01030169 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: VERAll'INO.
79EO MC CLELLAN RD # 4 PSG FENCING INC 01,03 0169
OWNERS NAME: AI'P1.ICA [ON Still DATE
-9/2001
IONE: SANITARY NO. CONTROL NO.
BUILDING PERMIT'INFO
O❑,p❑ ANCHI'IEC'I'/IiNGINF.ER: 11I ELECT PLUMB MECH
U U L J LI G-1 CI
FaN
O N/ LICENSED COcenBACnder p DECLARATION ]llb DCSCrIpI n
�_ 1 be,cby allirm that l c 3 cI II cIff under P iun,of Chapter 9 a lly 11t cin,
K�JC_u withSo,,III ..71X)111,fDivixinn3ul the Ba,incx, - Icx,.fmC Iyylyten.
K<x�� I,mfunna<eaaderlc � I' 2ND FLOOR BALCONY REPAIRS
o Liven.- p2
3 hale x <i•'.}1" S DECI-nr
F G ANCIII'I[CT'S DECLARATION _
gCot
g I unJcrunnJ m>'glans xhnll R Bled as puM1lic rtund,
y O�O hiccroul Prolccsio ral
OWNHf-BUILDER DIECLARKTION
W y 1 hereby nffinn flat 1 ala ,x rap,fnnn,nc Conlmcmr'c Licenm Law for the
followinb rem,a.(Section 7031 5,Buune,and I'mfc.,.ions Curb:Any city lir rnunty
S.[y which«quimx a .it to ron,brum alter.impmve.Jemnli.h,fir repair any'fracture
ce ac
m prior mit,imuanee.alw reyuiesthe applicant forsuch permiun fileosignulminernent
a--S— thin he is licensed pursuant it)the ptouons(if the Contramnr,Licencelaw(Chapter 9 Sy. Ft. Floor Area Valuation
(colonialism,whn Section 700)ofDomino 3 of fill,Basins and Pr..fies ons Code)
e
on hanSec he is cacnlpt they apad andau� the hums hr the cls the corruption pilocto Any I penalty
on
of S,c,inn703 s,than by nnydred nn for uuit). nul.jcclx the upplhvnl ofncivil hcnally
„fno,nlnretnanrsennneredennnr.,rasa)). APN Number � - Occupancy ype
01,as owner if the progeny,or no,nnployce,with wages as their sole conpensation. 3621 20011 00
will Jo the work,and the urvaum is nit intended or obtained for,ale(Sol.90-14.
nn, ,and Prole,,; a,Cale:The Cou racmr,License Law mots an apply m an Required Inspections
owner OI party Who build,lir iroprova,Nereua and who does xuub work blm,elf - -
oI ,lglt mor own alffpbryae,.provdal,hal anal in,pn ens ace nal:mended n 101. — FOUNDATION
ffered for sale.11,however.tine hudd ing or....pnrvarlmnl`in sold will....one year if
alnplction,lineowner-builder will nus,,de nwJenaf pros in, flat he didnot build or A ] 02 — PIERS
impmve fir purq,m of sale.), p e
O L usa,will It property..,it ei clu,i,dy cano-auarg with licensed con "n ALSO 103 — UFER t
construct he proJec,(see.7(P4.Itione,v and Profe,liona Carl) the C ,meters 104 — REBA R
Genre Ll,w dies ort apply to all owner or p,nlwrly who bfdld,or improve,(hereon. O zal 105 — ANCHOR BOLTS
and wl.i eowaen
m , for eh Pla'ii,ol with continuous)broiled Pascual In -
Colnrlcur's Licence Luw. r
O 1uncWnip,audcr See. .B B.PC fordd,rea,oa 1.06 — SEWER & WATER
O,c Da1C UILDINCa' 202 — UNDERFLOOR PLUMBING
WORKER'S COMPENSATION UECLAILVTON 203 — UNDERFLOOR MECHANICAL
I bcrchy of onunih,,;,anityol rjay Door he rounwin,declaration,: 204 — UNDERFLOOR FRAME
J I base :uW .,If mainlnin a Cenil7,na of Conacnl to off-in Bre for Work,,',
Compensation. as provided for by Section 3700 of the Ulau Code. for e 205 — 'UNDERFLOOR INSULATION
perfommncenflhe work firwhientm.permd i,i„sed. m 301 — ROUGH PLUMBING.
