01020071 CITY OF CUPERTINO t -.r:<<. "' •..,,,, ' - sz-.,. .. , . _ -
BUILDING DIVISIO" PERMIT CONTRACTOR INFORMATION
BUILDING ADDRESS'. " i PERMIT NO.
01020071
OWNER'S NAME: ,I APPLICATION SUB DATE 1'
09'/14/a00J
LAKE• PHONE. IBILT;MDRE - SANITARY NO CONTROL NO _
f 1
❑CZ ARCHI('CC'LENGINIER - ,BUILDING PERMITINFO
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•xBLDG FLEC
'y ' T" PLUMH MECH n00 _
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2 7 LICENSED CONTRACTORS DECLARAuorv' Job Description y
I
qq' iea heory,ftvrit,.,b I rectified I r' ffCh'p9 '
in,
nB will,s 1 7000).tDvsat9 if Bu II Cd andyI
fol I B IrLp
INTERIOR REMODEL�',fr�e I.TpppAfp1 •/./[�y�r{TI
WHOte Contractor _ ��,, .' - '� RNA
�/r'O
ARCHI TFCT'S DEC]ARATION +'"r ,
�yy l e .,' r r rI n u rue I n n1 ennE
yiU
I C ap'O Licensed!Profess,,al -. q r '
OW W R BIJII DEN DECI,ARAMON . MAY' 0.9 2001
m I n vabout
rr- ro l l hill o h C 1 1 L La (loo. , • •,
l:�d .fu0 b .(S t 70315R dl f: .Cd AY oily county 1_
y B t J .
.pr l t I thePPI .. hl ,1 1Iurinated.11 t 61 Bin rillmlit
1n 11 Ir 1I In p - n m c 1 1 r I L.
(Ch I1 ) Sq..Ft. Floor Area , a LDn'
•(Game cox with Sul 7W0) ID' l fth B . IP f '(ole) `
o,Far he is es'ned threat nand the ha.'.�,fnr lire uttered er,lon.Alysnllfot -. y - � lw
(11 Saloon'10315 by ta"appioadf perionsbJ 1:the applicant in a oivilnnalty
ofned» C Ill.,rise un Ire I a Bar, (S500, . , - - ', : kAPN Number" _ -w. - 'Occupancy Type
- ❑1,as ewne,,flhel nPerlY.or,,,one'lloyears wnhwaxL,s mer sole conpensu n
oil do II k ;Ind.the structure 6nor 'Intendedofferedl sal (ser,loon "'
Bit i and Pr fool n. c d TI e Conlr 1 r s I lease L does ant apply to a n Required inspections' -
f property Whon ild p c:d h J I. k Foresail . -
ord kir his pI5' presided tht: 1 ' p t t t'eeaor 10.1- - FOUNDATION
inhooll for sale If,floweret,the h "Edi n,......i,owearof in Id within.,no yen,of
ralopetool,theworeste-hoolder sellhave the I...oden oftrd,lnxa,,[at did no,loddor 102 =T PIERS--
initial,1 ......... el )
10� - UFER
theolue,of property, exclusively I x with licensed l l :I �J',
,8, p )e,ls 7Bna B 11 I Code:)Tn c i 1,04,'— REDAR
1 leaseL- 1 apply to - Ir n IY 'n n 11 p u there.. S — ..
w 1 t t. r such Icela with contractor(l) dp :am, the ' 105 ''ANCHOR 'BOLTS
of d I urho.re 1fAfi:'= SEWER R ,WATER
�G
Owner Da, c"0c -- UNDERFLOOR'rPLUMBING
WOR SCOMP N ON DTCLA ZION
} ?03t— UNDERFLOOR MECHANICAL
' A - -br r1 r 'hy P ) m f u ,d 1 ', - 204„7 UNDERFLOOR •FRAME .a .
• z' __
❑'I d' ''11 , C I r I f Consent m If f Worker's
Compensation,rano he eak'En tm by suaon 3Oo m the Labor cdd r, ,n205 UNDF_RFL_OOR IhISIII�ATIaOhI
Iwif rn c or he kl Ii 1 ,M1' pel n d. !
