01020024CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS
7580 ORANGE_ BLOSSOM DR
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PERMIT NO.
01020024
OWNER'S NAME
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APPLICATION SL&L1.N :
0�ia6/2001
STEINER
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y PIIONF.:
'ARCHITECT/IiNGINI?EN:
SANITARY No. CU,vI'RUL NO.
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BUILDING PERMI'1'INFO
BLD IihliC'I' PLUMB M[C
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LICIIISED CONTRACTORS DECLARATION
Job Description
1 hereby alfinn that 1 am licensed under proviGons of Chapter 9 (commencing
Sim sats„n nnfu ')iu;aiensnnn=xu.nes�"dr e enw
w o run eta. CP
.sante em,. _ Lie. x
_ w..,�t_ cunmrlar - — —
t/p .uty+r iacl S: J_ t
KITCHEN/BATH REMODEL
I Indene, d my , nssh: , used us public, o
Licensed Pmles.ional
OK'NERt
m the. Commerce law fertile
1 hcrchy .flan aha 1 am .Bunn Lam ,he Commerce's
exian , from
Aw
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Co : Any city ur county
reason. Ulaorenuir.t ]NLS. c
altar, and
(�
or.
Jemnlish, or repairanyod swears,
se. demolish,
s n Feast re comwa,,pert Unloose.
which roquire, t,
which
bur...
prior, , 4 theppl , I me t, file -(, J a d men
its m
S Pt. Floor Arca
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Valu' ��'yn{p�
�� 4' tlaaa
coal t l Ib p 10 L ,' .... fl ker,C de)
WnanIhec' afd s f Code)
with e
(u. e'thS'e
In sah,cussed...encrus t. Any moln n,
ortbmio s rnr, me l
dor
nr applicantWr t subjects the arplic.nt m a civil Penalty
any dred d
APN Number
Occupancy Type
ll rs 500).
re mom than
of nut more m.,, r,<w„drcd .anus. asap.
v
36611060.00
r=^sr r s re ny
01. as owner or, h,rr„re r a,nr to mesa with wme,.ndmi,sol. cont lon,
Mired InspeCllOIS
will do the work. and the structure is not intended or offered tor stile aec. 7444,
11 u, , and Peol'c..i ro Cale: Ila, Cuntrucmr's License Law doe. n, t apply un ^
`a
p,upvly Who hadles •mrovea timmon, and Min don., wnm,'work hi,.,ell
' 10 1. —
FOUNDATION
urihrnngh his own cnnployac, pmvlded ,hat ,nh hnpa venvau, arc Boa intended in
for L however, building omprovement i, within one ar
1 a2 —
PIERS
olrerw ..ale. the or ,old year
icompletion the owner- `u ldr, will ha,e,he theNeo of pr..in, that he did nm holder
LIFER
mpronc p.'eveo-
103 —
01, as owner of the prere.y, am exclusively contracting with licensed committers to
104 —
REBAR
114
Linstruct the project (Sec. 7(, Holness and Profession, Code.)'I he Contractor's
License improves
105 —
ANCHOR BOLTS
Law dm docs not apply an owner or property who build, or IhOcon.
