02020029 CITY OF CUPERTINO " -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10305 MORETTI DR DAVE STRIGLER 02020029
OWNER'S NAME: APPLIC TIONsy..B DATE
DAVE STRIGLER 10305 MORETTI DR 02(07/2002
PHONE: SANITARY NO. CONTROL NO.
C Z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
m F0 BLDG ELECT PLUMB MECH
a`� r_U I"."1 LJ L_7
LICENSED CONTRACTOR'S DECLARATION
ZO Z y I hereby efrrnn that I=licensed under provisionsof Chaps 9(commeacing Job Description
Fo,tu9 with Section7000I.fDivision3oftheBusiness and Professions Code,and mylicense REPLACE WINDOW & FRONT DOOR &
�msn Ialnmllf...andaRect. TILE BATHRM.
se0 i U License Cie. Lic.B
Date Contractor
G ARCHITECT'S DECLARATION -
E1 1 understand my plans shall he mud os public rec«ds -
Y11
un
o o Limnxd Professional ,"�� r 1/ � '
o,^ OWNER-BUILDER DECLARATION T--'—"
1 hereby ahirm thin 1 em acmpt from Ne Conuecror'v L ``nu W for)bel
F z a following rteun.(Section 7031.5,Business end Professloa3 Code: -5�y city or cc
F G which rtquires a permit fin const
ober,improve,demolish,or e.ai re j
Tie prior to its isuen«,also requires she applies.formchpcmiss.fil at - -----
tly5thgl9pi«gmdpuqueolro stip provjsiom of d,e Conimcmfv Li«nx law lChager9 `- h Valuation
(c.mrycmcing wish Sec 012)of Division 3 of the Business pnd PrpfGssimo Code) �/I IIi�-',5, + �i:4, t1Y;'c�ar.., �.� •{"�`ys '
or The
t he id exempethe both end the basis for the.III'geeB esemptwn.Any violation
-of Section 7031.5 by any applicant fore permit subjects the applicant to a civil penalty-
ofnotmarcthanfivehundredday.Is5oo1. APN Number ee.r..,. t Occupancy Type
01,as owner o(,he properly,ser my employ.with wages se their mle compensation. 101 FOUNDATION
-will-III and
Prll,o and is Code:The
not Intended Contractor's
Lie efeud for sale apply Toa, -' --- ---_
�eusinels end'Profernons Cade.The Contracror s License law a«a not apply to an 102 - PIERS Required Inspections, '•>' ��
owner of pmpeny Who bmlds or improver thereon,and who docs such work himself 103 - UFER
or through his own employees,provided That such improvements art not intended or _ _ .._ ...._.._.._...._.____..-__.___._.._._.._. .
For sale.IL owner-builder
he building or improvement n sold within one year or' _ I O4" - RE-'BAR a'•I'
completion,purpose
owner-builder will have the burden of proving thin he did not build or
improve for pu,poaeaaale.). 105 - ANCHOR BOLTS
.. u .. _ _.... _
peat -_
a.mvne oath property.Ma cxiness,and Pro.sionsCIThe vacrorsro 106' - 'SEWER -& 'WATER '-
conswct theProject' TSTIapp Ito a Business and erty w ons Code)Th les tm.roraLic2 02 - UNDERFLOOR PLUMBING r'r r'
and%e Law does not apply to an owner of progeny who ounce or sed puns 4 thereon,
and who.CpL On.,tonmch.projeets-wins a contractor(s)licensed pursuom fin she. 2 03 --UNDERFLOOR- MEGRANI(."AL---........__.........._.....___..
Cyntractols License Low,� l .
_ .atop_
sola.scamp,under se ,B&P C•for this reason 204 - UNDERFLOOR'!.FRAMEi,
oald' �Z�� /Qao2_'- 205 - UNDERFLOOR INSULATION
\' RKER_S COMPENSATION DEC ARATION 301 - ROUGH PLUMBING
I hereby uffina under penalty of perjoryine of the following declarations: 302 - TUB & OR SHOWER
'L 0 I have and will maintain a Cenificme of Cununr to self-Insure for Worker's 303 - ROUGH MECHANICAL
CMI....lot.-or provided for by Section 3700-.( the Labor Cade, for the
pvcfrmOnceolhhe wink for which this permit is issued,,, 304 - ROUGH ELECTRICAL
1111..and will uO s iiworker's Compensation Indumace,ai required by Section 305 - FRAME
37W of the Labor C.le forthe perfdrmanfe of she work'for which this permit is. 306 - HOEDOWNS
issu d My W rke7s Compc.',tion Insu.c e fide nd P I y a art: -
307
�y t
CERTIFICATION OF EXEMPTION FROMWORKER$k"
�
� ir30,8. 3 _CS1�EETROCKi. f+..'IT.
