00030023 CITY OF CUPERTINO - -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: 1'EHMI'f NU.
7:�99 RAINBOW #B cru 00030023
OWNER'N NAME: APPLICATION SUB DATE
T1 MY r.HPNSt\ t"I %111 03/02/2000
PHONE. L� SAM LARY NO. CONTROL NO.
�W
O e•"-LN ARCllll'[CI'/IiNGINIiIiR: BUILDING PERMIT INFO
<o ri p 3 p_SSS .UG HLIiCf I' uMH Nil CH
y c a J 1
6
o IimnlaultnCON rencfoR•s DECLARATION k06 Description
Qy n_ thereby affirm,hal
mFam IannA underpnsion,of ,
w n..Code,malmylicense
<-_< nd,fanrn ea nal �3R0_4_'K� NEW TOWNHOME
�z�'a Lttn,c FIl9lI�I--�®
o d u Dole_ 313 -\-�Z n,Inoalm _\.te.
w s LL to ARaarec*s DECLARAHON -
C I m,desland my PI hill he used m prlldie record.
a=o o Licen,ed Pmbe,,kaml AUG 15 2002
?Joy_ OWNER-BUILDER DECLARATION
¢� 1 later,affirm that I am csempt from the Contracens Liceme Law for the
F a following reason.(Srmion]1031 5,Bulincl,and Profession,Calc:Any city orcounal,
cic e M which nyuires a pem,il m construct,dhcr improve.demolish,or repair any.uucan
iRI Ill QING
6= prior in'itsissuance,also nyuin:s the applicant for such remain to file a signed.aatnnen,
but he i.beersed .,..a,It,On,limit.,nl:..I lot Commatn'sLicrn,vLaw Wh,prr,9 Sq. Ft. Floor Area Valuation
(cnmmencing with SCRion 710X)of Division 3 of the Bmiaco and Pnde„inm Cale)
or thin he is ex,a,n tlmrarnm,and te hba.l.lin the allegN csaumnor.Any violation
of Social]031.5 by any applicant for a permit subjects the applicant a,a civil penalty
of mil mint man Eve hundred dolhr,anon. APN Number Occupancy Type
01,as nwnetofthe properly,or myemployees with wase:as thei,sale mnpenson n, p
will if,,,he work,and the stma,ve'o not intendal or ott'etcd 1'ut.:Ilc(SO,.4194,
Business and Professions Code:The contractor's License Law doe,not apply to an Required Inspections
of properly Who builds or mpro es hacon.Ind who docs such work himself
or hmugh his own employees,provided that such i:aprovencm,are not intended or 101. — FOUNDATION
offered Our safe.If,have.,the building or inpmvemmi,is sold within ooc year of
inn Icioun.die nwnrt-n(dlae,will have he burden of proving mat bedid ran build of 1.02 — PIERS
mprove for pr,Hlnse of wlcd.
❑Lasnwne,ofthepropeny.aneschtswelycounted.,withlicemmrnntnemrsto 103 — UFER
L,nsnuct the project(Sec.WAL Business and Professions Calc:)The Conmaaa 104 — REBAR
ich.«Law does mil apply u,an nwae,of ryoperty who build,of improve,me,co t.
