02020039 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR MORMATIO
BUILDING ADDRESS: PERMIT NO,
02020039
OWNER'S NAME: APPLICATION SUB DATE
LEE & JANET COWAN 02/11/2002
PHONE: SANITARY N0, CONTROL NO.
O Q ARCHITECT/ENGINl BUILDING PERMIT INFO
w F BLDG ELECT PLUMB MECH
u L baI r—U C_1 U a
S y i LICENSED CONTRACTOR'S DECLARATION Job Description
Z_L• Iherbyoffirm0)of that 1amlicensedunder provisions of Chapter 9(commencing P
maul withScctiorcemidefect. on3oftheBusinessendProfessionsCadc,andmylianse 8 ' HIGH FENCE. FINALE®
[Y u in full force unJ effect.
00 i Liccnsc Closs Lic.p
Date Gantmrtar FEB
3"Yi+ ARCHITECT'S DECLARATION Q Q
O S I onaersmna my plans shall be used as public records /� O ZDOZ
T
i a p O Licensed Professional
Oat I AM
DECLARATION BUILDING
u� 1 hereby.(Brn that 1 am exempt from the Contractor's License Law for the
C?< following reason, armil to
]031.5,construct,aluc impr and Professions Cade:Any city or county
s€o „mien mgmrea n e,Man to luimstaper.improve.h corm
ors t or repair any structure $1300
3 ..prior m s licensed issuance.ossam to the the applicant for such parrot's fiu s signed Chapt eno _.
WtheiscngwpSetionto the provisions of be Ce Business
Law(Chapter9 'Sq. FG Floor Area, -
(mmmcncingwith therefrom
ad
thebasis
oohheBmincsaamp...Any
Code) " •' "�: ;t '� Va1llaIlOn
or Sero he is 31.5 b tAny Applicant
p m'and the basis for the alleged exemption.Any violation '" ` t753002-1 .'0W'-
of '
- o.,. 1the.5 v anydreddvvtfor apermit mbjects drc applicantmecivilprnalry-
rrnatmarethanfiveWmreeamlarsfssoB). APN Number Occupancy Type
1,as owner of then,urm employees with wages as their sole Coro nsation. 101 — FOUNDATION
Prate Y YcmP Y 8 a
will ne the work,and the strun is not intended aed oro feredLaw for sale(Seeapply to An —
PIER-
,will
and Professions builds
Code: int Contractor Liceme Law saes net apply m an Required Inspections
owner ofhthisoyWho builesorimprovesthereon,and whodoessuch wmknded u 103 - UFER
or Aso,(for
his own employers.provided Sero such improvements are not imm�dW of 10 4 - REBAR
comple for sole.If,however,the Wilding avt or improsemont is that he
one reed of -'
completion,the
ose[PWlc.)lwill have the burden ofproving that he did not Wild or 105 - ANCHOR BOLTS
improve for purpose of sale.).
__ 106 — SEWER & WATER.
L'as owocr of the'pro
pend.am exclusively jonuzodng with licensed eonuanara to
Lsaver the Project lsen.Tan.Buamcaa and Professions Cede:)The camranmr'a 2 02 - UNDERFLOOR PLUMBINGsa La v does hat apply to an owner of VropenY who builds or Improves Nation' 203 - UNDERFLOOR MECHANICAL_ _
and who contracts for such projects with s Conan o(s)licensed pursuant to the
[a xesU«nae Sec 204 - UNDERFLOOR FRAME
la xe pt and«sea. ,,aate� BkPeforthiareason 205 - UNDERFLOOR INSULATION
Own r m W R SCOhTPENSA�10f�DECL RATION 301 - ROUGH PLUMBING
I hereby affirm under pimahy of perjury one of the following declarations: 302 - TUB & OR SHOWER
303 - ROUGH MECHANICAL
t ❑ 1 have and will An
a Cenificate of Consent to self-insum for Worker's
compensation. as pro vieee for by Section 37W of the Labor Code, for the 304 — ROUGH ELECTRICAL
performance of Sec work for which this permit is iamee.
305 — FRAME
❑1have and-w ill mainuin W6rkvi C6mpenlaiion Insurance.as required by Section 306 — HOEDOWNS
3100 of the bo
Lar Cade,for be peAa arrom,of Our work for which this permit is
: [ issued.My Worker'i Campensnion Ins unnre carrierand Policy number are:
307 — INSULATION
ComerP LcyN .. ...•. - .- .
CtERTIRCATIOWOFE%EMPTIONFROMWORKERS r �; e3OS''r—::SHEETRQCK' t .
COMPENSAT10NINSURANCE - :. ,_ 3,0.9 $XTERI;OR_LATH,,,,,:, - _ -_.• _ _ _ __ _
' 'flLssemion'n'ced not becompicied iftbepermit isforonehundreaaonars 310 ' - -INT'ERIOR LATH l ,
st . `•"' 311 - SCRATCH COAT
c'i ify)hat in the pcif.ma.ma 6f the work mit
for which his pers isauea,-I.a . 313 — ROOF NAIL_
.. .
.fall not employ any Proton subject n In any manner so as to become to tWorkers'he Work
ComppnamimLawarcaufori..Date 501 — FINAL ELECTRICAL ENERGY
_.Applicant'.' -
'NOTICETOAPPLICANT.If.After m.kingthis Certifirma of Exempua..you should - 502 = FINAL 'PLUMBING ENERGY-
Z become subject to the Worker's Compensation provisions of the Labor Cade,you must 503 — FINAL MECHANICAL ENERGY
O fonhwith comply with such provisions or this permit shill be deemed revoked.
