01060002 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING DDRESS: PERMIT NO.
10837 NORTHRIDGE SQ BRAND KITCHENS & DESIGN 01060002
Dwl.HitLVFS tay DATE
Am RUIZ & CLARA TURNER 13715 APPLICATIONS
QUITO RD 06/01/2001
, (408) 871-8190
PHONE: SANITARY NO. CONTROL NO.
❑s Z ARCHITECT/ENGINCER:0 BUILDING PERMIT INTO
0
E 0- ULOG ELECT PLUMB MCCH
5th= LICENSED CONTRACTOR'S DECLARATION Job Descri tion
ooz°'o lnerebyaffirmtnmlamlicensed under provislousofChapter 9LL„mmen`ing KITCHEN & BATH REMODL�L
FyFu with Seniun]0001 or Divi:ion3 of,lie Ru+iness and Professions Cale.andm licenu
u, is in roB foal and t. C�0 rL & ADD LOFT.
eco U License Clua Li,
,
3 n y Ude Commw or _
F=O AR 'S DECLA rcc N
I un emu nd my plans shall be used as pubs oN.
L
y n O O Licensed Professional
o z OWNER-BUILDER exam
m the Contractor
u I beeasouchy alum an 1 aI.eB usin from the f somas Co e:Any ccense Law for the
F z C following reason(Section]031.5, t..10 ss and Professions Code:Any city or roomy
E x O which....irce permit re cor amctpplic improve demolish,or rtvair any swmere
i 3 priort t issuance,seism rcy the applicant Inc such pent,t to rile a vg edstatement - - -
that M1 s licensedpmsndmtom No,,,m.nf(he Coome,,or.License Law(curlew S FL Floor Area . Valuation
Icommemang with Section 7”)of Division 3 or the Business and Pmfassons Care) q'•
or that he is exempt therefrom and the basis for the alleged Exemption.Any violation11 n
of Section]031.5 by any applicant for a permit subjects the applicant m a 6-1penalty
of so,"nore man eve hundred dollars lssau. APN Number : tt' ,• Occupancy Type
O L as owner of the progeny,or my employees with waxes iss their sole compensation. 101 - FOUNDATION
will do he'wmrk:and the structure is not intended of Opened for.ale(Set.70,D11 1 O2 - PIERS Required Ins serious "
business and Professions Cade:The Contmcmr's License law does not apply to an CI p qy
owner of Pe
pa, ny Who bairns nr improve.therewonimprovementsnd who does such work himself 10 3 - UFER ._.�'E Y A �C
or through his own employees.provided that ch improvements are not intended or ,
_ .... _... Y V�A G _.._. __...
.pried for vise.If,horsever, he building or;mprovemntn is sold within one yru of .. . . 104 - REBAR
completion,the evoconuilder will have the Wolon of proving that he did not bund or
improve for propose or sided. 105 - ANCHOR BOLTS -
NOV._0.1 ..2001. ..
. 106 .._._SEWER &--WATER
-
❑Lnsownc oflM1e'Pmpmy.am ex_dusivclY cnmracting with licensed contractors to t "• ...
:. emromm,the project(Scc.70.41,Business and Proresslom Cade)The Contractor's 202 - UNDERFLOOR PLUMBING "
' License Law does not apply to an owner of property who builds or improves thereon,
_ '. _ anawhocontracts for such pomccswith a.cmumcmra).ecemedPnaont,rn.lhe - -UNDERFLOOR—MECHANIWg
UILDING_._.
c. punSoO lem mdo v. . .__.. _.._
`,B'&PC fordo,mason 204 - UNDERFLOOR' FRAME,�'�
_7. owMn Date 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING
'
I hereby affirm under Penalty of perjury one of the following deolmations: 302 - TUB & OR SHOWER
0 1 have and will maintain a'Cenidcnte or Consent to self-instem for,Workers 303 - ROUGH MECHANICAL
cmaysm-tion:a, provided f try SeefiW 3700 of IN labor Code, for the 304 - ROUGH ELECTRICAL
penforma nee O the wok for which this permit is issuer.
