00080160 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRAC'T'OR INFORMATION:
BUILDING ADDRB.SS: PERMIT NO.
10500A RIDGE VI CT LSI 00080160
OWNER'S NAME: APPLICATION SUR DATE
WDCI INC 256 E HAMILTON AVE 08/22/2000
BONE: - SANITARY NO. CONTROL NO.
(408)370-1970
OKL ARCHITIiCI'NNGINFER: BUILDING PERMIT INFO
F O p BLIX; gELEM iti MRCP
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o l< LICENSED CONT'RACTOR'S DIR➢.ARNI'ION
=c hatch,arfiraI mai l ao heca..d ander pmviai.,o.r.r Chapter 9 aonm,aneiag lob Description
Zn t-,u who Scctlon 71X10)ofD'w".ioa 3ornc Broin,,and P,oro,ion,CItIL calliny h'en's
ne ' i,11finveandet e III N/ B OCCUPANCY
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o e. Doric_l 13 Gmtmem'r CCCk�
in u pRCHITECI"S DECLARAI 0.
1 underaem my plan,shall fie.,ed as public record,
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v z c Licensed l'mfcssinml
v K n OWNER BUILDER DECLARATION
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— 1 hereby.farm that I am exempt rmm the Comment'.License law for the
L z a following reood.(Section 7031.5.Business and Profen ions Gyle:Any city or county O
z=C which requires a permit to consumer.alar,improve,demolish,or repair any aruchum
prior to its issuance,also¢quire%the applicant for such penniuo file a signed starnmem
mat heis licensed purmanttothe pmvmnnsothe Commemr.LicareLaw(Chapter 9 Sy. Ft. Floor Area V�'lIyIy ``o
rcommcneing with Section 70X1)or Ukivoa 3 of the Boa"ncs.and Pmrcorions Cale) $1 1�9@
mica he is crcmpt therefrom and the nasis far the aneaed exempdnr.Any violation
,It Sec,am 7031.5 lb,any appfieam Ira Pemdt s.bjc,i, he applicant m u clvll pc,a,],
on nor Imre man hatehundred dalle,(a500), APN Number Occupancy Type
❑1,.e,ower of 11he,,,It,ita or illy camplo,as w ill wages a4 their sole Cillopirrvailial. 31606042. 00
w111 all the in ,and the.ruemrc ie nm Intended ur oltlum lin sale(Sec 71414.
If !,,a,,and Prrdes."ur,Code:I'he Cn faonr'e License Inw bars rv,t apply n,rot Required Inspections
r ori progeny who nnild.fir...prove,, here I,and who does.such work hn,t.,11 101 — FOUNDATION
o,ihnmgh his awn employer,.pmmded mat auen iinpmvan.am,are not intended fir
orrered bar sale.B;however, he holding or improve cal is sold within one rear of 102 — PIERS
inmplctinn,the owner-builder will have me burden or proving that he did not build or 1 @3 — LIFER
mprove forputFowi xhiel. -
0La, nerunheproperty,amexclusively contracting with bcenaeda,nmctor,m 1.04 — REBAR
Licoastal the pri(sec.7044,Basme„and Professions Codec The Commemr's 105 — RNCHO R BOLTS
cense law does not apply ,,an owner of pm1'eny who(wild,or improves meters.
and who c„rtams for such project,with a commemlq licensed panoan,in the 106 — SEWER 8 WATER
Contractor,License law. ,
01.,a exempt trade,See. .B@PC for nth teat-`fir 202 — UNDERFLOOR PLUMBING
0,neTData 203 — UNDERFLOOR MECHANICAL.
