00090123 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
RIRIA)ING ADDRESS PERMIT NO,
OWNrR'SF$".60 MINF_TTE DRIVE APPLICnaA"SOIi Omit2"3
Otm P110N1i: I. I SANITAR N6. +ti` R I.NO.
�00 ARCIIII'F TRNGINEER: ]JUILDINGPERNUITNFO
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LICIiNSGD COM'RACfOR'S DECLARATION Job Description
z•� 1 Jonah,ullinn that I o[n llean•cd under faci.innx of Chapter 9(comma cin,
�4 C liti wi0,Scetlon ilX)(p f Divivmn 3 afthe Rminm,and l fir,ioa,Cato.and no,license
Y F. i•in full force and t.
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Limroe Cla•• X_
dJ Lit 7.35_7_5d�
3gy Dat=- ///� y�gRCHI ca�nmetm� 2227 LIVING SP/451 GARAGE
ARCHITECT'S DIiC1.AKA
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8 E° Liaa[,xed rm
OWNF II, i. LARA'1'ION p (, (t
I herey amort than 1 ton c enpe[from the Contractors Licenw Law r"A G O 2001
following at(Section 7031.5.]Justness and Profira iota Cee Any city or county
dF wInch requires,a permit w conxtma.:dmr,improve demolish,or repair any suuclure
a 3= priont)ilk issuance.afsu requiresthe applicant t l I Jacinth tofile 'b d a torn
mat tie . alp [t n p force t , r.L 1., ,L'nap,� q. FL Floor Area alualion
(cam b m 5 f 7111X11 D' M1 t m II cxx d I 1 - •Cndc)
ended he is e.empt,bnefrom nttd the bash fm the alleged e,emptmn.Any violation
of See[loll 703 1 S by any applicand In a Pamir wbjnnl the nppreant u,a emu penalty
orna ntom than fi.a hanAmddnllaa laLHp. APN Number 6ufpype
❑I,as owner of the pmpany,or my employe,with wages a%their sole compen.,m;on,
will do the work and he xtmcmrc is nm intended ,,nRered for at,(Se,7(W,
au,in„and rrnfe..ion.Coda rale Cama oo,Lmanw wan ma,ton apply to an 37531.0,:,7• squired Inspections
r of p.,,a,Who bu;ldn or improve%thereon,and who d00%such work hin,elf
ovthrough his own employes,provided[hut such int inmtnn ate out Inmnded ar .
aTcred for sale.If.however,be building or intpro•cmetn is add within one year of 101 — FOUNDATION
eooldetlon.meowner-builder will have theburden til proving milt he ton build nr
imprma I..pugvu if sale.). 1,02 .- PIERS
Ol.as owner or the propeey,"nie,clushely, controwing with liacnxd aontmulout 103 — UFER
u he pm]ect fso,7144.13 re",still Pr..fe"mr,Cndc)The Contractors
Lice m Law do not apply to an ownendpmpanY who build,or imprne,thereon. ].04 — REBAR
and wlm enmraCIS for such proieeu with a contoxfow fiance puamtnt m the
Contrams"l.ieen,elaw. 1.05 — ANCHOR BOLTS
❑I am e,en,p,ander Sec. .R&P C I,,,this mason _ 1.0E — SEWER R WATER
0,net Dane
WORKER'S C0a1rENSAT ION DI;CLARAOON 202 — UNDERFLOOR PLUMBING
Ihereby eft on ander penalty of perjury one of fallow ing declaration, 203 — UNDERFLOOR MECHANICAL_
❑ I have and will maimain a Certificate of Cri a •ell„asure for Worker. 204 — UNDERFLOORFRAME
• Compen%aron, as provide lin by Section 370() of [tie I.ahor Code. fur the I 1
perronn:ince,nnework For whid,do,pc _onitisissued, 205 UNDERFLOOR INSULATION
0 base and will naintain Worker'•Comperoation Insurance,as required by Section 301 — ROUGH PLUMBING
37W of he Lola,Code.for[tie nMiallaal of n[e w,ak for which his Pesti i, X02 — TUB & OR SHOWER
",wed My W'ader's Cnmpcn,mion Insurance carrier ad 3
er and Pnbcy mmr
care
can;e � �_Pnney Na.: 4211113 303 — ROUGH MECHANICAL
CI!RI'I PICA'TON OF IXLMPfION FROM WORKFKS' 304 — ROUGH ELECTRICAL
COMPENSATION INSURANCE
(This section need not be complemd;l the permit is for one hundred dollars 305 FRAME
SIM)"tle".) 306 - HOLDOWNS
1 randy the,in be performance of me work it,,whleh this Pere is i...ad.I 307 - INSULATION
..hall it...cmplay any"moa in any m allon,n a,[o beeline mbJect to the Worker,'
Crampen,ationlaw,ofCalifornia [).,a308 — SHEETROCK
NOTICnt 309 — EXTERIOR LATH
z O
A, ca TO APPLICANT.If.after making Certificate of li,emptinn,you should
111101111 xah)ceta[na Worker,eotnpenwiaro,i,i......of be Lantra ade,yoa roust 310 _ INTERIOR LATH
butkh comply with such pmviao,or this permit.hall M dirk l revoked.