and who contracn n„such projects with a romnarolist licensed pursuant to he 105 — ANCHOR BOLTS
lvexmneo mempt License
go. .B xt P C Intnis reason 1.06 — SEWER & WATER
O.nc, nate 202 — UNDERFLOOR PLUMBING
WORKER'S COMPENSATION DECLARATION 203 -- UNDERFLOOR MECHANICAL
1hereby ofinntraderpenalty ofp jury one of due following declarations 204 — UNDERFLOOR FRAME
0 1 have and will nainain a Cer ilicmc of Consent no schGirsure bur W..kc,
's
On:npen.acan. !LN provided for by section 3700 of the Labor Calc, for the 2205 — UNDERFLOOR INSULATION
pcdnmmu.oltireworkforwhichthisprmlhI,I.,ara 301 — ROUGH PLUMBING
❑1face and.iBlntlinainWmLet's Compcmationhomince,:s,pdredbySerlion 302 — TUB & OR SHOWER
of the Loon,Code.for,he performance of the woak for which this permit is
sbed.MyWorke„Cnmpa:.ado,m.urancecarrierandPolicynannerme: 303 — ROUGH MECHANICAL
Ca . b\t�_Lv0_rnEeyNa304. — ROUGH ELECTRICAL
CERI IPICAI ION 017 EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 305 — FRAME
(This section need not be completed if the l,cond,is for ane hundred dollar, 306 — HOLDOWNS
($11X11 nr Icw.) '
1 cer ify ma in the penmnancc of,be wark for which this pcm,it i,i.wcd.1 307 — INSULATION
shallnm emploh
y any hars ,m t r any Ihanna .o a. ,,n.t»ore,ania't m me Worker^ 308 — SHEET ROCK
Co..rensadn.Laws of Carfomin.Date
AEphs'a", 309 — EXTERIOR LATH
NOTICE TO APPLICANT:IL alter making this Cenilicate of 12 cmplion,you should
ecame.ubeeltohewnrkar,Compensationpmvkian,ofthel WlCode,"mnon't 310 — INTERIOR, LATH
O Z Gmhwiln comply with end,pmvisinm ar O,M Pana(shall be deemed revoked,
Z
311 — SCRATCH COAT
CONSTHUCB'ION LENDING AGENCY
C > 1 bemny atim,in.,hent i,a construction leading agency for the performance 31.3 — ROOF NAIL
of the work lin which his penal i,l...ed(see.3097.civ.C)
yC Leade ,Name501 — FINAL ELECTRICAL_ ENERGY
.J 7 Lender's Address 502 — FINAL PLUMBING ENERGY
U O aapace dd lateve how, 503 — FINAL CHANICAL ENERGY
0 U to build I g con(o chour,fly and
city and ennmy nNimnes Hud city laws enter
upon
O U mbaddingcom,rvednn.andncrcnya,clion cpm.cna(ivcsalhisci,ynrntcrupnn 50 — FINAL LDING ENERGY
Iy 4r] the xh Wx).,oned pmpeny for Oily
n don purptxses.
y (wc7 agroe w,a,c,bwcl„Idfy amt keep narnlaa,the cif,.,fenlxnian agall,.t
.F. V1 liabilities,judgment nd chN.ws which may in any way at against said 5 — F I NA CAL
U � City in ennNnlucnacvnl :g nntrng of this penult. -
AtPULRICANT 'ND\I�TA—DSAND WILL COMPLY WITH ALL NQN.POINT Issued by: 0 GAS - Dale
c3 \o\_
signaun ,pplicunVContranor Date
Re-roofs B — F I NAI_ MECHANICAL
IIA9.ARDOUN MA'I'EItIALS DISCLOSURE -
WillthcappGcamorfu,ureWildingaccul'anatmorhaalmnavdousnaalaial Type of Roof e 09 — FINAL GRADE
;is delin'd by the Cnpeninn Municipal Code,Chapter 9,12,and the Ilealth and Safety
codSec, 255321x)" 510 FI AI_ PI_ANNIIk�G.
oYm "" All roofs shall be ��nnS.J� CIA p 9,�ttry,,[[ b a 6 installed.
wn he appheanmmmm m,Bdmg tnrapan,use cgaipmem mdcvias.Inch If a roof is iIt 11e2Y bv1 hou[ first Cin IPA
L�, ids�'Sec'EY I` rce to remove
�. (mit ha,utouux air ctnnantinnnm;o detinc l by the Bay Are,Air Q.,llty plan i,enterl t I]
Di.mrr, all new materials l(JA spccti pp cat to i s �d will comply with
°Yp, 0 N all non-point sourA@9�ultHiQR..0OF BATTENS
1 have read the hwaNnus materials nyuiremetn,under Chapter A95 of the 604 — ROOF IN—PROGRESS
California Health k S,fcty Oxi,Scsaions 25505.25533 and 25534.I understand(hilt
ifthe M,ildinearesnorcuncnd have a tenant.that it is my mnlemu
ibility )notify the
.....puna of Thr retudre:nent Itich an."be are,prior m issuance of a Ce"Bea,c of
kcupanr
8�9t b\ Signature of Applicant Date
Own trizedager,„t -- \Date All roof coverings to be Class "B” or better
OFFICE