01030164 CITY Oh CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS. PERMIT No
79-38 Mr CIELLAN RD # 4 PSG FENCING INC 010,30164
OWNER'S NAN117 APPLICATION SUB DATE
{ONE: SANITARY NO. CONTROI.NO.
C m i ARCO[UIC(ENGINEER: BUILDING PERMITINFO
O c_ 13 UG ELECT PLUMB MECH
m>°1 LICENSED CONI RACIOR'S DECLARNI]ON ,lob Description
1 hereby affirm that 1 am licensed under provi.oinn•of Chapter 9(minimal ng
p v;t•a with SmionnMq)ot vt.i n3nfthe Bnsincssand fog( Yu
n GJI font um ,=�— �/ , I
w i.i�mt.a cl, r `a.a ���...LLL —„_ _ 2ND FLOOR BALCONY REPAIRS
O a Dae_ ]] tovi
V ��aARCHITECI"S DECLARATION -�
E.a3—'co.O 5 1 i n icisamd my plan, hall be used ow public rcO ds
yr_
u`a_'.p Licumnl l`rnl'ussionul
g o OWNI!m13U11 m;pa it DIihe Colu no
u7 1 hereby.(Section
on I ten exempt Gnat the ColumCs License Law for the
C=a whifollch
ireuiresa permit
7033.5.onwrl Rusineas and Pe,demolish.
emlih.or Any city orrummy
`S O which,it,"tu n fermi)m enemata drcr,improve,h penin t t or repair any structure
is pnor;n i,smo,ed,mearnl,, he thcnppliann for such pnminn Btu n,1,w smnmcm
thmlha is rel Sectiomda polooki...'he lhaBntne,,andprofess(n,Chose, Sq. FL Floor Area Valuation
[a,mmeneis a with Section nNln)of Division J of the It gad ex moil ionfAny profession,C,del
or that be is 31.5 b thefufmm and the per for the alleged the palmation.Any violation
of Section iBJLS v any applicant fora permit wbjttN IM1e applicant m a civil penalty
err ao ochre m„n rat n„mind nnlm,a t550p. APN Number Occupancy ype
❑1.us owner of the pmacny,onny mnplo,mv with wages as their.nle uompmamion,
will do the work,and the.nvcmrc is not intended or oRcnd lot sale(Sm.NW:
Be.iress and Promwion•C,de:The Contractor,Liecn.e Uw thes not apply in an Required Inspections
owner ol'prory ny Who build.err in a,thercan,and who dons such work himself
or thna;gh bis„wn empinycu.prnndad lh:d.nch bnprnnamaal.ara mot imendcd err 101. — FOUNDATION
odeml for sale.If howmcr.the building or oupmvemmilt is sold within one year or
imm,pletion.the own elholder will nava rhe lardm rel pawing that he did not builder 1.02 — PIERS
prove foe borrow ref.ale.).
❑I,a.owner nrn,a the, 103 — LIFER
qmo ,
cl he project(ser,nuc.Basin,nod 11oft, ,.insadenine Commnnrs 104 — REBA R
1 ceranse Law docs not apply man Diner of,wo,ft who build,or in urse ec hhensn.
