01050035 ri•�„ ` -e?ff OF CUPERTINO' ,
BUILDING DIVISION PERMIT. CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20200 LUCILLE AV CARPOR .9 ROYAL (ROOFING' �D105k'1035 '
OWNHR•S NAME: APPLICATION SUB DATE '
TRAMMELL CROWRES. SERVICE 1345 VANDER. WAY. _ 0 /03!2001.
PHONE: ' SANITARY NO. CONTROLNO.
(408) 279-2332
9 Q ARCHITEC,ENGINEER: ... BUILDING PERMIT INFO
BLDG ELECT PLUMB I 'MECII
a H - R , Job Description .. '
y LICENSED I.CONTRACTOR S 1]I CI ARAI'I(1N
z0 :� I hereby II r(nut I n l' nseJ J r p I Cb pt 91 s eni'n6 J v
B •with Seehon 711dh1 of Division 3oftheR nes.'and Proh.ssl Cale andnylcense
�Y� Alts:rcean eR++��eggk L ! ,REMOVE SHAKES, INSTALL..1/2' CDX & 30. )
I'C' Liam"CJyy LIc.M �..
3 y nate 37/ cummcmr .
F LL O S ARCI3ITF,CrS IIBCLAR ALED•
1 understand my plans shall be used as public records
ce.i ,
w se p O Licensed Pmficsaional !
CLAATIO
e 1 hereby alarm Il II am e exempt ORDER
Contract vis License Law for IJ AN..2 4 2002
F 2 r hollowing reason.(Section 0031.5,Business and Professions Cale:Any city or county -
-Y C cep which irquire,a permit to construct,alcor,improve,den ish,6r repair any structure -
w3m
prior to'its issuance,also equirrsIhe applicant fsuch permit File asigned academe
.
that he is licensed pursuant R the previsions of the Contractors License ense La (ChapturB U 1 LD Iq. Ft. Floor Area •Valuation
I. non ngwithSecl Section fDiv" nJ uh 11 dl f .i i,Cade) - $73��
or t:a hex ......t thum elroand the bo,),for the paged exumpt nn.Any violation
of Section 701.5 by any applicant for a pe'moc subjects the applicant tit a civil pennh,
of not anae tint INe hundred dell.PS510o. APN Number. , Occupancy Type
❑I I Isevro r .ply ilh wages their. i p n,an , 31,602094.,00
II d k 11th .vlam,is iiol'imordad or ollcaadl left 7(94.
Ifs e..at1 rtax.:nn,CadL The cons tars 1,ce to law does rte apply Cann •'Required Inspections t .
ner of ryoporty Who build,or improves thereon,and who dors such work himself i 05 — FRAME "
or through his own entployces.provided that such impmvamems are not intended ar .,
mel finsicle.u:however, he building or imprnvemeat is smd wmdn rete rear of 307 — ' INSULATION
in rdi,cu o,the owner-builder will have the buNcn of pmvinS that he did not build or r '
mprove for pugioe of.cme):' 601 — ROOF TEAR OFF-, '
. 01.as owner of the properly,amexclusively contracting with licensed common to 602 — ROOF PLYWOOD NAIL '
Li.shad the proal(Sea.7Uf4,Business and Profession,Code:)'fhe Cummnnr's
eenseLaw does not apply to an meter ofInapetywhit buildsorimpasses tharem, 603 — ROOF- BATTENS _
and who contracts for such projects with a commator(s)licensed pursuant to the
Co.bal License Law. 604 —. ROOF IN—PROGRESS I am exempt under S .R&P C far this mason '
Owner 'Date -
WORKER'S COMPENSA'ION DIiCLAR61'ION '
4
I he
ach,arr... d Pe IIY-fP 1 ry m Ith I'll Pohl lam '6 ` - ..
O l have and all[ inalracin a C rtf c 01 Consent 0 sulf-buLic for Worker's
Coun,sauction. ;.. pmv'del for ny Seulon 37(X1 at the l.nhor Code lot the,
Inca an .'clic woo,for which this permh is Issood P "
have:nm will maintain Worker's Compensation Imvmnce,as raµtired by Section
3]1X1 cI ale al
Ede,for the performance of the work is which this permil is
issued.My Worker's Compensation Insurance Cartier and Policy number
'canier:Ann�:Cae.•'f Policy Na:Fi 131200�3 Fs•76- . . ' ..
Cli TIP9i 'KATION OF EXEMPTION R(lM K'ORKEbb'
COMPENSATION INSURANCE -
fTLis succinct need not he cnmbleled if the permit is for one hundred dollars
IS I(p)or Ics.)
I aertity that in the performance of the work for which this pemlit is issued 1
shall not mnploy;any person in any manner so as it,become subject In the Workers'
Campcttation laws of Culifomia.Dam Applicant - i , L I
NCHICHIO APPLICANT:N.aper,making this Certificate of Exemption.Yon should r "
hen am
rte subject thcW k C ,penes p ionsnftbc Labor fshlc yanneem
� Inffiwul enlplywithsuch In `sn orthtl 'l shall be located causeA.
tib '
I. CONSTRUCTION LENDING AGENCY
[r tr
Ix7Iherehn .sorm that s a ednslre9b'ben
c for the Pedumwnce , 41
uPte work Irwhch thispennh issued(Sa..07.Cil.
