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CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
PFRMI'INo,
10413 NOEL AV
SHOWCASE
KITCHENS
01030054
OWNER'S NAME:
APPLICAI ]ON SUB DAI'E
HANNA STEPHEN J AND CAS
IE 12333 SARATOGA—SUN
YVALE RD03/09/2001
IONp:'
SANITARY NO. CONTROL NO.
(408)253-0412
ARCH] I'ECE(ENGINEER:
BUILDING PERMl'1' INFO
RLDG ELECT PLUMB MECI4
I—I I—'i CI CI
LICENSE)CONTRACIOR'SDECLARATION
Job Description
I hereby affimt that I am licensed Indo provision of Chapter 9 kommencing
with Section 7010) or Div 'siren 7 of the Burros$, and Plofes: ons Gale, and my lies me
,,for
KITCHEN
REMODEL 't
I:icenc law hies M
Llum - f� a Colnmeor
An—hall ECDECLA Cx
FINALE D
toed rec.
I cunul 1ny plans $null be cd us pnhllc ord
nndo
MAY 3 1 2001
Liecncd ProfieWan d
OWNER-HUILDER DECLARATION
1 hereby apron that I a nipr from the Contractor's License Law for the
Bri and Piote nCole:Any cityn nnty
ff1,cviag. (Section 70315 �v
n
cotrv. offer, improve, demalixb, or repair any structure
which mqui Wta permit to md
,,for to its i oa... c. also m,idne, the ippliento hasten permit to f Edea sigma gacment
Sq. Ft. Floor Area
BUILDMion
lhal he is liscovd parxuant to the provisions ofthc Cnttmeor's Llccnsc Law(Chapmr9
(c'nn+mecein • with Secdun 711011 of Div..ioo dol the Bu,ines, and Preld,sinn, Cole)
exempt
$23500
or that he is fumfron, and the basis for the alleged ucmption. Any violation
of Selion 7011.5 by any appdicam for., pe.,it subject, the .,he., In o civil penalty
A PN Number
Occupancy Type
of not ,rune than live handrm dollar, $50(s
° 1. n owner of the popmry, or my employees will, wase, as ,Inco sole cunipmwtion,
32647063.00
Required Inspections
will do the work. ami the supreme, is on intended or offered for sale (Sec. 7044,
Business and Professions Code The Conimator's Licerve Law aces, not apply Io an
or pnsproy Who milds or Improve, then..., mid who does end, work nir,ch
10 i —
FOUNDATION
nrvthrough his nwn anployn's. Pn+vided that such mprovnncntx are nor intended or
offered for 1.1c. If. Ltmever, dte hill in impmvcmem is sada within one year of
6
1 02 —
PIERS
completion, the nwmr-builder will have the burden of proving that he did no, build or
onpn+,efor pamo,eorsalcA.
103 —
UFER
0 1. us ons nor of the propearry. not exclusively contracting with licensed contractors or
104 —
REBAR
the project (Sec. 70LI. Business and Profusions CdeJ The Ci
iinstruct
iiiemc Law does not apply loan owner or property who bund, or nnprovc, thereon.
- 105 —
ANCHOR BOLTS
and win contracts rot such prrNr% will, a vonbaemrf.) licerved pursuant to the
Contmeo License Law.