— ROUGH PLUMBING ,
❑II- d II t Worker's C l l Insurance, :- I IbyS I f. _
3708 fthe LaborCad r thel,erfor northeworkl i" nm I ;lir - „s0� TUB 8' OR SHOWER.
issued.My Workers C p s, un I s,n and Tracy ober arc: ! '
303 rfROUGH„',MECHANICAL
Carrier: Policy No.: t” - !T --,' ROUGH C '
511 -CERTIFICATION,OF EXEMPTION FROM WORKERS' _ .S¢,4 - ELEL.TRICRL - .
COMPENSATION INSURANCE - wt
31D5 ,="'FRAME '
(Co ronneednotb.a,;,,rleld if the peroli,r 'handed dollar-. 306 HOLDOWNS-
.- (illeyo I ) J -
w" 307- - INSULATION,;
I IY Ill 1 thepath) - f the work for wh h Ill p , . uL 1, - .
- ball not eml loy any re t n„ty arauee,.o a.10 nuom ab,iu„o me Wnrkees '"-308 — SHEETROCK > .
Q, p Lw.mclr D1 '� ,r.
Ahrl 1 ' - - .,09 EXTERIOR, LATH
'NOIICI TO APPLICANT II f1 rk ,Ill Caulfield, If to 51 should
be ' hl ,tthwk c n .au P 'ono LI Care,1y a.t 310` — ' INTER IOR' LATH
z a,ra,dm,n,mlywm nP or his pe ,:nI1nd Ii 4k d. 31 I-x.—' SCRATCH:•,COAT e .
F � CONS rIl ION LENDING AGENCY — ,
Y. 9 • II ly rr trtlh ne I 'txe yrrmeroff on ,313 ROOF,°'NAIL
of theDeft I' hlI I rt.I s-nsued(Set.3097 Ci,.C.)
i o Led :N:ne 501 . `FINAL ELECTRICAL ENERGY '
o z Loudoe's- AdI : 5Lb2 FINAL RI UIIBING'ENERGY
I ' ,tylitIn 'dthl luTh , auditor hit,the h I t
W Fy col t 1 y t RIY lh II ty: I Iy ab ad.t, 1 t s ;SQ3 FINAL MECHANICAL ENERGY, '
O'V ,nI lalx ,.t dI n> m rte. F, nba.elro, tnrll 1 tv 5 4' _ - FI�IWL',BUILDING .ENERGY -'.
the b Y Ir IMly 'n:rc1 nl ...... - r b
(R') x , d 'fyand kph .J City fCr , t r
n b:mll idx L 1 ,d p n y ,> y acetoneagainst a 505 ,— FINRL ELECTRICAL
CJ,Z Cllr ,e u.wncnue or the'oude,of,B .a per», ., �- � 1
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONPOINT .1506 'ORS - TEST
SOURCE REGULATIONS. • ISsned by: ' 81e n Z-.! D
Sl, I fApplire t/Contrumr - , f Date Re=roofs .508'—
' — L 1+ --
HALARDOUS MATERIAL S DISCLOSURE JQiFS Jam' FINRL MECI lAN'I t RC "v,
wed aPTT , future1 Ir , .. p ,l dI h M not arl " Type of,Roof 509 `FINAL (GRADE ;i
vdr Eby II Clat M Ia1Cd Chapter 9.12 I,h Health ISfty o - '
Code at 2553x) ary EINaL PL NNING "
yes All roofs shall'be i e ted rQ }� {Q to msialled
Will n ppi , r building' P t Bt p , ilicy r n If a roof is installed Dui fi �s bUPAin�i'�Sg c on,I'agree to remove -
aull I a n1 I, It dlyh they Area A Q I"IyM ay ent
'
),error ,r all new materials for.irispection."Applicant understands and will comply with .
all non",point source regulations.
' 11 ,,,,id h 1 at I I ems under Cheaper 6)5 of the 'I
Cnl fort6on,,eaf,I 'fcty Ude beeli nn 2550525531 and 25534 unde'str nd that
I,h ht II h' - t ttl tl': Y .pn.bl' l - IfYlh ,• „ -- '
up ''1 uln ,p- , f Cnlet ISignatirre of Applicant Date
tr
Coterie-a,m -, I I. I 1 ate All roof coverings to be Class `B" or better _. .
OFFICE '