,
,
Lender's Name
Lender's AAdnss
' U O 1 certify that 1 have read this application and state that the ahnve infumenion is '
F➢ ["u comeel I agree to comply with all city and county omlinarces and state laws relating -
Q U rebuilding ctmonnalion,and herchyauthanx mpresenutivesidthiscity to aaterupon
W the abns•ruemianed property Lor inspection purposes. -
.F••t q (Wel agree to save.indemnify and kap harmless the City of Cupertino against _
ZI liahilicica.judgment,costs and expenses which may in any way accrue against said
U City in consequence of the gmming of chi pennh.
�• `APPLICANT UNDERSTANDS AND WILL COMPLY N'I'fH ALL N- T ' 5 :3^/ '
SOUNCB REGULATIONS, � �. ' Issued by: - Date
si ;c0fin✓pplicaartC'alnmrraetor 'Fate Re-roofs
HAZARDOUS A (ALS DISCLOSX., •- -
sumtheapplinmrnr more milling oeeapanl ware or handle hmanlnns a iai Type of Roof' '
„demmd by the Cnpctmn Municipal Cade,Cnumlr y.l2,and 0e Health and Safety • .
Code.Sell 21532(a)'
❑Ye.
�N All roofs sh.dl'be inspected prior to any roofing material being installed.
Will ppb rla building pat ',ern p t rdm�e•,which If a roof.is installed without first obtaining an inspection, I agreeto remove
Ili^ enttut taus it wnl ams 1med by therea
Bay AAil Qahly Munagene '
�.n t u • Ydl/ m
all new materials for inspection'. Applicant understands and will comply with ,
❑Yes No all non-point source regulations.
I have read the hmnrdous materials requirements under Chapter 6,95 of the . .
California Health&Safety Code,Sections 25505,35533 and 25534.1 understand that G/ '
if the building does nm Catena,hav'eacenunl.Cha is is my¢enpmsihilicy lm notify the
acupvm of the requimments which must be mal prior m issuance of s Card to m' �".,' '
°"°pa°`y' // ignature of Applir3 Date
' `— Lroof coverin s [o be Class "B" or better "
• ser nr amhodxm agcm m g .
�rr,' OFFICE-, `
ri•�„ ` -e?ff OF CUPERTINO' ,
BUILDING DIVISION PERMIT. CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20200 LUCILLE AV CARPOR .9 ROYAL (ROOFING' �D105k'1035 '
OWNHR•S NAME: APPLICATION SUB DATE '
TRAMMELL CROWRES. SERVICE 1345 VANDER. WAY. _ 0 /03!2001.
PHONE: ' SANITARY NO. CONTROLNO.
(408) 279-2332
9 Q ARCHITEC,ENGINEER: ... BUILDING PERMIT INFO
BLDG ELECT PLUMB I 'MECII
a H - R , Job Description .. '
y LICENSED I.CONTRACTOR S 1]I CI ARAI'I(1N
z0 :� I hereby II r(nut I n l' nseJ J r p I Cb pt 91 s eni'n6 J v
B •with Seehon 711dh1 of Division 3oftheR nes.'and Proh.ssl Cale andnylcense
�Y� Alts:rcean eR++��eggk L ! ,REMOVE SHAKES, INSTALL..1/2' CDX & 30. )
I'C' Liam"CJyy LIc.M �..
3 y nate 37/ cummcmr .
F LL O S ARCI3ITF,CrS IIBCLAR ALED•
1 understand my plans shall be used as public records
ce.i ,
w se p O Licensed Pmficsaional !
CLAATIO
e 1 hereby alarm Il II am e exempt ORDER
Contract vis License Law for IJ AN..2 4 2002
F 2 r hollowing reason.(Section 0031.5,Business and Professions Cale:Any city or county -
-Y C cep which irquire,a permit to construct,alcor,improve,den ish,6r repair any structure -
w3m
prior to'its issuance,also equirrsIhe applicant fsuch permit File asigned academe
.
that he is licensed pursuant R the previsions of the Contractors License ense La (ChapturB U 1 LD Iq. Ft. Floor Area •Valuation
I. non ngwithSecl Section fDiv" nJ uh 11 dl f .i i,Cade) - $73��
or t:a hex ......t thum elroand the bo,),for the paged exumpt nn.Any violation
of Section 701.5 by any applicant for a pe'moc subjects the applicant tit a civil pennh,
of not anae tint INe hundred dell.PS510o. APN Number. , Occupancy Type
❑I I Isevro r .ply ilh wages their. i p n,an , 31,602094.,00
II d k 11th .vlam,is iiol'imordad or ollcaadl left 7(94.
