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02030224 CITY OF CUPERTINO "' - - BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 10100 MARY AV AVERY CONSTRUCTION 02030224 OWNER'S NAME APPLICATION SUB DATE Abu L. BURT AVERY ET AL. 130 EAST DANA ST 03/29/2002 PHONE: (960) 961-8330 SANITARY NO. CONTROL NO. WO-Z ARCHITEC iENGINEER: BUILDING PERMIT INFO g w C BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION z5„z IIs Toms m,IlamncenxdaroW,rayyyisimo orchap,n 9(c ncing Job Description asH5' g tt Boo) Ba.iness,ggProfessm ewegpayyettnx ALTERNATION TO 2 GUEST RMS . Y f so full of effec oma Do Lick ������© O a O Comm r 3 u.1"n ARCHITECT'S DECL ..,.L C S I understand my plans shall be used as public records 'eM c.E c`o u«mea Proressiinal c E P 1 8 2002 c ,x OWNER-BUILDER DECLARATION 1 hereby of.that I i m exempt from the Ciama 's License law fourths f gs a following mason.(Section 703 1.5,Business and Professions Code:Any city or county o pp p /� $21000 F o which requires a rommt m connmct,alcor,improve,demolish.or repair any structure, BUILDING LD!I tl V� i 3 ._Dnor to its issuavice.also requires the applicant for such pemlil m fie a sigr¢d uammcm a rhm Sti�limauJpv(<wsh tyyt poroYitions of she Cnmmcmis Liccnsc(aw(Chapur9 ,,pper�,� , Valuation Ecom_ naming wah Secuild,_s fDwision Sof the gasinea.,naP ressrons side) CCJN' '32._ 3 i0. -�° rTr1a1'�!l'It'�•T �"s' or Inas fie In dempt Meiefrom and the basis for the alleged damytio,.Eby violation I of Section 7031.5 by any,,,,I,tins for,permit subjects the applicant in a civil penally tof not,mom than eve hundred dollars($500). 101 �g1�15ATI0N APN I t•e;;s..r s.l Occupancy Type - O 1,as owner of the progeny,or my employees with wages as their sole compensation, I will do the wore-and is Code: re's not intendstar's dire feredLaw for sale apes ]o an ----- - _ Required Ins ectionsl_ 0.'B i \:f Bun eros and property W o s ease Th my s tcmrthereon.and w law docs not opply t alf 10 3 - UFER q p owns r of propcny Who to ee i es atsuchand who dues such work himself or Ihmugh his own employees.provided that such improvements menm a not intended or 104 - REBAR oRciN' 'for sale:IChdwdveClfic building or impmSrmeni'is wldwithin andyell-of ----- —`-`--"--------- --------------------'------'_...___.___—._______._ nmpletme,the owner-Wild.,will have the burden of proving that he did not Said or 105 - ANCHOR BOLTS I„ I%'.ill v: \. ._.• improve for purpose of sale.). 106 - SEWER & WATER -- , Oi;papwner,nnne -- ------------._.__-_—_.. _ - -- -pow�r. m=•=wml'rolmCieWimrc :dcon�torsto -- 202 - UNDERFli00R-PLUMBING r.:: ,_:.t-; n.(' onsthe project(S«.]OJJ,Business and Professions Code:)The Contractor's tit T h �m Lwct icense law does not apply to an owner of propcny who Hailes or improves mcreon, 2 0 3 - UNDERFLOOR MECHANICALtil f; _.and who.contraao for,such.projects with.a.contractors)licensed pumuant.m.thc. .._.._ .- __ ...-_,_ _.._-._—__.—....._______.-. Contractors License Law.,t 204' - UNDERFLOOR"FRAME____.._.__— ❑Iame,emptudddrSir. E�" Wit: 205 - UNDERFLOOk ')fkSUI;ATION Date,, . . r .:.• e m, . 301 - ROUGH PLUMBING WORKERS COMPENSATION DECLARATION_-_ 302 - TUB & OR SHOWER In by rrmm d illpenhyoLpejuryi of followingdeclaration, 303 - ROUGH MECHANICAL s� O I not o d II marl n C n fcme oYCo sent m`s If for W rkcri 3 04 - ROUGH ELECTRICAL C pcmnm on;as provided for by Season 3]00-of he Labor Cade. fur the -_ = peifbrmanteof the work,for which this .it is issued.