00080109 OF
CITYBILDING DIVISION PERMIT CONTRACTOR INFORMATION: -
Buu.Dlrvr,ADORESS
HELLWIG MF_C14ANICAL PERMIT NQ@@B@1.@9
19@909 1 F'RUNERIDGE AV V�
OWNER'S NAME. APPLICATI S n TE
HEWLETT PACKARD CO 1309 LAUREt_WOOD RD � y1 �D,/2000
WILE: SANITARY NO. CONTROL NO.
(409) 727-5080
❑ceZ ARCIIITEC(ENGINEER: BUILDING PERMITINFO
UOw wBLDG ELECT PLUMB MEET
,ei,E gtnIUJ CI IJ I_I
FN, I.ICENSIiIJCON'TRACTOR'SDF.CLARAJION Job Description
p1 hvmby shunt that 1 am licensed under Froviv'iom of Chapter 9lcommenco,
f-w with Section 7Muof Division 3cfthe Businewand ProR„icn,Code.and my license
�x=� i,inmd0neaan T t. 434/0TENANT . IMPROVEMENT
is e< License c n Lic.a
°iOa Date /,� SDECLARX[ION bF_ �� �'w'1
d 3 a m ARC(II'I'I!CI"S DLCLAI�A,'I((Iry d •[A'r5'k
tEt NO 1 understand my Plans shall M u.wd as public record.
a`s Lican..111 1..,lonu JUL j 1' 2001
OWNL+N-BUILDER DECLARATION
w n, 1 hcmby affimt tha I a emm th
c ,t froe Cnntrmho',License Law for the
f(lowson.
ing reaSection 70315,
l urin—and Prufelliuns Coda:Any cilli re coumy
which requires a vernui tocupwract.allcr. p derrolikli.orrepairany snuclum B NG
n 3 Pr t o t 1 y the ppl' t f hI t fl signed disconcert
d:nist isr II t lo m 1 of Coturat L I (Chapter 9 Sq. Ft. Floor Area �elk��tf
(eontman ng woi Sect nn700(ool vo,k nt 3 aloe Ua, ikne,and Proe, n'lode)
,,,,bar he is exam,,thcmfmm and the basis for the alleged exemption.Any violation 23
of Section 7131.5 by any applicant for a Penin,suhjectu me upplieatn to a civil Penalty
of not tome Ib:m line hundred dollars(6500). APN Number Occupancy Type
❑1.a.nwneronnepro,ny.olintyent,mrce,wintwalaslharaolecnnpro,.tion. 31607043. @@
will do the work,and,he structure is no,intended or offered or sale(Sec.7614.
Bn.inev.and Po,ty nut,C A,:TT<Contract License Law ares not apply to an Required Inspections
mrol u,,enyWho build—,iropmac,themon,and who cine.such work himself 1.01. — FOUNDATION '
mrongh his own em,Inyec..pmvid,d,nal salt im,ruvcmenu am not imcndcd nt
offered fat%ale.If.however.die budding or bnprovement i,sold within one year of 102 — PIERS
i .. lelin r,the owncnhuiv,,will have the burden of,rovir,that he did not build or
umprove l e'upaseoaalcl 103 — UFER
C3 I.a,owner of the property,am eamn,mely counmr in,with hao,ed contractor,m 1 L14 — P%EBA R
Linosine,the pmjed(See.76W.Bmitar,and flint,ion,Cuol l'I he Comrnclor's
imroe law doe,not apply to an n vnertn pro,st ,he bind,of nnprnvn.stereos. 105 — ANCHOR. BOLTS
nd who conencs for such Projects with a conttachotO licensed pursuant to the
acmnrae,nr.ueen,e Law. 1.06 — SEWER 8. WATER
❑I am eacmpt under,%m. ,B&P C lit thl,mv.on
202 — UNDERFLOOR PLUMBING
owner WORKER'S COMPENSATIONDECLARn'r1ON 203 — UNDERFLOOR MECHANICAL
I such mnntt mtder,nalkyof pc,ory ode bt d,e rnllowi,tg deelari,iottw, 204 — UNDERFLOOR FRAME
❑ i have and will maintain a Cenifi me of Consent to.elt-insure for worker, 205 — I INDERFI_OOR I NSUI_AT ION
cmnpun,,:natt. a, ,rovi led fir by Scion 3700 of the Labar, Code, for he @ 1 — ROUGH PLUMBING
,erformmnee o1,he work lit which this permit is i.n,ued. J
