00070086 CITY OF CUPER'I'INO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS.
'IiRb1 I'N(
19111 PRUNERIDGE AV & f e14WATERPROOFING ASSOCI ES Z
00700B6
OWNEWS NAMH V APPLICATION StillDATE
HEWLETT—PACKARD 975 TERRA BF_LLA 07/14/2000
HONE_ SANITARY NO. CON'IROE.NO.
a (650)937-1299
:4 7O ARCHITECTIENGINEIR BUILDING PIiRMII'INFO
u_ BLDG ELECT PLUMB MECH
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1•J y= 1.10ENseDCO NTRACTOR'S DECLARNI ION Job Description
LO 1 hereby atlinn that[,am rice led under pm.i.iom m Caepter ,9(commencing
4�t with Scetimn 7lNxB of Oivisionio(me Business and Profeasn,ns Cade,and mYlicena
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°'x< isinfullforce aad a39 /0 6Z OVERLAY B. U. R. W
El6 License Cls __ Luc.N
O a u Dam
'S 3 u.y /3 —nl(cerrr
pcs Dl:cf.nR [ON
s-a O 1 undeotand my plans shall he used os public records
s a5
w p p Licensed Profcainnal
Oat I affBUILDER DECLARATION If
w w I masa,(Sect Inns I stn cuceinl rem the QInmactos's Liccmc Laws for lie
county
4 following uim,,a.(Section t 7om,mu)business and Toles moll Code.Any city m canny '
=1 0< which q -epctmurn o t e Inc nln demolish. retell,utry swcture
that
eissuance. su qmm thepions at[tic
ch rermit rI g statement
a Is,n h .alp suns thep _ nu I tl Central l cnsc l IChapmr9 Sq. Fl. Floor Area `x) l�Jjsst
fano e 'tl S•he om I IU' aie l IIM1 I3 :' cls Ip f..' fllmi i T Gr}H.1[I
or mw he is exempt Ime applicant
li and the basis Gtr the alleged pplica to Any l penalty
of Salinefi d is anyapplicant r,apermit,ubjecu the applicantmacivil penalty
or Bat mete man R,<humarea donaR(ssuur. APN Number Occupancy Type
❑I.us.ewncrofto ofwd,ormyemployµ,..,If ages osItself a.to comnea,tiun, 31607042. 00
will do the work,and the m'uclure,is not intruded tar ol'lcool Elf sale(Sec.7044.
Business and professions Cole:I'he Connector.Licence Luw does not apply to an Required Inspections
ocaner of property Who builds or improves thereon,and who dews such work himself 305 — FRAME
r through his own employees.provided that such improvements am not intended or
offered for If,however,the building m iurpmvemem is soldµ;min ore year of 307 — INSULATION
n. 1,11an,lime own,halldef will have the burden of pawing the he did not build Or
a,", orpurptaofsme.). 601 — ROOF TEAR OFF
01.a..comer ohne pmpeny, at e.elusivel, emoclid,,in licensed comments m 602 — ROOF PLYWOOD NAIL
construct the projso(Sec.70,14.Business and Professions CudeJ The CommctoCs
LicrLs, av;doe,,Ill arldymill)ow net orproperty who hu'Ild%orimprovcsthcremn. 603 — ROOF BATTENS
and whO comms,,(m such pnpects old,a cousin tnrlsl Ilecnred putvenu w the
Coauaetor,License1,., 604 — ROOF IN—PROGRESS
❑1 am exempt under Sec. .ILP P C lin this mason
Os'ner Dae
WORK171Z'S COMPENSATION DECLARATION
I tical afien undo penalty of penury one of the following declarations
411 7 I have and sill maintain a Cenifcam of Consent u,.elf-insum for W'orker's
Cnnm sr,atifr, us nrovikci for by Section 3700 of the Labor Calc, fur the
performance of the work for which Ibis permit Is isxted.
have and will maintain Worker's Compensation Insurance,m required by Section
�lilxl mf the Labor Coda for the performance of the work for h,,h this permit i.
Issued.MY Wo cr'a o pCnsntinn Insf(ryyJ�fy�� - J Policy number are /
Carrier. fJION, rrTeN nrrrer and G � 3/2y
l:RI119CATION Oi:EXI!MI'1'ION PROM WORKERS'
COMPENSATION INSURANCE j
(TIll.s section nand nm he completed if the pm
permit is for OTIC mdred dn
nlla - -
1$10or less,)
1 sentry than in she performance of the work for which this permit is issued.1 `)
shall not employ any pvr,an in any manner so as to twcotne subject to the Warkerv'
Compensation Laws Of Culifurnie.Date
Applicant
NOE er.TO APPLICANT:If.cher making this Cenilic,m of Excmmbar.you should
b,nma suh,sO ee the Worker'.,Compensation visitors Ichor Code of the IcCode,you must
Q O forthwith comply with such Pnwision,of this .it shall be deemed revoked
z CONST RUCTION I.17NDI NG AG IiNCY
,F1 > I hereby elfin that there is a conduction lending agency fur the perli,mtmce
Of the work for which this prnuit is issued(Sec.3097,Ci,C.)
6. 0 Lender,Name
= z lender's Address
V Q 1 comfy Ihmhove rcud Ibis application mudµcult,be the above INmrntmion is
an ,
Ir+ tom. n cct.1 agree ,comply with ill city and enunry ordinances and on,laws elating
0 T,) mbeildlag cammuction.and hereby autherim repmsantatives ofthls city to enter upon
one shute-mentioned property for'mspcninn Pmmoves.
.find
(We)agree msave,indemnity and keep harMess the cityor curl against
r/l City ill to verpeonan,core cud aspcnsaµhob nuay in any way accrue against snit
U z cityinamagaenceof the grant legeatrisf..Itil U
^ APPLICANTUNDER.STAND WILL CO PLYWITHALLNON-POINT Issued by: Date
SOURCE REGULATIONS
Siguatera it Apl,I',,nucomruelor D.oc Re-roofs
HALA tDOU5 1AI'IRIALS IIISCI.OSURE
µdl me apprcane or future building occupnn.bum m handle na.amoaa material ' Type of Roof
Its definN by the Cupertino Municipal Code.Chapter 9.13,and the Health and Safety
Cole. Sectio 25532W)? ❑No
All roofs shall be inspected prior to any roofing material being installed.
Will me:tppneamof jam eEdhmgoce,p,muse equipmen,ordevieexwhich If a roof is installed without first obtaining an inspection, I agree to remove
nnit ofoudem,air no iamiwnts as defined by the Bay All Air Quality Management
Diono?. all new materials for inspection. Applicant understands and will comply with
❑Ye. 0 N all non-point source regulations.
1 have reel the hvnrdoud mawfull,rcyfiremerl,under Chu,"695 of the
Colilor is Health R Safes Cede.Sections 25505.255)7 and 15534.I understand than I,
if the building dews not currently have ahat that in is my responsibility to notify the
occupant of the rtquim:ncno which must he met prior Lit issuance ora Certificate of
Oatn:mcy. Signature f App ant Date
Owner ofamhontedagent Date All roof coverings to be Class "B"or better
OFFICE