01050019 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
RUIIJANGAUDI�S$:979 OAKDEI_L PL KITCHENS BY MEYER PLRMII No 1
01050019
OWNI7R'S NAMAPPLICm'ION SUR Dn'ni
'ROBERTSON ARTHUR D AND ANNE l_ 278 CASTRO ST 05/01 /2001
1
PHONE: (415) 96878318 SANITARY NO. CONTROL NO.
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Geri. ARCIIITECTIENGINEER: BURJANGPERMII'INTO
cu,,_ BLDG l-u EPI.1 MR ME 11 r L C
to<� hICIiNSED C(1N'IRACTOIPS DCCLARrcnON Job Description
Qti W I herchy rJlirm that an,Ilcen.ed undo nmvi.innv lir Clarcr v Ieonnncncing .
with Nation 7IXM)l,l Uivicinn lar the Buainasxad Prnfo,ione Codc.andnry limmm KITCHEN REMODEL.
axE ' i,aciscs imm�force. t. Z 0`1
o i O num / �_ _C_/ Convannr_tt{�[�1 ll� CSDblocetz—
h / AIdCHI'I'ECT'SDECLARAT11 N
t g O so
I undemm�J n,y plans shot.he uneJ as puNie rccoNx -
ci<" Licensed Professional
aaoO
ff OWNER-BUILDER DECLARATION
W=' 1 hcenco attic mal 1 am cxmnp.fmn,.he ft,,unewr'x r:A n.c Law roc the
I- T followingrays,..pernlnt J03L5,Business un:ll'r deconx Csxuc:Anyray nrewarre
S C which In, ,pari
p n panni.b,a the uhcr,improve,h proih t lir e.6 any.wcmre
i3= priorsuiscense prsuartquireethcupplicambn Ctaucamti Liceno Use swtemcm
malheisliin,,ipanuanuomcpfDivim,lthetheBrvmr',Llccnmlaw(ChCode) Sy. Ft. Floor Arca Valuation
or it I oncingwhy Section7000)load Di vision 3ortne Businessandion Art, Code) $48700
or dun he Is 31.5 h mcnGom and the ha co t..hc auaga, ,,,I,.ni to Any l,scad ty
lir sanion JB3156y an,applicantrmisrapennil,tmj«I,tee apl,lioa.t toauivB lxnalty APN Number Occupancy Type
ill sol mom than live hundred dollars ISSIMq. � P Y YP
01 f the property. rmp^y : .with g :theirp .c ti . 32639004. 00
411 d th A ;,oil ti t o i. . hicined.,ottared or sale(Ser.701
B.I II fr,s 'C 1 ' I'I Cot 't , I' 1 : . p,l,I .. Required Inspections
owner of prnpecry Who bu Id.lir hill thereon.and who docs such sulk ourself 101. — FONDAT I ON
or Inroagn his own onployces.provided that such impnwerwris are cut...rcndod or ,
offered for sale.If,however,the Wilding or nnprovemem i,sold within one year of 102 — PIERS
,n,plednn.the owner-builder will nave the burden or proving Ina.he did aot build of
i„Ipr,.nfnrp^:p,.eorxalc.>, 1.03 — UFER
❑La,owner ohne property.aot exclusively cm,lmcting with licensed conlmcmmm 104 — REBAR
crm cul,,the project sec.70,14,llu,ii oa and Profession,Code:)The Contractor s
Li«me Law does not apply to an owner of property who nuilmorimp.nee,(nemon. 105 — ANCHOR BOLTS
and who contracts for-ch projcns with a eonaaemr(,I licensed por.aant m m` ].06 — SEWER & WATERGmloulor,Licca,Law.
Gfcon ernnip.ttmhrSw. ,BFlPCill in,111oa 202 — UNDERFLOOR PLUMBING
°M1f1 Da" 203 — UNDERFLOOR MECHANICAL
WORKER'SCU lburATION UECLARAI'ION �-
I ncreny all!.....Ind•.varlalty or pminry one or ma fuu,wing deeun.lit 204. — UNDERFLOOR FRAME_
0 1 have and will Ictulaln a Cenisane of Consent m wit-inxare for w'orkerx 205 UNDERFLOOR. INSUt_ATION
Compensation, as provided for by Section 3704) of the Lal,or Code. for the 301 — ROUGH PLUMBING
performance of the work for which thi,permit is issued.
