02070084 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
10225 ORANGE AVE. CHARVEZ CONSTRUCTION 02070084
OWNER'S NAME: APPLICATION SUB DATE
SEETARAM VEMULAPALLI 360 W 8TH ST 07/15/2002
PHONE: (408) 893-7693 SANITARY NO. CONTROL NO.
O O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
U BLDG ELECT PLUMB MECH
8 " LICENSED CONTRACTOR'S DECLARATION
ZO Z 4 1 hereby affirm that I ata licensed under provisions of Chapter 9(commencing Job Description
F_1-va an Section 7000)ofDivision 3 of the Business and Profissisions Code.and my license REVISION, NO NEW PERMIT ISSUED
rK�6 License Clam and eRcet Lie.x NAL 402020090)
a G a O Date Contras.,
u3.LLO G ARCHITECT'S DECLARATION
FS'— 1 understand my plans shall b,used as public rtcerds (/
aE O O Licensed Professional
E
o LL OWNER-BUILDER DECLARATION
u�=` 1 hereby affirm that 1 am exempt from the Contractor C s License Law for the �S�
C? following reason(Section 703 1.5.Business and Professions Code:Any city or county C
S o which requires a permit M UiMSconstruct.oilier,impose.for such
demolish,or rtpmr any swcwm,
e 3 m..prior b i¢issuance also re It;rhe applicant Me Con pcmdu(o icesfile a Law(Chapter
s hapten t.
War 1plSclir[nted pursut+ntt prpOivmof rhe M,4MiMs License Ww(Cneger9 1�� 1 5q y❑ ) I,p�C 1♦ ' 31UBIlOn
(commcnarigpuh Smnonlg )oftlivisionlofrhe aMsincss aQd Pmfpssiom Codel t.oLT'i,xAl'•] ) Ol:'d t' LI-IMATIOIN:
or that He 11 escmpi rheiefmm and the basis far the allhgdd Q4mptbh.Any violation ^
of Section 7031-.5 by any applicant for o permit subjects the applicant m a civil Penalty
lot not more Wan fee nandred dollars($500) umber P.c Vn <, Occupancy Type
❑I,as be,of me pmpert,or my employees with wages as Weir sole compensation. 1I
"-will do the'work:andWe'structure is not intended or offered'for sale(Sec.
1 hmo.x'is'and'Pr maa..n.Code:The Commcmr's License Law does nor apply m an 102 - PIERS Required Inspectionsly. _B mTi
Dvmar of pmpeny who milds or improves thereon,and who docs ouch work himself
or through
or mmugn his own employees.provided that such improvements an not intended or 103 - UFER
;oRcrcd foTsSle:If.hbwever._ncc building-or improvement is sold within use Year of
104 - REBAR Ysn
ampleeon,the owner-wader will have the careen or proving that he circ not wua on-
improve
improve for purpose of mle.3. 105 - ANCHOR BOLTS
cansaxawner of the property,ante usineselycammnssions ode:)The Contractor's
I06 - SEWER & WATER ... . ..
as ., OI V.'•b P'.e'' v'l*L
— _
can
the does
project(Sec, to a Business and Professions Cade:)The Coownorn,
-- License Law a«.nor apply lin an owner of proany who wild:or improves mereon, 2 02 - UNDERFLOOR PLUMBING ,
A -And who conwcu.for such projects wiW.a cummnods),Iimased pursuanr.m.me. ._.______..2 03—' UNDERFLOOR"
Com mase License Law.'„, „ _, m I;,,;'I, b
❑lam ase pa under see. ;'li'e�'re(Mr n+int rtam°^ 204 — UNDERFLOOR•'FRAME«:':
205 — UNDERFLOOR INSULATION
'WORKER'S COMPENSATION DECLARATION _ 301 — ROUGH PLUMBING
Ihereby Rm amb, aRy feelury,6ne of rhe following dmmdon` 302 — TUB & OR SHOWER
t• 0 1 he d will maimmaiman a c fie r f c t to mINname for worker'. 303 — ROUGH MECHANICAL
Compensation, m;provtdW for by Semmn-3700 of me Lather Castle, for the
_ peomaneennn2wnrkrorwmm�misamil,.luMea., . 304 - ROUGH ELECTRICAL
❑1 have'dndwill thaimairi R'orker s Compensaripn Insumnce,ws required by Section 305 - FRAME
3700 of the Labor Code,for the arfor cane of rheLwork'farwhich this pemiiu is 306
- HOEDOWNS
issued.My W .k C pc i Insurance "d Pot y tuber are_
.. ---307 ':=-3NSUTATION'---
a5fi;L't ERTIF,ICATION OF EXEMPTION FROM WORKERS' .S'
:'' !+• 3OS-,?— HE.'ETRO�CKj11
'COMPENSATION INSURANCE'I s -s
.._309 EXTERIOR-LATH—, _
BF-I .(This sen on deed not M completed if he armies far one hundred dollars
($100)gness,) _ „ 310 - INTERIOR LATH
F
Ir ni that in r the dr whichthist . issued,i -- '3'1-1 =—SCRATCH COAT ' . r -'---
'sh:lls t plry yp al Hymn as to becml subject he Workers' 313 - ROOF NAIli ' Il,r .t
Da'ten. .: „ ....
