02030041 (3)CITY
OF
ILDING DPERTON PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
21075 MANITA CT
RASTOGI
LAXMI K AND RASH
I 02030041
OWNER'S NAME:
,2ASTOGI LAXMI K AND RASHMI
APPLICATION SUB DATE
03/11/2002
rHONE:
SANITARY NO. CONTROL NO.
ARCHITECnENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
-1 -1 L-1 LLA
LICENSED CONTRACTOR'S DECLARATION
Job Description
I hereby affirm that I am liecowd under provisions of Quince 9 (commencing
With Section 7M) of Division 3oftheBusiness and Profes.romCodeand mylicense
REMOVE
NON-BEARING WALLS AT
uc°�o,ll Cl.i; andeReC Lica
UPSTAIRS
BEDRM.
Date Contractor
ANCHITECT'S DECLARATION
I Cased E LAR
`�4 F`� Ra.r
FI tp g ,q ® E®
understood my, plans shall records
0
APR 2 2 2002
Licensed Professional
OWNER -BUILDER DECLARATION
Cammnnr's
1 hereby affirm than I am exempr from rhe License Law for the
following reason. ISectian 7031.5. Business and Professions Cm1c Any city or county
which requires a permit m constrain, alcor, improve, demolish, or repair any strucom
.- prior to its issuance also requites the applicant for such permiuo file a signed statement
- - _-
,`l�.,t_gy Sq. -FI. F] -1-,
(. '. i5
Valuation
NStheislirmidpdrio3numnepmvisiomoftheCommctursLittnaawlChapmr9
(commencing with Senion l(p0) of Division l of the Business Prgfusiom Cade)
9M
or that he is exempt rheiefmra and the bast. for the allegeE exemption. Any violation
, v a I.
t a ? . F V N.% 1.: f_
-of Section 7031.5 by am applicant for a permit ,.bjwr, the applicant to a civil penalty
:of not more than nue hundred dollars (s5lro).
— 262
A
um er
.,. ., Occupancy Type
01, as ewner of the propcny, or my employces with wages as their wlc compensation.
will no the work: mm me ..til:came is or intended or offeree far .1a (Set.'71»4,-
'BC,hses, gad Prmfe eimm, Code The Contmeter. Lie=n. Law does an, apply m an
- - -
102
- Required Inspections'
- PIERS ERS ,.. ..
owner or progeny Who Huila., or imp t... c,,hereon, dad whit docs wen wink himself
103
- UFER '
lir thrortgh Itis own employees. provided that such improvements ammo intended or
"oRcrcd
for
104
- REBAR " 'r
'. ..
completion, the owner -W inter will have me burden or moving Nm he ere not beim or
improve rear purpose of sale.).
105
- ANCHOR BOLTS
17_.. _...._.__._
1.a,.wnn inn=prapertr.am=xeuxmelrtaatmntingwnnbten.atnmmnoam
- ---
EWER & WAT "---_..._.. .-__.... .._.
combect the project (Sec. 76rq Bosmesx Una Proms,ians Ctwe:) The Comraetar,
License Law does not apply to an owner of property who builds or improves hereon,
2 0 2
- UNDERFLOOR PLUMBING
and wno.contmeu for such project: with a commcmrts).ficenam pursuant. to Ne..
. _.. ._ 2 03---
-UNDERFLOOR-'MECHANI'CAL " -
CommitteesLicenseLaw.
111 ran seem proadcr Sec: .B&PC Lurid, reason
204
- UNDERFLOOR- FRAME'�-
o"c'. -' . .-''°Date',
205
- UNDERFLOOR INSULATION
" WORKER'S COMPENSATION DECLARATION
301
- ROUGH PLUMBING
Ihereby aRrmunder penahyprwrjuryone onnefolio%ingdeclarations:
302
- TUB & OR SHOWER
❑ 1 have and will maintain a Certificate of consent to self -insure for Workers
303
- ROUGH MECHANICAL
Compensation. as provided for by Section 37M of the Labor Code, for the
petrotmanm ann=wnmk e,r,wmtn Ni, lretmit is i„aca
304
- ROUGH ELECTRICAL
G I have and will maintoin worker's CompensationInsuramc, au requited by Section
3 0 5
- FRAME
3700 of the Labor Coda. for the peolumance of rhe work for which this permit is
306
- HOLDOWNS
issued Myu kers Ci pc t 1 mm cecam< end Policynumberorc
Camt 1.,i l .iIr'"PolicyN
I- CERTIFICATIONOFEKEMITIONFROM,WORKERS'{`
C i :.y I. , ..r
3O8s
INSULATION
lf. l ..
