01120034 CITY OF CUPERTINO
BUILDING DIVISION PERM CONTRACTOR INFORMA N:
BtI LDING DURESS: PERMIT NO,
JL15 �8 ROSARIO AV 01120034
APPLIC
yy06jyyD MLL WILLIAM J AND ELIZA E 2001
'HONE: SANITARY NO. CONTROL NO.
O O O ARCHITECNENGINEER: BUILDING PERMIT INFD
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
Iliom7 affirm Nmlam of
0under proWilonsof Cs ode.an ommencing INSTALL ROOF. OVERHANG & INSTALL 2 INCHES .
_ascan with fail omeand)cf Division3 of the Business and Processions Code.end mylicenx ���
as>e Y i.in full(nine and cHcct.
Y z a 6 Liccnu Class Lic.a e Imo'®
e O U Dain Conirvctor FINALE
a O Yii - ARCHi rECT'S DECLARATION
f gI understand my plana shall be used as public records SEP 2 5 2002
r
in p C Licensed Professional
oil OWNER BUILDER DECLARATION "
w - I h by.ffirmSect ohm 1 1. inns boom the Contractor Cc t r factor "+'V I�DII V
C Z Q fall 'nb r Section 703 1.5,S Business terimprove
roProfessions or"P y 'ry or 4 Q Q'
O wh<h«qu'or
a nems t t construct
Ire np demolish' r r pa any'tincture
e3$ pros is ante,also y '«-the aPPl cum fu such peon no Rleasg ed atamment- --- - ----- - - -- ---- - -- -- -
that her IiansM puiwv t to.be pmnstoo aids,C tractor Ll tt la Qheger 9 ,
locomotion,
comment..with Section 7(m01 (Divi oo 3 of me Business nd Pmrsstons eotln) { ,+,1'4 f j.3�s( "1 �(4,'; 9r,�gpaay•�-r t ; 1, Valuation
or.rhes he is erempt therefrom and dtc basis for ilia alliged rslminim o violmmn
e 'strimr"31.5 by ony appbeentfor o istoon subjects she applicant a a civil nursery
of not more than evehund«tldonors($5o0). 305pPNM E Occupancy Type
307 — INSULATION
❑1,m owner of the and
the structure ur my employees with wages a their wee compensation.. l 1
-w111 nc oh nil Prrik.r and thCodeThis not intended or rou,Lawred for sale(set:to an 6 01 - ROOF TE IGERns ections"
.no4.
Bul,of .,Ay Alm
Wild,
The Conuanor's License Law doer not apply to an p
.no, his ow cul lvlds or ovidedesat such ane vendors ruck wodnded or 602 - ROOF PLYWOOD NAIL
or eyed through his own move,eecs.provided sem such improvenom mems are not intended or .- 7-
completion,
i
offered for sale Ir,er builder the busheseurdenof pro is rain he did Weldor _... .603. .-_ROOF" BATTENS'
oprove far theownerf le.) will have the burden of proving that he did not build or l
improve far purpose attain.), 604 - ROOF IN-PROGRESS
OL asmctthe of the pmpeny,am rsdmi,eBusiness a nomrrctinionsCo licensed Contractor's construct she Des out
(Sec.7611,Business" A,who
Cade)The Cmnnctor's -
- License law docs not apply;o an own.with
property won builds to improves .to the -
and who Livens for such projects with a conwetorfs).littnwd purauant.m the - . ........__._.. .._ ...`. .. .___,._
n C 1 runorsfrcunde law..
❑tam comfort under Sec. .B&PCfor this meson i-. ._n:'� .••..
Corsi - 'Das
WORKER'S COMPENSATION DECLARATION
'ry I hereby affirm under penalty of perjury one of the following declarations:
f1 ❑ 1 have and will maintain a'CeniGene of Consent to sel6mumn,for Worker's
{� Compensation, as Provided far by Section 37W of the Isom Code, for the
'Performance of the work for whim this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,m required by Section
3700 of the Labor Code.for she performance of she work for which this permit is -
issued,My Wader's Compensmon Insurance carrier and Policy number are:
Gainer .CERTIFICATION OF EXEMPTION FROM WORKERS' f �.'•- .' ( . .A.t ;l}tJ ir:' lir/ ; (.,.
COMPENSATI1.ON INSURANCE'
a,r'.
' -
m I s scnion need not to completed if the Permit is for one hundred dollars
`I�`
(81001 0)nrcssJ. il..,.
. . , .._ ... _. ... _ ... .._., ,..,. ....
