01030187 ;OWNER'S
OF CUPERTINO
ILDING DIVISION PERMIT CONTRACTOR INFORMATION:
G ADDRESS: PERMIT NO.
50 MC CLELLAN RD # 2 PSG FENCING INC 01030187
NAME APPLICATION SUI{UAI"E
(: 11.33 N 10TH ST 03/29/2001.
ISANITARY No. CONTROI.NO.
397
OOC1/ENGINEER: BUILDING PERMIT INFO
kC — RL1 EL C1 PLUMB MECf1
T i ce - L CI CI I-1
w>In I.ICEN.Irl)CONTRACTOR'S DECLARATION
5 y a - Job Descrl ti n
d z_c I he.rery anion Inas I stn uryr...I under pn,vt�yt, rchaprer u Ifnnnnnnn:ng P
I.,y C W ism
11 I....clang tifD�ol Buninc.�,unJ Inlc tt I` td l e_x$ DInraue„fen„efry !/�\j9 2ND FLOOR BALCONY REPAIR.
E.d 2 LicenseCO iODam �.._ ComrvaorT'S DLCLARAr10
C'=O 3 1 understand my plan.shall h Dred:u Public records
W $
pO Llcvnmd Pntfosiunul
c o UN'NIiRI{UILDBR Il1iCLAItNION'
W='v: I hrrehy rollout Ina,1 un,exompt Bono the Cnmrmoo,s Liandc Law for IM1e
1-=2 k4low'inRInion.ISwinn70315,Brei....and Pmliavinm Coe:Any citycrccounty
Z O which require.a pcmti,In Construct,alter improve.hnmli,h.of no any wmnare
wprior u,it,i...split,.[so reuires,he appfearl Imsuch permit m file a signed statement
throne i,firmwd pur,uism to the pm.,sinn.of Contractors License law(chrpmr9 Sq. Ft. Floor Area Valuation
(comrmneing wtlh S,.mu i/IANII of lu,i.ion J onhe Business and I'rufeF,inn,Cade)
or Incl It,,,e.empl Ihemfmnl and It.basi,fur Ina alleged e.engnien.Any violation
of S.ction l?0315 by any appli-nl he.pump,...hoos,le apnbcare u,a civil penalty .
offeumom Bsmi five handled dnnat.($5w). APN Number • Occupancy Type
•
will
do theruf,hcnd the ytmclyemplot intended
wagcsa.,hcir s0`11 n i 3G212 ,
will Jo the work,and the.tmamrc in not imm�deJ or nRemt fin
Ba.ine.,amt Poefea..ie.,Cesm:'Me Crntm u”,I.icen.c 1,aw does m„:Imply to n - Required Inspections
,w rl Prolu'ny woo build,ur in.....—Imrs"Ts and who door,such weak rhomit
r ti,�lc,ll 1111 rt,I co,plurw..pr,..ded dad such inuuo,cmenta lin It„ 1 t 1.01. — FOUNDATION
orlcmd wr fide it,hrwmer.ore Wilmng or hnprovemrm .nm wintn r., 0 2001
fompmaon.ate orvner-Wilder will cave the burden oil pricing that he did no,build or 1.02 — PIERS
impnoc lar pmryne of sale.).
❑I.as owner elf pmpeny.amc.cm,iccly conimcting with licensed a.M.4, 'NLG 103 UFER
Ln,mic, he pnijc,l see.7044.Bu, and Prole, .Cama)Ilie \A 1.04 — REBA R
icemrl.:tw doe,nor om,ly to an wo,,r�t Pm won,whe hula,nr i:anr,ww,Iheretm,
and won fw105 — ANCHOR BOLTS
amh'nmla or ell ply,joe will o rontrneturlV I'c,n,rd punuanI m the
Conune,or'v Licence I.aw.