F h CONS1'RUC'IIONLIiNDINOAGE NCY - 311 — SCRATCH COAT
a 7 I thereby:dfirm that there i,a construction lending agency for the pafforna tt —
at the work far wnid,tot.permit i,i,wed(See 3097.Ci..C.) 31.3 ROOF NAIL
w� p Lenders Nan„Addr501 — FINAL ELECTRICAL ENERGY
U
UO Under Karl,
lc,fdythin lnose ,ad mi,ap,kalaamlstatcbill heulmvei[m,nnad„n;, 502 — FINAL_ PLUMBING ENERGY
. ettree.fagrea,nemnplywith allcity eadcounty ominanee,cad ,.alaw,refinng 503 — FINAL MECHANICAL ENERGY
O U [o building um•vualoo,and larch,atnhnrno rcpruanl:nfvas orae it,to after up'n
IT, mea”'°"""n,m"`alpntpnyrnr[nxpetinnpa n,. 504 — FINAL BUILDING ENERGY
P4'cf4 ore ms,ave.indemnify and keep hemda,a[he City of Cupeninu again•,
V) liabilities.ia" pet,m cxpcn.e•which may in,toy way accrue aguimt raid 505 — F i NAL ELECTRICAL
city beomegaan.. ands '[.
All .ICANT-' Dill n 'A LL COM• IIIA ND rot ' - Issued by: SRIF• - RA5 TEST Date
RE"d -
Sigaaareo A - L"auaen,r Re-roofs 507 - �.
IIA%Al{UOUSI MA AL
.CLOSl111F: 508 — FINAL_ MECI-IARIICAL
Will the applicant or ramal buildingsacupont store or handle Institutions numriul Type of Roof
us,defined by It,Cupcnin,Nboakipel Co de Cnnpar 9.12.nal he I lmhn and safety 509 — FINAL GRADE
Code.Scabs 25534(.)7
0 Ye% 13No All roofs shall.'M Ospectfdlklt3d.to l;lly0bittlAilfttaterial being installed.
Will the upillicant or roma building occapan,use equipmnn or devie,which If a roof is instolp(l.withgaq�tpLgbtraik 1k.dif-ln4oE'ltiblS l agree to remove
craft hvallous air couai tinant,as defined by the Hay Arco Air Quality Managemm�t
nitrates all new materi:o inr insp"tj �ppl}t' iB(tlLtdel9tltids and will comply with
El slits 0 N all non-point source regulations.
1 Its,,read he hmu.dau,manelul,requ'nenmm,under Chap,..6.95 0l the
California 1lenith&Safety Gale.Sections 25505.25533 and 25534.1 undersand that
it the buildn"doe.n..[amrcally lore"tenant,that 1['atoy repnn,dolhy[u all the
accvpain of the qui¢ment, Iti e,prior to iswmee n'a Can m of -
'V Signature of Applicant Date
)wa all - — Dae All roof coverings to be Class "B” or better
OFFICE