00080197 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
I{UILD]NOAUDRIigS; PERMIT NOOO 0 es � 97
A)WItER'SNA 7`542 RAINBOW DR KITCHENWORK APPLICATIO, C.ty Y
uON: LIEBERMAN DBA HONEWOR14 SANITARYN
Q O O ARCurrrC'IDENGINEER: (415)456-4696 HU1I Dwa PERMIT INFO
1L1 EI.FM PLUMB MECH
1=) 1=J IJ
mj I,ICHNSED CONI RACIOR'S OFCLARAI'[ON Job DeNt.rl DD
Cym❑
I hereby all irn,thin I am li=mned under provisions of Chapter 9(commencing
p_Cw with Secainn 71g of Division}n(me Business unJ l'rnlecsions CnJtayunQmy license
6 f In hull force and cffcc,
ce c z - License Class__ — IG Lic.p_�OrJ
3'c D.ne.b+ /D�' ur
ARCHITECP'SDECLARA1015*_ " — REPLACE WINDOW/CUT IN
1 BAY WINDOW
t- a I understand my plans shall be used us public records /
— �! 7/1 w Licensed I'mfcssiowl
OWNER-BUILDER DIiCe Contracto
w m 1 hcrthy xfhnn that 1a.1. csemp,from,he Conmacmr's License how for the // Y
C 6 f Ilnwi ngmrs,a(Semon]0.i L5,Bminms aa1 Pnde.,ionsb.oa Any city shot /
S F o wbicM1 nquircs aµr:nit:n ronstmcL nlwc vnpnrve.Jen:olish,nr rcpuir uny-grvemre O
zprionoifr is.n:mm urc
.ulsyulres,hcupplic:mo
ltuch pconit o ilcuxigned s,amarmat
4= II ho is Il ce:ncd,,:Danns lathe prnvi,lons Dube Conuanors Liecnw Law IChapar9
a'ommeacing will,Soon a:,7lwo)ofDokion 3olthe Husioess::nd Fra4osaiorc Coda Sq. Pt. PIbDr Arca Ya tion
m oral br Is roanp,mcrufrmt and me basis I'ur he alleged esemptlon.Any illation
rel Selena 7031.5 by any applicant for a train,nuhjecax the npplicaa,to m civil penally
an In m Ian time hundreddollars(s51x). APN Number Occu�.fliL}pfl�7e
❑Las turner of the oupany.or my enp,loyces with wages a,their sale compea.vahnrm
will do the work,road the sWtlurc is not intended or of@red air sale(So,.7011.
Business and Professions Cale:The Conuac,or's License law does no,apply to an 3661.1.043.Wuired Inspections
u.ne,of property W'hu build,or improves,hercnn,and who docs such xork himself
or through his oxo employes,,provided thin such impmvene rm arc no,marched sir
offered for sale.If,however,the building or improvement is sold within one year of
completion,the owner-builder will have the burden of proving that he did mu build or 1.01 — FOUNDATION
improve ma purin,a"franc.).
1.02 — PIERS
❑L un owner of aM1e property 7( 4,exclusively y all
Pro ,,i with licensed is ohe Cam ml'h,
,cense Law room
(Sec. toa,ownern,andeftystrbildsorThrve%therrom 1.03 — LIFER
Lion,=Law ua,s no,apply,r an owner PaU,my who baud,or improve corm.
