00110017 cITrr;OF CUPERTINo
"I I BUILDING DIVIStoN PERMIT- CONTRACTOR INFORMATION:
1
• BUILDING ADDRESS: _ - - PERMIT NO.
10827 LINDA VISTA DR
00 i 1'¢1017
OWNER'S NAME' - APPLICATION SUB DAI'E
11/02/2000
PRONE: SANITARY NO. CONTROL NO,
J 0 ARCHITEC171iNGINIi1'.k: BUILDING PERMIT INFO
w C _ BLIX'i ELECT PLUMB MECH
,x11 a
QD: LICENSED C(INTRACIOR'S DECLARATION ;t - JOb Description
2_o 1 hereby akimuhat 1 am licensed under provisions of Charlem
,9(comencing
t_w with Section 70DO)of division 3 of the Rail nes and Pmfe'sions Cade.and my license '•
Y 7 j' is in full lurce and effect. - '
sro< Licenseclue, Liu.N INALED2ND STORY ADDITION' OF 237 SO. FT.
X,.,
3 I N Dutc ContractorEt t
ARCHITECT"S DECLARATION,'
g 1 arderNimd my plans shall fiercest.,public records MAR 2 5 2003we OO Licensed Professional -t.13 '•7 r ,
a ES'o (IWNI N IIUII DI R DECLARATION
ng ,ca (Section
In I d < I t 1 city
for The BUILDING' '
$<
following ,Ism 911,1 5 R : I1 f.. :C N A y ty aunty
x C ken ch regt'rec a rano, nstmet altar, raprove,dentol'.sh raq n r any snueu a,
toCo Aral las ,Ic 1(Ils If 'hl ',III gld.ml•nenl Y^ . 4
t m 3 Ibul he is licensedIII henoakinisoi the Conanxions License I ch plerr) Sq, Ft•'Floor Area VaIHatlGn _
(co y 1hS '.I a7000)(it Ids! 30 fid' 0 . I'I f Code)
- - -
nhal h i, ai ,s II 1 m III bI s l II fly 1 i A y Tal fon p. Y - — _
(if S t' 70315 hY Y 111 I ha i peomirxuhj,cl.,The q,11c,al 1,as bl penally - CIA _
of It haine owTlvL lrsn heddllr,($500) • APN Number a "- OccupancyType..-
❑I fah l 1 ly ' uy a 11 y hit w E th :,Ad con,pen,ation
ill 6 The k I The no,han,is anT ineauad or nuesad f (See 7044; -
Bh,inas,iId I massa T Code:The catT , Licauso I.w does no,apply I an '' Required Inspections
owra, flf p per,What harld, ,,Oc,duch T and xho does such work himself _ -
or through his Own Landoycos. cowided that such Impmvemems are col intended or 101 - FOUNDATION
offered lot sale.11;however,the building or hapmvearcor is sold within one year of -
completion,the owner-builder will have the homed of pricing Thal he did not build or 102 — PIERS
nnpmve for pta'?,e nf'le.).
I,as owner of the pro,m),um exclusively c tome ing with licensed contractors to 103 — UFEIR
smct me pmjeal Sea.nN4.Bowness and Pmfesslons node:)The Contractor's 104 — REBAR
License law docs our apply u,an arras of pmpeny who wilds nr improves merean, -
ane who contracts for such pro ecis will,a contract licensed pmanant to the 105 ANCHOR ,BOLTS
contractor's License law.
Clxel e.aenTl dkr see. Bd PC for his reason '106 — SEWER B+ WATER ,•
'Gx .Das �2�0/ _ - •
WOR PLUMBING'
krk•s co.Mrlmsanc: DItcl.nknnoN
_ 203 — UNDERFLOOR MECHANICAL '
Ihereby mmtOccur prally ofperyuryma, ifthe following deelamduna: 204 — UNDERFLOOR .FRAME
0 1 have and will nminmin o Certificate of CoTnem To self-inure for Worker's '
Catupan.aron, m provided for by section 370B of The Law, cats. for the' 205 .- UNDERFLOOR INSULATION
performance of the work for which this permit is issued. _ -
01base and xdl mfaai W,ker',CmNominee. , 301. — ROUGH PLUMBING -
need if t m hick i by Section
37u0 afros Laker calm.by atenIRmrancec ifthework Tor which his permit is 302 — TUB 8• 0R SHOWER
issaea My Worker's compensation m.11mnm easier and Policy another am:
303. — ROUGH MECHANICAL
ca i` CfRTIFICA'r[ONGFEzrMPIIONFROMWORKERS' 304, — ROUGH ELECTRICAL
-
COMPENSATION INSURANCE s 305 - FRAME '-
oTTlTeval T011nea fired if rlarsrortnelTanTlreTidou.tr" 306 — HOLDOWNS
ISIIXII I :1 - .
