01020121CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
HU H.DING ADDRESS:
PERMIT NO.
01020121
OW.NLWS NAME: -
�eL
APPLICATION SUB DArL
t2ty
�Co
02/22/2001
IONS LIEU
SANITARY NO. CONTROL NO.
ARCHI'r1iC l'IIiNGINIiIiR:
dUl1.DING INFO
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I'LMI'r
BL_>G GLLCI PLUMB MECII
LICENSED CONTRACT 'OR'SDECLARATION
Job Description
1 hereby ufnma that 1 am licensee] under pmvisinns of Chatter 9 (commencing
ywith Section 7000nof l)ivici.e3of the Business and Pmlmsionc Code. and my license
'n full pace and efl'
sa Haile spy./_ a m.N 7 ._ 87
CUT IN
WINDOW �/
Dote 7FP=l Cemrmm
ARCHIl1'e DLCIARA RA ION
use
g I undcmmaA my plain mull xJ as public at
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erebyaanal
P., OWNER -BUILDER DECLARATION
1 hacby.(Sect that I ale. for the
Imm the Contractor iCole: License.,city
O
o
a' ]IDES. 1 Bodn vnd P,ofmsinnv city nr county
ire rcaa a
/
h.orAny
R which requires a peed',, le Golanlic alter, inapmvc. Je;maid.. o slmceee
which ecou to alter,
lea,iir ed
to ,ow, gaw(Cha
s the;IiWoo,
Sq. FL Flour Area
Valuation
Chior t he s Inecoa d per,n m b,flle,air
of ,he Contractors ter 9
- (commencing edwnuaotmoaepmviivwonnnecenmacmPaLicomedewon,Cor)
efomlaNr DI 3 atl Code)
(commencing withSectiontherefrom
exemption. Any violation
the alfffic leged Any
anrefmm and the buvis 1i. the
or be is thaw
ra,th ,pfi,m l
of S«ben 33.5 la any applicant by a pecrail wbjao Inc uPPlicam m a circ penahy
Ser
APN Number
Occupancy Type
v
of net more man Bre nanmw donut. ($situ).
a than
D 1. ai owoerof [tic propety.o my Oopb,yee w;m s,ro a,evtheir aom compensation,
Inspections
will do Iecwnrk, unit the amcaae Is not hummed or offered liar sale (See. 744.
Buincvr mad Pndccioos Code'. Tea Commemrt, License U. d-, out apply It, Ian
Required
w r at peapmy Won build. or improve, thereon, ..,Iwho docs web Werk on,df
or through his own mtployees. provided that such impr".emcm,, are nm intended or
101 -
FOUNDATION
offered for sale. If however. the building or improvement is .cold within one year of
completion. the mrner.builder will have the burden of,mving that he did not build or
102 -
PIERS
improve for pimputt of sale.).
103 -
UFER
❑ L a, mor cr orate ro,md, at e.dnaivcly contracting with [i.naed contractor,
he (Seo. 9Uf4. 13 crr and 11-ro"ite, Cede.)' me Conn-ac"ar.
104 -
REBAR
Ijait.lrnel nmien
iecavo Law docs ma apply to an ewne; A p;olwny wet, build. ", hopio," um,
and who cemmetF Far such projects with a aontmne(.) licenced pursuant to the
105 —
ANCHOR BOLTS
Contractor's Lwcmc Ina.
