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01070120 CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 22003 RAE LA ROOHPARVAR 01070120 OWNER'S NAME: APPLICATION SUB DATE ROOHPARVAR 07/24/2001 PHONE: SANITARY NO. CONTROL N0. p O O ARCHLY /ENGINEER: BUILDING PERMIT INFO BIG ELECT PLUMB MECIi < G o L_1 1—I u ¢ LICENSED CONTRACfOR's DECLARATION Job Description i z'-' I hereby affirm that 1 am heamsed under provisions of Chapter 9 bermmemarig „C� witoSection7")ofDoWon3ofthcBusime,sandProfeesimi,Code.andmylicense ADD rte �=41 91�©F .� is in full toand effect. °`OB7ta� License Clan fie0 Date Cnmra<mr /f ((]] i3 t<F ARCHITECr' A 5 DECLARATION UG O U ZOO2 a O g I understand my plans shall he umd as public rccnrds L s<o c Licensed Pmfe,,ionm LL OWNER-exempt from the RATION BUILDING moa 1 naso.(Sect that 1 bum exempt from the Cosions Cause: Licence raw co the L®IpI/� 'i z following reason.(Section]831.5.Business and Rofessiens Code:Any city or county V l7 $16968 c,-0 whah c4 re a perm t t .t o Lae improve,&.fish w y swetnrt ____ __ _ mm prwrt t. a - that he i=vied puisumud lh P t ns ti the Cmims,tor s License Los(Chapter 9 pp,��yµ,�p.assxass pp,,�� Valuation (comm to ng wtlh Sect tW0)nr Divsun3af Ne Baine dPrpfc sons C°dq +-'i� \ ,_3 O'V'T V;%'?rs`lrsa � 1.Ts'31 or Section 7 eiempt Ncrtfromand the amts forube cts the eicicaut t l Pena°n j 1 of..mo]031'.5 love any hundred dollars for a pertmt subjects the applinm to a civil Penalty rornm more Nan B.e nwaarea mnaa(ssan 101APN tjIi(gfttbATION '"'r Occupancy Type ❑I,vs ownu of thepropeny,or my cmployres with wags m their sok<ompetsc tiom102 - PIERS Will;do ntework:and the structure is not'intended"or offered for tale(Sec.70,14,-'. 103 - UFER Required Ins ec[idns^" 'Buiincis an&Profosione m Code:The Cemetor s License Law,does not apply to an q p miner of property Who wads m impraveshis own employees.provided that such improvements are not intended or thcmrn.wml who does such won himself 10 4 - REBAR or throw h pfffrda f avlc.If:however,the wilding or improvement is sold within one yea of 105 ANCHOR BOLTS aomplearm.thOwner-wilder will have Ne burden of proving that he did nut wild or npmsetorepurso'corxale.). 106 - SEWER & WATER -_ _ -- . -- - .. .__ .. 17-1:azawmrertleproperv.:wmexew.tiveyconouetingwhhucenxedco.- n�'a<m.rx_to 202 - UNDERFLOOR PLUMBING :.rl_•� i"�.. coaxtmntw project sec.70wq Huxittea atN Prefesstona Cadc:)The Contractors 203 - UNDERFLOOR MECHANICAL`" .t:. •lLt. License Law docs nm pPI,man owner of pmpeny who builds ar improves bear , ' ...nd.who mmmns.for such projeus with a contractors)licensed pursuant to'" UNDERFLOOR FRAME .. .. .. . Contractors License law. 204 - ' r ❑1P order Ser. ' "' a&Pcfommxreaxen 205 - UNDERFLOOR'7INSUliATION xaD to o� 301 - ROUGH PLUMBING W ER'SCOMPENS N RATION 302 - TUB & OR SHOWER I hereby.fro,°"derra:lty of imrjury,oue or the following declaatiomx: 303 - ROUGH MECHANICAL D I have dad'wIn maintain a certifi6me of Con;ctd'm self-insure far woncra 304 - ROUGH ELECTRICAL Cumpcns.u.n. es,provided for by Section 37M of the Labra Code, for the _ pearentarce of the work fm which this permit is Issued �s 305 - FRAME - D I nave and willmaintvm Worker's Camuvi paor lai aoanoa,as 1equ1¢d by Secium 306 - HOEDOWNS n00'gr Ne Labe:coda for the pertotman« r the wen.rar worn mix p�pnit i.