02030041CITY OF CUPERTINOBUILDING DIVISION pERMyT;,CONTRACTORINFORMAI'IO,
BUILDING ADDRESS:
PERMIT NO.
21075 MANITA CT
RASTOGI LAXMI K AND RASH
4I 02030041
OWNER'S NAME:
rRASTOGI LAXMI K AND RASHMI
APPLICATION SUB DATE
03/11/2002
ONE:
SANITARY NO. CONTROL N0.
c ARCHITECT/ NGINEER:
BUB.DTNG PERMIT INFO
BLDG ELECT PLUMB MECH
L_7 L�
LICENSED CONTRACTOR'S DECLARATION
- 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing
lob Description
with Section 7000) of Division 3 of,hc Business and Professions Code, and my)iunsc
REMOVE NON-BEARING WALLS AT
s infullfnll formand affect.
C eClou Ce.a
UPSTAIRS BEDRM.
1 YY A
Date
aCommnnr
ARCHITECT'S DECLARATION
1 understand in, plans shall he used as public records
APR 2 2 2002
L,renue Rafeu:onal
-BUILDER DECLARATION
E ON
that I A
1 hemby alarm that 1 vin exempt from the Coni... Co License law for my
Ccm
reason ]031.5,Businessand Code: Any city so county
BUILDING
whichfollow
] which requires a permit a rore,th alcor. improve, demolish,
Permit%e. demolish.repair my structure
priwus file
for auchperm',
S Ft: Floor-Area .. .
c, `'
. qq r •. E.'-' %, �ti 51:'1. ii..a-• ValllatlOn
_
film piormarequirhe I., Wars Laeduaument.
rsof
it nal, Npuactwn7 theDiiision3 eCannndorsLiccnulJw(Chepur9
License
(cmmmebcin with Stttion ]000 of Division 3 of the Business"t"
comthat mercial,
B ) PadCode)
or he is the basis for the alleged exemption. Any violation
ion. Any
rani
,''
Sec 31.5 b
-'d Section ]031.5 by any applicant for a permit subjects the applicant to e civil penalty,
applicant
of not more than five hundred dollars 8500).
A um er Occupancy Type
01, as owner ofibe pmpeny, or my employees with wages u their sole compensation,
101 _
,will
' will do the work: and Ne structure is not intended or offered for W. (Sea. 7044,
and Professions code: The Comment', License law does not apply to an
102 - PIERS Required Inspections' '
owner of progeny who Wilds An improves thereon, and wb^ dose such work himself
or re throw¢h his own employees. provided that such improvements anot intended or
10 3 - UFER
offered Tor We. If, Lowever, the Wilding or irl'provemeniissold-within(ie ycyrof
completion, We owns-Wilder will have the burden of proving that he did not bona or
'- -" -_"_'RE_BAR .._
104 — :', , • , _• '
..Prot. for Pwpounf sale.)
105 - ANCHOR BOLTS
as tether of propcny, am with licensed comnaou to
106 - SEWER &- WATER-
cons
Businessla d Pmfcing
eWn the projec, (Sec. 1044, Business o and Professions Code) The C , diama a
j.
License
License LowdoesArt mwownwth popm,
202 — UNDERFLOOR PLUMBING •• '
for.suly
purveethereon,
and whq,',Lic u fw.wch projects with a contnnor(a) licenced pursuanrro the.
este aA"TmptA aur. ....
203-- UNDERFLOOR-MECHANICAL__
❑lemexemptundnga.'-,B&PCfarthisreawn
204 - UNDERFLOOR- FRAME.
Data
" WORRER'SCOMPENSA1UNDECLARATION
205 - UNDERFLOOR INSULATION
301 — ROUGH PLUMBING
' IhembyaR'.0 c.rpenahy,ofperjvryoneofthefollowingdahernions:
302 — TUB & OR SHOWER
1 heveme wail maiinain Ia CenifSectioof Consent t Label for worker's
CompeNation,- u-provided for by Section 3]00 of the Labor Code, �for the
3 03 - ROUGH MECHANICAL
performance ofthe wmkfor•which coir parmll is !as.
304 — ROUGH ELECTRICAL
In I have l ma
and�wilintain Worker Compehaation'Insurince, as required by Section
305 - FRAME
3700'6f the IiWr Code, fm•ue performance of the work'far which this perm, is
issued. My Wwkee. Compensation Imunnce carrier and Policy number arc:
306 — HOLDOWNS
Policy • ':. '. -:
.307':=' INSULATION:
:
n0OF
'• 1•'IT: CERIIFTGTION OF E%EMPIION FROM',WORKBR$';"
TIONF M
"•
2 j •:� 'YI a•c.11� .. a
08'-SHEETROCK
..CEN IN URANCE`.,:.•"'�
.