and who tomr vt, fe Such on,i<tl, with a toal"Oods) l„nwm pus ural n ro`
1 a6 —
SEWER fl WATER
C:o ram.', Li,voo, 1,.i,
D l on carter, ants, Sa,. . x k” C fur d0,. r,a,a,
202 —
UNDERFLOOR PLUMBING
Owner
203 —
UNDERFLOOR MECHANICAL
WORKER'S COMPENSATIONDECLARATION
204 —
UNDERFLOOR FRAME
Ihereby aninnunder Penalty uf'prrjuryone nthe following declarations :
205 —
UNDERFLOOR INSULATION
o I has and will t i,nain a C,nil,am ,I Corwin, ,, wiein,me car Warkar',
Cantron ain r, ^, Povoded fa, by Sud... r700 A 0,,e Labor Cod,. for It,
301 —
ROUGH PLUMBING
perli,rmne,. of ,b, work fns which In, Ixrn,it I, Iswod,
302 —
TUB & OR SHOWER
0 l have and w ill maintain Worker's compensation Insurance. as me. by Secn,
mIo of c„d<. rur�6, QQQeee Immwce wnrkjn f }
—
ROUGH MECHANICAL
iof pm<
, 11,11
ssu . hfy Wet iiSyynppry.9 hjyyumnc g ,- l ”'
�a(W((/"�
303
—
ROUGH ELECTRICAL
Carne 1"Ificy�So:1/—
304
CER'TBICATION OF RXEMPI'ION FROM WOkKl:kS'3a5
—
FRAME
COMPENSATION INSURANCE
306 —
HOLDOWNS
nhi,.wdionneed nor batumple,edit hepcn,d,isbur mmhundred dollars
307 —
INSULATION
I ce,lifr ma, in the 1 am n.ore of the work for which da, p=mto is i... ed. l
308 —
SHEET ROCK
shall not employ any person in any manner so a. a, become subject m the workers
la—urculrr.i.. nate
309 —
EXTERIOR LATH
cumpm,auboa
Appllc.m
310 —
INTERIOR LATH
NOI'ICII IAPPLICAN'r:h:after uAiagthi,a+blain.11 oc..raat.yon.emde
Mcome sunj,o lo the W ..ker's Cnmpenoilion pmvwmn. rel the iLabor Code, you roof
runhwithcu,nlaywith such pboi,idsur in, permitshall n,drrmedr..oked.
31.1 —
SCRATCH COAT
CONSTRUCTION LENDING AGENCY
313 —
ROOF NAIL
1 hereby affirm that ahem is a coul..n landingagency for the rerfomonce
501 —
FINAL ELECTRICAL ENERGY
dlisi...(See.3o97.Ci.,C.)
aPhewmkfor which this rro.d
Lenderr,Addrews
502 —
FINAL PLUMBING ENERGY
i,
503 —
FINAL MECHANICAL ENERGY
I,rab,ISM lharr read this ^ppRetmononislide that the above indonm,eu.
mted. I .gree In o n,l, win ad oily and vision, ominunrr, and Slate law, renting
Budding
504
FINAL B I LD I NG ENERGY
cm,urratiun.:md hereby nuthod.c representatives or this coy m concretion
the above mentioned rnrin,prtannrrP,<,.
—
FINAL LECTRICAL
M'e)aprccm .indemnifyandkeep hmmlesstne Coyof Curoninoagainst
.nils c ; idgmrnt ,sn and c,,enws which may in any way..crus, ag ' a .aid
City i me wane, the grant g el this Peron.
06
G S T T �s
AP N it TA' .NOWII.LCOMPLY Will] AL , V-
Stied by:
- BINGDate
�Ny
1 RI I I
e-roofs
"pna mo AI ,Ilet%:and, 'm,D m
.ARD USMNUIRIALSOISCLOSURE
Will th'a fu, chuildin,eecuyan, Marcor bundle memrdsm, nodal
Type of Roof 5 9 —
FINAL GRADE
apt c ,
r Ma mired Code. Chapter 9,12. and the fmaltn and safety
d by the Per n
.s deincn,
—
FINAL PLANNING
Col,. Salon 255 01”
D Yes 0N
710
All roofs shall be/i5*&ted
�rdlNAlutyPUffih€31Gath4(a%kFag installed.
,gartupa„tuwecyuilnnen„rdc.i.rnwhich
Will the it, ,ucadInInumbadsin
roll haeodo,u nlr coomminnntw as delinvl by the Bay Area Ah Moralby Mora
If a roof is instil �d without
first obtaining an inspection, I agree to remove
D"otm7
all new materia s for inspection.
Applicant understands and will comply with
' ❑yes 0N
all non-point Source regulations.
I have read the nmallous redeem, re,turcments under Chapter 6.95 of ,he
Coloh,mla cadh.CSafn,CNc,Scmiom 3550,5.25533 and 25534. l understand that
iI bebuil, ng, ner'y have a mom,aha, it isny msgmsiniloy,, notify the
,
vupan, I P r 'ch tno'. I .Boca prior to issuance of a C'of one ill
°cam"'to, `
Signature of Applicant
Dale
All roof
coverings to be Class "B" or better
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ad,
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