cy'pe n..... ... L 'c fl. _-501- = -.FINAL.-ELECTRICAL.-ENERGY-. ----.-._.-.
INOJICETOAPPLICANT:ILaBcrmakingthis Cenificamof Exemption,youshould 502 — FINAL PLUMBING ENERGY' r ""
bee me subject o the Wok Compensation provisions of the Labor Code,You must
O Q
forthwith comply with sucb poovi,ion,oris. .it hall k deemed ra,.kadr
_ ...____._503 ---Z i"? r .cra1CONSTRUCTIONLENDINCAGENCY - 504 FINAL BUILDING ENERGY p ""
> r 1 heresy Affirm that inert ix.codswgency for We pcdomdn& I 9
nmisamymn.Mearse 3097,c..e.f ,;; ;, 505 - FINAL ELECTRICAL
Un foh e
None'
5Z see Address 506 — GAS TEST
U O I terrify that I
cont dm city
and a state Wes and
to laws mining 507 — FINAL PLUMBING
'coved I comp tion. with II<ry O<county ordinances d ttyt . relating 508 — FINAL MECHANICAL
O_U to id.v gcon.vned pr Mad c�mhYa mo repos enWri o(rh city to enter upon
} y then eP amt P t Purposes
q 509 — FINAL GRADE
'r1 0: (We)agree io'sme.Indemnify and keep hamdes,M".Cnyuf Cupcnino against —
h liabilities,judgmnns,costs and expenses which May in anyway creme against said 510 FINAL L ING
" U.4 CitYilicnnsequcnceofrhegmpringnf OiJi m,iL` ... : 14 F: F A WORKS
_ "� APPLICANT,UNDERSTANDS A\D WILL COMPLY WITH'ALL°NONPOtY'1` S� Dater
d s6uRce REGULATIONS: ;i." Issued Dy:
Signmme nI Applic.o/Commcmr "' Cr . ' 'i Umc ,
W 11 nth IHALORDOrc M�Tg«IACs DISCL' hn1 haz RedOOfs
pp pa no,ones
l ."'Type.of.Roof
_
i dcrned by th C., M pal Cad Ch fa 9.12.a d theH.16 and Safety' +.. — —— - - —V - --- -� •�
. \. 6I IlTi
Care.,OY. r5533)Aist( fJN
'All
A Fr G ,{'i i{'- ':wFe•%w t
+ + e 1 I ,_All roofs-shall,be inspected prior to any roofing material.being installed
wu m- ppr t I r n m g n r g p a " <. n�m If a roof Is installed without firs[obtaining an-Inspection I agree to remove
emth d coli r dfndbyrh ByA Am.
Qal tyM ag nt,
ort r all new materials for inspection Applicant understands and will comply with
❑Yes,r :b oN - non-point somrice regulations ;: ; ,
1 h ve me'd'the hazadow narenak Teem¢menus under Chapter 695 of the
Calif.
inia Health&Safety Code:Sections 25505,8533 and 25534.1 Mastermind that'
if the Wildingdocs not currenrl have a tenant.that it is bilin to norif the
Y Y reuamea Y Y
oicopam of the rtquiremws which�tquu be'md prior m issmnce of a Certificate of
OccupancY•i:::. .
Signature of Applicant Date
All roof coverings to be Class "B" or better "
Ow a monzea agent -
Data
t -OFFICE