01030178 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRENS: PERMIT NO.
7942 MC CLELLAN RD # 2 PSG FENCING INC 01030176
OWNER'S NAME: APPLICATION SUB DATE
CAMPBELL ASSOCIATES 1133 N 10TH ST 03/29/2001
ZONE: SANITARY NO. CONTROL NO.
4089953397
BUILDING 1;1 RMI INFO
�'❑/O❑ AHCIIIfF,C'rlliNGl NliliH: I31.D ELECr LUMB MliCfl
�0 I _ IJ L=I G'I
S?� LICENSED COINBACn1RS DECLARAnON .lob Description
z. I Intense air..a thou I am licensed under pmvislmm of Chapter 9(commencing
0m_1-au x-iuM1 Section]IXplaIr Uivi�ion3af the Rminmsa Pm CnJa and my cenx
5 is in IJII fust an,/,/Icor
� Lenn<fc)ln�e.&I l_ Lif.x 2ND FLOOR BALCONY REPAIRS/RESIDENTIAL
Ilmc=/—"r.s,dl Cnntrunor_ G'_x__
w ARCHITF.C'I'S Of-CLARAI LUN
C ON 5 I umm,s,and my plum shall be o"d as public rcmms
w p,O Licensed P..F—inual
a 6 OWNER-RUILDER DE LARADON
I herchy.!Oran thou 1 am cmnnpt I'mm the Comma,lor's License Law for the
t•=.Q following reason.(Section 70315.Business and Professions Gale:Any city or county
Fc ahcM1 requires a Permit twctafter impnac,demolish,or repair any structure
i5� pr ort t :. is y ' tlapplicantt such pe tt 11signed.t,met
an he I poison ,t th lillal 1.1t CorrallLa.lIA,vii,v 1 (Chpmr9 Sy. Ft. Floor Area Valuation
(u Ing wish Seen i 7NN1)or Dlv t 3 A he Basin and Ptol ...on,Code)
or,hal hems exnnpl dwmfiron.and the basis hm the alleged exemption.Any violo,ion
of Section 7031.5 br:my applicant bar pmait wbjects the applicant h,a civil penalty
afnot mom than five hundred dollars u5an. APN Number Occupancy Type
[11,as owner of the properlyor my employees with wages as their.mle compensation. `�1 P01711 M(71
will do the work,and the snaetufs i,no,intended offered for ale(sem.7014. ® Required Inspections
Business and Professions Gx1e The Camn¢uor's Lice ��((p m Q p
a Kir of property WI m hail ,Ur inT,,m,thercun,an l)<{Yd��m
ntigh his own amployee%.provmed teat meh in,pa,senfa,x are nn,imenaed m 101 — FOUNDATION
otrered for sale.IL however.the building our Impmvemen,Is w,I I within Uncy�rp r
ampledon.meow„enorilaer will base me nnrden ofprovingllgti51�id ftYSid'J '� 102 — PIERS
improve fee"pmmnf of-le). -
103 —
UFER
❑I.as owner of the pmpeny.am exclusively d Pmeing with IimnxJ nmleacuorx to
constructthe project ISa.]to a.Busowarr f anderty whomild1§ l y` DI • 104 — REBAR
ANCHOR
miff Lnwdtk,mnanerytnannwnnrt,rpmpanywnn nudr3}�ClcOv41� 11D5 — RNCHOR BOLTS
crad who mhnets for such pmjecs with a unnraclon%) lioenw, po t m t,c
o tractor, Li,, 1.06 — SEWER & WATER
❑I an,exfmm ntmler See. .If&P C for this reason
Owaer Due 202 — UNDERFLOOR PLUMBING
WORKER'S CO.MPENSAION DIiCLARAION 203 — UNDERFLOOR MECHANICAL_
Ihecby allimn under wbahyal fw,jmyom,ofihe following declamtiuns: 204 — UNDERFLOOR FRAME
3 1 has ;,ad will t Intuln a ConiOc:ne'If Concent In lelIA-um for Worker's n —
^^ 05 UNDERFLOOR INSULATION
contpem:eion. ax pm,hdfn for ray seedo�n 3mo or 'he Labour code, for the 2
performance or he work bur which this pnmh is 1NiuBd' - 301 — ROUGH PLUMBING
hue and sillaiaintain Worker\Compcnsadnn brmanee,as required by Scolum 302 — TUB & OR SHOWER