SHEETROCK1
COMPENSATION INSURANCE .. r '�;
.,''
rl (This section need not be, completed if the permit is for one hundred dollars
310
- ''-
- INTERIOR LATH'
fs100)nnesa.)
311
- -- • �, - ' '•- -
-' SCRATCH '-
It nrrmnm�n per' rte kr which this permit issued, I
shan'n t employ any per y t o t m to W kers
-.D�O °�
313
.COAT
- ROOF NAIL' �
Compensation Law, 1'c
Apnfiea"
-FINAL ELECTRICAL -ENERGY _
NarleB i. r. 4te�k.titcemrac.mittExempn"nyoushould
become subject m the Workers Compensation provisions of the Labor Code, you must
502
- FINAL PLUMBING 'ENERGY '
Fanhwithcomply with each movi,ion, no this permit shanb<dnemmre,oked.
. ._. -. __ _
._ .CT
... 50.3
- FINAL MECHANICAL ENERGY. - _ -...
I "It EN
JCTION LENDING AGENCY' - ' '. '
Cat
504
'
- FINAL BUILDING ENERGY'';, '
r I boob afflos
yet 6th that then isacondmction leading agency for the perhitmance
them
nnhe work for which this permit i, issued(sne. 3097, Cie. C.) ;"
505
- FINAL ELECTRICAL
I<nder's Namr:r ra ..... ., .•._.:: _._ ._..::..-.. _._. ..,
I<na='r•:AJureu:' -
_. _ .._ _ ..._
506
_ _.. ... .. .. .. .-.- _.._ __.. _. _ ..
- GAS TEST.-, ..•:. r
507
- FINAL PLUMBING'
lamrymwlna•=;caetmsapp6t�nonanastm�mmm=abns=inmmn,arfovis
curtain 1 ngme to comply with oil city and enemy ."rdium,ess and state laws claim,
508
- FINAL MECHANI CAL
to building construction; and hereby'authorice rep.esenmtives of Nis city to enter upon
meabn.e-rcntianedproperty far impactionompas.
509
- FINAL GRADE
(Wc) igre= to save, indemnify and keep harmless the City of CLpenino against
in
510
- FINAL PL I NG
liabilities, judgments, costs and expense, which may any way a«me against said
City in consequence of the riming of Nis peri ..1
PPI (CANT UNDER DSAND WILL OF1PLY WRH ALL NONONT
sa)1�tcEA2GUL��,
514
Issued by:
.- N I WORKS Jf� v
D e
s.)j
Signatur,o Ap ono 'r - Data'
Re -roofs
ARDOor
HAZARDOUS MA t1ALS DISCLOSURE
Wl1,, ppl dot future Wilding p t to.mhandle material
Type Of Roof,-
Co he Health
Colo.nW is th Cupertino Municipal C<xl Chapter912 and th H hh JSafety
Colo.11v n255M121e)
t
All roofs shall
be inspected prior to. any, roofing material installed. -_-
wnNe applicant futureWilding w t agdp t devices which
-being
If a roof is installed without first obtaining an inspection', I agree to remove
nit ha rd is acoria antaasdefined byihe Bay Area Air Quality Management
�r,
all new materials
for inspection. Applicant under stands and will comply with
..
all non -point source
_ _ ---
regulahons:.-. .'
I have mcaE'the hizivdoux maietials requirements bade, Chapter 6.95. of the
'
California He ai& Safety Code. Sedtiom 25505,-25533 end 25534. I undenund Nat
ifthe Wilding def not currentlyhaveelenonLthat it is my call ruibility tont the
acupnm of the req.' cots which must be'met prior m issuance of a Cent II to of
ore '"`y' '.
Signature of Applicant
Date
..-
e' . .. .... _ . _
Al] roof coverings to be Class "B" or better '
»Her nria=a agem ;
... .. I. .OFFICE