1.06 —
SEWER R WATER
° 1 am excerpt under Sec. . B & P C t this mason
202 —
UNDERFLOOR PLUMBING
WORKER'S COMPENSATION DECLARAI ION
203 —
UNDERFLOOR MECHANICAL
n,ecby nmmt under penally of pcuury one of the muowin, deslaraaon:
204 —
UNDERFLOOR FRAME
) I have and will maintain a Ceadk.le or Consent ,, sen-m,am I... workers
205 —
UNDERFLOOR I NSLII_AT I ON
Compensation. a, provided for by Section 1900 of the labor Cadefor the
perforin:maof the work lbrwldchthis pertnnis(sweL
301 —
ROUGH PLUMBING
° I have and will nminmin Wo der '% Cinpenmtion Insurance, as required by Section
302 —
TUS R. OR SHOWER
3700 of IM Labor Code. for the perfnrnwnce of the work fin wbkh this p[m,il is
sued. My moniker's Compensation Insurance carrier and roue numncr arc:
303 —
ROUGH MECHANICAL
c ie /� C0%� roEeyNa:y ] d0�
304 —
ROUGH ELECTRICAL_
CF.RTIFICATION OF EXEMPTION FROM WORKERS'
FRAME
COMP17 INSURANCE
305 —
e hand'dollar,
rndssection need not Eve colnpleted if dwpermit is for ans
306 —
HOLD014NS
IM(gum te""
307 —
INSULATION
1-carIify drat In the Pu.I n n,c of tha work for whit, tins orodt is issued, 1
308 —
SHEET ROCK
shalt not c,npiny any pros.... in acv nanne, ,o awn, E+ecolnc subject ,, me worker.:
"Date
CnmpemitionLaw, ofCalifornia.
Applicant
309 —
310 —
EXTERIOR LATH
INTERIOR LATH
NOTICE 10 APPLICANT ICatterinakins this CeracemcofINcmprion,riashould
mcnme subject to the worker's Cmnpcnaron provision W are Late" Code you muss
forthwith eomplynitssuch pnnismn or this pomdu shat] lc deemed invoked.
311 —
SCRATCH COAT
CONST RUCTION LENDING AGENCY
313 —
ROOF NAIL
ction, lending agencyr the pcdbnmoc,,
I hereby nnlnn.hat norm is a construction, fo
nnhew.rkforwhichdo,pem,nisissuedSite.3097.Cic.C.)501
—
.FINAL ELECTRICAL ENERGY
lender's Namc
Lemw;,Address
502 —
FINAL PLUMBING ENERGY
I verity that l havemadmis appl4mfon and ,tam that tic above irfloronion is
503 —
FINAL MECHANICAL ENERGY
tor¢cl. I agree In comply with all city and county ordinance, and aim laws relating
bn'ddingnn.00wliir,and hereby authorizerepro: tativesotthiscitytoenterupn
504 —
-
FINAL BUILDING ENERGY
tionel 11,1110y El1.111, lion pnrpo'o
the atone-men
(We)a,.is....c. mdmnndy and keep l,an,dess be city of Cupertino agama
505 —
FINAL ELECTRICAL
liabiliuin, judgnieno. cows and cxpcnxs which may in any way accme against said
City il, of in antis ret fitia>crn,ir
506 —
GAS TEST
ann,cguenm
PPLIC IT UNDER S D WILL COMPLY WITH ALL NUN PUIN'1'
Issued by:
Dille
5 U EGULATIO O90
7
Re -roofs 508 —
FINAL MECHANI CAL
sig n1 a Apphe, vcor me .. e
wzARI -filum MA'I'BRIn11, omor handle
will me arpbcanl or futam biodins,ccupanr coat air Handle na..ldou,,,mredal
of Roof 509
— FINAL GRADE
a, defined by the Cupeniou Municipal Code. Chapter 9.12, and the Health said Safety
Secaao 255320u)'
510 —
FINAL PLANNING
Code,
• °Yu^ El No
All roofs shall be d grcted
�rifhWerqilqttlLn0 ILnaWLi4 ng installed.
Will the applicant or future building occupant use equipment or dcvicc, which
If a roof is installed without first obtaining an Inspection, agree to remove
it hazardous air containments as defined Im the Ray Ares Air Quality Mansgc,nent
em lien'
all new materials for inspection. Applicant understands and will comply with
ore, El No
all non -point source regulations.
Ihave mad ,he hazardous material, requirement.. under Chapter 6.95 of the
Califon luIlealth&Sife.yCAv, Sections 25505, 25531 urea25ind 534, 1 r dersnthat
if he huilding does not currently have a tvmnt. that it is my responsibility in nosily the
occupant of the mg0tem which mus. Ire incl Prier to issuance of a Certificate of
span`',O
Aonn"
Signature of Applicant
Date
All roof coverings to be Class "B" or better
t reds nI Dale
OFFICE