00100184 CI'T'Y OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
HIJILDING AUURF.SS: I'IiRAtI'I'NU.
10079 OAKI 17AF P-11 U N►M"7/�o �-l� tf ta^� . 00100184
OWNIiR'S NAMI' APPLICATION SUR HATE
10/27/2000
PHONIi: SANITARY NO. COMROL NO.
❑z z ARCHI'rCCUENCWHEW BUILDING PERMIT INFO
NLDG FLEC'1' PLUMB MF,CH
baa
Z NL
LICENSED 111 CON'trocal ale, DEion,.1 IONh.pa Job Description
1 ben:by 0)of osi [.,it of the d unJer p add
Paln..of Chapter 9(comn,eicame
F"'^de with 11.111 ]tMIU) fDi iinn3nfthc Business unJ Pmfcoirn, c,vn ylicam_
in r,Iu h,neaml KTCHN REMODEL/SLIDING ' DOOR/WINDOW
a Limn..CI b. Lic.x O
i u Dale (0p'►_I_ Coln Our
—
t�i S u.H AkCll❑ECr'S 111 t -
�'u�g I unecomnl my Pinn,,hall he Bock;Is public mcmnl..
z Y Licensed Pmfn,ional
2
( IIU1LDIeR DFCI.ARATIl1N
Ih lyalt that
I am1tt ffic Car,, I L Law to,cayf-2
infusing nal IS i ]BILIS Ensure, dPn l'..- Coda:Any
'20 waeh y - pa n a I h p J h p ur onlmmy,
l.t core
a3°ctO Part,namdpursoup}cxthellitall nl hr.r.hpcmit hflc .'b,chuphcnt
- Ihalhaench,.glut.lion7000)the of i.,n,nn,lmfthelr.etnr., adPelftwlch,ptery Sy. FL Floor Area Valuation
(mvmmcnnng wall Sbalen 1.and
full
h,aion y of the R gee axa and PmfAny f Codq
,r thin he is a n,pt baleful.m ane Ihu t p...For the IJIageJ exemption.Any violation
of ma num]IIJ n by:hu Bred mu lm a pcl'Init>ubjcctn Ibc npplicunl to a civil 1'<'nuhY
ofma ttmm man hue hundred anuata(.sans APN Number Occupancy Type
❑I-oonta ,of Chep o,any.i,Iny employees w lth wugcse,lhci,nola,ompa...iim, - r
will do the work,and the structure is not intended or uttered fort sale(Sec.7044,
Basins..and profession,Crxla azmra,,,The Contrs Liccrm law does n ,apply In an Required Inspections
w of property Who builds or impvas does Ibecron,and who dsuch work himself
v ihmm
ugh his own attpinyee,....,waled than such on,moa
ab em
cu u nal ended n 101. — FOUNDATION
offered tor sale.If,how r.the building or improvement is sold within one year of
nmplc,ion.fleowner bprov
builder will hmadue burden mf ing,ht he did mm Wild ser 10^e - PIERShnpnme rte purryl..a alej.
rel.as rmmer of pmprit am exclusively contracting wilt licensed contractors,to 103 - UFER
Lrmmuct the project(sm.70114,business and Prnre,vion.Cadc:)*pw Contractor, 104 — P.EBA R
iters,Law Jne,run r,ly to nn owner of pmpany who builds m in:pmvas Iheteon. _
and who contracts for such projects wlu,a contracmas)hcenscd pursuant to the 105 — ANCHOR BOLTS
Contractors License law.
❑Iattl extuda under Sec. ,B&p C for this reason I06 — SEWER &. WATER
Ownor�lare 202 — UNDERFLOOR PLUMBING
wORKiR9co>�PENSATION Dr:CLARA9'ION 203 - UNDERFLOOR MECHANICAL
I hemhy alarm unJer pc:mlly olu perjury o u ul he Ibllnw'ing Jeclam,iona:
204 — UNDERFLOOR FRAME
❑ I have ane will I,,:,,d,d f Certo Name of Crnscm u,,c1--horre lune wooers
em,lpm„mind, n, pmn'wm foo by seam, 3701 nr me lynnr cr:de, Ii,r the 209 - UNDERFLOOP, INSULATION
perhmnanceorthewnlsfia hieh,hi,p.oiliai...ad, 301 — ROUGH PLUMBING
❑1 no and will maimam worker,Cmmpersation Insurance,a,required by Sectio, ^ TUH & O R SHOWER
of the Labor Code.rnr m pu,Io...Dar of doe work far which do,permit is 30G
asued.MYWinker,Comperadnn mammae eania,a ad Policy mamAer are: 303 — ROUGH MECHANICAL
Can rlelSlYil!�"t±�r±T.�Is,I,No.--b-7 —CMD 304 — ROUGH ELECTRICAL
URTHRATION OP EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 305 — FRAME
(Thisctfinn need mol rte ao,nplemd Jmepc,ni,is ha ore hr:nhml Jnnl,ra 306 — HOI_DOWhIS
(Mall or lass.]
