01030177 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7934 MC CLELLAN RD # 2 PSG FENCING INC 01.030177
OWNER'S NAME: APPLICATION SUB DATE
CAMPBELL ASSOCIATES 1133 N 10TH ST 03/29/2001.
UNIT. - SANITARY NO. CONI ROI.NO.
19
4089953397
Oil ARCIH fI
loc IIINGINCER: - BUILDING PIBMI f Ul
-, Ill ELECT PLUMB MECH
ttea- W
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LICENSED mrrrl(nf-roR's DEc,ARnno" Job Description
_O 1 hareby allirm that I am licensed under pnwis.ons:d Chapter (commencing
].
rw with Section]1XUIofUrision3oftM liusincnun f Cde.a lmv icena
i i.mlull to udrlf
_rcda Banes Lic.X —=t 2ND FLOOR BALCONY REPAIRS/RESIDENTIAL
o a at, — commc or
�3 6
w0 RClII I IiCf'e UEC Fli"'ON jr I
� m g I undamm�J ter pinm.hall he mcJ use public rtcoNx ,
m O O A....M Ponso anal
a.S o OWNER-BUILIDER Ac ARATION
u7 I hereby uflfr;n that,a;n uroun frn;n the Corur;nnr'.License]-a, Fur(be
E_ < bilawing reason.seed 7031.5.Itu.lna,,;:ml 11.oles.ion,Cade:Any coy or eon ly
x O whin,mjuires a permit to rnnsmaa,allee improve,demafreh.ser opal,any.ancone
ue prior permit o file a signed statement
that he is lieo,v•d pursuant 1. be provisions of the Cnmrwnds Liccntt lsw lChapmr') Sq. Ft. Floor Area Valuation
(mmnmencing with Section)BBB)ml Division 3 of the Business and Profnaions 6Ne1
nr den he i.exempt,aerefma,and the basis liar the alkgcd eaemption.Any violminn $3500
of Section 7101.5 by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars SM10), APN Number Occupancy Type
❑I,will of the pmpcnn ser my employees with it a Meir sole campeosmion,
will do he work,and,he structure is out Intended ser NRred fur .[a(Sec.(S.A."
�Sperc.Y p]IrB�4.
Inti n and Profession.,code:The Ca.,.rador,Lmea,e La •dh Kyle r� Required Inspections
r of),open,who milds or Intpnrvcv mcrcna,and who
1 IIED
urhrongl,his own ea,luynes.n,ori l,d la each imirmveme f.,sols. 1 @ 1 — FOUNDATION
a1'fcren fol-.Ile 1L however.tie huiloling or inap.ove ncot is sold within r' of tee — PIERS
nrie,
criers,,, will havn the nndd,olj pro i ng.hat h n I
n,p.me'Lmpm,aseafs.led. MAY 0 2001
1@3 — UFER
❑I,strainer nl the property,not esdusce,a corroding with IiccnecJ umbacun.n, 104 — REBRR
,set he proiert(Set.]1uy aasine.a and Pn.mswns tildes', t m'
.......