ami wba ansate, liar nleh p,ajw,u will, a tamra=wrla liaessed na,.aam m ere '1.04 — REBAR
D I sen.ohm License Law,
❑iron esem,l,t a:nacr Sec. .use roar tea rctt,,,n 1.05 — ANCHOR BOLTS � _
own,, Daae 1.06 — SEWER & WATER
WORKER SCOMPENSAT[ON DECLARAr[ON 202 — UNDERFLOOR PLUMBING
1thereby afEm,order miltyofpc;nryaarathe raBawingd.lamtinn,: 203 UNDERFLOOR MECHANICAL_
a I base and x;B maintain a Ceni i=me of Concent to,elf-insure for Worke„ 204 UNDERFLOOR FRAME
nnpensmion, as provided for by Section }Ag) of me Labor Cole, for me
performance of me work for which this permit is issued. 205 — UNDERFLOOR INSULATION
❑I Eine and will maintain Worker's Compemation Insurance.as required by Section 301 — ROUGH PLUMBING
}700 of the Labor Code,for,he performance of the work for which this,emir is
issued.My Workc,r�', 'm�nl,�com�tiom Irwmare carierand Policy number are: ' 302 — TUB & OR SHOWER
carrier 4/_ Pah=yN:,.:(.✓G 21..2 303 — ROUGH MECHANICAL
U3RTIPIC COMPHN.SAiONIINSURANCI WORKERS' 304 — ROUGH ELECTRICAL_
cI h,, all mem mat be onmere
ld it fell t oaba
h it la rar aerc l dollars 305 — FRAME
)
($100le".) 306 — HOLDOWNS
1 madry that in the psafmmmftcc of the work In,which,his onus,is issued.1
shall nor cmnploy any person in any manner so a,as become subject to Ne WmketY 307 — INSULATION
Compensation Law,of California Date
Applicant 308 — SHEETROCK
NO1 ICE:TO APPLICANT.If.after making this Cenificmc of Exemption.you should 309 — EXTERIOR LATH
become subject to the Workers Compensation provisions of the Labor Cole,you mus,
O O fart,itn comply sits such provisions or his,amid shall he deemed Ranked. 310 — INTERIOR LATH
z ^ CONSTRUCTION LENDING AGENCY 311 — SCRATCH COAT
I herchy aBirrn that hem is a construction lending agency for the performance
of the work m,which this permit is issued(Sec.man.Civ.c.) 313 — ROOF NA I I_
GQ Ire rria"'N:n,e
o z Lenaersnanr<ss 501 FINAL ELECTRICAL ENERGY
uO I=enlryonIlowemad :q
rois )plicutinnandstatethat(henoveiamrnartiois 502 — FINAL PLUMBING ENERGYlist F agree.I agree to comply wpb all city and sourly ordinances road aam laws relating
O U mhaudimgcam,tin=lion.and arebyaamnrimteprewm,Avc-o iseityaamm=r.,a 503 — FINAL ME . ANICAL ENERGY
the abet>memlancl proper,far....polar aPrr,ov,
F a
(Act ugtoe It,save,indennitymid keep handes,the CityofCupcninnagain,a 504 — F . 1_ BI _DING ENERGY
V] liabilities,juJgmenas,costs and rspemes which only in any way accme against said ,
Id z City incamwqucnaeofthegranting ofthis Permit 505 — IP _ E -CTRICAL
AP CANT UNDERSTANDS AND WILL,OMPI WITH ALL Issued by: Date
URCE REGULATIO y' _ ..
ignamaornpph nat= Re-roofs 507 — PLUMBING
PLUMBING
HAZARDOUS MATERIALS DISCLOSURE
detinet by
or furore building nccupam mm,or handle humdrum mamod Type of Roof 508 — TPIAI_ MSCI-IANICRL
as deet by the Cupni
cno Municipal Cale,Chapter 9.12,and the Health and Sam"
Colo.Section 25532(0? SS�9 — INRL GRADE
dye` C1 Nu All roofs shall L t �tqrh(es. 1 I terial being installed.
Will then lienar or❑eons buddinneml runt car oat ko,device,x hi,h a ftelt f11-I f, ' i, ay 1 b
1y, Inial If a roof is insta�l4withot�l. i �Ybuµ{Iial�ttlspgjSl-1 agree to remove
caul hanmlrn:s uinontnnilnanumAdincsl by thio Huy Anil Air(gulllty Munugcmeu ��`"'``f1 ••f� iil1
m,Irap) all new nmtenals or mspecnon. Applican enders an sand will comply with
oval 13 No all non-point source regulations.
I hread me hmadous nwmrials regallrearent,under Chapter(a95 of he
liase
latah k Safety Coda Sections 25.105.''-55}}end 255}4.1 understand ms,dling Joos not curently have a tenant,that it is my rceprmsihili,y m notify the
rel the requirements wh in t M met prior to issuance Carn Nam of
y' Signature of Applicant Date
moat cm � ]).at All roof coverings to be Class"B"or better
OFFICE