of,he IrMn Cale,tier the pcdinma am of the work for wealt his permit is
issued.Nly Work compensation laxomee carver and Policy another art: 303 — ROUGH MECHANICAL
ricer: -ps kQ/.,,J�oreyNo.: f age 304 — ROUGH ELECTRICAL
CER11f ( ON OIC I3XLMYI'ION PROM WORKERS*
CONII'IiNSAI ION INSURANCE 305 — FRAME
rfn, cctinofedno,beco,nmletedit the pfrout ixroronehundred dollars 306 — HOLDOWNS
1511X11 a Icncl
307 — INSULATION
I fempl that in,be pcto any ba of Ins work roe which this ctttoh a orka I
shall er employ any fcmn it any nonose zo as to become subject m the WnrkeR 308 — SHEET ROCK
Applicant l,aw.vorcmvoml''D°t` 309 — EXTERIOR LATH
Applicant
NO ICE ujc,I.,&CAN'I':Ill C imaking this CcrliEcac of Ilxumpti,,dyou would t
hefotnith .nethrtheworkedCo...noo3Aas vc...mohollbef c.,,,dre,ok,oJmas, - 31.0 — INTERIOR LATH
O C torinwim eomply whM1 xnfh pro ei..ion.or this ptrinnh.d,aB of demneJ re"ok`d 311 — SCRATCH COAT
CONSTRUCTION LENDING AGENCY
F•' 1 hI
freby a .... but Inert is a construction leading agency ro,the performance 313 — ROOF NAIL
of work for which this p moil is issued ser.3047,cis.C.) 501 — FINAL ELECTRICAL ENERGY
Q lender',Name
Z) z Lor,e'sAd`'feis 502 — FINAL_ PLUMBING ENERGY -
U 0 1 artily mat I have read,Ilo' appllfatm
lon d state that tum above infnnnalinn e _Is
Iv P eonfft.I agree In eI ly with an On,:Iml ftt
ay ordinances and once laws s.imm, 03 FINAL MECHAN I CRL ENERGY
O U mIsmidingaonrtmclimon.aadherchynab aimm,m,wmativesofthis cityto enter.,,a 504 — FINAL BUILDING ENERGY
Fthe aMrvc-nmminneJ p.,,ny for mspcnioa pngnaes.C6 (We)a,.In save.indemnify uadkeep females,the City ,ICupeninoagalnst 505 — FINAL ELECTRICAL
to liabilities,judgment,casts and cxpfnms which may in any way aceme,against mid
U ! C9%VJJw
f the mining of this penndt.
ARSTA D WILL COMPLY WITI}pLIZ ON-PpIgT Issued by: 506 — TEST Date �^ r
.Stic tie Datf Re-roofs 508 — FINAL_ MECHANICAL
HAZARDOUS MAMMALS DISCLOSURE
aut or fJ,Jm building aoupam aaeor handle haatJon,material Type of Roof 509 — FINAL GRADE
Its derneJ by the cupenino Municipal Ncoarser 9.13.and the health and Safety
G,de.section:5532(arr GB 510 — FjNAL PLFqqqll[[[1llMMMsINING
Ort, ao3441, All roofs shall beImWied �CrPht�IIan �I qla� g installed.
Wiit hearpnetorInamehaE mnm
,Engoou,lausee,u ntnordevicesweh If a roof is installs without u's oblalum n in'F.pe 1 gree to remove
-n t hmantum ear Goan mrams'.ts de"
ned by the BILy Area Air Quality M.-,11111
.nlgdfr all new materials for inspection. Applicant understands and will comply with
0Yes �"rI all non-point source regulations.
1 have read the haeallous matelot.requirements under Chapter 6.95 of the
California I leal,h&Safeuv Calc.Sections 8505.:5533 and 8534.I undersand that
if the building Jas not curmnily have a mount,that it is my responsibility to notify the
¢cupant of the requirement,which most he amt pride a,issuance of n Cfni revue of
"° - er ¢ d( Signature of Applicant Date
e or aafnori agnnn, Da,e All roof coverings to be Class "B" or better
OFFICE