01090026 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDR[SS: PERMIT NO.
10600 RIDGE VIEW CT GORDON-PRILL INC 01090026
—J0OWNER'S NAME: APPLICATION SUB DATE
00MPAQ COMPUTER 1245 PEAR AVE 09/06/2001
i PHONE SANITARY NO. CONTROL NO.
(650) 335-1990
C OO ZARCHITECTENGINEER: BUILDING PERMIT INFO
NCO ELECT PLUMB MECH
Z' LICENSED CONTRACT OR'SDECLARATION Job Description
I S i% I by"Io Ihm 1 oto licensed under provisions lef Chapter 9 containment,n with ronp111101orDii<ion3oftheBnxinexxanJynycod/e.aadmyfanx TEMPORARY PERMIT GOOD FOR 30 DAYS (10/06/
oil fusee and effeel s". Ll(B
a0 Closes l
i LL O N al[ Coal
AItCHI fECT'S DECLARATION
1 unJcrslaM my pbro sM1all bo used as public acoNs
I c p O Licensed Vmfeainwl
OWNER-BUILDER DECLARATION
c—m 1 hereby affirm that 1 am exempt from the Contractor's License Law for IM
tza whichingma•ta ersont ]IDIS. t.atm sand Profusions Curie:Any city structure 61
xo
which requites a person re construct,aper,improve,demolish, fie a sig any stucmrt
a3=° -prlalo Llu 1 q the PPIant fon su[hpamnmicense gaw(Chater9 - - -
Incl he xl'anseJp amNot to thep of the Commnols License Law misc .) I Valuation
(comm a •'Ih Secy ?ooBl r e tion eof Inc Bu Incas and Profess ons Codc) ( (? ! 123'•
or Shat he 6 exempt thcrtfmm•and Inc basis for the ets thelaMlicam to Any l person
of not mo than v any hundred
applicant for a pennil subject the npplicant to s civil pcnahy
`ser not more map f.o nnnaxa douals asBln 516°'PN �OL BUILDI j'" Occupancy Type
111.ex owner of the property,or my employees with wages as their sole compensation,
-
will-dothe work.and the vmaae'is nornten led-oroffered for sale(Sec.7044i' - - '
Busiue{and'Piofessions Calc The Colnmetor:s License Law does not apply to an Required Inspections
owner of property Who builds or i......heaan,lead wIW does such work himself
nr through his own employees,provided that such improvements me not intended or
-
�offered flow ask.If.how a the buildingeimprovementnsola Imdid not carof - _ .,:v!s,t' ♦ r ...
c
opro i thefsoo o b 'Id ill have Inc bard f proving Inn he did not buJd a
Improve B,r palpns Dr aura).
_.___ .__........ _tract_ . .. ..tact contractors._ .. .. _tract.tract _ _ .. _ ___ _.______._ _ _____ ___.
ODazctthe orlhc p(_ c.T ,, usinessla mmmfessi witCW,:)ThCoracto - LLT
_ ciccuse the does
n Lyes.TM,,uusmes and arty who coaerl The Contractor tmaox
License Low Jas nal apply to an owner of a.or nY who builds we improve(hexon, --
.. -
-and-oho contracts for such ,. with, ,. ,1.actaial.littnxed.pursuam to the
C nhucmra Liccnsc Law..,
❑I am exempt under bee. "" ` ,I..)� ;H&PCfor this reason (rn; 1'•.."„ ;;ItIUD
- .. .- .. . .tact
Own• Date '
"WORKER'S COMPENSATION DECLARATION
1 hereby affml under penahy of pe�jliry,Line oft the following Jedamtions:
E + ❑ 1 have and will maintain a Cenifeme of Con em to clf-in urt for Wmis
Campensaooa as provided for by Seaton 37M of the Labor Cede, for the
' - perfonnbnce of the work for which this permit is issued.
7 : .
