00030029 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
Bun.DINCADDRI'7359 RAINBOW DRIV #G PERMIT NO
00030029
OWNER'S NAME: APPIACATION SUB DATE
JUDY CHEN bV 03/02/2000
PHONE: SANITARY NO. CONTROL NO.
p z Z ARCHITEC IENGLNEER:' - BUILDING PERMIT INFO
PLUMB 00q �(
LOO IIIAG El-r= METH
cal
G«
M= LICENSED CONTRACT'OR'S DECLARATION 10b Description
I hinny alrnn nett I ant Ikcnncd under pnwisions of Chlmler 9(,ai awing
2_t-a with Saniun7olgpof Divhio 13 of the lonomess and Prolesionn Code.an(] license
�c i_ in fan force ana 1. TOWNHOUSE NEW
cwa i`iaesecla,� u�tl__
w 5 a y ),at —d11S1. oi— Contnaa,r
F a O AR shall be used
DECLARATION F'N A L S
4Vi_ I undmmnd my plans shall a uzcJ as public rttv,Ns f ^.
a 5
ce n hiccnad 1'n,lessinnnl
that I i.comUER UIiCLARA'I'ION ZOOZ
_m 1 hereby a(See mat 1 am cacmet from the Contractor 1:Any c Law for the
AUG 1
f-Z" Inflow Ing rc n (Sectio1703 11 nainuc and Prole, is h.oa, Any dry nr why
2O which)equinaupermit requires
thepplialmc int lot such profit it are a sig any unicanne
statement
m5$ paonoin issuance.also rcyuirc,rbe applicant iia such penniuo Eleaeigned statement
that he is licensed punuam m the pmvisinm of the Conrtctor's License Law(Chapter 9 BUMD[flGr Area valuation
(Ci nnnenelag with SI not 7000)of Division 3 of the Business and Professions Code)
or Not Ie,.camp Iherctrn I amt the hasis for the xllegmJ rin ntption:Any violation
of Section 703 1S by any applicant for a permit subject,the applicant to a civil penalty
of not more man rive hundred dollars MOB.
APN Number Occupancy Type
❑I.a.oxherordie fre st,or mycniplo,,,.anwages:r.mdrsale contpm.ati1. 36231,029. 00
will
6231.0" -
will do the work,and the manure is not intended or offered for sale(sec.7(W.
Business cad Prote,ebrs Code:The Como n n,,Llssma L.,w macs ant apply Ia an Required Inspections
orvr of PmfertY Who Mudd,or Inlprovca Ihercnn,and who draw such work himself"
tl rough his own empfoyecs.provided that such improvements are not iamndN an 101 — FOUNDATION
otTercd for sale If.homcwnr the building or impmxinimm is sold within one year of
Impletion,the owner-builder Will have the burden of proving that he did not build or 102 — PIERS
improve frpmp„e'If
”"'e''' 103 — UFER
01.as owner of the yroN'tty,am exclusively vommcting with licemscd contractorsm 1,04 — REBAR
raw the project(Secs 7W4.Un,lnes:sed Profession,Coal:)The Cnntrenor's
IJceme I,aw don not rip ny mon owner of Ionpeny who hadd.or Improve,thereon,
and who connotes for such projvOs with a conamcbrtsl licensed puemam to the i.05 —
ANCHOR BOLTS
Contractor's license Wwa 1.06 — SEWER & WATER
❑Into ncmpl under Sec .B&P C far this reason
Owner Dare 202 — UNDERFLOOR PLUMBING
WORKER'S COMPENSATION D1zC1.ARA1ION 203 — UNDERFLOOR MECHANICAL_
I hereby tdrrnn under penally of scipay one of the mlwwing declaration, 204 — UNDERFLOOR FRAME
0 I have and win maintain a Cemeeate of Cometn m,elf-imare for Walker's 205 — UNDERFLOOR INSULATION
pemmoContpn,;eeu, as no,idcd It,r by SCOIon 9700 0l the Lubar Cod=. for the
a
nee of me work fa which this Novel is i%awd 301 — ROUGH PLUMBING
0 l have and will ntaimain Worker's Compensation Insomniac.as"trired by Section 302 — TUB R' OR SHOWER