1 have and will maintain Worker's Compcnsa,ion Inscrow,as required by Seclum .,
3 a)of Ise Labor Code.for file perburn a of life work for which this permit i, 302 — TUB R' OR SHOWER
Island III/y/w�oI$(ke�r,cm/,^m-n,a',ll/d�nnm,lir:fn<ce.rr;e�r�a`n•nt�r,o�lin�m,l/nbe,�are:
�•,('� — ROUGH MECHANICAL
Carierl[,ah 1, t�C oncy Nn,:/1.3! _7 yL� 304 — ROUGH ELECTRICAL
Cli II ICAAII ION r F EXEMPT ION PRO l OR 1i�ti'�''
COh1P1iNSAr]ON INSURANCE 305- — FRAME
1'this ection need not W carpeted if pinch Ili for one hundred dollen 306 — HOLDOWNS
181(X11 or(Goad
,I anlfy Ilial in In,
....i in any lir the woe for which thin ct,,t e Workers
issued,1 307, — INSULATION
Conn Inn enldoy any p=ant In any ora..ner,n:I,n Iwentn,anleel n the wonkes' 308 — SHEETROCK
conpen,an,n Uw,lir California.Date
Applleant 309 — EXTERIOR LATH
NOTICE TO APPLICANT.IL of tan making this Cenificae of 17acmptlon,you should
beacon, object to he Werka,',Contrail rovikion, if he Labor Code. orr infol 31.0 — INTERIOR LATH
O Z' Iithwiln nnnply wlfif such pcokicr,lir ods perm II shall M,deemed tavoked.
Z2 311 — SCRATCH COAT
h
CONS'IRUCI'ION LENDING AGENCY 313 — ROOF NAZI_
I hereby uflinn thin Ilam consultation aconsultation bonding agency Ior the perfommncc
of the work lin which this permit in issued(Sec.3097.Co,C.) —
a c �nade,�NatmM1 501 FINAL ELECTRICAL ENERGY
o z 502 — FINAL PLUMBING ENERGY
U'0 l n -1 acni fy,ru I have rend fid,,ITAicafiin all male hat fhc ahovu Inmrmatiin le .' .
eee 1.lagrce,nem,.plywilbaueityandco,lmyordinane,:ne„ale law,nl:Ding 503 — FINAL MECHANICAL ENERGY
O U : Wildinge.....lur,in.andherchyau,nor, prewcoake,ofIf,,,citytoenter upon 504 — FINAL BUILDING ENERGY
k7 fhc a so,nineninnm,surrynea
ed property for , hou p .
(We)".ato-'re.inJcnniby and keep harmless the City of CnpeninoagvnstZI 505 — FINAL ELECTRICAL
U G City itiamvcyucnnevof,nt gnoting and enses this hick mhy in any way accrue against said
APP CANT' NDERSTANDSANDWILLCOMPINWITFI LNON POINT GAS TEST
., s c1aR uLnno"s. �0 Issued by: _ Dale
;�a,ana all,1,p uNG
Dale Re-roofs
HA ixuouS MATERIAls lbscl-osuRE 508 — FINAL MECHANICAL
wnntepplicanterfutwe Wilding navigator atucrnhadlehrua,Jousntandal Type of Roof 509 — FINAL GRADE _
a,defined by the Curacao Municipal Ede Chapter 9.12,and the Health and Safely
Gale. Myer z5532m7^ _ WA T Ml 2 pht(�7 fir:.' g
otic, Rni All roofs shall be cted n t anti 1t� a tial b=in installed.
Will tbeappdmalnl once bull d'ngoaupanlmaalalpmealnrdavlccswhich If aroofisinstallerKhhoui�,AK$tainRYFAri� peNpp,49Gigreetoremove
cmi,halBir enunciator as,lined by the Bay Area Air Quality hlnnagenent
> ymnous _ IN all new materials for inspection. Applicant understands and will comply with
oY=• No all non-point source regulations.
I have rand the hazardous matcrids requlrcini under Chapter 6.95 of the
Culitorniu f(call,h Sufcly Cal,Sections 25505,25533 ane 25534.I andealand thm
If tile building dues nal collect,(lave a III that it i,,ny o,""I'ibillly lu notify the
°�ccopam of fhc mean wldcll ons,be ,I,,prior I,issue n of a Cri incac of
ley. _ 2 Q Date
-�6 n ro Signature of Applicant
caner nn.at �, ed Dae All roof coverings to be Class "B” or better
OFFICE