❑1 ha
-d. maimam worker'x Compclisalion Inmmnec,as mquixd by Section
cs 37t of the Ubur Code,for the raifoolmom of the work'for which this pern"t is
I ed.MyWori,eesCmaa
pensation 1 . Ixx a//r��and
�P�oliaAaty,,II be a¢�:]y� n n tt tp
Bm�rY/IW/�txt i,r'a PolicyN Y:C9I��ZS •1 �' i�'w. ( 5:. `'.. l�Y\�I 1 r f [ �.��, ..._ . r' .'it
CERTIFICATION:OF EXEMPTION FROM.WORKERSi•
' COMPENSATION INSURANCE"'
''' CDI s writ on necdtno,tickomp11tod If the pemm Is for one hutdred dollars ;C. ' t P
(510(]) 1 .)
_ _ _......,-..-.. ...........-__. . . _._......_ I �. ..-... .. ..,, .7 �..,
N`ta ,I copky1 Ito Ne inforrninany inaofthe oRTawhich Ihsct tot eWorke 1
Rall not employ Boy f Cith m any aunner w as to become subject m the WorkeR
CAnm Earu L .. i_
pc ;sofC if �',D�I
NOTICE TO APPLICANT If, Be, akin,d CClbfc 1c ofE pt you-should
� X
R-'E z bceo hl n 111 W k Co spent It n P ul the Lobo Cod y .1 "L
Z nh th I th S h p s orlh.perm t h ll W d ed A J 'Q O fo p Y _ _ .Zi I.:' t 'CONSTRUCTION LENDING AGENCY I hereby Rn Ih t the 2onnmct on IerW n
a'c 1
w.E 'or lhewoRmes., mapelmd alxxacalsM VB9] rv.e.)
•.v.,�,:�,_...._. ... - tract . . _.
c' Left Aadxsa +
.p:Z . .::C .L. ..
rlcmify than l have rend this application and state thin the above infnwlion is
W [`". Icmmc,.I agree re comply with all city and county ordinances and slate laws relating
PeU ,to Wilding cuns0union,and herebyaudmrim n:presenatives of thi:city to enterupun
. >j-W the above-mentioned property for inspection polpnses.
,l ,- _, „
.0. (Iscs)dgrec ui,.w:lldintify and keep harmlessthc Ca of Cdpeniooageinst
W liabilities,judgment,costa and expenses which may.to any sexy nerne ageinn said
U ,'� On'mibnsequ....of.hegmnfn8of tho"rmil."' '
c 't'u iAP CA`4UND. TAND AND WILL COMPLY WIT N-POINT° Issued by: Date /v U
s ftCE YI
Ig Lirr fnpprte vCrmr mr•-,r" ...,.;h' 'Dne �' ' Re-roofs
f HAZARDOUS MATERIALS DISCLOS E '- -
IM1capplicant ftu bu'IL' g pant ser a h61Mle hauNous mom Type of Roof.
as def dby lh Cupcn Mun ip lC de Cn pte 9.12 and lh H lth nd Safcry ,1 y.s
Cole, eecY n 25532(al`p t Of. i t' sr "td t"- ' ' - a _f"
r '4 All roofs,shall.be mspected.prior,to„any,roofing,material-being.installed.
-------
If
_ _If a roof is installed'without first obtaining an'inspection; I'agree'to remove
it h d - onln t -d f ped by the B y A 'A 0 1 ly M g inept
Oanl t - _ all new materials for inspection. Applicant understands and.will comply with,
( ) .oY ❑N all non-point source regulations.' . . 7 1
It el lead the h zadou aimal,xquixmcnt aid Ch pt 695 of the i i
omle Health d Safety Code.Smuons 25505.25533 and 25534,1 underhand Inas'
,he building does notemeendy haven tenant,that it is my xsponsibility lonotify the
'nccup m of the reyu' 'nt wh' h maxi Ire mei pour m issu a of Ceni(me of
°cup 1' Signature of-Applicant Date
< 6 All roof coverings to be Class"B"or better '
Owne thrived ab'_ l- to . .
OFFICE