01090016 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10270 N PORTAL AV ARGONAUT WINDOW & DOOR 01090016
OWNER'S NAME' APPLICATION SUB DATE,
AdIkii OLIVER JOHN L AND JOYCE L 10624 S DEANZA BLVD 09/05/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 996-9670
p Ow a ARCHITEC-DENGINEEW BUILDING PERh11T INFO
P O❑❑5 L v ELECT PLUh1B MECH
1.-7
ad
z LICENSED CONTRACTOR'SDECLARATION nen Job Descri lon
erehy affirm that 1 am Ikensed under pmrisions of Chapter rang
„_? wit ectron7t3W)urDivi,inn3nnnsBnsine,,ane rnre,.dunscna ,:y�e«,yheen,e INSTALL 7 NEW WINDOWS.
yK NII force and effect
:OCU -items Clm,_t i,ic,b _
rs r'r/illi/� SDECtr
ARCHI'TECT'S DELL TION
1 undctaand my plan>shill be used os putilic record, Q /
i z or O Liwnud Pmfeszional
K o LL OWNER-BUILDER DECLARATION
_ 1 hcrzby aRnthat I am exempt Britain,Contractor',License w for the O
f z< following reason.(Smion 9031.5.Nosiness and Rofcssions Code:Any city or county
46200
I En which requires a permit to constrict,alter,improve,demolish,or repair any structure
a3°° •prior, , alsoacquires,. the applicant forauch penniuo lilt aegned smmmem - - - -- — -- - -- --
th�t he s I . d puma t(O the p bn,ofthe Contractors L cense Law(Chapter 9 0 �Tssas p,�
(comm 'pg 1M1Sect 7000) fD"sion3oftheBromesaandstatissc.,Code) [7V"Yr.'l!®'f�� -.. . Valuation
or(hat be Is exempt fhcrcfm,v rind the basis for the alleged eiemp(ion.Any violation
of Section a him by unY rend doll fur a permit subjecrs the aPpl'man(m a civil penalty
ur nut more ma„fivennarea amlan,(s500)' 101p'PN 41C9L�7bATI0N `' � Occupancy Type
❑I.mowncrofine property,(army employees with wages as their sole compensation, -
wiB do The work,saidthestricture is not imicaded or offered for sole(Sec.7814,' 103 — UFER Required Inspections
B.I ,,and Profusions Cody.The comracom's License Law does not apply to an 9 P
owner of progeny won wilds o,improve,the,eon,and who dues such.,it himself 10 4 — REBAR
o luou h his own employees.provided that such Improvements are no,intended or ...
-nir«d o sale.If.however,the wilding or improvement is sold within on year of 105 — ANCHOR BOLTS
completion,the owner wilder will have the burden of proving that he did not build or
mprove for purpose of sale.). 106 — SEWER & WATER
202. --.-UNDERFLOOR PLUMBING .
01.as owner ai the Pmpcny,um exclooltialy contracting with licensed contractors to
Lnnornct the project(Sec.71114,Business and Profusions Code:)The Contractor, 2 03 — UNDERFLOOR MECHANICAL'
icense Law does or apply(o on owner of proptny who build,or Improve,Merton.
Rd ww.contracts mr.wa,pr6sns%ith.a cnntravions)licensed patto the .. 2 04 — —UNDERFLOOR FRAME
mmctor's License Law.
Olamexcmptpda,Sae. ' .B&PC fortlnaramam 205 — UNDERFLOOR' INSULATION
owns: 'o'af2' 301 — ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER
Inertbyaffirm unaerfamily ufprrjaryOne nrtnefollowing d<elatannn,: 303 — ROUGH MECHANICAL
(- 0 1 have and will n(aimnin'a tcnificme of Crimean to ,elf-imare for wn,kera 3 04 — ROUGH ELECTRICAL
Compcoonam,-as provided for by Section 37W of the Labor Code, for the
.. pt,fonname of he wmk for which us pent is issued. 3 05 — FRAME
01h as will mnintiain worker:Compensation himai nee,as ra.mrsd by section 3 06 — HOLDOWNS
37 f to Labor r -th pe r'rmance or me work mr which th s permit is 3 0 7 — INSULATION
d My r lis Co t c i dP hey number am „-• _ t
"tanesa terpnn n- 308 SHEETROCK.
