00100021 CITY OF CUPERTINO
BUILDING DIVttiu1N PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT Nfl.
OWNER'S NAMIh1 0880 NORTHPOINT APPLICATION SU61SIe00021
ONII: SANITARY No, CON IHot.No,
HOMEOWNERS ASSOCIATION 10/03/2000
O ee 7- ARCH]I'EC IENCINEER: BUILDING PERMIT INFO
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S NIacENsnD r.ON'rl<ne'roRs DECLARATIONJob Description -
humby utrm,hat I ain liwowd m,der pwwisitmv of Chapwr 9(v,mmaneing .
f,yCy wim Section 9lNXB of uivisi cnllhc Busines an'd�lr'mli„ion,code.and my limnle
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cen,Cl
me,. -� J 196
(J/JUX—/C'LC
0 < I)mcnw ls,_ l.ic.a 1G
O n L' Dae • S DECLAf
a w neclH En s DecLARAr1oN POOL HOUSE REMODEL
til: ,de"mad my plo hull be used:- blies nwood,
E V\
ae aeC<p
Or hoAcnOIN
1 afrm that I nm exempt from the Contractor's
os 11 6 law for the
followingtea (Section 5 ❑ J Professions CN Code:Any mentally
which - Permit 1con construct. hr mi demolish. repair y.l este
o, n„tri d, e tt n , flue ,i r:I I ,(Cb,nr5s
S-
y. FL FloorArea
I ce.'I 4 ,PI I
Q/
Valuation
(sun t 6 'incest 90(Np IJ' 3 t que 11 JI Curio) '''j j� pp
or that he is exempt IM1erefm n and fisc bane flue o.f11,gW'exc nil on.Any mole 2
nn O (w J
of Section 7031.5 by any applicant for a Permit%objects the applicant In a civil penally APN Number 'OccupancyTy e
.1 ofmnrctarirvehundreddollars(SSW). Sot _e
❑1,us owner or the pmpeny,or my employees with wages a,teireole compensation,
will do the work,and the structure Is not intended ot offered our vale(,,w.W4
4,
Budueu,aml,mre„lon,Colic: rhe comt-aeto,11.11121111 Law chest mit ripply to an Required Inspections
ovvie,al proPerry who huJd,.r improve,thereon,and who doe,each work nimmlf
lir trough his awn employees.provided that such impmwmenu am net intended lir
offered for sale.IL howeve,the building o.improwmmin is sold within one year of
completion,the owner-huildcr rill have the burden of proving that he did not build or '
mprove for paga,wof,de.). 101 — FOUNDATION
❑I,.t,owner of thu axeo,twly emnmc,blg With nuet,ed Contractors to .1.02 — PIERS
i1,nsuuct the pmjmt(See 904.1.Business and porev,ionv cele)Ilse Contractor's 103 — LIFE R
icenw,Law chess not apply In on owner of property who Wild,or impove,thereon.