COMPENSATION COMPENN INSURANCE^`"'s"' •
-... pate_ -_... ..... .. . s
w';m,"aEtion need not be complcmd if the permit is for one hundred dollars _ -
(s10(Ilorleae) 310 '` '' INTERIOR LATH `
_-311---=-'SCRATCH COAT
.. 1«may that n NsI in any inihn the ora Tor whmh subject
to,the nurcor ;tato .n--•„�� , r
p , 313 - ROOF NAIli`- `•`
shall not employ uny,person m any manner so ns m become wbject to the Workcn
Applicant.
Lawa.t callfamia:nate _,- . 501 .-_ .FINAL_-,FINAL
_Applicans.
NOTICE TO APPLICANT.If.after making this Cenif.ate of Exemption.you should 502 - FINAL PLUMBING ENERGY ,'TO '
Z
ticcome subject m the Wbrkefs Compensou.n provisions of the Labor Code,you must 0 fonhwisitcomply'withiuchprovisions.r,hisperminhallbed<emNsevoked. 503- _ _FINAL MECHANICAL- ENERGY
pato._ _ _ pato. pato. .. pate _ _
'� t" - "- CONSTRUCTION'LENDING AGENCY '' 504 - FINAL BUILDING ENERGY •'
W:7 1 work
kfor whim,that vert ie o cons Sion IendinB agency for Ne performance -
en ',Nmrsomanvispetp,hisirs.m(see.3097,cm.e:), 505 FINAL ELECTRICAL
W`lz -Cender'e t+dme. __ _:.: _._u•� _..t_.. _-....':'-... . _
oa^ Ladaersndaress - -`506 = GAS TEST
VO - ' - '' - - - 507 - FINAL PLUMBING•
1I a sit.I have read this city
adtion end Sax shat she d afta laws sitting
is
U caZl l agree so comply with all city anJ a repr ordinances and smm lows enter
upon 508 - FINAL MECHANICAL
=oaf, .bub Ic-memwction,ana heutaapccodzerepreeenmtivex of skiscitymenurupon
theabore-mentioned pmpeny for inspection Puquu}.-, 509 - FINAL GRADE
we)egrce'ioa5k;mdemnityandk ph mlcuth GryofCupninoogainss 510 - FINAL P ING
u'-Vi liabilities,juagmem.,costs and cautious which may in any we, cc.e.gains,said
^ City in consequence of the gronsingofthis permit514 NA WORKS
IYPPLICANT UNDERSTANDSA ' ELCO`1PLYWrTHA'LLNONIPOINT'"
souxcE ECULA Ns. Issued by: Date
Signaure,of Atpicant u.muor IData Re-roofs
HAZARDOUS MATERIALS DISCLOSURE -
Wllthe�PPlieantrfuture building uc.panNmi or hamdlehoza,dnps masenal -,Type of Roof_ _ ._ _. _....,. _...^......„_...__,..
as def.d by the Cupertino Municipal Code Ch p.r 9 l2 and the He tih and Sef ly
code
Section 2553.0 •i ,Sasjn'^"F",;,yy1 r t
❑yet,
$ No r U s ♦ ♦ ! , ..,.
_ Al] roofs shall be inspected prior to.any roofing material being installed.
w ,heapplcautn f building Occupant use equipmentorde ices which If a roof is installed'without first obtaining an inspection;llagree to°remove
III n
aM 'air cormorants as defined by the Boy AnenArQual ty Mon.gement
D ' " No all new materials for inspection Applicant understands and will Comply with
y �pf q p _ _.-for ate - _ I I ._ .. _ ..
t °Y` J]•- all non-point source regulations _ ,. , 1,
-. L
a read she hoz do s mmenala r ontems ndc Che ter 6915 of the
Health&SafetCode Sections 75505.25533 and 25531,1 unders.ndthntY authan Y aumm�ihotitlsn,yrcsponsibd tyro nmi( they ni M1 metp i.rtoiasnanceofaCeiificoteof
s /� Signature of Applicant Date
t .. pe _g nes note nem mf the requ nmpm bah
All roof coverings to be Class B" oi,betfer
Dau ,
OFFICE. .. .
..... .. pato_. . .