I an'Iry n,:It in tha,I.bll,lmnr of dre wok lot which has mare is issued,1 307 - INSULATION
,hall all,employ any 1 rose in rnr Inammee,I,us Ire become object In the worker. 308 - SHEET ROCI!
cnmpen.anint law,nr cabh,mm.Dam
Applicant 309 — EXTERIOR LATH
NOI'ICI!TO APPLICAN'1: L altar making thh C'mifcam of INanptior,gnu should
become,ubjmt to the W'orkch Compensation provision,of the Labor Cola.you mus, 310 — INTERIOR LATH
Z 0 forth.kh comply w ill such provisions or this Penni,shall M deemed revoked.
Z 31. 1. - SCRATCH COAT
CUt SI lhare RUCTION LENDING AGENCY —
1 hereby uthmnhauhRe is contraction leading agency for the performance 313 ROOF NAIL
Q afthe work for which this permit is issued(Sec.3097.Civ.C
Leader —
aNn u, 501 FINAL ELECTRICAL ENERGY
z, z LcndcrsAddres 502 — FINAL PLUMBING ENERGYU O I canily that nave read this application and state that the above information i,
❑. F art,eat.Ia,raaIn air,plywill all ra,and ,mal,oadiaa asand,,are In.,miatmg 503 — FINAL MECHANICAL ENERGY'
C) U ,abaifdiagcnown,find.aadbarebyarminrerepro,emadve,.1his chymcrteruh,n 504 — FINAL BUILDING ENERGY _
w he:mna-manrnned pro,r,for inspection pugmw,.
p„ (We),Igicc In xam.'mecnddy;,nl kca,I'll r.mr„It,City of eupemm�agair,t —
(n Ila hilitics,judgments ansa.sad espcnw,which unity in any way aarue against said 505 FINAL ELECTRICAL
v z cPSOU&R
sequence r tni,p mit. 506 — GAS TEST
OU DBRSTA SA WILL COMPLY WIf Fl ,IL 10 �.N'NP1 Issued by: Date
e of Applicam/Cn err — Luse Re-root's 508 — FINAL_ MECHANICAL_
IIA%A )OUS MAI IIRIALS DISCLOSURE
win the applicant remainshundmg«cupaat somorhancle hm:wrua tmacdal 'Type of Roof 509 — FINAL GRADE
a.okhncd by the Cupertino Municipal C .Chapter 9.12,sad the Health and Safety
Code,Senora 2552(e)'I 10 — Fz NAL PI_Ahlh IhIG
0Yes ”" All roofs shalt" ))�ns ec�}��SSyy{{��((to a �,ro n s {�being installed.
sun me apphtamormarr naadiltg«mpam rw ayaipmam ordm;ee,winch If a roof is insle`tl w'nhbut'flF3trob�'aCdir}g �'np¢C[IoTf, 1 agree to remove
nil b:vnrdoua Dir cnntxndn;mn:ndatinal y the flay Area Air ouility Maneganem
i.miarI all new materials for inspection. Applicant understands and will comply with
°Tess all non-point source regulations.
I hava read IM bvmrdnus Inamrials relluircmcols anneal Cb:y,mr 6A5 of the
California Ilcallh d Suter,Crile.See,ioms 25505,5533 and 25534.1 mndecwurd that
if the building does not currently have a,enunt,that it i,my do,onsihility to nmify the
of the rcquir,ruen„wheel he Incl prone m.....race of a Ceml (me of
""p' av' Signature of Applicant Date
ulb • Igen 1 u a
— —fid y7 ! All roof coverings to be Class `•B•'or better
— r nr aorie I � '
OFFICE