02070154CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
22740 SAN JUAN RD
SCHAUMANN AIR CONDITIONING
PERh11T
2070154
° SOvR JAMES E AND DOROTHY I
HEATING & PLUMBING INC
APPLIGAIIVDPISPfk 72002
L.i/
PHONE:
(408)428-0640
SANITARYNO.� CONTROL NO.
ARCHITEC (ENGINEER:
BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
L. U
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that l am licensed under pmvisions of Chapter 9(commencing
,.�Qb Description lL
REPLACE A/C UNl
with Section 70X)1 of Division 3 ofthe Business and Prutcssions Code, ndmylseense
Lacon°"(°ro`° P 7raO3
Limn I Lic.p
l
JUL 3 1 2002
Data Connnac
CHITECT'5 DELLA ION
I undennnd my plans shall be used as pubbe records
BUILDING
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License law for the
following reason. (Section 7031.5. Business and Professions Cede: Any city or unry
$5500
x Inch requires a permit to construct, almr, improve. demolish, or repair any stiunae
prl sego( f1 the
dso signed statement
pn la
cti;m 3$� 1Q7o3r.�Q@a�\,,i,,,f.Il.z ,,,
Valuation
he Ca
comma cinsuancs,
(i,mim isrch,it itptiection7" to the ofDi ikimions o Commsin iLindPrcense LawlChoger9
( Section Business and CW.)
gwnh Professions
anfhe basis3ofthe
the basis for the ds cticmpnt to Any violation
or that he is es'1 5 b any
.'\,; .�Y_d.-, A,; al 3,Ax„ _
the
of Section 707 m v any orphan] for o permit subjmx the applicant m e civil Kathy -
applicant for
of ria male then 0.-e hundred mn,a essX)).
3 0 1APN
�_ .I .,+ Occupancy Type
°l, as owner of property. or my employees with wages as their sale compensation.
303 — ROUGH MECHANI
AL
will do the work: and the structure is hot intended" or offered' for sale (See 71 ,""
o and Professions Code: The Conuonore License law docs now apply to
tions --
Ow'Buiner
Owner on property Who Wilds or improves thereon, and who errs such work if
5 0 5 - FINAL E
need or
or through his own employees. provided that such improvements mems as not intended or
:offc¢dfortal:i.
_
- -- 507- -- FINAL- PLUMBING"
`- -------- - --- -- -- -
r If, hbwceq the building or improvement is sed within one year of
_
completion, the ownenbuiider will have me burden of proving that he did not build or
- FINAL MECHANICAL
improve for purpomid sal
---._.._tuft e--
ID contracting contractors m
° L as owner of me property, am with Isi
t.1 n : r� p ; N: ,
me project (See, Business a si n
a, Business and Professions Cade:) The Contractorthereon,
x
License
License Law dos not apply loan owner of propcny who bodes improves thereon,
appl to
_andwon. such camncmKs)licensed pursuant tome..-.-..
s
License
1noexContractors "ansa
❑ls excmpn under gee. "" ;B'$PCfm this rtsson
'f'I' ,c'. x.i lr liJ:w
Owner'' I Dote"
- WORKER'S COMPENSATIONDECLARATION
I hereby affirm under pcndry, of perjury one of,the following declarations:
❑ 1 have and wit( maintain a Cenifiam of Consent to selpinsure for Worker's
"
Compensation. as; provided for by 'Section 3700 of the Labor Code. forme
perfomunce of the work for which this permit is isslud., ,
° 1 have mid will mainiiili Worker's Coin, prnimion'lnsurxmm, as rcgbi ad by Section
3700 f th Labor Cad fo th se entrance of the work'fo which this permit is
Issued M //p9t/�!Y/�fsJJs����o�?,Z a$uon sunnce tamer end P u W ea:,s
y'/ �a�tJr/ r A t ,. h
Cent P No
_
\al:.a::i•i:
r CERTIFICATION OF EMPTION FROM WRRS -
:.�1-.'�'. , su iA' s s. a! .., inti in �I.
` -
. COMPENSATION INSURANCE ":KE
.I �d not be completed in the permit is for one hundred dollars
This union nee
s ., �.L .•.C'+G '1'Itit 'vIYJ;`
� ! t ' '1
_..i .._
}I calory laid In the perfotmind f the o k f whah Ih s pe n rs nsued Ilisall'
.. _. _ _. _. -. .....-. _,..-.-,.,.._._. ._.... ...
laws oft Calf -'D ie, ' "
Com ria cmpl L any Pcrso In any manner so es no become subject 16 the Workers'Apply
nit'
NOTICETOAPPLICANP.If. after making this Cenificam of Exemption. you should
become subject to the Worker's Compensation provisions of the Labor Code, you must
norshwidi comply with such provisions or this permit shall be deemed remlod.
v"
CONSTRUCTION LENDING AGENCY
- l
' 1 hereby iRren that mcreis a cdgtfttc11o0lendinIf agency forthe perfeI umce
- 'n `
of die work for which this is issued Sec. 3097,;
permi
I2ndar'x Name""-•`_:�._....u:__..r.. .._. ...d"p_.-....... n,_.
.. _._. .. ____". .. ._" _ __.__... _._.._..... ._
Lender' Address....,
lu.ns
., I certify that I have reed this application and state that the above information is
'
collacin agree m comply with ell city and county ordimusect and sum, laws allomg
a
to building conatrdttion. and here.by aulhprm mpresentathm; of this city to enter upon
the aWa Zoned property for spatia purposes
(We)agrce io lose and<m (yo dkeep harmless the Cisyof Cupenmoigdnv
liabilities, judgments, costs d expenses which may any way accme age nst said
City n cor+sequcncc of me gran( g f tha a t
UNDERSTANDS WILLCOMPLY WITHALLNO,'POINT
i
APPLICA.'.R AND
SOURCEREGULATIONS.� +
Issue y� Dale
Du
Siynsn fAPpIj HAZARDOUS MATERIALS DISCL .. ''I
-" ,,.. OSURE .. ..
'
Re -roofs
; Wel dr app - a roma W kl Y acupent core or handle hica dohs minenA
Type of Roof -
as defined q' th Cuport Mun opal Cod Ch pm 9 12 d theH 1th e d Safety
Cole Seclon25532(e)°\ i.I` r " I'
,
?'• i''s-4~ 4 . '.. .\-.;; s .+ r
...All roofs.shall be inspected prior. toany. roofing material being.installed.
ln,e Will thea applicant flu Wilding Occupant use equipment devices hick
P -
`
If a roof is installed'without first obtaining an inspection, I' agiee to'femove
emit h mdous e+ anumm i de
Diimn"' , Encd by he Bay Arte Art Quality Menagemem
/7 _
-
-
all new materials for inspection Applicant understands. and will comply with-, _
ore: J, .,,;'d ,. /3Nal „-, ,
all non -point source regulations.',,,
I have W Ihe:hawdo materials qu rem nu'under Chapmr 6.95 of the
Calif Heihh &. Safety Code Seasons 25505 25533 and 25336 1 understand that
Bate buwi.,does note rmil Yh aala t that 1 s yrespa, 6lty to notify the
1 of she requirements h c must be a poor to issuance of a Ce +rite
any I -
r �G
ure.ofApplicant
Igo Date
All roof coverings to be Class "B" or better
O oth ogn Dm
tip I I s trr j.: I
.
' OFFICE ". . _... _. _ _.. ... .._