¢neon need hbt be compincd if the pe,mit is fur one hundred dollen
3'0'9:: EXTERIOR 'LATH* ------
(s!oB>nr!ess.)
310 - INTERIOR'LATH' -
- ...
1 wf� th t in Ne performo of the work f r which this permii Is kcued 1
t
- 311 ' -' 'SCRATCH :COAT
`'
Compo gran law y Cao I. pe n erjp����0 ryg eub)ed to the Workeu
S
313 - ROOF NAIL `'
Applaw - -G'` --'
T. to sCCNBamoe
m Oo you
Ncome
_- 501- FINAL-ELECTRICAL-ENERGY,...._ .__ .. ...
become subjen to the Workeh Compensation pwvirular
subject Labor .you inuld
the ISWr Code, you must
t
502 - FINAL PLUMBING ENERGY
(oMwidi comply with such provisions wthis perms she] WArrived! revokes.
.50.3 - ENERGY..._...._.
•"CONSTRUCTIONLFND!NOAGENCY
' "I heteby affirm that Vert its "noutub" lendin6t al:cnry for me perfomunce
ofdiewwkfmwhich
.FINAL ,MECHANICAL _
504 - FINAL BUILDING ENERGYf
miapermit is i-Lcmdio'1N.cm�` 11 .1rd(Sec, 309]; Ci,. C.), ,' -,
505 - FINAL ELECTRICAL" '
LenaeraAa:i_
506 - GAS TEST ..._ _.. ..__.... _ .. ..
I can fy that I hely read and ante thattheabove is
507 - FINAL PLUMBING''" ,
ancon
coc�us.Iagreetocomplywithell cityandcounryordmarricas intative,oend note to en relating
all citylaws aft i
to building construmion: end hcrtbyeJthnrire rtpresenutivea of Nii city to enter upon
508 - FINAL MECHANICAL
the above-menroned property for inspection purposes.
M) eime Wave,' inc emnify and keep hmmteai the City of Cupenin:i eirimst
509 - FINAL GRADE
liabilities, judguama costs am aspenses which may in any way accrue agabot said
510 - FINAL P I NG
City ti4n eo sa seance of the" ung of this pertmt '
�RcGv1:A�e"�"'S;nNn urn. ON3LY WITH ALI.ro
- N I WORKS
Issued
S
���� g
by;54
D e
$tgnaNrdofAp�IR1MdL•�ntmnor 't. v a�
HAZARDOUS IRE :•'
Re-roofs `
N'ilIyda wfuupaChaptsoreor h]ndle
6, rtuteriel
......T�e Of. Roof
1...
estEeflnedb the Cupertino Cos,
Cade Chapter aHealth
And saw .n4 Safety
Municipal\ p
..
Code Sttuon f S :
❑Yea t7 Nn (
i :� •�. j r , 'e s^f t r { t
.
•- All. roofs-shall be inspected gnat to any roofing material being installed_
,.� Will the pplirantw fumrc buudiagnerupmt use equipnrmtw Aevias which
't harardouka'v cone imA as aefined by the Bay Ara Air Qualtry Mwgement
If a roof is installed without fust Obtaim.n an ins ect10It�-I agree to remove
g p g
ant.
❑Ya '-. ❑
_ as_'L - -
e u
a new materials for inspection. Applicant understands and will comply with
•
allnon-poirl[ source-regulations. - -
"�' , I have need the hvardous'maieda requirements under Chapter 6.95,of the
"' " • - -
Califlimia HdaOli & Safety Code, Sections 25505,-8533 and 25534, 1 understand that
.if the Wilding does not'curtendY Nvee¢naY,Nuit este. responsibility to nota the
'adeupem of Ne requ' -cuts which must W met prior m isivancepf! Cenif a of
-
Oaenc :, ; ...:. �:. ,,.. ., . ....:..
Signature cf Applicant Date
All roof coverings to be Class "B•' or better '
r'^erw.a ori=m.gar;u,} ,,; " ^ 1 is -' :' .. „ .
... ._ -
.- ...... OFFICE_ .... .- . .. -
--
�
COPY
SUBMITTAL
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'day fN%�irf
37&.,9 -043
fd/Hance / 35 MMU,
ui, SER = 73-67-
�jAPPROVED
utCITY QU
'791 N CODES AND 0 E I NC�9
This set of pFlilot'laut
be kept on t di times and it is ungawful to many ch nges or alterations
in same Wthsu: fj-Itt6n permiE310n ifan'
he bw,dmg Oept.. C;ty of Cupertino.
The stamping of ih's pan :nd speafioatIM .
;HALL NOT be he d to p.. mit or to tre an
,oproval of the vida:ion of any provisions
" onv Ott, 0 d.nance or Slate, Law
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