'2
- 504 - FINAL" BUILDING ENERG9 -
"'-CONSTRUCTION LENDING AGENCY •
�'+� .•" lheieby affnm that there,isamnoructlnn lending agency for the performance 505 — FINAL ELECTRICAL + _.
W... of the work for which this palisissued fsee3a97.Cm.C.) -- 506 - GAS � -
QLender'a Name'. .. ... .. ........ _, :.. _ _ TEST • .. .....- ... .._� ...
Adt-zdress
U, sa..aveeseppcmonanstainatcaovevomuon 507 FINAL PLUMBING
.0
is 508 — FINAL MECHANICAL
0,&4 eoisercL I agree to comply with ill city and county ordinances and state laws relating
OTU to Wilding const%tion:and hereby.umorire,representative:of this city to enter upon 509 — FINAL GRADE
Y-� the abovee)aiianedproperty(oriy Andbnf,harmless .. 510 - FINAL PLANNING
pa' es,j grtem.c.,m demtdf A,c.brief,phamayin the way
against
�." rn liabilities,judgments,costs ana expcntts wNch may in any way eccmc egainry said 514f.,— INA WORKS
Utl� City in consequence of the¢taming of this pesmiL'
SP ICE UULATISNAND ' LLCOMPLVWRHALLNON�P INT" Issued by: Dat
P,:;�0
'Sign am p ican✓Conuactor '• Re-roofs
1.• ,' H RDOUS MATERIALS DISCLOSURE „
. . wn'the,Ppuc,nt err fumm W;Mmg aecapim sty err huW1a he:ydoi-noract ... Type of.Roof ... . .-. ... ... . .. „_-
ssdef ed by N Npeq M pal Cod Chapter 9 13 and the Health and Safety
Cede,S❑. 2553Ne1' rd.,ill't.� i .t . r y 5 ry R .'C• i •'t I I t.
All roofs shall be mspected.prior to any roof ng material being installed,
iW ll the ppli m f t W ldmg pant use equipment o devices which If a roof is installed without first obtainingan inspection,I agree to'remove
heraNeus u comm ams as defined by the Bay Area Ai Quality M agement P g
Y
Muriel' '/ all new materials for inspection. Applicant understands and will comply with
V( ora. N No all r on-point'sotirce regulations. '
1 have mad the WrnN s mamdils rtgmrcmcnts under CM1apter 6.95 of the
ethfdmia 11 611h k Safety Code.Secdom 35505.25533 and 25534.1 understand Nat
if Ne Wilding docs not curcntly have a tenant,that it is my responsibility to notify the -
'�ec�Ppgqn the req,o be met prior to issuance of a Cent&am of '
is Occuya aY. '.i. . .. :., . ..
.,. I f P Date
-
Signature o A plicant
f^'-r. caner- arirea-.gent,... -'•-' . Da . All roof coverings to be Class"B"orbetter
A CITY OF CUPERTINO a Z o 2
cuPE�rtrvo PERMIT APPLICATION FORM
? AP N# 2, Date:
Building;Addiess:..
t -Ave. c t o e t+(,..
Owner's Name: hl ho #:
L_ee ak4 o s) as7-qo S
Contractor: License#:
Contact: Phone#:
Applicant/Contractor:
Building Permit Info:
Bldg Elect Plumb Mech
Job Description: I
Residential: Commercial:
Sq.Ft. Floor Area: $/Sq.Ft.:
Architect/Engineer: Valuation: I CrD/
• Type of Construction: Occupancy Gro p:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bld Permits . foot BUILDING
BBOILERl Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler>I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX, Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= IOOOA ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA I Investigation fee BUILDING
BMITIGATC I Comm. Housing Mit. Fee BUILDING
1 of 3 73s�
977
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Permission from Neighbors for 8' Fence
•
I hereby give my permission for Lee and Janet Cowan, living at 18860 Newsom
Ave. , Cupertino, CA, to build an 8' fence across the back of their lot, along
Bollinger Road. One end of their fence will join with our back fence along
Bollinger Road.
i
Signed: P G
O_
Prin ame and Address: ��1 L400p —7bf.
Ot,z-e.VVI !R-as h C-4
C� e-v k Y1 D , e A g 5 a 14
Date: (JZ 16$ 6Z
i , e
•
4ClO C'JO1JV
Feb-11-02 01 _55P AIM MAILCENYER #9 408 2538194 P.01
Permission from Neighbors for 8' Fence •
Y hereby give my permission for Lee and Janet Cowan, living
at 18860 Newsom Ave., Cupertino, CA, to build an 8' fence
across the back of their lot, along Bollinger Road. One end of
their fence will join with.our side fence along Bollinger Road.
P
0
Signed:-----------
Print
igned:--___--_—_Print Name and Address:
to
C, c er+-i1..c ! CA q�-C,tLf
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'REALTY AOVISORS
M A&mn.M Lie,company
Faaic's C.Smailry, 939 iaurti$crtc[;S[c.B
Cn?�S,;¢re e SIA Car!csi G 9407^.916
(650)596:1840`
h.x(650}596-1845
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