OB
lnaveamI,icoutrainW..",Compare.;.tior,b.,untmen,cipaurdbySerum.
302 — TUB R OR SHOWER
3710 or he Lahar Cod,for he pmmrmamn of the"Ilk in which this perms 1. 303 — ROUGH MECHANICAL
-wad.My Worker',Compensation Insurance carrier and Policy number arc:
Carrier:5cR WK PnlieyN:o: —ej9 304 — ROUGH ELECTRICAL
CIiRI'l chi, N t VEXIiMV11ONLROMWURKERS 305 — FRAME
COMPENSn'I1ON INSURANCE 306
306 — H01_DOIdNS
(This>cdinn lived not he cnmplewvl if the permit is future hundrtJ Jullam
Ial04uorNxv.) 307 — INSULATION
I candy that ill dta rvdtal nmec or the work lir which tuiv permit is teemed,l 308 — SHEET ROCK
,hull m,r erai any rc,,,,a in arty Ian.ne.so se na bacoma,.bjcc,to me W..sets -•09 — EXTERIOR LATH
Contpenxntlo.law.of Cellfer ion Dale J
Applicant
NO[ICE TO APPLICANT.IL after making suis Certlficateof Eamplinn.you mould 31.0 — INTERIOR ._ATH
,same subject to the worker,coolContpenxat ion pmv'aa,of dic taloa code you must
Q Ibnhwab ly will ouch provni.....Ir ills panni, be deemed revoked. s 11 — SCRATCH COAT
rZ.r r^ CONSTNUCI'ION LENDING AGENCY 31.3 — ROOF NAIL
aIhereby arrmtthat he.isaaonstawlic.leading ageacyfar that,par...ce 501 — FINAL ELECTRICAL ENERGY
of the work for which this prntit is issued(Sec.LWJ.Civ.Cf
y `p I<mlerasante 502 — FINAL PLUMBING ENERGY
Z Iwmdcr's AJdre„
U O 1cmifythat lhave read this application and slate dta the above allocation is 503 — FINAL MECHANICAL ENERGY
lastE= cnrtn.lagree mcomplywimallcityandcountyuNmancesmd,tweTansrtlaing 504 — FINAL BUILDING ENERGY
Q (�
to building construction, d hereby authorize representatives tativ f the city 1 enter ups.
m nd1uni,ellyf :pa. p 1 505 — FINAL ELECTRICRL
(We)agrehr save, nalectily act]scrip l ,m-C.y ofCoperino age»I
0
liabilities.paignients.toss and ecciallev whichY inany way accow ig.indsad 506 — GAS 'PEST
V Z Coy m coqucnce ar the gmnlrng of thr,pennm s s o l
APPLIC rUNDER.TANDSANUWILLCOMPLYWITHALLNON�M)INT Issued by: 507 — FINAL PLUMBING Date
S(JUN .REC)LAT i � it, — r
J
s�• .,ta�n„p.en eomr:tetm Dale Re-roofs
BnznauouS M,vERInls DlscL osuaE
Type of Roof 509 — FINAL GRADE
sen me nlmhaant w ru.un Wadding mcupNl,.me m na.dm na,ata,a,material
as darned ny me capenmon pal CWe.Chapmr9.12.anJ the Heuhh unA Safely 510 — FINAL F'LAIdNIfdG
Cndu.Section 255111^)?
❑vu, �"�� All cool's shall bfDSifiF¢ectecFpliNlb.a11yUdilfiTipmllLGhnEG6eing installed.
Will the applicant or fawn buildingoccupam use equipmcm ordevlaes which If a roof is installed without first obtaining an inspection, I agree to remove
C� emit h,7,Aoj ssir contamimmsas defined by the Bay Area Air Quality Manngemem
Di,tr;e.," t all new materials for inspection. Applicant understands and will comply with
_ ❑Ynx "° all non-point source regulations.
I have read the hxmcdous tortillas rcquircnmms tinder Chapter 6.95 of the
California Health M Safely Code.Section,25505.25533 and 25531 1 understand that ,
a the building doe,not currently have a tenant,that it is any resptttnibili.y a,notify the
overcall of the regalremem.s which must he ran prior a,iswanee of a Celli fica,of
°coil� Signature of Applicant Date
owner r -i— e- Date All roof coverings to be Class `B'• or better
OFFICE