01010004crry OF CDITRTIN0
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
PERMIT NO.
10760 MORENGO DRIVE
01.010004
OWNER'S NAME
APPLICATION SUB DATE
01/02/2001
SKOWBO
ONE:
SANITARY NO. CON]ROL NO,
ARCIII'I ECUENGINCCR,
BUILDING PERIM IINFO
BIDG ELECT PLUMB MECH
IJ
DECLARATION
LICENSED COYnRACnder
1O6 Description
p
I hereby affirm the I um ONTRJ under provisions of Chtp¢r Y tmmurnencins
with ](°Xn1(11 Division 3 of the Nu.inca.nJ rrofrasionr C,de. unJ my (seen..
°of
ha$ill in
BATH
REMODEL
nnreChlo Sic. a
I
D.ae Connnma,
ANCIII'I'IiCI'S UECLARA'1'ION
I u lda'sdnd my plan, shall be .....I a. puhlie Heard,
,
-
hiccn,cJ Ymfc„ianml
OWNER-BUILDER
he
m Centimeter's License,: law for the
he Caston
1 hdchy .(limn that 1 do eBusin
s an
Co
(Section ]Ill L5, alms. and Professions Cale: Any city nr county
ny
O
whim myuim, a permit to t. or repair nay ,wanes
which re uire%a eL alcor. impmve, dnnonit
/
rafters t t asig
prier a, its iswmm, also myuirce the applicant such pcnniuo ole a risme( smmment
Sy. Ft.
Floor Area
Valuation
that he PSrsuannntnePoisson. nitne r9
Cade)
mornalcticin with Smtrefro X the Basins ancnmlawom, Ce
t of the Business Priion.
is ofhe
$ rJ000
basis Any Vi
li and the hzerc for the allege) exemption. Any violation
or the he is exempt a
or danhe
zany
31.5 b applicant lar a 500)/0 subjects the applicant v, n civil prnahy
by am lot
of $onion ]t ban
m moo mrWmad dalmr,
APN Number
Occupancy 'Type
1ant
not tm,re fs5nm.
ishe plait... leem„pcn,afice.
35735057.00
1, as nwm,A pmpeny,nrmy...... e, wid, wnsee ax
win do he wall:, and th. onn,ttne Ix con Inm eked or offered far ram ase. 7044.
Required Inspections
,mane., and lit, Cede; IId Conn'anurx 1 icenw L^w dms con mpply m ua
e 9 P
ofpro,wayWho bondscrimnpmvesthereat, and wnodoexsuch %orkhi,n,elr
1.01.'—
FOUNDATION
orrthmugh his own employees, provided that such improvements arc not intended or
011e” far sale. If, howeverthe building or improvement is add within one year of
102
— t
PIERS
'eunehurdeofp,uving thin heldirm Wilder
ncircuar, darewneabullderwill hmn
mpnwe for pm,roa of soled'
103
— UFER
01.a., ewneronhe pmpery.am exclusively contracting wih liecnsaleadrucmrs to
104
— REBAR
i,attract the project (Sec. 7M4, ,-Lines, and Profession, Ccdc:r'1'he Contractor's
ncense law does not apply hail owner to property who builds or impmve.hereon,
105
— ANCHOR' BOLTS
icon who v...1.1, for such pruje t, who n uname,aa a) Ii,croed .,.art m the
Citraetar,Lia^,cl.av,,
106
— SEWER R WATER
[]Inns aaetlp coder See. .HffiPClb, thixrca,on
202
— UNDERFLOOR PLUMBING
Owner Uatc -L-ol
WO KIiR SCO—MI'13N5A ION DECLARATION
203
— UNDERFLOOR MECHANICAL
Ihereby amanends, nrally ofperaryone ofdue B,liawingdrela,:mon.:
204
— UNDERFLOOR FRAME
1 have land will maintain a Certificate of Consent to ell-insum, for walkers
205
— UNDERFLOOR INSULATION
Compen,dion, as provideal for by lection 370 of the Lahr Code, for the
PLUMBING
,performance othe work for which Bus permit isissued,
301
— ROUGH
O l have and will maintain Worker. Campea,ation Insurance. a., rc9wred by section
.. 302 .