Ifs e..at1 rtax.:nn,CadL The cons tars 1,ce to law does rte apply Cann •'Required Inspections t .
ner of ryoporty Who build,or improves thereon,and who dors such work himself i 05 — FRAME "
or through his own entployces.provided that such impmvamems are not intended ar .,
mel finsicle.u:however, he building or imprnvemeat is smd wmdn rete rear of 307 — ' INSULATION
in rdi,cu o,the owner-builder will have the buNcn of pmvinS that he did not build or r '
mprove for pugioe of.cme):' 601 — ROOF TEAR OFF-, '
. 01.as owner of the properly,amexclusively contracting with licensed common to 602 — ROOF PLYWOOD NAIL '
Li.shad the proal(Sea.7Uf4,Business and Profession,Code:)'fhe Cummnnr's
eenseLaw does not apply to an meter ofInapetywhit buildsorimpasses tharem, 603 — ROOF- BATTENS _
and who contracts for such projects with a commator(s)licensed pursuant to the
Co.bal License Law. 604 —. ROOF IN—PROGRESS I am exempt under S .R&P C far this mason '
Owner 'Date -
WORKER'S COMPENSA'ION DIiCLAR61'ION '
4
I he
ach,arr... d Pe IIY-fP 1 ry m Ith I'll Pohl lam '6 ` - ..
O l have and all[ inalracin a C rtf c 01 Consent 0 sulf-buLic for Worker's
Coun,sauction. ;.. pmv'del for ny Seulon 37(X1 at the l.nhor Code lot the,
Inca an .'clic woo,for which this permh is Issood P "
have:nm will maintain Worker's Compensation Imvmnce,as raµtired by Section
3]1X1 cI ale al
Ede,for the performance of the work is which this permil is
issued.My Worker's Compensation Insurance Cartier and Policy number
'canier:Ann�:Cae.•'f Policy Na:Fi 131200�3 Fs•76- . . ' ..
Cli TIP9i 'KATION OF EXEMPTION R(lM K'ORKEbb'
COMPENSATION INSURANCE -
fTLis succinct need not he cnmbleled if the permit is for one hundred dollars
IS I(p)or Ics.)
I aertity that in the performance of the work for which this pemlit is issued 1
shall not mnploy;any person in any manner so as it,become subject In the Workers'
Campcttation laws of Culifomia.Dam Applicant - i , L I
NCHICHIO APPLICANT:N.aper,making this Certificate of Exemption.Yon should r "
hen am
rte subject thcW k C ,penes p ionsnftbc Labor fshlc yanneem
� Inffiwul enlplywithsuch In `sn orthtl 'l shall be located causeA.
tib '
I. CONSTRUCTION LENDING AGENCY
[r tr
Ix7Iherehn .sorm that s a ednslre9b'ben
c for the Pedumwnce , 41
uPte work Irwhch thispennh issued(Sa..07.Cil.
,
,
Lender's Name
Lender's AAdnss
' U O 1 certify that 1 have read this application and state that the ahnve infumenion is '
F➢ ["u comeel I agree to comply with all city and county omlinarces and state laws relating -
Q U rebuilding ctmonnalion,and herchyauthanx mpresenutivesidthiscity to aaterupon
W the abns•ruemianed property Lor inspection purposes. -
.F••t q (Wel agree to save.indemnify and kap harmless the City of Cupertino against _
ZI liahilicica.judgment,costs and expenses which may in any way accrue against said
U City in consequence of the gmming of chi pennh.
�• `APPLICANT UNDERSTANDS AND WILL COMPLY N'I'fH ALL N- T ' 5 :3^/ '
SOUNCB REGULATIONS, � �. ' Issued by: - Date
si ;c0fin✓pplicaartC'alnmrraetor 'Fate Re-roofs
HAZARDOUS A (ALS DISCLOSX., •- -
sumtheapplinmrnr more milling oeeapanl ware or handle hmanlnns a iai Type of Roof' '
„demmd by the Cnpctmn Municipal Cade,Cnumlr y.l2,and 0e Health and Safety • .
Code.Sell 21532(a)'
❑Ye.
�N All roofs sh.dl'be inspected prior to any roofing material being installed.
Will ppb rla building pat ',ern p t rdm�e•,which If a roof.is installed without first obtaining an inspection, I agreeto remove
Ili^ enttut taus it wnl ams 1med by therea
Bay AAil Qahly Munagene '
�.n t u • Ydl/ m
all new materials for inspection'. Applicant understands and will comply with ,
❑Yes No all non-point source regulations.
I have read the hmnrdous materials requirements under Chapter 6,95 of the . .
California Health&Safety Code,Sections 25505,35533 and 25534.1 understand that G/ '
if the building does nm Catena,hav'eacenunl.Cha is is my¢enpmsihilicy lm notify the
acupvm of the requimments which must be mal prior m issuance of s Card to m' �".,' '
°"°pa°`y' // ignature of Applir3 Date
' `— Lroof coverin s [o be Class "B" or better "
• ser nr amhodxm agcm m g .
�rr,' OFFICE-, `