Lamer CEMMCADONOFE EMPolicn[ONFROMWORKERS'; _ 3O`9' `-'}EXTERIOR LATH
COMPENSATION INSURANCE i. .._,. .-.. -310- -'INTERIOR- LATH-
(Thus in'00
ATH'(Thusaecddu need an(he'c'mod,dedifineIemmaisfor nits hundred dollars 311”— SCRATCH COAT
313 —'—ROOF 'NAIL,.... .
"t;.11
i nnymt' til.,pef f, ' kfbrwhich r 1 l . ':. ed•1 I,'
Coun,amenpbLw,yfC n nbcome,anla, d, workers 501 — FINAL ELECTRICAL ENERGY
cump�n.arn,Lawsurcarn,",ia.b.i " " _ 502 FINAL PLUMBING ENERGY
NOTICE TO APPLICANT ILancr making this Ccnifi,alc of Extraption,yousimuld 503 — FINAL MECHANICAL ENERGY
bctnme subject to me Warkeh Cm„pcnsstion piovi misdithe L,wr Criltyoumust
040 ronhwitKcomprowahsucnprovi.sion,in hi,permilshanbedeemedrzvMed. 50.4_ —. FINAL BUILDING. ENERGY
CONSTRUCTION LENDING AGENCY505 - FINAL ELECTRICAL
1 hereby-alum(that there isaconstiumion lending agency for fhe Katt ane<'
? Mthe work for which his permhisined(sda3o97.Civ.C.) 506 — GAS TEST
yq Cancer's Name'• _. . • •-•d..:•. -•.•.. ... .. .. 507 — FINAL PLUMBING,,.. -
--
U;O Lender's Address.. .. _
lcertify thmihavo read this applkation dna smtc dim the above informa(ion is 508 FINAL MECHANICAL
cancel.1 agree to comply,with all it,and county ordinances and%late laws rclming 509 — FINAL GRADE
Or, to building conswcdon:andbernbyimmorlacldprt.ssnmilvesollhi>city inciter train 510 — FINAL PLANNIN
the shove-mentioned pmpen)for inspection purposes.. _
F.y (We).item,ave.indem fyandkea Word ss'thcCity,dCuj,eninnagainst 514 — FINAL PUBLI ORKS
h liabilities,' groans,costs an pcnses wb¢h may in any way accrue against said /m O
O Z City in qucnce of the gr ting of this permiC. 7
APP( A. RS . 3s 'ILLCO>iPLYWITHALL'NONPOIPyy Issued by: Date
SG' E g DDISCLOSURE
OP/6/ y
_ fare of ApPrcanVContrdctbr Date Re-roofs
HAZARDOUS MATERIALS DISCLOS„REF d
w n m pprca r r t n la e res p �', .ma( .d. Type of Roof -
s a r d by the C pen M iP l Civic,Cn pt 9.12,n d t H lth and 5 f,y ”
Chile OY. 25532(x) 1pN ,i. .,9,1"( h (. 1 h , '�'.` . e t, . Pi,,. .7
Y ' , _ ; _..All.roofs.shall.be inspected prior to any.roofing material being installed. . __...
Will the applicamor future building Occupant use equipment O,device,which If a roof is insialled without first obtaining an inspection, I agree to remove
emit harsNous air conmminars as defined by the Bay Area Air Quality Management
Diatdtt+ ' all new materials for inspection_ Applicant understands and,will comply with
/ ❑nn1 . 1. , : -all non-point source regulations. ,
C)
.r
Phase read the haardou,materials requirtmems under Chapter 6.95 of me
lima Health&SftyC S<a( n2110515533 ad 255341 d rand that -
41d,lng.1casno,c yhm ,thin my,n po hltyt not fy meiu t M1 h tp t sf C rant of
Signature of ApplicantDate
iatbnnzcdageat Dats. All roof coverings to be Class "B" or better
OFFICE ._