00060064OFFICE
CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING A y h.3.
PERININI 00060064
a
(yWNER'S
a
APPI,ICN'1 ' I—
PxrJNC:
SANITARY NO. CON'IROILNO.
3
ARCHITEC AINGINEIEW
BUR DING PIiRMI'I' INFO
.DO ELIiCr PLUMB CH
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Ni
LICH SED CON'I'RAC'IOR'S DIiCLAItAT1ON
.lob Description
I hereby offirmthm l ata licensed under P., Won, of Chapter 9(commensal
REMODEL
Cce
no See, 7000) of Division 3,d the Bueincxn a!II'ml'csinn. Code. tmd my license
in full fo vd a fe
a
Lian.— Lica
l cont
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ARCH1TIiCf" CS 4RAION
I Dad nil my plans ,shall b scd a, Iia ne I
Q777777
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1, '.nail „ — - - _
OWNER-11 t I .'L RATION
hereby affirm that I am ese t from the Contractor's Licenv I�w for the
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following rens..n. (Sccllon 70315, Buninels:md Profession, Code! Any oily or ettmnly
O
which require, a permit m com,mmt. cher, imPmse. Jemalisb, or repair any shewrc
5=
prier w its issuance, ala, refire, the applicant lar such permino file a signed statement
mmhei,Bcen.edpursuant mthe provisions ofthe Contractors License l,aw(Chapter 9
Sq. Ft. Floor Area
ViO&II800
(commencing with Section 7000) of Division 3 of the Business and Professions Code)
or mal he Is evempt 111 1, and she basis fol Is, illcgcd excnlptiun. Any vi0ation
of Section 7031.5 by any applicant lira Nn,dl%objects the applicant o a civil Penalty
A I
EMN1 081.. 00
Occupancy Type
P Y Yp
of nal mare than me han doom" Wffl).
❑ I, a, Inner of me rropeny. or my employees with wages as their sole compensation.
101 — FOUNDjt INIlMspections
will do the work, vad the mnlam, is nal intended lar oll'ercd h,r sale Sec. 7044.
License law due• to
Bushmss and Profession, Ctak: lase contractor.. not apply an
o. r of Pmpvny Who builds of Improve, theram, and who does such nod himself
through
,
102 — PIERS
his own employee., provided that such improvelnems are not intended or
hucveq the holding lar trip mscatter, i, sold within one year of
offered for ,ale. ILw
103 — UFER
completion, the nwner-huimer will have the harden of proving that he did not haild Ir
improve forpmtr„seof.ale).
104 — REBAR
01 of pr, pen, mea l.nei, contractingwilhl d commation,"'
105 — ANCHOR BOLTS j
nl tit project (5 7OYt B n ss P f m CIJ ) ThContractor's
d n lapply � of prowo, a hada ir' I here.
Lice 1 -
1.06 — SEWER & WATER Q
and h contracts r projects 1 cl: withcontractual 1 - ti pursuant to the
Cut I c' : Law,
202 — UNDERFLOOR PLUMBING O
01 am esempt under Sec. . B & P C for this n vson
203 — UNDERFLOOR MECHANICAL
Own, lyase
WORKERS COMPENSATION DECLARATION
204 — UNDERFLOOR FRAME
I hereby of fou under penalty of peritay or of the following dcdmmmus..
205 — UNDERFLOOR INSULATION
)0 1 have and will mammin a Certificate nI Consent to alt-insure Ina worker,
301. — ROUGH PLUMBING
ontpen,adon, as provided far by Section 37011 of the Lmor Cods. fur the
edom.ameolde„orkrorwnichmi,perni,isi,,tcd.