I ttnploy m in then in any
be-'"as t roe which tbij ct to me orkerl i ••t'•1 •-� - '
shall not employ any,person in any manner so as m become subject to the Workers'
Compensation laws of Celi(nmia,Da¢'
� O _NOAPPLICANT:If. makingCcrificau, oshould
become subject Worker's
CompestinProvisionsof the Labor Code,you must
fonhwsh cmplywioh wch prosim.as or driv
permit shall be deemed revoked.
e - " CONSTRUCTION LENDINGAgii,me '
1 he by Rim Ill.,tea - cmed(Sao.
lending age y f th performance n' r
Lendarok for rich rho.perms rssocd lSee 3097.Ci, _., -._ .,, ., .. ... .... . ...,
Iknd lis Nomer- . ..:.. -... ... .. r. - •. .. ..... . ... _.... _. .. ...
z Le a Address
1 cenify that 1 have read this application and stare that the above information is -
emreit.1 agree to complywithell city and county ordinances and state laws relating
f. C) to building construction.and hireby authorise representativer of this city to enter upon
g,J
the above-mentioned property for inspection purposes.,
kyr Tye- I Wjudgme ts,ave,i and upy and which
inthe way laCom against
said
F.V] liabilities,judgments,costs end joining
ofds which may in any way eccrvc against wid
V APPLICANTUNDER consausence the granting o(tbILLC it. - `' '" '
'SOURCE RE UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issuedb Date
SOURCE REGULATIONS. � s y
Signawrepf ApplicandCommotor.i "" •"' "'Dole' Re-roofs
_ HAZARDOUS MATERIALS DISCLOSURE'
a ' W ll the applicant or plane building occupant store or handle hoaoNous material ._ �fype,of Roof._ t — - -• _ .
as defned by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety -
cdde.s etc nS53zta1 .All roofs shall,be msfected prior-to roofing material bei
r:;,�tii
ovea - a.
(10 t1 t,: I - - - p y. ng.installed.Will the applicant or future building occupant use equipment or devices whim If a roof is installed without first obtaining an inspection, I agree to remove
ema hatuadjus air contaminants as defined by the Bay Area Air Qualily Management
Dissnm _ all new materials for inspection. Applicant understands and willcomplywith
ty ❑Y - ON. all non-point source regulations..
V.ys
I have Health
&Safety
ety Code,maienals rtyv 25533 and 255 4.1 te;un erstoo f the
if the Il do&Safcry Crile,Sections 25505,25533 itis and 25534.1 understand that
ochelono In,resnaim5ors whichhavucnant.tooth.,my responsiof Cornmify the -
ec; p m of she,iequi menti which must he met p'or to its nee of a C<ni0cme of
Signature of Applicant. Date
Owner rte eutnoriud.,.t Da All roof coverings to be Class"B" or better
;. .. OFFICE - . . .. . . .. ...
� n
3�� l a"ax l: 1iii-s, eajper' Cr �rX 64-y,,5147-0.,
akv '
APPROVED
I X 4 10-ACCORDANCE WITH THE CITY OF
(✓ t� MP_ERTINO CODES AND ORDINANCES
Section A A axz . o < �4T Ce Fere RATE
2rG — d /
(orI(dces SIGNED_ _
This set of pians ano specdications MUST
be kept on the j:h at a'I times and it is ur.
• lawful to make ary chnpyas or alterations
on same witho-ut ',v accn permission frorr
of Cupertino.
The Stam no Gt ,hs p cri and specifications
v ° SHALL f )f he bed to permit or to be an
r�rtN 3pprovr of the v.ok:ion of any provision-
pr e anv ,itv O t:nan = or State Law
2" 3`..
UQlclvP
PLOT PLANS --
'CM BY
11 C,
D t 1002 9 330
OFFICE COPS �1
PLANNING21 DE - �zt Lt1 :�' Tj (l
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16
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/ A I z"
aiirewS apfnces
• a p Pfau: 3/8 fx 6 11 LzF Front V' Scale V=20" •
10o�'�s 2r.�v Wu.0 5'�uaQo
1a 67
ll DEC 6 2001
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• Front Ve Scale 1"=20" •
Detail 1
w..._.. Simpson TP37
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DEC 6 2001 Dli
ower Joist
Lower Simpson LUS 24 Joist Hanger aattached
Header as specifeid by Simpson
/8" x 6" Lag bolt
Wm�w
'DEC 6 2001
� I_
86� � 'ltd2u
I
Air Conditioner
Scale kW'
• Chaulking
Flashing
Composition Shingles
ar Paper
(7 1/2" C X Plywood
after
Simpson NER-421 Rafter Hanger
z��- attached as specified by Simpson
Upper Header., I�u
M
C7 ` C
• C-•
ob C-_ -,,
I 3/8" x 6" Lag bolt
c czg
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• Work Description
• Remove existing Aluminum Upstairs Hall and Master Bath windows
• Replace with same size energy efficient windows
• 3'0" x 2'0"
• . Milgard double pane vinyl window
• Nail Fin Style
• Wood siding on exterior
• Master Bath: Obscured glass, Hall Bath: Obscured and Tempered glass (window '
in bath tub enclosure area).
�Ii IIIi1i� iJ
J DEC 6 2001 I�i.