04060043 CITY OF CUPERTINO
BUILDING DIVISION PERMIT '�co 0WINFORMATTION:`
UILDING ADDRESS: ROYAL POOLS INC OF SANTA C MVI"04060043
,'1_Q49r MANZANTTA rT
RS NAME: PERMIT ISSUEDATE
BRINKMAN 2258 CAMDEN AV7 orl 4/2004
NE: SANITARY NO. ' CONTROL NO.
7A1CHITECT0rlZNGINEER: 4083718000 1 BUILDING PERMIT.INFO
BLDG ELECT PLUMB MECH
'z LICENSED CONTRACTOR'S DECLARATION
I by affirin ortat I Am licensed aster provisions or Charter 9(commencing Job Description
7 )of�ron3of�B��wd�fcssio=Code,mdmylic�is
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DLJ� Lice 1 Lu.# SWIMMING POOL & SPA
zg' Dart Co.[.
I I ARCHITE�S D
IeUnd my plans shelf An used Ax Pull Me mCWdA
Do,
W 0 Licensed Professional
OWNER-BUIWER DECLARATION
I berchy affrom that I Ann exemp,foom ft contorcons License Law for the
00 ftillowit,...a.(ScOon 7031.5.BoamaAA And Protemions Codo:Any City or county
Ks� Which.,air.A Permit 1. miumix,Aur'.hopmWe.demolish.in oarall,Any suncluna 2ono
He,to its instrance.,loo rear.h.Oe Applicant far sunh Permit in file A iusined.tamormol
�i Sq. Ft. FloorArea Valuation
0 (commencing with Section 70M)of Division 3 of the Busirmaxi and Promosi
9 Out he is career,Lhestairman And the bruis for the alleged exampt...Any=nor
Section 703 1.5 by Any Applicants for a Permit subjects ft applicant to a civil Penalty of 3 4&1fMQuAcr0 0 Occupancy Type
rof..than five hundred d.IlAm,(�). -
0 l,m�nuOfEhCMKnyWMYCMPIO�"Wiffi�MU�eirMICCOMNnUtiOn,
And Proficsomm Code,71.Communim's Licureas LAW does man ,ply in an.,of Required Inspections
property who builds at improvestliencori whodoessuch work himselfor through his
own cerplirc,",Provided Oat such improvements Are notimanded or offered for sale.If,
however.the Wilding or Improvement is sold witifin oure You ofixomplaimn.the owner.
bdflde�will how the hundred of proving that he did do,bruld or im,.fail roo,oss,of
sak.).
C3 1,Ad moner of the proWny,am exclusively contracting with licensed to
construnt the p.ja(Sol.7W.B.,mess And Ponficadins,Code:)The Contractor'.Lt.
crude Law does not apply to an moner of pmWy what Wilds or Improves therearn.and
who contracts for such Projects wiO a emotionalist licensed purstrom to the Comirommes
Licerne Law.
0 loonswinpa.imers., —.118:1'criltai'moom.
r Data—
WORKERS COMPENSADON DECLARATION
I hereby affion under posaIty of Permit,one of Oe(allowing cmelanitione
I ban and will mountain a Cenufficaur circulation to self-imum run Worker's Compon.
salion.As romovicird for by Section 37W of fire Labor Code.for me Performance of Or
work for Which Of. .it is issued.
C]I how And Will maintain Worlos'a Comixemsimn As na,drad by Sectmo I/
137W'of the Ladim Code.for dac offoornarince of file work farwhich this mindit is issued.
M W=k .=] numer.nner dP I
Tin "'c mon' 7 5—
Fix
OM
M W�
OR
CERTIFICATE OF MEMPT WOR ERS"
I S.
COMPENSATION I SURANCE
Milosectimt do.,brixtroplimil Robe romm.11r.l.are hurolked an[WA(SIM)
in I...)
I CCIfify that in the Parformance of file"fit for which Ois Permit is fasted.I shelf not
a.pl.y.ay peorm in Any rroandmirso ax on tx�rcmm subject to ft W.lkrnA'C.ad,oARs'd
Laws of California Dow
Applicant
NOTICE TO APPLICANT,If,after making this Cenificam of Exemption,you shoud5
become subject W RAC Wmwr'3 Comfuroushon Provisions of the LaWr Cork,YOU Must
z ficurdi.ith coni.4A such in,wismus.,dus famou shall be trained.1sed.
z C
T7 CONSTRUCTION LENDING AGENCY
. I hereby affirm that them is a constomfinn lending agency lor die Noformarma of
D4> fire wuA for which mis poodii is Wood(Som,3M,Civ.C.)
Loride",Name
Lenrier's Address
z
U C I crithy that I how lead this Application and Store OIL the AWw information is
"P 1 0 "and I...ty onfiromme,.nd state lows; I.fi.t in
0 U 2 Z1di`.`g c=culd P"'re"Y"Ariduni-mp.n isfives or is c i ty in enter upo n file
>� above-ommumied N#ny orzarefi,mm
(W.) 1 77
agree,.. a in i P Lm ess the city of Coleman ,at.,
Agree
Habilitin.judl andex , whichm in my WAY."one Against said City
z I=ncc t1acc an&0 A It. /
ANT NO STAN IL MPLY W ALL NO -P NT Issued by: Date
PRE U DNS, S4
Si,�Iru—. Re-roofs (�;7
ftum,y�f ALpph' room am
or 0 ATERIALS DISCLOS R Type of Roof
A or
"A" Hili.g.,rantsunciarl,ad, . a.,memo.]
dcr,2 , rm.Mino 11 Code.Clampacr 9.12.And the Hould,And Safety
Section 25532(.)?
J YeA All roofs shall be inspected prior to any roofing material being installed.
/I If a roof is installed without first obtaining an inspection,I agree to remove
Will the a"Ecom ou'.!�.ubadlding..Pont.ri,inparend or dew.Which
it froxd.i.oil learromirmous difincid by me BAY Am.Ail Quodil,M.na,ernmal all new materials for inspection.
District?
0 Yes
I h. read! a am ornament undcrClurplar6.95offlucColifor.
nbH Alto Saf Code. 25 33and 534.1unacramodOwifffic,Wilding
does no'U 1,h . at.On my ma bilily to oil the cup.
Pan
requo ooh no i P exed f.Ccmrica orle
- 4Y Signatu e of Applicant Date
.norm..,hon agrol Z DAY All roof coverings to be Class "B"or better