3700 it(he Labor Code.Ill the Perkammnce of the work ser which els lKrndl is
issued My Worker s Cnmlensation Insurance wrier and policy manner are: 303 — ROUGH MECHANICAL
Carncr_ boa _leib_PolicyNo, 41222.e. 304 — ROUGH ELECTRICAL
L!R I IFICAI ION OI'EXEN't ION FROM WORKERS'
COM]IGNSAT1ON INSURANCE: 305 — FRAME
r1'1i,«,Iron ao,d noa a co....I It if the permit is For I...c hundred dollan 306 — HOLDOWNS
$"""°r' "'' 307 — INSULATION
I eenify that in he perfnmence of the Work for which this permit is issued,l
,hall oro employ any"on in may seaman so as n,hc,ome.sumect m n,e Workers 308 — SHEET ROCK
et,,
Conupaamt Lax,of California.Dale 309 — EXTERIOR LATH
Apphcam
NUI'ICETO APPLICAN'OIf.after making this Cenilicate of Exemption,you should 31.0 — INTERIOR LATH
M1ceante lane t ,,the Walk nr's Cooya,n,an a pmvieions of the I.ahor Coic,you must
Z2O mmtwimcomply wim,u,b pravkioeor this piman,dallIN,decnedrevoked' 311 — SCRATCH COAT
Fr~ CONSTRUCI'[ON[.ENDINGAGENCY 31,3 — ROOF NAIL
a > I hereby rubor that Mery is a construction lending agency for the perl,mtanee
onheworkhrwhichthispermitisissued(Sec.3(NZCiv.C.) 501 — FINAL ELECTRICAL ENERGY
q Lenin "Adtoe 50'r' — FINAL_ PLUMBING ENERGY
Z LenJef's AJArcma
U O 1 certify the 1 hmc read this application and state that the above Inlimnation is 503 — FINAL MECHANICAL ENERGY
Lr. F.. Correct.I agree to comply with all city and county ordinances and sum laws relining
O U In btrddipg cotnstraction,aml hereby amhon,m,m,emaavesof this city to enter upoa 504 — FINAL BUILDING ENERGY
r� the aeve-ase nred pro,rt,ser maltcclant Ourrydex.
(We)agree to sitvc.indemnify and keep headless the City of Cupertino against 505 — FINAL ELECTRICAL
Ilahilitics,judgmenn.cans and expense,which may in any Way acerae against said
U 7 *�IRWU
e nn lite • tsonn'r,portnh. 506 — GAS TEST
^ ERS' D AND WILLCOMPLY WITH ALL NON-POI M' Issncd b DatC
ATI .S. y'—
ant .ontmntm Date. Re-roofs 5L78 — FINAL MECHANICAL_
"Its".
.ATI?RIALS DISCLOSURE
Will teapplicant orfuture nuuai"eccuPant'nom orhandeM1teandcu,.',aal Type of Roof 509 — FINAL GRADE
a,deleted by the Cupertino hwnicipal Cods.Chapter 9.12.cad the Health and Safety
Code.S,,anm 25532wn 51.0 — FINAL PLANNING
Oyes 0N All roofs shall b55ip4)e(aedFp1iM arpomfimmw � Ing installed.
Will be applicant or fuure building rccupam me lampmm�t or device,which If a roof is insta .+yithout,,�lJ�f�Jbt� n�I) s 1 ❑ agree to remove
enol lrvuNoto air co utantlnansa,d,fiatrd by the nay Acca At,Qaahi,Maoayv7nno $ I Kl1IJl' t-'I Y �}'� h Qt
41 Di,trietorc, ❑No all new material., yns�ec;llAl},.A�ticr,l lied rs I and will comply with
all non-point so ?egula ���111 1 TTTEEE
I have read that hn,mdoas neneaals mcuncecoo ander Chapter hos of the 604 — ROOF TN—PROGRESS
California lleahh&Safety code.Sections 25505.25533 and 25534.1 makremnd that
dive building does not tomo umnanL lM1vr it i,my rc>pm,ibility to aotifythe
vccuptn I uI It ren normae wI h nota ria mer prior no is.naace of a Cer irtnac of
ecapan= Date
Signature of Applicant
zN—OA!�_ All roof coverings in s to be Class"B"or better
ow o —d agsatt time _ g
OFFICE