❑Ihave ar:dw,If annainWul,c,,Conlpen.adottln,n..... ,."'I'imalbySection 302 — TUB & OR SHOWER
37141 of the I.aBt Cole,for the perforotance of the work for which this permit is
i,lied.My workcr,Com,ensaaolt Insurance carter and Policy number are 303 — ROUGH MECHANICAL
Catr;er:'�;111*66.10 Pulmylso,lG ( .__ _,3325--4- 304 — ROUGH ELECTRICAL
C17RI'IFICASI0NOr EXEMPTION MOM WORKERS' 305 — FRAME
COMPRNSA'ITON INSURANCE
('[fits meson need not he cont,leted if lie pt is forone hundred dollars 3@F.r — 1,1111—DOWNS
SIARorlc.l.) 307 — INSULATION
I eenify trial in the performance of the work for which this fiction i,issued,l 308 — SHEETROCK
.hall not roph y any lenses ill any,mmnc'w a,,a neco...e,mjc"to the worked
Campen,anon,sensor California.Date 309 — EXTERIOR LATH
Applicant
NUTICE TO APPLICAN 1:It,vl,er making td,Certificate(,IINempdon,you,honIf 310 I61TERTCIR I._ATI-I
Mcome subject to the worker..compenwtion,rovi%ino.,of ate Labor code.you must
p 00 tmb%th cmnply w0hsuch provisions or this permit shat]be d«mrd revoked. 311 — SCRATCH COAT
FVi CONS'I'RUCTION LENDING AGENCY 313 — ROOF NAI(_
a > I hereby oflen that mere is a construction lending agency for the pertommnce —
or'hcwurkfn,wIdehnd,r-'Ilti,i, IIS- 3097.Co.C) 501 FINAL ELECTRICAL ENERGY
d c Lrder%Natne � 5@2 — FINAL PLUMBING ENERGY
ZD O Iecitilythat Ihav'emad this appreaaonand state that the above inhtnttationi, -03 — FINAL MECHANICAL ENERGY.
far [•,t unreel.I agree nt comply with all city and county nodinances and%lute laws misting
O U ohad:Gngcon.Iraeliolaan.Ihembyaidtori,erepre,emadveanlthis enymenterulatn 5@4 — FINAL BUILDING ENERGY
ILcalnwomentinnN,m,eny to,inspection purryme,. —
F y (N'c)agree tosar.indc,nniryandkeephassle%sthe City ofCalven against 5@5 FINAL ELECTRICAL t�\V
lin Rani" s,nam..,t�t<and Lon""'u"""may i,t:poli wav accrue asam,l,aid ej@6 — GAS TEST
U7.' c' t enc[on ,ins nr mi- tail.
nrn.:nn'r t +TA' :nND .L coa+rl.Y wlTI+nLL/NON rohlrrr Issued by: — Date
SOU( 'R t��l G�OfP
ot• hie:—ttrac... Date e--roofs 508 — FINAL IYIE _
At oriut1USM,VERcupard smrehanE 509• — 'FINAL GRADE
Ad
Will me applicant ser mwre nademg«enram%,ore rehandle na,�mna,tnalanW Type of Roof
as defined by the Cupertino Municipal Code,Ch.pmr 9.12,and the Ileddi and Safety 510 — FINAL P1_ANN I NG
Ced,S.nlon 25532Ia1'I
0 Yr, 0N All root's sha11,4¢41specpJjlNj4LtoP01BorTj)g ltkiltlkilAbeing installed.
W.n16capplilalllorfaralebnudlnsoccupantuseetrv1irvnent:tdeviceswhich If a roof is installed without first obtaining an inspection, I agree to remove
emit ho atdou,air nuns ni o ns a.defined by,be 0,Arca A.,Quality Mmrtsenmm
Di%tdc,o ve, ❑rvo all new materials for inspection. Applicant understands and will comply with
all non-point source regulations.
I have lead the haaatnlnu,nmteri d myuiremems under Chapter 6.95 of the
on
Culiltiu Hadco k Sxf ety Cole,Seelinn,255115,25533 and 25534.1 understand that
ifine M1t' •daqch",4
ntemt tba it i,my,espm.inilip 4t nnlily the
t of t act Prior m iwa f a Cenilicmn of _
Oc u p nry.
���^ Signature of Applicant Date
o _ I All roof coverings to be Class`B" or better
OFFICE