�ictense Lax'does not apply man owner of property who builds o,in
and wba control for such pmjeds with Itcommcmrls)licensed �� 105 — ANCHOR BOLTS
Clinicals Licrnse Law. 1@6 — SEWER 8 WATER
❑1.m s scan ur uncle,See. .B&P C oar this reason
ox.netDac 202 — UNDERFLOOR PLUMBING
WORKER'SCOMPI?NSAIIONDECLARNHO" 203 — I.INDERFLOOR MECHANICAL
I hereby al ander penalty of Ill title anhe l„nrwing dee hnation.: 204 — UNDERFLOOR FRAME
u, have and will ,naimnin a Ceroficale it O.nsnm It, wif-i.wt.o ter Wa.krrs 205 — UNDERFLOOR TNSIJI_AT TON
Cnmpen ails, a, provided liar by Scc,ir 3700 if rbc Labor Cale, fir he
prnar.nance of ate work mrwhin,this perint is 1VfOed' 301. — ROUGHPLUMBING
_)KIhoc and x illnuhusin Worker's Cmnpenmriun btwmence.asrequired by Sec,in 1 302 — TUB & OR SHOWER
1 of the Lahr Cde,for the technical of the work for which this permit is
Issued,My Workcrs Com .ohm,Ins.rv,ee Canier,na Policy nua,ber ate: 303 — ROUGH MECHANICAL
ca er:(k{ Cil asFel'>'"oa � �— 04 — ROUGH ELECTRICAL
C 3 DON OF ILK[NI'I'ION P M1 ORKF.RS'
COMPENSATION INSURANCE 305 — FRAME
1'lhis.anion need nuhe completed if the permit is lin Inc hundred dol lays 306 — HOLDOWNS
fil"b ar I.11J
307 — INSULATION
],nilly n,a,mthe 1n'ru,r..,:.mema it III lot whentmr1I Ill'he issued. 308 — SHEETROCK
nmdl ern c.nplar u.tr pe, any;; ;ao:;.m nnra,ar eon«�;m.nn worked a
C.....pen.:man Law"Acni�i...nia.fare '309 — EXTERIOR LATH
Applicant
NOf10E10 APPLICANT:It,armrnwking mi,CcoifieateaniLaMar.cmmion,ro.should 3]@ — INTERIOR LATHhecome.whjecl to In,Workers Con,prnsaion provi.our,of,he Clark.rom.0 ll n
p foahwimcoundywin such prcrimon. it m
Dani.pennhall he deeedre,nked. 311 — SCRATCH COAT
F r_ CONSTRUCTION LENDING AGENCY
I hereby amt died there is aconstruction]coding agency for the performance, —
mnce, 31.3 ROOF NAT L
i C othe waarkfor xtech,his p.it isI.mled(Site.30I)lCin C.l 501. — FINAL ELECTRICAL ENERGY
Lender's Name
o y Leal Address 502 — FINAL PLUMBING ENERGY
U O 1cenirr that,base rend this appfr:Aonamltime,that he ahere lydbrmmi"II,the 503 — FINAL MECHANICAL ENERGY
W t^, c rod.I,gree ,I nnnply with alt rely Old.vn.ny ominous,and state laws relating
O U b�hr.ILdin,camlmeran,anti hereby andmriaerr'sc.rntahve.onhis city 11)enter upan 504 — FINAL BUILDING ENERGY
al pr pray far impnmon pu,al,rl.
E�;Iy (We)ag.lir.oeaverade..a.,ilyand urpla.mnle.. heCity orC,meNma:.gails, 305 -- FINAL ELECTRICAL
UIn liabilities,jodgnen,s,clew and reticule''which our in umy way accru „e.gainnuid �-
G Cry in consequence of the gmmimil.hispernti,. 55 S TEST
APPI.IC UND EmAildi,oco,sund
LLC'OMPIA II ALLNON-POIN//T Issued b ate
SOUR fe„—GIDE. Oy' —gn rep rear DateRe-roofs 508 — FINAL MECHANICAL_4 RIALS DISCLOSURE
Nell the app an, sourcnr handle harmdoos ata l Type of Roof 509 — FINAL GRADE
as defined by the cnpenma Munieprl Code Chapter 9.12,sad the Ilcalth and Safety
caleSection 25532m) � o 51.0 FINAL FL KING.
05'O' +Y"o' All roofs shall be �IypQcI d ( y� ny,{ yn J ate- �g installed.
Will me:.ppli 0Iftnmendldmgo.rrr.pt'clripmemordrvice.wmm If a roof is instal le Ni hoeut fir�tA inC"n IY"N efS I "!`3'gree to remove
c.nit hvuNann air come all,,as drlined by,he]fly Arca Air Quality Mamngemmut
Dimdmr all new materials for inspection. Applicant understands and will comply with
❑Ye, _,k< all non-point source regulations.
I have read.he heiardnus materials mquimnacnte under Chapter It of it,,
Calilomw Hcalor&Safety Cade,Section,25505.25533 and 25534.1 understand that
iffle Inilrhngdoesn nnuy n:rvr:sea,:,m.eta,hi..ny rny,n,.inai,rmm...yme
excell d the re Iant.which.oust M est prim oa i.,aaace of.Certificate of
°Cel ' Signature of Applicant Date
2-QI
or am arired-a, DateAll roof coverings to be Class"B" or better
netOFFICE