CITY OFCUPERTINO' -
'BUILD NC DtviSION PERMIT CONTRACTOR INFORMATION:
BUILDINGADDRESS: PERMIT NO,
1:03'05, MORETT2 DR DAVE STRIGLER 02020029
nyA11 11 b9TRIGLER 10305 MORETTI DR APPLICATION
HONE: SANITARY NO, CONTROL NO,
pfit . .
Woo ARCHITECTIENGTNEER <.. "' BUILDING PERMIT INFO
E
BLDG ELECT PLUMB MECH
QU .. „ : y i 1,.11 Ij::' s ',,. ", .,.,.I ,.-.. .... i 4 'Ll ,•V7 .. •L7 1_J
Z
y',2 LICENSED CONTRACT'OR'S DECLARATION Job Description
ZO Z•�p I hereby afoot that l am Recruad under provisions of Chapter 9(commencing REPLACE WINDOW & FRONT ' DOOR &
Mxwith Section]OW)o(Division 3 of the Business and Professions Code,and my license
is in full to=and effect.
TILE BATHRM. - -
e�.id License Class Lich
3 a w Dom Contractor
ARCHITECT'S DECLARATION
(=t=y 5 1 understand my plans shall be used as public records
O O Licensed Professioml -
-OWNER-BUILDER DECLARATION s
1 hereby affirm that 1 am exempt from the Conwemr's License Low for the
t•.•Z hollowing reason.(Seetion 10313,Business and Professions Cock:Any city or county - -
fS o which reel a permit m construct.alter,improve,demolish,m ni:m
repair my strc
i3 pnonon usum,alw req rhe ppbmmfmwcn pumiuo fila usig«d wmmem- - - - --- -- - --'
Nat he'of littpf 4piirsuans Mrlle pmvtsianx of the Contmnofa Licenu law lChepter 9 y. S Ft Floor•Area, a , t' Valuation
(co�encmg wiN Sttuop70001 of Dinsion Sof Ne Bulinus and Pmfauioor Code) t„�;�rw-J 31i!9 '! t-lb`,. 11 sq'J:t•.i109t0,yti: -
or Nalfie o eacm'pi Mercfrsim aqa Ne basis for Ne altegfdldjttlp� .AnY I rn n-
-M Settionl0Jl:5by any upplicanrrmepennit sublecis"Ne'opDlfcan ec pe
,ornatmoreNannvehunarceamWr (ss001. Number .+:'lu:':. Occupancy Type
TD
❑huowner of the progeny,ter mY emPloy«a wiN�mfat��pptr sole pensa ���� .,
-wdl tl -N w rk-and Ne srrocwre'is'normmndM'- -o-«e3'for I ' tt-7 - -
':BaaonuaarttlPrnkatt code Tri contmtrortu ulaw tl« lyt � 10 PI S Required Inspections ' '''"'
owner of progeny Who bued m tmprovca ahcrcon, who d«s w h If 10
or Nro Bh h s own empl y<u P dM Nat such t nm t d
-aB<r2d for isle IChowev<e I}ie Middin8 or tmpmvcmcm rs so d wiNm y --'-`- 3:0
ane ear of _
12&mpledon,Ne owner-Wilder will nave Ne burden o(pmving Nm he did ria build or
improve rdr,.purpose or wle.). ' ._ 105 - ANCHOR BOLTS
s,ownq.of!hn Property,un exdu;ivelyc«wcaing wiN li«ued connote m 106`='—SEWER—&—WATER. '.•:':b.P'.:..ii.y•,iia+,..
cmnwcttnrprorey„<c,]w4.Busumasand profoationsCode;)Trienntmcto<a 202 - UNDERFLOOR PLUMBING
License law dust not apply m an°wner'of property who builds of improves Hereon.
-,and who;comratii[orsuch.prolufs:wiN.a conuacmrtsl.licensed:pummnl-m.Ne. ._.._
Contractors Li«rise Law,- -. - ._.__.203----UNDERFLOOR'--MECHANICAL•-:.--—_-...-------------..
- - 01anlaemptuMer'Stt. 't^"'''�','^ - '"''';'':Bi�P,CfmNiartuon 204 - UNDERFLOOPi' FRAME''c:;
Sf -
205 - UNDERFLOOR INSULATION
"""WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING
- I`herebyeffien..Orpenalty ofkury�«ofthefollowingdeclwions: 302 - TUB ,bc OR SHOWER
° 1 n6Be and'wil nesinmin:'ceaifcae of Concern to self-mature f«Worker's 303 - ROUGH MECHANICAL
- C gimes u prortded f rby Section-3]00 fah later Coda, for the
perfomm�ce of Ne'svrk f wh cn Nis 11.