and who contracts for such projects x;m a mntmctorf9 licensed pursuant to the 105 — ANCHOR BOLTS
G,ntractor',Liccnsc Law. �g
❑Ianh caOhhpt,tater See, .B&PC nrtG n 1,06 — SEWER & WATER
Owner Date �� 202 — UNDERFLOOR PLUMBING
WORKER'S COMPENSATION R IO. prt
de B ^e03 — UNDERFLOORUNDERFLOORIMECHANICALIbera, m"""nderaa":Jtyo t pe;jnrym;en np„rytlf{:i°�• 204 —' UNDERFLOOR FRAME
1 have and will maintain a Cenilia:na of Cnnvemt�l 11Gimurc for Worker's
Compensation, provided for by Section 37M of the 1,0ur Code
pe205 — UNDERFLOOR INSULATION
rfonuan¢oftheworkwrxhiehIs" .bir.i.snes] ILD G 301, = ROUGH . PLUMBING
E] hav
I e camai
l will oml's Wader.Comp.alcol l Ia.aaRC�alohed b��ime
nun of the LaMn Coln.ter the aerf„nmuce of the work for which this lennit is 302 — TUB B• 0 R SHOWER
iasrca.my Wo era Cn,hh anon m.aana carrier and Policy Bamber are: 303 — ROUGH MECHANICAL
camin(xi.IlQ[,,_rnlla>""'' 304 — ROUGH ELECTRICAL
CI!ILI11' IIUN OIC 1!XI!MI"PION FROM ViORKERS'
CONIPENsnnoN INSURANCE 305 — FRAME
fThls anion road not he completed if the permit is far one hundred dollar. 306 — HOI_DOWNS
($IIXB err IcxJ
1 cenily that in the iscrfornsalm of the work lot which this permit is issued.l 307 — INSULATION
shall not employ any person in any n amor so aw ah become subject to the Workers' 308 — SHEET ROCK
Cominn.ado"Lax,of Carfomia.Date
Alml,can1 _309 — EXTERIOR LATH
(
Nil ICH 10 AI`I`LICAN'1':It,after making this Certificate of Eacmption,you should
become aubjeet m the Worker',Compen.anon provision,ofhhe 1.alar Code,ghat relics) 310 — INTERIOR LATH
pC foom,docomplyx;msuchprovi.ioh.orthispc„,IiIdmIIhedecimalrev�oked. 311 — SCRATCH COAT
CONSTRUCTION LBNDI NG AGENCY —
hateny amen that there is a cons maoah lending ngamy nor she rna»tinea 31.3 ROOF NAIL
^ of,heka,,,which,hiepennhisissued(See 307.CiwC) 501 — FINAL ELECTRICAL ENERGY
7 Tender',Andnes 502 — FTNAL PLUMBING ENERGY
UO I iee ,Iahlhae,rat;Bandaatpandnnlydedhm,callnmoilaw,:amnia 503 — FINAL MECHANICAL ENERGY
ot,oC) F ,mea.1g Con to ction.a dhh.all city and e,repo ordloaneow amt sate laws enter
open
O ;,� a,bolldingmmmrA pro nyforipamhmiuurfowenmtivasnuhiscity e,emeruan” 504 — FINAL BUILDING ENERGY
ry
the atw(We)no onN propany for inspection purryuca.
u0. (We)ugneat,s....isdamnayandkhihin.,IarCity t,'minenmoagmnn ,�j05 — FINAL ELECTRICAL
V� linbili,ics,iu,lguhcot.,coots and onpanwe which n,.;y In any any accmc nguin.f slid y`J -
tJ z City in canwgncom of the pmmin,of this IsemhiL
APP CANT NDERSI'A DS7�WI�LLCOMPLYgy ITHALLNONEN)KF 5 — GAS TEST
S CE
Rir Ar � ( Issued by: Dale
Si alte -n-, t Baan Date Re-roofs OSURE 508 — FINAL MECHANICAL
WII moa can ml Ilumn ho dlnB mlmlpomsauv or honod ii,haot,nmtedal Type of Roof
asdernednrthe panianMunicipal Coce.CM1apter9.12, ad the Health and Safety
509 — FINAL GRADE
Endo.Scnion 25 2(u0" WA I'p'Q� �jl b TtJ L. b
ova. 'II(No All roofs shall he"111� [.�c[ed rllb'IY�"�I[O�� n Ibo11❑ (r^11HlLe/rfi�apl{b.{e�i^m installed.
Will the appleam or forum building occupant use equipment or devices which If a roof is instal]AlNllhOut iA @6idRyq M' YpeLLloRgqigree to remove
emit lnvurduus air contaminants I, tined by be Bay Arm Air Quality Managcmem
ukiriul'I all new materials for inspection. Applicant understands and will comply with
El Y,,, "^ all non-point source regulations.
l:wc mw
ad the hard" a
n.s marials requinro
acs under Chapter 695 of the
Cal ford.
Ifcodh&Safory Code.Sabin 25505.25533 and 25534.1 undemmiA that
it the Mti lJing mann)cnrrcal ea onion,tha h is mY responsibility to notify the
n oft nquireonnn w ''h test M;mut prior m iss ante of u Cenif Bre of
O�u
13 Data
of Applicant Date
DataI— All roof coverings to be Class `•B”or better
OFFICE