„ , 305 - FRAME ❑1 have and'wiu'nt6im:dn WorkrCs Compensatmd iniomnec.ac requires by section 3 06 - HOLDOWNS 3100 of doc-Lathoi Cod for the pirformonce of b work for'which thisperm i's '-osed My Work< ,Cmp<n t ni m e stPoi y be tie 307 - INSULATION cin 7th '� 'hI1 , pmaJPoneyN zi5#0b58(Y�i 308 = SHEETROCK-,•v.,, "'i c, r e ;C6RTIFiCATION OFEXEMFTi FROM WORKERS, l •_� 5•� a309.�=�D I�',}{'I'')•'.•'RIOR•�LiA'IvHS• COMPFNSATIONINSURANCE't t 33:0­.­-INTERIOR:, "LATH.__.._,.._..,., _-___.,_,__....,w.�._.., ' I(nTrs union need nil ase complrmd if the permit is for one hundred dollars 311 - SCRATCH COAT ' { t•I' 1 ` "'tits nrrm tall me pear - baro ikr n-hrn 1K . aedl -- ... ,., shrill not employ'any person in any mann as to become; bj n the_Workem 501 - FINAL ELECTRICALr+ENERGY Cumpeud-'Laws" California. ' ' ` ..._502---- .FINAL-PLUMBING-ENERGY-'-`---`----�---- --- - -ADDIaanL ,.,., i __ _ oNCTICETOAPPLICANT:If,after making his cemacatcofElom,lum,y..should '' 503 - FINAL MECHANICAli'ENERGY z Z . Labe C ,yo um t Q ed _ 504 .r_ FINAL.. BUILDING__ENERGY.-____. .forth th c ly liinch proonr thprsall be Jdiek 'PCONSTRUCTIONLENDINGAGENCY "' 505 - FINAL ELECTRICAL ., I• ' " ' C i he by affirm that the ,S connbmtan ng agency for thc performance .. .. 'one kr nehmen x t ea(s 3097c c) -506 GAS TEST LQ (lend Nam - .__.. ......_ _. ... ._ .. ___. Z Unde sAddret 507 - FINAL PLUMBING .,,1 U � IcofylhalIM1vcreadthis applicuonindsmmthmm boeofom„noois 508 - FINAL MECHANICAL tza [.. ,tearer Iagx r comply lh Ilcry'and rY, d cc. M.Ir I srclaung 509 - FINAL GRADE .rob ilei g vh tion dM1 reby rho rcprc a mf es'fm xCryt nmr upon 0. ;the - b et. '.J ..ado pcti p 510 - FINAL PLANNING S I W) , moa a dein fy anJ k hick i way i e wit ti said - W liabilities,) d6 t!_ t asp ..ensu which may; any y «ryagainst.sins 514 FINAL UB C. WORKS UZ 'ly c eeemuh 02 �' R F D NAIL Will the applicant or fur buildingip OMPLY KITH ALL JC !NT,' 0 _ SOUPHA \RD a gMATE l G, gS o\RD a kMATE l GJ JS Issued Date lA°p ✓ RIALS DISCLOSU Re-ro(B94� - ROOF IN-PROGRESS tie donnedbyeapupenn.fat Municipal race pa I Ire corn dl hafamn s material ._..Type,of..Roof.... .. . ..... ....... ._.._... _...__..... ,...._.._ ._............__.__. .... .. 8 _ ,C ode Chapter 9 12 d the H alth and Safety t, CMel Secion 35537(s) �s. n•`•s•!f�•`i, ••.i ami. .. all be,inspected pnorao,any-ropfing.ma[enal being.ins[alled_ I __r.... . ...._ l y+ Wal the applicant or future building occupamuse equipment or devices which If a roof is installed without first obtaining an inspection;-I',agree toremove cont h...rdoasarc,maminams as delmed by the Buy Arco Air Quilty Mmmgcmenr Mount,? - �. . . 1 all new materials for inspection. AppLCant understands and-will comply with__ YP . I -. . _ _ - ... _. ' , me. _ "all'non-pont[source regulations.,. 1 have r ._ . .� i( I, ;,, , m .•;.. ead hazard is ara i n ils requirements under Clhap cr 6.95 of the -tial f m Health&Safety Code,Sections 25505.25533 and 2553) 1 undersand that jib buldingd s nm porremly have o tciamehat it is my.responsibility to notify the C pccupam of requirements which man W mel prior m issuanceof requirements which mull mel prior trounce o�Cer ifiesse of 7 ( �Jof a<wp<r - yg at a of Applican at . . 7i _.. admin- ,gen,- '. , t ,, Do, All roof coverings to be Class "B" or better ..•. ,_._,.,::: ..;.t.. -.... . -OFFICE - -.. .. .. . ..... .._ . . ._ ___ .. ._ ....