION
ItD
` KER'SCOMPENSA�gf oEc�LAI�o�� ` 301 - ROUGH PLUMBING
_ 1thereby affi under penatty,ofpejury one nnm
the following 302 - TUB & OR SHOWER
• 303 - ROUGH MECHANICAL
.:f ❑ 1 have tuad'wi11•mainuin'o'Cet irate of Conum to self insum for Workers
:=F ' Compensation, as provided for by Section Doo of the "bar coda fee the 304 - ROUGH ELECTRICAL
performance oldie work far which this Perms is lamed.., 305 - FRAME
❑I ha4md will maintain Worker's Compensation Insurance,as recimed by Section 3067 the"bo C d f 'the performance t thfor which he permit is - HOEDOWNS
issued.My Worker's Compensation Inwc andPohey e: O 7 INSULATION
r
Policy Na _.It,; d310a8l.fhSHEETROCKk2;nit'.'. ' ..Irr
t ' CERTIFICATION OF EXEMPTION FRAM WpRKERS _ f
-, __ . COMPENSATIONINSURANCE-q :•_L-, ."__, ,____ ., 309 -_EXTERI_OR 'L'AT_H_� __
(Thsii,iionnccdnotbecompletedifthepermitisforonehundreddollars 310 '-':INTERIOR----L-A-TH v f• •'I , �,� --•— -
(9pq)gr¢ss.)„ 311 -_SCRATCH COAT
_ - -
1 c n fy rhaun the performance of the work for whroh this permit is issued 1 313'-`--ROOF'-NAIL , -"-
r'hall hot employ any peso ort an usher so as come subject to she W ken
Crmp tua Cbl hni. _ ( 1� 501 - FINAL ELECTRICAL ENERGY
..Apphcah _ - . ... _. 502 - FINAL-PLUMBING ENERGY:"
NUI 16
OA q,��TT It he muting@i.Cenifcat tL Exemption,y should
Z hecm ublcnlyWk< .Cmpenstonpovionsofthelan Code you must 503 - FINAL MECHANICAL ENERGY
C O Orth)th ply ith hp isonsn the permi r shall h 1 ed revoke)
Z, - - - - 'N - --FINAL--BUILDING--ENERGY' -
F'-> [�l ' affi, CONSTRUCTION LENDINGlea AGENCY " " - • -t
(,;' Thereby affirm this Phrcsaconed(See lendngagency fonhepcdbimancc 505 FINAL ELECTRICAL
or ihii'sNmfor which tor.p<m,n is issued tsre.3o9z civ.c.)2. ' .506 -_.GAS- TEST__. __
p-;Z 1<�aera_Addrc.a" ' - 507 - FINAL PLUMBING.'-t�
C.7
I ccmify that I have hood this application and vote thin the above information is 508 - FINAL MECHANICAL
-CZE. cor7eci.,6agree,to comply with all.city.nil caunty,mlimmices and nate lows relating
yfVad1 to building commanon:mdhemby'aushrimem1mwmWivesafthiscirympmerupon 509 FINAL GRADE
othose-mentionedpopenyf inspection p rw. 510 FINAL PLANNING
L m` S
f I'mb l t es.judgment,. d ments costs and a pe . keep p h n yn the
anyC ay f Cupertino
again,said
[J Z City c n gacnce fth y ting pith p mit 514 r- FINAL WORKS
,
AVJA \b i DERSTAV .DS AND\VIL�COMPLY, THALI NONIPOINT I '
SOURCE RrG LATIUNS . . �Zf Issued by: Date
ig t C ilm,or I' Vr/ to
Re-roofs '
l - HAZARDOUS MATERIALS DISCL RE
Wll the pplt mm(m rtboo ld gacup tsmremhandl hraNuusm tell .Type Of Roof— _._..__ .._ ..
as d f ed by the Capco o Mun c pal Code Chapter 9.12.and the Health and Safety
Crde �que 25532f�lt 1p
All roofs Miall be,tnspected prior.to.any.roofing.material.being instglled
Will theppl t rt, rtnnlieoccupant use chuipmentor devices which if a roof is installed without first obtaining an inspection, i agr6cro"remove
•'mrt,h1 d it contaminants as dened by theBay Ar`ea�rr QualityMnagement
allnew materials for inspection, Ap hcant understands and will comply with
m / ° t all non-pose)[source regulations -;
1 have read th ha doses Zrial,roproments order Chapin 6.95 of the '
Caltfamta Health&Safety Code,Senium 25505,25533 and 25534.I underhand that
if the building does not currently have a unant that ta MY reponitbdir to notify the ""'""'- - ""-'" - - ."-' --- -' '
pat
6fha regmr m s which must be man,p .r to issuance f Certificate of \ "
p°` 6 r2t�,py Signa[ure_of Applicant Date
/ 0
t-yrn"—tno6f<a`agem . Date, All roof coverings to be Class `B" or better',
OFFICE'
1