01050016 CITY OF CUPERTINO , '
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDINGADD10.280 PHAR LAP DR HIGHLAND CONSTRUCT &JITWID PLUM01050016
OWNER'SNAxuGERARD RUTTER 20073 NORTHCREST S APPLIcnnONSM{Y@1/201211
ruo E: 4062411858 SANITARY NO CONTROL NO.
BUILDING PERMIT 150b
O O AltClll'I'IiC'1'IENGINEER. BLDG ELECT PL MR MECH
a
Z y 5 LICENSED CONTRACTOR'S DECLARATION lob Description
O Z 4 G 1 hereby nRrm that I am licensed under pnwisions of Chapter 9(commencing
P y h w with Section 7")of Division 3 of the Business and Professioms Code,and my license
ec < ismmurnreean�j�f t. KITCHEN REMODEL.
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w U Imanx sass Q y /G Lm.« x
Date Contractor C NEW SERVICE Efi9i� PANEL.u r<n ARCHITECT'S DECLA A 10
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[understand my plans shall be useA us public records
p0
Licensed P1. I
ca OWNER BUIL Ill R DECLARATION
ARATION
="m I he by affirin that 1 am exempt ficia the Combatant's Licatica Law for the n
tall w g be n section 7031.5, d d Prialfics,ion,L d A Yity'a-Isi 1ty. 1 j
O which I reard to com,amet. ltar,improve,deal t Irl p ctem. 1 t,
a prior to its .s I bey :the applicant lot such U a 6 n Romet I
555
that he licensed puraa the provi,ons ortne LI a (CI tag T4,ft. Floo Are I Valuation
mm
(cucncing with Section 71VgH of Division 3 of Iuxines,an sam
or that he is exempt therefrom and the basis for th It, exemPn ny it
ofSation7011.5 byany,applicant for.petit subj bearouserousem ivil Ity p aSYb ®
of not nthan five hundred dollars(5500. A umber Occu
O L as owner of the pmpery,or my employees with as heir coon a
will do the work,and he structure is not intended Ic(Sec.704,
Business and Pmfevsions Code:The Contractor's Li was not apply to an 32639020Wired Inspections
owner of property Who holds or improves thereon,and who does such work himself
or through his own employees.provided that such improvements ore not intended or
ofleactl for sale.If,however,the building or improvement is sold within one year at -
ontplefion,the uwner.builder will have the burden of proving that he did am mdld or 1.01. — FOUNDATION _
improve for pur,seafsaleJ' 1.02 — PIERS
°I,as owner of the property,am exclusively contracting with licensed contractors u,
conmmcl the project(Sec.7044.Business and Professions Code)The Command's 103 — UFER
License Law dons not apply 10 an owner Lir property who budd.c or improves tnercan. 104 — REBAR
and who aommcts for such projms with a mmmmar s)licensed pursuant m the
El
emptuunse ser, 105 — ANCHOR BOLTS
°I oro exempt unser Sec. B&P C for this reason
Owner Date 106 — SEWER & WATER
WORKER'S COMPENSATION DECLARATION 202 — UNDERFLOOR PLUMBING
I hereby affirms ander Penalty of perjury one of the following declarations- 21213 _ UNDERFLOOR MECHANICAL
° 1 have and will maintain a Certificate or consent to self-insure for WmkerN 204 UNDERFLOOR FRAME
Compensation, as provided for by Section 3700 of the Labor Cade, ter the
Ivdlmm;meeof am work for which thispammt is issoe`t 205 — UNDERFLOOR INSULATION
°um,cmad will mmmm.WorkersConmansad...iImare,a,requiredbySalim1 301. — ROUGH PLUMBING
3700 of the Labor Code,far the ped rainerve ,I(he work for which this is,rmtit is
maxed.MyW..ka,Compensation lnruranee conic, a,]Policy number are: 302 — TUB R OR SHOWER
Carien Policy Na: ` 303 — ROUGH MECHANICAL
CERTIFICATIONOFLIXEMPlION FROM
WORKERS'
COMPCNSAt]ON INSURANCE 304 — ROUGH ELECTRICAL
(Imis scmion need not be complaned if the permit is for mm hundred dollars 305 — FRAME
)
($100Ies.) 306 — HOLDOWNS
I certify mat in the performance of the work for which this permit is issued.I
shelf not empwy nay p mon a say manrwrina ybi wylubject to the Worker 307 — INSULATION
Compcmmi califo Dom
308 — SI-IEETROCK
NmlcyT6nPVrTCANr"f�rtar�ttakng� if=c�rJl tdufexuu,pran.rauxhoam 309 — EXTERIOR LATH
Mxxmto subject In the Worker's Contpunsulimnpmviai txorme Lab rCmk,yountust 3
O fortnwiuteuu,plywith such pmvkmu(ithis crnitshall nedemnaarevoked, 31.0 _ INTERIOR LATH
r`3
IF"7"
CONSTRUCTION LENDING AGENCY 311. SCRATCH COAT
1 hereby nfftm That there is v ronmmdinn lending agency for the perfnnnunce
Qof the work for which this permit is issued(Sec.7097,Civ.C.) 313 — ROOF NAIL
UnitName
U C Lsmd` sAddess 501 — FINAL ELECTRICAL ENERGY
I cmtify that l have read this application and state mat the above infatuation is X02 — FINAL PLUMBING ENERGY
06 E.a correct.I agree to comply with all city and county orefinonces and state laws relining
O U to building consurtudion,and hereby unitarian reprasentativas ofthis city to toleration 503 — FINAL MECHANICAL ENERGY
�.
the ulawomcmlomed property for innpecsion purposes"t y (We)agree tosave.indemnify and keep hrniesathe City of0i,crin,against 504 — FINAL BUILDING ENERGY
Fn V] liabilities,judgments,conn and expenses which may in any way ara
cee against said
v z City inenn.eyuaneeofthe"comiugofthis"not. 505 — FINAL ELECTRICA4 0 6 GAS TEST LL
A11111.1 ANT INDI 'fS. y'
ANDS AND IL 'OMPLY WITH ALL NON-POINT
UL ONIssued b bate
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S ,' S—/O
ignaturr of App iamalCmremr Data Re-roofs 507 — FINAL PLUMBING
- HAZARDOUSMA'I'EIS I9 DISCLOSURE
Will the applicant or future building accupant store or handle hazardous material Type of Roof 508 — FINAL MECHANICAL
n defined by the Cupertino M f lCafe,Chapter 9.13,and the Health and Safety
Code,Section25532m)a 509 — FINAL GRAD
❑Yes All roofs shall iromter� Flo aR r material being installed.
Will the applicant orf woe bu*[Jing sncupant use equipmem ter devittswhich if:l TOOT IS Inst' with •p[yrI p t 1 a sp��.(jI([t�1��,�j�] agree to remove
emit hazardous air conmmina ahs Jeftnnl by the Bay Attu Air Quality Managelnenl P ,L �Lp��` yJLI❑Sall
Datrier. all new materials o ms ectl n. A 1 Tt ersS[tddlilUS ai d will comply with
°Yea all non-point source regulations.
I have read the hazardous materials require acres under Chapter 6,95 of the
Culida is H.111,&Safety Code,Sections 21505,25533 and 25534.1 understand but
it he hudding does nut currently hove n tenant,that it Ix my mcbmsihility m notify he
cmupmd nt the ropairi whit mint he met prior to issuance of a Certificate of
Ocmtry y
s F Signature of Applicant Date
wncroruamarimcl,t um= All roof coverings to be Class"B" or better
OFFICE