01 have and will maintain Worker'.i Compensation Insurance,as required by Section 305 - FRAME
371ro or the Labs Code,for the'perfdrroanca of the works
for worn this pemnit i, 306 - HOLDOWNS
issued.MyW kersC pc is lsvmnce ciirterenJ Polly bcr arc: _
. (J�.a�pJ�. . . . , 6 7� — 307 . - ; INSULATION-- - 1,
Cameri " ^ � PohcY No `3 p -
t;' CERTIFICATION OF EXEMPTION FROM WORKERS" 3 O B - SHEETROCK
COMPENSATIONINSURANCE -------'3O9 ; EXTERIOR- LATH _ --
-
'ITossectirmneNnmbecompletedinheperanisfornn<hundreddonara 310 L INTERIOR LATH
ISllpl I x.l
311- - SCRATGH,•COAT_ . , .. .. . . .-.
,v l l mai in tits .t any
fou of the work fox which tit.Per n t e issued'l ,
shall not employ any person in any manner ra,as m become--wbjerYto the N'orketi 313 - ROOF NAIL"' -
Compcnsvtion taws of California.Data
.Applicant
501 _ - FINAL._ELECTRICAL. ENERGY. ... .-_ ... _ ..
NOTICE;OAPPuowT:u;'armrmawdglhisEcraRcalrofE.s,rulau,yoy,hmdd, ' SO2 - FINAL PLUMBING ENERGY
become
.subject m the Worker's Compensation provisions of the Labor Coad,you must
O Forthwith comply with suchprovisinn,orthispermushall beM.emed.,.kid. 503 FINAL MECHANICAL ENERGY_,
CONSTRUCTION LENDING AGENCY 504 FINAL BUILDING .ENERGY' ' '
"I hereby self..that dere Is a conamclinn Iendlbg hgency for the Perfulmm�ce
~ nrth mkt wmcnmkpe tsismad(S 3097.Cm.C1 505 - FINAL ELECTRICAL'
C >
G Lend sN pp . . - - 506 -GAS TEST_ _. ... __ . . . ._
r'1 Z IsrW .AJd to "
I story mat l have read this application and,wle that me above information is
507 - FINAL PLUMB I NG I,
` ; correct.I agree m cmrol)with all city and county oN�nances and state laws relating 508 - FINAL MECHANICAL
U to Wilding con.amctimn.and hereby authorize representatives ofthi.s city to enter upon 509 - FINAL GRADE
.a. the atwve-nsmdoned proPeny for inspection purposes.
IWelagreetysirc,imtctnnlfyandkcepharmlesslbeCityinCupertinoagainst 510 - FINAL PLANNING
UW liabilitiesjudgments,casts and a�pcnscs which may in any way accroc against said
z City in nmsequemrc of the granting s INMIL. 514 - NA P C WORKS
_ APPLICANT UNDERSTANDS WILL COMPLY WITH ALL N N-POINT Issued b Date
SbURr .I W\TIONS. y'
VipsmarourNpitheartAC.anict :ne Re-roofs ,
_ NATAR US MATERIALS DISCLOSURE terr^^
WllmeappGcan rt aging l t a nnaameharardonsmatcrial Type of Roof
as d!r e 1 by the Copan n°Mun 'pal G,J Ch pt 9 I ,enJ he Hcahh end Sunny' '� ,� , ,
Cale.Seq,on 2553?IU.,.
ares•.' '; 13b All.roofs shall be inspected prior to.any.roofing,material.being installed _.
,,.„WBimeapprcanior imine building occupant use equipment ret devices which If a roof is in'Stalled without first obtaining an inspection, I agree to remove
emit Woundnus air eanlaminunts as defined by the Bay Area Ab Quality Manaseme nt
District? all new materials for inspection,.Applicant understands and will comply.with
Dye` ' a all non-point source regulations.
. I have real tHmhamNnus muterinls requlrcn,cnu ander Chotino, .9.9 nide
Californiallioi Safety CWCSecIOa,25505.25533 and255}t.l undersmnJrha
ifthe boildingdoes not curoully have a tenant:that it is my responsibility to notify Oc
occupant of rite regnircmems which be met prior to issuance of a Certificate of
r. Signature of Applicant. -_ . .. . Date
All roof coverings to be Class"B” or better
rec nr auJmnixcJ agent c ,
•c: E _ ' ':' r ... ..- �' ---, .. .. .. ., __ OFFICE .. ... - _