02040064 CITY OF CUPERTINO -
BUILDING DMSION PERMIT CONTRACTOR'INFORMATION-
BUILDING ADDRESS: PERMIT NO.
SWAN POOLS 02040064
OWNER'S NAME: APPLICATION SUB DATE
BARNUM, KEN 1495 S WINCHESTER BLV 04/15/2002 •
.10NE: SANITARY NO. CONTROL NO.
(408) 866-6893
QOOZARCHITECf/ENGINEER: BUBDWGPERMRWFO
B BLDG ELECT PLUMB MECH
` II C-1 L.'J U
ii LICENSED CONTRACTOR'S DECLARATION Job Description
IherebyaRrmThe,lamliccm.dmder,.vismmofChapter9(commencing SWIMMING POOL . p
w with Seni.r7000)of D'iyisim%3oft est and Professions Code mdmylimme
y
XM is in full force and @nth.
o`� Lan Lic.Con,_ NEW INGROUND GUNITE POOL & SPA. (432 SQ. F
Dmc cnmraawr
LL C G ARCHITECT'S DECLARATI
y 5 1 uncle and my plans shall be used as public records
se
o0 Licensed Professional
a'u5 R 0! OWNER-BURDER DECLARATION ,
I hereby affirm,hal l am exempt Irom the Contranor's License Law for the
t?< fallowing reason.t5ection 70313.Business and Professions Code:Any city or county
F o which requires a permit to construct.olmr,improve.demolish,or repair soy euumure
as
nZrt 1 «also requires, pplicant far such permit to file a signed statement
Zr
he ul«mN pursubn(wU¢prL lsianx of the Ccotrxmh L«nx 4wlCheger9 , Sq.-FtFloor-Area ,. aluation
(com e g rm Smuoni7000)Of D' Sion 3 of the Busnmss sod Professmns Code) '',�V sy'_ S'['j i,j
or Ihaihe rs eacmpt theiefrom and the basis for the alleged etempiitin.Any violation
--ofSecdw'M I Z by any applicants for a permit bit.the appl¢ae,ws evil penalty" UmbeD ?.`.{f:\.7
i6fi of mtha
at B five hundred dons,SyW). Occupancy Type
[31.as owner of ere mnite Y,ur my employ.with wines u their sole com,cour on.
w➢'do the woik.and IBe strunin a not immmded'or aRcree 7oi sett(Sec:7W.
'21tiiu and Professions Code:no Contractor's License law does not apply to an 104 - REBAR Required Inspections
owner of property Who builds or im,nowas thereon-end who dean such work himself
err thran{{n n wn employees provided uses such improvements are no,intended or __.1.0 7.z.P_QOL/BONDING
u(fesed f 1 If,however the buildin-
e a pmvcmrm is sold within ort scar of 3 01 - ROUGH PLUMBING
'completion,the ow«ebudder will have do Wheat of proving that ha did not build or .. ,,.•
improve for puryoxof sale.)' 304 - ROUGH ELECTRICAL
------------'--"----- —......----- ---'- - ------
0 -' — ----- - - --.._..--- --' -r- .....__.
1:as owner ofdu propcny sum exclusively contracting with licensee contractors w 502 - FINAL PLUMBING �ENERGY'�`'-':, N-)t..ilr i�r%"-"`--"-"
conswct the pmjm(Sec.]Odra,Business and Professors Cade:)Thi Commaor's
=+' Li.law does rot apply.an ewaer of property who builds or improves therm..
503 - FINAL MECHANICAL"`ENERGY
.
and.w1hoem u,mmLasach prolmu.with a cmtracwr(s).u.....�s purswnt to sM.
Canuam eL«nx La 5D-6-..___GAS-TEST___. `..
❑lam uemPt udder Sm - C I ';'I L' 'I BAPCfee.Nu moon T ' �_ `11
WO,;. te ,. ,,..trot;.