302 — TUB R OR SHOWER
❑ 1 have laid will mslintain Wldcrs colllrcostal I ism; r, as r<pohed by section
303 — ROUGH MECHANICAL
37011 of the Labs Code, for the perfonhunce or the work for which this permit is
acd.MywolkersCom.�j�ornt,,atio\mm.m:mcecaniera Pulicynom rare:
304 — ROUGH ELECTRICAL
nim:/Polley No: `♦r(71 �9—
305 — FRAME
CHR'I'II9CA'1'1(1N Olt EXI:MP'1'ION PROM woRKF.RS'
306 — HOLDOWNS
COMPCNSA'1'ION INSURANC12
fnd'mananneedranbeeompmled it theusnoofsterorae hamra dollars
307 — INSULATION
(.alone"s')
308 — SHEETROCK
1 rem y that in the performance of the work for which this Permit is issued. 1
309 — EXTERIOR LATH
,lulu ran employ any perms in any manm+so vs to her or macot to me Workend
Corn,wo,atlnn Law,of Cahfomm. We
A,l
310 — INTERIOR LATH
311 — SCRATCH COAT '
N(Mcaa1'0APPucnN'1. If. after making this cenalcaleofUsclmrtion,Yin, dotdd
Z
hecnmfalsesubject toe W kers Compemavam provisionsofthe Lubar ust Code. you mO
lomwilh em 1ply wI'll such paw ,nms or dei, permm,nal hedevoted revoked.
313 — ROOF NAIL
CONS ereis.cONLENUNG AG1iNCY
501 — FINAL ELECTRICAL ENERGY
Y
Irk for wlich that there is a umsm(See.097]coding agency forme Prlinmance
of the work for which this
—
502 FINAL PLUMBING ENERGY
ip
Lendcr', AJAddressdersAmne
Isn
503 — FINAL MECHANICAL ENERGY
Dz
*) 0
1 entry but Ihas. read thisaPplir.lum ad same hot he abuse infomsmionis
— FINAL UILDING ENERGY
i ;:
D U
el rrecl. 1 agree to comply with all city and county nrdimoces and state law, relating
n�huildingconpwcaon, and hereby aulhod,.creproammivesofIIt Inylnmar, .,mm
505 FINAL LECTRICAL
W
the vhove-mentioned property far inspection pmP w,.
o,sea.limen.... Is, 11kmphamlle,sthe City orCaleniaoalmost
506 GAS T ST
lT
Z
It. " es, judge .es, cost, and ev wI In may in any way accrue almost sail
sly"Icousesp feel r usegrom Olin Pmat.
PLY WITH ALL N( N8O T
507 I PLUMBING
APPLIC NDIiRSTAN AND ILP C
SOUR( '.GU TION. Q (aft
Issu'd by: — L Dffi
-
_
Re-foo s — FINAL GRADE
Si eof•PPlican 1 — - — Doc
xALARDOUS MATERIALS DISCLOSURE
wdltheapplicanlorfmouroiming rcvmpm mom... lunate hmanla,ls nwlarml
Type of Roo 10 — FINAL PLANNING
as defined by he Cu, mo Municipal code, Chapter 9.12, mal the Health sad Safety
514 — FINAL PUBLIC I C WORKS
Care, Section 25532(1)'
E) Yes 0N
All roofs all be inspected prior to any roofing material being installed.
Will the applicant lar future buildingtweupanl lice cyimpmenl or devli w hich
If a roof s installed without first obtaining an inspection, 1 agree to remove
emit cliardou.s air containments as defined by the Itny Arca Air Quality Management
Districn
al new' na[erials for inspection. Applicant understands and will comply with
OYes 0N
all non-point source regulations.
L read the locations crucial, requirements wader Chapter 4.95 of the
.:d' ran xe. lh&SBI ty Cade, S«tin,25505.25533 and 25534. 1 understand that
e huildin doesno cunenllyhv, etc anti that'd is my rc,ponsibldy In amiloy the
ccup c rcyuiremcnn w ' h mu M ran prior m issuance of Cmifi lac of
Oo Pa s
Signature of Applicant Date
q
—h,
All roof coverings to be Class "B" or better
OFFICE