` 307 - INSULATION swat MY Wun rte pe. Imt lnwana rnmentM Pmry be ti_ ce '� „ : ,�, t PobcyNo..N t 308 .,SHEET;ROCK• :,t'•r.t __ .. " rs'.',.ICERnFICAT-ISN°FEXEMPIWNFROMWO "'i 13 0'9* TERIOR'LATH. COMPENSATION INSURANCE,;; ' '' L .,. . , .. -'--.._ _3.10., _,..INTERIOR" LATH:—- 311 ATH.__.. "l' (Thsfsemi&tinccdnmbecomplcmdifthepermittsforanchundreddollan 311 - SCRATCH COAT ''-� u,;.;r,.. ;': ?r• (Ellpl ser less.l � .. , . ., . . .._ .. .. 313 ' -' 'ROOF NAIL- .. ._ I_ ._.. ..._,.... - "_. ._._ .. . . 1 Geri flog at in tl performances b the M1 f which a ct i s issued.1 I• )S shall not employany Personi in any manner w as to wcotrc xubrect io the Workers501 - FINAL ELECTRI CAli ENERGY Campepsotion Lsws of Califomra.Date ' Apphcam= 502 - -FINAL PLUMBING ENERGY- - - NOTICETOAPPLICANT.ILaOcrnakingthisCeriBcamofExcmption;yooshould 503 - FINAL MECHANICAL ENERGY become subjeu to the Woher's Cmnpcnsatinn provisions of Ne Laver Code,you mull 504 - FINAL BUILDING 0z fold th ply ith. hp .or N.pc t hallbo Deemed oLeJ. 'z) il J CONSTRUrnONLENDINGAGENCY ° ' 505 - FINAL ELECTRICAL ,1 a,; I h br mi th i the m eot cl si nd!g age y f therm perfoItce . Orme kf" Yfl orWhichth l• t :iweal5 3w7 Cis,C.) ' • 506 - GAS TEST Z LL`ea` tndae. 507 FINAL PLUMBING tl,, U OI certify that l have read mi5 application and vete that above information is SOS - FINAL MECHANICAL Lss.F c'orect.1 agree to comply with all city and countypNinances and state laws relating 509 - FINAL GRADE O.U to building construction.and hereby unhorse oeprescntauves of this city to enter upon y-y 510 - FINAL PLANNING he wlbosrc ammacd pse mpeny for inspection purpos.welagratoxave.inaemniryand epb tele tacit>oraprioa w 514 - FINAL PUBLIC WORKS V] liabilities,judgments,costs and expenses which may in any way accrue again',said U i� City in<oasequcna of the graining of Nis permit.' n AN.7 'DERSTANDS AND WILL COMPLY WITH ALL NON POINT' Issued by: Date ° lTjoSr .,'9/7/0/ y` . grtewre ofA nnU nuenor',.,, ' 7-Dam Re-roofs HAZARDOUS MATERIALS DISCLOSURE > ,: bun N 'pPhta t r m waging aemisant Dare orAaMl ImvLons matena' .Type of Roof as derined by as Cupertino Municipal Code Clus 9.12,and the Health and Safety r Cade Section 253321 ) " .- ro •s . s ss '.: _ f .,' •' ' :.All roofs shall be inspected prior to any,roofing.material.being installed.,... .. _ . . Will Ne applicant o,future building occupant use equipment or do&es which If a roof is installed without first obtaining an inspection 'Fagree'to remove emit hazardusoair mm c'm rami,as defined by the Bay Arta Air Quality Management vast t all new materials for inspection, Applicant understands-and will comply with r y ,� DY'. I r t�, i .. all nOn-point source regulation*. . 4i 1 have revl.Ne hwrdous-materials rtquiremcnk under Cwpter 6.95 of Nei Cilifumi6 HedN&Sa(ay Coda Secuons 25505.25533 wad 25534.,l understand`bet ._ f0h,Wildir,docs not n'll,base.tenant tht it ismyresponsibility to notify the , f thq"pubarmon,is C host be me,Prior tour c'of a Cerificate of 'V �0/ Signature of Applicant - Date - ow r p gag nt Date All roof coverings to be Class,"B"or better ' ,t 'yt -;'ill , . 6 - . . - . . .- OFFICE