WORKER'S C'OMPEN'SATION DECLARATION
_ Inerenr anir,t rotes,I+Bahr of perimr ane or me fuuowhtg ee::Ia,ation.: 204 — UNDERFLOOR FRAME
r 205 — UNDERFLOOR INSULATION
C,
have and wit ,owanda a by
or Comm„ m estiLah..am nor Worker,,th.
coatpenartian, a. pr,vined Or ny sratmn 3700 or he L,mor code. rm me 301 ' — ROUGH PLUMBING
polo na col'the work rot wlndt mll permit in in.aed. _
]]I hiwc and will nmlmain Walkm'I Cor,prnwtione Bomaee.as reopdmm by Section 302 — GLIB & O R SHOWER
3701 or he Labor Code.rot me performance of me work I.r which Ili,permit is 303 — ROUGH MECHANICAL
i cued,My Worker',Cmnpemmlon Insurance carrier and Poll,rammer me:
3114 — ROUGH ELECTRICAL
Carrier. Palicy No, -
CIR'1'IFICATION OF EXEMPTION FROM WORKERS' 305 — FRAME
COMPENSATION INSURANCE 306 — HOLDOWNS
Alda section nerd a.,he mmplaltd if he pe mi is ms'one handrail dollar 3@7 — INSULATION
(s 00)m leu.)
1 cettily that in the performance of the work for which this permit is ismed.1 308 — SHEET ROCK
.hall not employ any Person in any manner so as to become.object to the workers' 309 — EXTERIOR LATH
Compensation Laws Lir C.1ifomin.Date
Applicant 3l0 — INTERIOR LATH
NOTICE 10 APPLICANT:II:after making thin Ceniticaro of Eoannptian,you.hmilJ
Become subject to the worker.Compensation provi.iomot tb :m
el. or Cole,rounnol 311 — SCRATCH COAT
O 2 kadoxith.amply wilh such pmekior.or this pcnnh luau he fair rd creaked.
z all) C'ONSTRUCI]ON LENDING AGENCY 31.3 — ROOF NAIL_
1hereh,allaamm mete i.ar,mtraC1011 leading agency loth'pa or"aace 501 FINAL ELECTRICAL_ ENERGY
of he work for sub"al,mix Pcrnr,,s eeued(Sec.3097,C"v.C.)
a p 1.enler,N:anm 502 — FINAL PLUMBING ENERGY
ZD z Lenders Addles. -
U O 1 certify that I have ivad this application and stale that the above obannationv, 503 — FINAL MECHANICAL ENERGY
4. F cornea.I agree a,comply win all city sad ewmy..mimanec,and ,are rows.claim, 504 — FINAL BUIl_DING ENERGY
O U Lir building cotwim iow.and hereby armanm representatives of this city to anter upon
y ca meaMnomenticacdproperty far impecth,rpmpovel. 505 —IF .
AL ELECTRICAL
F., L (W'e)agreem wve.i ndemnify and keep tamale„the City of Cupcnim against —
rn liabilities.judgment%,costs and expense,which may in any way.neme against said 506 F O
Uz carmeomxegreree unhc gmnemg fir avis perndt. • 507 — RING 'ZZ•�
A .ICANT UNP' STANDS AND WILL COMPLY WRH ALL NON-POINT Issued by: DatC
URGER I 1 I y' _
Sigwmrc n dCnn,racmn- !� Date Re-roofs _
HA%ARDOC'. ATEWALSDIIIIAP Els 509 AL GRADE
W,11 the applicant orfuwmWilding occupant store mmmdmna.amuu,material Type of Roof 510 — AL F'LRNNING
a..defined by the Capenim Municipal Code,Chapter 9.12,and the Health and Safety
Cute Scotian 25532(a)?
[J yes ❑N° All roofs shall bey" .,$ccledFp ''t)19b-arPylIMfiX6f;iiV ; b ing installed.
Will the ahphcaat„rmm,rehoudngaeupw,tase egairvrcatordaviaxwhich If a roof is installed without first obtaining an inspection, I agree to remove
cntit huvuJnus air'l ant Baa,a,dehnal ny me Bay Area Air omdity Munuscnmm
,"alar? all new materials for inspection. Applicant understands and will comply with
Dyes 0 N all non-point source regulations.
1 have mud the harmdoo,materials requircmm�¢under Chapter 6.95 of the
California Iicalth A Surety Calc.Sections 25505,25533 and 25534.1 underatind that
if the building doe,not cumently have a¢rant,that it is my tesmmsibility,,mmiry the
u am of me reyuiren,.ms which must he me,prior u,issuance of a Certificate of
eaforey. Signature of Applicant Date
All roof coverings to be Class"B•'or better
Ownerm ruin "gem — Date
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