❑I am eaemin under See .B&1'C for this ramal 1.0E — SEWER & WATER
Owmr Vale 202 - UNDERFLOOR PLUMBING
WORKER'S COMPENSATION DECLARATION 203 — UNDERFLOOR MECHANICAL
Ilmrch♦v Ifinntod,,suahyAw1jj.,'u,cof lie fnnowingdttinmtirn,: 2@4' — UNDERFLOOR 'FRAME
❑ I lav alkill n inwin a Cunlficotr of Consent to.elf-in.n a for Workers
Comper,atire, a, pro.Mod for by Section 3700 if me Lahr Code. ail, the 205 — LINDERFLOOR INSULATION
performance urine work Orr,which this permit i.i...ed. 301 — ROUGH PLUMBING
�v and will maintain Worker',Compensation Insurance.a,required by section n —
Oilll'it he Lahrr Code,for 1)e perrornarre of the wrrk 1),r which nti%permit is 30e TUB & OR SHOWER
issued My wo.ky' c,lttprn,ltl hn,Iranme ranlyramI . ltilinbe II 303 — ROUGH MECHANICAL
car Gf _ zQ_0T—Bier"n.: Q 304 — ROLIGH ELECTRICAL
CE IIP ION UP P:. SIPf1(lN B(IM WORKERS'
O BIENSAlION INSURANCE 305 — FRAME
(9111,section need me be completed if permit is Lorene hundred dollars 306 — HOLDnWNS
($11)(001 less.(
I crniIy Ilan in the perku ounce'or die work Ibr%lien this permit i,issued.1 307 — INSULATION
shall amt nnpluy any pe non in rap'manner w Its m,haomc subject m,he Wnrmrs 308 — rJ-HEET ROC1e
Comprec ion Wwvuf California.Dam -
Appwmu 309 — EXTERIOR LATH
NOTICE TO APPLICANT.ll;alter making this Cambium of E mmption,you should
W,unmsubject,othe wrrker,Crtrpn.aarrtor...ki is of theLanr —
Lab... 31@ INTERIOR LATH
Q O frnnwith crinply wlill such provisions or this penuil.hall be derated revoked.
FCO55TRUC LONLENDING AORNCY 311. _ SCRATCH COAT
a, IherebyaflimBellthem i.acorntmcimllending agency ourbepeflimnarim 313 ROOK" NAIL
onhe work far which this permit is issued(Sm.3l Civ.C.)
y 'p [,We,,Name 501 — FINAL ELECTRICAL ENERGY
= 7 Lenders Address -
- 502 FINAL PLUMBING ENERGY
renily It, Duro real, ,Ifcitoldcnnly oil,tmtt,ned 1)i tllaw,mlooln i. -503 — FINAL MECHANICAL ENERGY
Gs. fd unrcnt.1 agree 1)i ctintNv waft all city alta enemy ntafimec,sod.city law,e, Pon rt —
OU therdsingmmwallprand,forya,nhrdretcls"c"nitysofadsraynl`n"rupOn 504 FINAL BUILDING ENERGY
} r- Ire aM(Wee)a lice to pee.indrt,Ibrily and keplimble.
.r„ L Iwcl agree to ave.and c pmlwn which
hmay in an way acme against
nt said —
VI liabilities,judgments.aids and c.penses%limb may in any way aremr again.,Lara 505 FINIAL ELECTRICAL
tJ �_ AA
,rhe ting mnhl,punnit.
nRsrNns,t�+a•Pi1LLcomrLvwl mgt L�NaN.ro{n7r Issued by: 50 _ 5 TESTDate Iorcle, '' .•- DaleRe-roofs 50B — FINAL 11ECFIANICAL
AZARDOUS MATERIALS DISCLOSURE
Will lheaggierd"a(mum building tecup:w wore or handle WAmJru.material Type of Roof 509 — FINAL GRADE
as Jebel by the Cupertino,Municipal Code,Chapter 9.12,and the Health and Safety
Code,section 2553210p 51.0 = FIN L PL
El Yes Irl All roofs shall be {s0 red pt'l� ani Fnt��,[�t�,�j � �4n installed. I
Will nte:Ihphram fir lnlnrc nnoding«Lap,Ilttawrgaipnmm fir dovlrm.wbirlt Ifaroof is installE 'w`S(hou[�tirs ICaidil .h'h1F'pebt0,�l'tiggree to remove
emit haronlnn,air comnminanl.u,J•gncJ by tic Ray Arca Air Umliry Management
so
Vnmrn � all new materials for inspection. Applicant understands and will comply with
we, all non-point source regulations.
1 nave read the hazardous materials rcqulrentenn under Chapter 695 of,he
Caf T....11 location&Solely Coda,Sectors 25505,25533 end 25531 I ader,ard that
if the bar Ill,doe,nooltull u a Icumo Let iti,nryrapnns,ledly,enntify the e -
Uer,
panl o the req Bents w ich mutt be me,prior In issuance of a Ce tifimm of
Signature ofApplicant Date
,to i — nate All roof coverings to be Class "B"or better
OFFICE