I certify that in Ilic Ifu,lo,numca of the work Iia which rots Penni,is issued,1' 307 — INSULATION
'ban oat employ ally Person ill aay Iountue,so a.In I,ceOlne object m me workica 308 aHEETROCK
s Coinp 'I' awx nl C I'r a M l
Ap,li,hl309 — EXTERIOR LATH,,-
- NOT ICI TO AII'LICANI II arta Tuk Tg Th',Ceahc.ue of lis u,hoT you should a
z became auhj,alInIt,Worker's Co.T1pemifnapravW...LaThe Labor Coca,r(,aime 310 = INTERIOR LATH
O O fnnhwitn comply kelt,shall pmvi.ions n,this p tout shah be deemed revoked. -
E' CONSTkUCl'[ON LENDING AGENCY 1 311 SCRATCH COAT -
Q:
ORT '
C > I to rch,main alar mere i.a canslmerolT leading agency Ter the perfamiance 313 — ROOF• NAI L
of the work for which his peoull is iionel(Sec.YN17,Civ.C.) `
a O Linenr'sNam0 501 — FINAL• ELECTRICAL ENERGY
Link,a Address
Z)
C Iccnilylba,Ibavereadthi.:ppfieaaonand'IaomatThemmeot,,, lionle 502 - FINAL PLUMBING ENERGY
STs [r cancel.I agree to comply wish all city and moray inch...ces and,side law.relating '503 — FINAL 'MECHANICAL ENERGY
O f) tobuilding conswetion.and herebycathodicmpmsenowavesofthiscitytoenterupon-
theawve.manaanedproperty forinspechnnpurposes. 504 — FINAL•BUILDING ENERGY .
F 0.' ieWelagmemsavts mulemmfyandk which
in the wayaCupe against
against
Z) liabilities,judgments',curb and in,Of d:.whish may in any say acerae against=aid 505` FINAL ELECTRICAL e
U z
City in conuyuentt of the 6mining of,bas penin. + '
SOURCE
AN'T REGULATIONS. IssuedAND WILL COMPLY WITH ALL NON-POINT Issued by: 5 GAS TEST - Date- -22
Signature nl dpplic HAZARD US MAI ERIAIS DISCLOSURE Date Re-roofs 508 — FINAL MECHANICAL .
Will the applicant OrmnTre holding occupamxml<1nhandle bacchante.material .Type of Roof 509 — FINAL GRADE
as defined'by the Cupertino Municipal Code,Chapter 9.12.and the Health and Safely ,.
Cotte,Section 25532(x1" -+ l.�
w" SNI' All roofs shall be i s cted F1'z�f'fyp•6 P �rN&N,latlgr-rr'i g installed.
Will the applic.nn or Inman,bulling Occupant use equipment or devices which •Ifa roof is installelsl out PTrst�rit'aini •tA'T11sjYecYf�ree to remove
wroth d , ant T ul' II Ihy The Bay A O 'ilyM Management
13ix+ -all new materials for inspection. Applicant understands and will comply with
w` all non-point source regulations.'"
I hate read the Invitations I yea t,trader Chunia,695 if the + '
`Culilrnua l lean,dr Said,C If Sections 255115.2559,3 had'355341thicasumidthal
t he haddha,docsn I a my have a anion.ilia,it is uyre.sl 1 lity To notify the _ v
a col' I fill I I tall Ip 1,'IXFI I' C,ffeWC of - -
Our, Y Signature of'Applicant Date '
N� �zy101
own lagers,' G,e ' All roof coverings to be Class :B" or better,
OFFICE