510 - FINAL PLANNII7G
_ Owner, - RRER'smMPIsNsAnoNDECLARATION 511 - FINAL POOL
1 hereby aad.penalty of yi jury ooe of following declarations: - 516 — FINAL BUILDING
Rrm
l ma O 1 have vM 11 nu a,Cen f am f Co m!.-.If imum fm Worker's
l /
Compensation. ;'providedfor by Sae, n 3700 of the Labor Cede. for Ne
peHomunie of clic work f h h IW ,emus u weed C; �
I haJc nd II no n W A CO I on ins ,«
� `
M3
hiySect on
37W'd the Labor Cde,frtenlroimm of e ohich s� tls
ssucd My WorkerCompe ° ncad Niyorbr
gq ,Ifill 1�q._2ooO
C,rnief I.I. tPoluyN :t`CJIX Y��I< ,' Y t tl �'l II C� �Ikt1U.l .Nil
n CERTIP7C TI ON OFEXEMPrONFRQMWORXERSyJ''tdk:(�g
COMPENSATION INSURANCE--L"" ...,_ _..._—.... ------------ ..-..._._...$Vf�LLlltl .............
.. . ..
(Thu secuon toed no,be tampleied f the permits fee one hundred dollars -j-N �ui e , '•1 1,_z,G G.'ln! �I t)1F5
«mfI Net in the p'in y of Ne ort f on, Nu pc a 4sued.l 1•' t'.r,e , - "Isnl s. n ,
sh'oll not employ any a y manner. to be me i b3e s t ,he Workers
A Iii 0,t on laws of C 1 Tom• Data
-'
Apps cent ,. :. �,. ... ._.
NOTIeETOAPPLI AN'Pif dt m Lin 066 Cedtrcaoo(E .Assam ye ho s, -I' ..
Z buome subs nw the Norkelt Cisim, ^tion per soruof thdeemed Code youm us,
z 0 .....forthwith comply w th ch prov ons or th s perm t h II bed coed k d
'N i:`t:s 7 -' t tCONSCRUCTION LENQING AGEYCY � _:.• `: _t':.. 1 1_iY)
� 1 M1ercby alts.that there,s e co twit o Ic d g agency for Ne performance'. ...
o/the.vo kfor' hien Nsp<wi sol Blsee'309]Cv.C) .,
� nders Name
Lender's Address � Ir'
O 0 :? 1 curdy sh t 1 ha e d th Apneas aha nm thn the abo fom'tio t is
Ila, F eJrr«t 1 gree, co Ply sh dl,cq e'd umY.9rdn p s d l t l sralmin,
fJ to bac Id nR nswd e a d herctiy,thor(ze rep scnun cs of W uiry.m enter upon
,fie I•a the shove uon d p perry for nspc sew puryoxs,
[r LI Ill e)egree itis ve Inde. fy.wE keep harms stheC ryofC pen bagmnn
.rn 1 obit t es.l dgmcnu cosu end espemes vii pb may o soy ay n'c.e.,guns,sod �/�/� iO
V'Z City In conuq cote of N gmel ng of Ino mut. -
AsoPPL�Lle C=A;1Ty�r y
r
Issued by: Date
Slgaomre ofAplcanJCoavec,oP!,pYGV, s, f ie `' Re-roofs
.HA]ARDOUS MATERIALS DISCLOSURE 1 r'' ?
atd•:` Will the,pplident or fdu boldo(occupant mored Poodle hvandmaterial Type of Roof
efimd by he Cupertino Mu.cpd Code Chapter 912;and the Health
andSfty , roofs
t \..eoeeonssssn.t l
7""a __All
roofsshall,be mspected.pnor to.any roofing matenal being installed...___
. ..
i.bu Will usitir zveorfunve buddrngbtt e I yxea irlQu W Ml a which If a roof is installed without first obtaining an'inspecnon,I''agcee.t0-remove
n hoodoos eu eomammanu as defined by the Bey Area Air Quality Management Jlamat = : - __ „_all new matenals for,ins ectton Applicant understands and,will com_ ply with
.. t'I all non-point source re Alantins z'C: s1 t - .- .....
v(1 M u read.thh materials mlitimumme under tsner 6.95 of the
Califortu,H. AS a,yC
f the l, le ng does not cuueally ve uenant Nat It Is my.responsib M1ty to notify the ,
mtupem of quiremenu ch mutt be ma Triocw i"... of a Cenif¢ue°f
onoSig reofApcant..... .. .._ _. . .. . ... . ... . Date
All roof coverings to be Class see rhorrtad
"B"or better
,, ! ' � '-. r� . .,. 1_, _.. . ...-OFFICE..- ... ..... . -_. .. . ..._..._ _. ....._.