— TUB d' OR SHOWER
]700 of the Lada Code, fur the l,erformuno, it the work for which this pcnnl, is
ROUGH MECHANICAL .
I.... d. My Walk,,,Coi,emaron lmnmacc<nnie, a ad Policy anmter arc,
30.3
—
Carie,: Policy No
30T4
— ROUGH ELECTRICAL
CEIO FICAT1ON Olt EX1iMI'i'ION FROM WORKERS'
?OS
— FRAME
COMPENSAI ION INSURANCE
v
dollars
(nd, serhm a" not he cd„pined if he Permit is for one hundred306
— HOLDOWNS
(sua)an""
307
— INSULATION
I certify that in But peffmornmee of Ila work for which his permit i. issued. (
308
— SHEET ROCK
.hall od employ any person in any number w, as to become wbject to the Workers
Compensation Laws nfcarfamia.Dane
309
310
— EXTERIOR LATH
— INTERIOR LATH
NO ICE PLICANT:IL:nmrnunkinghin Ccnins of
NOL'ICG
["aborti oll,y umn'd
provisions ofheLana, L'uJa. you coup
object Worker, o
heaame object
nnhwid,e„apply with smn provi.ianx ar his rte.mit-,Dau rte daeta,d revakul.
it or,i l,,, dr,
- 311
— SCRATCH COAT
CIINSIRUCTION LIdNUING AGENCY
313
— ROOF NAIL '
I hereby afnrm that there i, a construction lending agency file he perkariance
al hework lot wnichhispcnnhlaissued (So,.3119],Cie. C->
501
— FINAL ELECTRICAL ENERGY
1<ndrr'.a Name
I<nder'r Addma,
502
— FINAL PLUMBING ENERGY
ordethat above information i,
1 IagBy tncomply
503
— FINRL MECHANICAL ENERGY
cesad
city mW county ordinances and ate lawn relating
with hat ity and county
I acme to comply with
thFuddie-menawdian.undnerehyadhorirtrcposes
BUILDING ENERGY
i build hereby ex of this c'ny mcmcr uptnt
504
— FINRL
the ad(We).,me ,, pn,peny fin inspection ,ike p harmle me Cityya,copagait against
fwe)agrccu,co,,ianalc,dd,
505
— FINRL ELECTRICAL
which
City I r,, indgmedx. ca,tx:cod eapen.[,, whim ntay m:mr way ar«mr against aid
UND RS FA n s, p of hie Irennit.
AI'I'LICANr UNDLRS rAN1l5 UWILLC MrLY WITI ALL N(1WIYlIN'I'
506
— GAS TEST
4 rO
SM1RCIiuN r Y� S L�
`z /
Issued by:�j71,7
— F I lypt DI I LMR T N('+ Date
Si,miurm of Applicsnt,Conr'Sour Ude
Re-roofs, 508
— FINAL MECHANICAL
HAZARDOUS MAI ERIAIS DISCLOSURE
Will he app(icaat ortutom Fordo, occupant aom or handle hdacom; mdeaal
Type of R(1`�21?9
— FINAL GRADE
as defined by the Cupertino Mmar ICde. Chapter 9.12, and the Health and Safety
510
— FINAL PLANNING
Code. S�mYem25532(a)?
All roofs SIU.illbe-insperigf4prigDL(Pl r (Do6QF yMrial being installed.
Will In,.,lamnt,,futurefrothingeccapuduser<lai,mvatardevice,which
If a roof is installed
without first obtaining an inspection, 1 agree to remove
,,it hv;adoue tit cnnmminn ll ., I ed by he Bay Any. Air Quality Munagnncnt
,trial
all new materials for inspection. Applicant understands and will comply with
El yes
all non-point Source
regulations.
I have read the nva,dom it crxln m,boduteas under Cnaptd fi95 or the
Cthl'arnia Ilenlfb k Safety Code, Seetionx 25505.25533 and 25534. 1 undcnmad tout
if the twilding Jac, nut cummdy have a mount, that it is my rc,taliBility m, notify tire
serpon of he requirements which Dann be men prior to i.wance ill' a Cenificu¢ of
DieUr "`y,/[ �
Signature of Applicant
Date
All roof coverings to be Class "B” or better
Ow r thorized agent Dae
OFFICE