tn7ft m slued;., . 304 — ROUGH ELECTRICAL
❑I h and -ill iti m nWdrkeri 0pmpenuu n 1 umnbe a3 rbquird by Stttion 305 - FRAME O I-, /0-,7
3]00'f the!euro Cate r r she performs«e of tri. %mk f°r inch Nla pemnt t 306 - HOLDOWNS �6
iiaim My Worries Compensation_ Insurance cam r d P I cy numbe me: —
. r , ' e6.i a '3017--—,INSULATION'--
Cards ..:..: .,
a - Pohcy No.:
ftq CERTIFICATION'OFEXEM7fION FROMWORKERS," 1} 1308•-. SH$ETROCK
° µt'r'''' oit COMPENSATION INSURANCES-: Tri" .-,,.
-, .,.., ,-------'3'09 :'1=:,EXTERIOR--LATH---
” -7 p(phis'.i8coneadhatue�dm;kmdif,hepermni,rarnnenamn<edouars 310 = INTERIOR LATH '
3'13-•- -SCRATCH-"COAT-.,'
"' ,I c n fy tluthri rhe performance alit rk fm wh hal pe' n is i ed I I _-- I.� '-' I f;..,]+�t'�' ..,[v v
shall n t cmpioy any person to any manner so a be P. a tf a N w'r<n 313 — ROOF NAIL' -
empenufio�LawiofelfamsaDgre
_501..- ...FINAL. ELECTRICAL_..ENERGY--- .-
pNGTICETOAPPLICA If SfkrmakmgNosC mficam rE. puan,yau npuia• 502 — FINAL PLUMBING ENEAGY'
ince me mbldudlhe Wdhei i C mpen assort p mons of the Lntior Cade,you
must.
O O hath nh comply wish a hpr so ahspermtshall be J«med re ria _ _ 503 FINAL. MECHAN,I_CAL„ ENERGY-_ _ ._..._.
b o coesrqucloNLENDINcncENCY 504 - FINAL BUILDING ENERGY
1 hereby offirm that N<rc o e<on Wa«le tl n og«y fo the parr rih ce _
w q LenaersAdarets - 50'6 -GINATEPT,,_.BRICAL
ofN w6rkro wnknNa rmttutuJed(s<t 309] c) 505 FINAL ELECT _
I<nderl Name _. .. ___ .._. ... — .... ... -... .
z 0 F L LUMB TNG d.,;...
U-�
I candy that)have mad this ty and n and sate that the dabove maws salon n
correct 1 agree lo,con ply,wnh agciry and coumyprdinarua and sante lows rcleung 5 -L
M CHANI CAL
building connotation;and hereby authdria'eepresenmaives oQhis city to emcruPon 5 9 - E
phi above-mentioned progeny for inspection puryosee_ 51 -
i V] li b I"r ju�gmGnta,cuss and pagans h' h y to any way mme sgainsa said
U:. City sequence of Ne gianung Pahpe a - " ' " " Cj 14 RKS
'APPLICAfvT.tl(d0R5TANDSAND WILL COvIPLY WITH ALli'NON:POLN'T Issued Date
So RG by
;s
u of APplicanVComracmr,(:. " ,. Date',:i,', Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
•' WII
the applicant or f t rc building occ,a nustanciailiandichamedmimearial Type of Roof _.
I as def ned by Ih<Cupemn M pal Cod Chapme9 13 and the Hoa1N and Sm ty
:CodaS«pon255 260 x ia f t 4 h
°Ye + 't ' ❑",''' '^ t ' All roofs shall be inspected.pnor to,any.roofing material being installed
s Will theapp i.antorfot p iildi {occupant seequipment racv me which - If a roof is rosea led'wittiout first obtaining an inspection'I agree'to'remove
uhm
em azvdausaircammanm deft d by the Bay'ArcoArQality Management
Distrito all new materials for inspection. Applicant understands and will comply,with
pY � °"'°:i -: ' all non-point'sonrcfiregulations., ,.i
R ' I have rendthis'litiranolimstruitsliss rcga remems under Chapter li.9S of the
Califomi
iu Health Safety Code,Sections 25505,25533 and 25534.1 understand thin
occuptOche anf qu;not currently have e[nam Ih t it is my responsibility to notify the
pendo(g the req whements which must be met prior m issuance of.certificate of
'.ey. Signature-of Applicant_ Date
""y'. to neroraumarlae-ag nt Iool All roof coverings to be Class"B"or better
._......,OFFICE . .,..._._. , ._.. _... _. ,. _:_ ..._..-.' . '._......_.._.._.. .. -