and who cndow,forlash project,w;t a c.mraaogs)hwfwd Pumaam t me 1.04 — P,EPAR
c.mracuR,Liwm,u Lw,
❑l am exempt under Sec. .B&1'C for reason 105 — ANCHOR BOLTS
owe, Dn'o106 — SE41ER R WATER
WORKI;ll'S COMPENSNI ION DIiCLARAIION
I hereby oBirm under penalty of perjury one of the following declaration., 202 — UNDERFLOOR PLUMBING
L
I base and will nrainain a Certificate of convent Io self-t,are for Worker*, 203 — UNDERFLOOR MECHANICAL
Compenabn, a, ,..sided to, by section nal of to L,qW, tide, for he 204 — UNDERFLOOR FRAME
ssu
perfannun¢c of the work for whish mix permit iv ied
❑Ihave suer will mainatal Wnrker,Corinaneft..I lo,manem a,requhed by Section
205 — UNDF_RFI_OOR INSULATION
nal of the LaMn Code.Iia the sedurmance of the work for which this pem,it i, 301 — ROUGH PLUMBING
issued.My W'orkcr',Compensation Insurance carica and Policy number arc:
302 — TIJP d OR SHOWER
Carice Policy No,
CERTIFICATION OF ExEMP`HON FROM woRK1;Rs303 — ROUGH MECHANICAL
CllhIPHNSAI'[ON INSURANCE
304 — ROUGH EI_ECTRICAI_
I'I'hi,neninn need nut he cnu„Iecd if the permit I,fortune hundred dollars
Isux».ne,,.l 305 — FRAME
I my that int nothromeWmnn Work to, hich this Permit I,iomed.1 306 — HOLDOWNS
shall not employ any Person in any mann . t become subject I to Workers' '07 — INSULATION
Con p t n l v t CII [.t%ar.0�4—nn—�— J
Nailcl til nl rates 3ufen ,I� t utE , ym should 308 — SHF_ETROCK
e,uble, orae raker',Co 1per,auon provi,iotI,of the labor Code.you must
o loon:imcmuld,whhsaelfnvi,mm,orti,pemit,hallWedeemedmwked. 309 — EXTERIOR LATH
F
CONSTRUCTION LERDINCAGENCY 310 — INTERIOR LATH
k I,,,vlr.m that'here i,a snafu(Sec.XI97,ns asener Tonne p.fin mance 311 — SCRATCH COAT
of the work ria whim that'hemh i,k,avii(Sure. lending
civ.e.)
p Lender,Nane 313 — ROOF NAIL
I.ende2,Addre„ ,
U 0 1«rifythat Ihave mad ei,application and%latethat meabove Informal i, � 501 — FINAL ELECTRICAL ENERGY
Iz E= ”met.Iagree tcomply With AIcity and county ommancesand slate In—miming y 502 — FINAL PLUMBING ENERGY
Q C.7 rabuilding t f ads b Ih t mi I, ft:city to t upnf tx
y i tend mn,rdyl p,l larler, 503 — FINAL MF_CHANICAL ENERGY
C4 (We)alotI love neivanonly andkeep I I.. the cry IC pa gfna
m IinWlle,.iadgnent,.t„t,and,,pvmr, d ,lbn,ynany any tell, ,,ai ,,rad `0 04 — FINAL BUILDING RGY
U7 City in conttquence.f to grvtning of tis .mil. �.p �y.�T f `
PPLICA ON ER '05 AND\'L COMPLY WITH ALL NON-POINT Issued by: C r.RY
SOU .F EGULATION. y' -
aure noma r Dau y a
.tgn ,\„ic' Re-root's 507 — FINAL PLUMBING
r HAZARDOUS MATERIALS DISCLOSURE
Will lite ttp,ph-al on mare fuddle,roeownuto.c i,nandm ro„.don,mal12dw Type of Roof
as dcfi sell by the Calverial Mo nicipal Core.Chapter 9,l2.and life Desalt and Safety 508 .FINAL_ MECHANICAL_
Code.section 2.5532m? / .
OYe, qy✓ All roofs shall be51AQecTdFrTV LanPRl9fi1Fg material being installed.
Wit the applicant or future building occupant use equipment or dc,ices which If a roof is installe5-OithoudTT.MRltaif3i hIfThiPffs�Lfetion, I agree to remove
omit hionolnus air cequounnam,it,lief red by to Bay Area All Quality M:magcome
nine? / all new nmterials`& 4nspecfiulfNP.�PIIDh11l PTI9stWORkq9 will comply with
0Ye, all non-point source regulations.
1 have rend the nmardow materials requirements under Chapter 6.95 of the
Califomm Health&Safmy Code Scent...25503.25513 and 25534.1 undt
emnd that
if the building due,no'c—cmly have a tenant•that it is my respnuitudity to notify the
"Zen rat the requir ens,which w met prior m issuance of a Certificate of
Ouclip"' Signature of Applicant Date
o m ouI 12nt Dale - All roof coverings to be Class `B"or better
OFFICE