01 am exempt under See. . B k P C for this reason
106 —
SEWER R WATER
Owmer Datc
202 —
UNDERFLOOR PLUMBING
WORKER'S COMPENSATION DECLARATION
2.03 —
UNDERFLOOR MECHANICAL
Ineaa,y ;inn;, mtd,l,aaeyol smi..r..... e eeh;uewing ecdarmieea:
204 -
UNDERFLOOR FRAME
s M1ave vnd will nteintvio a Cenilieme of Cement to edbin.,me for Worker's
205 —
UNDERFLOOR INSULATION
cmnpeae.aon, a.. provided Ter by Section nal or the Ichor Code. for the
pelf"rmanceonneand,forwhi,hdi,pentmi.issued,
301. —
ROUGH PLUMBING
/4 have and will maintain Worker, conapcn.mmn ln.umnet, a, reynired by Section
302 -
TUB R OR SHOWER
'1]IMt W the lemor Code fill the permnn"ncv of the work for which this recruit is
,mance. ieramn`enevpamnne�lu,
issued My.�We'r�ke[���,yyy`cyy'
303 —
ROUGH MECHANICAL
�"nn.a.....i
"/U"�1`elicy No.: t58f_/_O
Carrier_
Jf Ie HFICAl'ION Cit EXEMPTION FROM WORKERS'
304 -
ROUGH ELECTRICAL
COMPHNSAI ION INSURANCE
305 -
FRAME
ma, section real not be complclvd if the permit is for"nc naadred dollars
306 —
HOLDOWNS
is IoIU or Icas.l
307 -
INSULATION
Iecm(y( hat inthe vrforualueofn;eworkfor whichthis permit i.ic.ued,1
,had inn ea;pley ;.ey narcntt m nny a ...Urso elm become sobjeo to be Wo,ke,"
308 -
SHEETROCK
Com"o,"lion Laws leiCnlda... a D:nc
Appneant
309 —
EXTERIOR LATH
NOTICE 11) APPLICANT: If. idler making this Certificate or 11scraptlon. y.a should
keome."bjecno me Werker. Cnmpemmton pmri.inmorme Laron Code. you mum
310 -
INTERIOR LATH
Ponnaah comply with such previaom or this permit shall be deemed revoked.
311 -
SCRATCH COAT
q C(INSTRUCTIONLENDINGAGENCY
Iheteby;drm.n,.,there i,"conmmel;Iendingagency bar tic performance
313 -
ROOF NAIL
r of the wink Ibr which this penin( is issued (See 3097. Cir. C.)
ELECTRICAL ENERGY
lcmlery Na;,til
501. —
FINAL.
7 Iwmd,,,Addres.
502 —
FINAL. PLUMBING ENERGY
I crony that I have read mi, application and, bac But the Axwe informandint i.
dstateI
503 —
FINAL MECHANICAL. ENERGY
comet. I agreet ply witin all city I county ordlfiwnccretailing
' B this I I t upon
to building construction, and p fl
d for
504 —
FINAL BUILDING ENERGY'
men tar property insfi par
L (W) agreeI save, indettinityand keep harmless th City ol Cup nb ext
505 -
FINAL ELECTRICAL
d .I,ca.vcc WhiCh nay in:ay way accricagaina..bd
A roll I Ig ..alas. I `
C city in eonw,umooc of the gmnungof nils Penna
APPLICANT UNDERSTANDS 'ILL CON]PLY WITH ALL NO�POI T
SOURCE NHONma/Ca ✓f( I_ (/y
Issued by: 506 -
GAS TEST
Dale
fAp, li Darc
Signature of ApplicanACnn�i
Re -rook
Re -roofs 508 -
FINAL. MECHANICAL
DSS M AI^~-"-`—
unynxuous mn'r[RIAL.S DIscl.osuRB
Willlbc applicant or famm bu'dding;xvvpam aor, nr noodle ha,allom material
Type of Roof 509 —
FINAL GRADE
ac defined by lee Cnpemin, Municipal Cale. Ch.rmr 0.12. and the Health and Safety
Cede. S,,t 25532o0:
S =
Nj%cled
p N�1 L P L N N I NG
Dyes tr)r"
All roofs shall be
prl any ro ``n r }}pill �g installed.
i9i'Fny
Will the applicant nr remre buildingocce,end use r,mpnnrnlo, deviceswhich
If a roofis installAlAhout�
h' Cpe�'t'Sgree to remove
mil haeardoun air ennaminenaa as defined by the Bay Area Air Qualily Management
Brienall
new materials for inspection.
Applicant understands and will comply with
Lw_�
0Ye,
all non -point source regulations.
1 have rend by h zardnuc ;nmcrials re,viremmras under Che$ mr 6.95 ill the
Cali forma health k Sa('ny Code, Sections 2550.5, 255]3 and 25534. 1 nnderstmW Ihat
O the building docs n"I cmrcn ly have a.runt, mw it may resr"n.vibility to Booty (hc
,ceoper of nae quir e s which nm M tea prig m hcnvace of a Cori
"""p""`y�
J
Signature of Applicant
Date
_`u/
�Ie
All roof
coverings to be Class ilB'• or better
Owmee, aahorued ae t
OFFICE