02030210 CITY OF CUPERTINO
BUILDING DIVISION PERMITONT1iCTOR;INFORMA.' Tr(?Ns,'.
Bu1WING ADDRESS: NICE & RIGHT CONSTRUCTION. ERMIT No.
10663 SANTA T-UrTA RT) Q��020:�10
'R'S NAME: 166 EUCALYPTUS DR PTRIMUMUEDATE
LARRY YU
NE' (415) 239-2696 SANITARY NO. CONTROL NO.
Fr.S- / — S
ARCHITECfIENGINEER: BUILDING PERMIT INFO -
BLDG ELECT PLUMB MECH
o
J00 LICENSED CONfRAC1OR'S DECLARATION Job DesCflpb00
1 hereby afRrm(hn 1 am Iiconsed under provisions of Chapter 9(commencing '
Zj with Section 71)00)of Division 3 ofmo Busincesand Profcasiun,Code,and mylleensel.
m� in tun force andctRm. //�� C _ ADD 831- SQ. FT. .
License 1 ��ff..��Lk.N
Dia• contracmr d-- PERMIT APPL EXPIRED 9/27/02 . LETTER SENT 1/06/
ARCHITECTS DECLAR A ON
all Iundersandmyplans ahmmtourist,public record, PERMIT APPL EXTENDED TILL 4/27/03 PER GREG 1/29
bG
Licensed Professional
OWNER-BUILDER DECLARATION
E A f 1 naso .fn.rm 1 em.Bump(from the Conoan 's Code:A n c Law for(m
i.po thawingruann.(Sudan 7031.3.Busmenend os.caetuns Any city or county \ Do
$rti whichrequires•Permite,alm maim teLalaempmso,deermitt.rirepair any ntmmrt yp� /1E/0(20
_Za primmIts sliemnco ekunt to the theapplicanta mrtmh Petit m Bleat Lacdeukmenl
< (commencing ed pursuant 7 the of Disiom arrive Cnnushrus'a Limneldwtchapmr9 q. [. Floor Area Valuation
E $
(commencing com int Section 7")the
basis n3 of the Bminwmton.Anynns Cnde)of
..
that e 7 31.5 b tiarefmm and Ire bssb for Ice allcts the exemption.an Any l Penalty
of
Satre than R.
aro'crepitant (S pemiuubjecu da applicant an a dull Pendry of APN Number $1(2E a0fty Tl pe
not mom than Rw hundred dollen(SSOII). 2 �T y� Q -
01,u owner of be u property,or my employcwith wages u their sale compensation. ✓�-2l 008
will do the work.and the structure is not intended.,.(fend for .to(Sec.TON,Budness Required Inspections
and Profusions Code:The C.nue(nt's Lt..law,does not apply a an owner of q p
property,who hulldsoramproves thereon,andwhodmasucb workhimmiror[enough his - fy
Owemployees.providedthat such improvements see not intended marmotforese.nt/' 101 FOUNDATION A bb
however,me building or Improvement is said within am year ofcompicaon,the owner- ry
bander will haw the burdens proving that he did rant mild or Improve fur purpose of 102 PIERS . I 1
a1e.). 103 - UFER AUG,�
❑1,as owner of the property,am eaeluively contracting with limned contracmn to - _ - 28 qo�� ,
construct Ire pmkm Business(Bea.7044,Business and Profusions Cade:)The ConlncaYa U. 104 — REBAR G
came taw docs not pply to an owner of property who Wilde or lmpmmes thereon.and. - 105 — ANCHOR BOLTS
who contacts for inu b pmjeeu with a mntanter(s)Retuned pursuant to the Cmtntto',
License law. 106 - SEWER & WATER ukoj/vG
Inn eacmptunder Su. B k P�CCfmr�thisreasun 202 - UNDERFLOOR PLUMBING �7
WORKER COMPENSATION DECLARATION 203 UNDERFLOOR MECHANICAL
I hereby anno under penalty or perjury ane of the following deelar&dlons: 204 — UNDERFLOOR FRAME
Ihawend wlllmeinulnaCeNRwa of CansentaselFinmmfor WaheM1C.mpcn- - 205 — ' UNDERFLOOR INSULATION
sation,u provided ler by section 3700 of the"bur Code,fm the performance of the 301 — ROUGH �PLUMBING
wad for wmm�ate pemukiuma. 302 - TUB & OR SHOWER
❑1 have and will maintain Wooers Compensation Insurance,a required by Section
370O.f the lamrcode.ler The petformance ofthe work for which this permit is issued. 303 — ROUGH MECHANICAL . .
My Wonker"Compensation
sInsurance choler and Policy number 304 —' ROUGH ELECTRICAL _
canler.S7 HAO Policy ONFRo.:�/9—�0 305 -` FRAME
CERTIFI ATE OF EXEMPIIONFROM WORKER 'COMPENSATION INSURANCE 306 HOLDOWNS
(this onion.acd no,the,completed aide Permit is formcbmamddmlm(sire) 301 — INSULATION -
... or less.) _.
Iunify Net In the Performance of the woh for which this permit BIssued,Ithat[not 308----SHE'E'TROCK— ----- — --- ---"---
employanypersaninanymanmranastubecomeubjectadteWorkers'Compenssion 309 — EXTERIOR LATH -
vwpiico^Calltomia.Daa 310 - INTERIOR LATH
NOTICE TO APPUCANC If.afar making thk Certificate of Exemption,you should 311 — SCRATCH COAT
become Subject to the Waher's Commmedion provisions of the labor Cnde,you must
.,Z fo b.]tb comply with itch provldnns or this permit shall W decreed Waked. 313 '— ROOF NAIL
CONSTRUCTION LENDING AGENCY 501 - FINAL ELECTRICAL ENERGY
F.. Ihereby affirm that them Isacommotinnlending agency for the perfafinenmof 502 FINAL PLUMBING ENERGY
�i the work for which this permit is issued(Sec.309'1,Cih,C.)
W p 5LeUnder'INama 503 FINAL MECHANICAL ENERGY
nding w AddrZ 504 - FINAL BUILDING ENERGY
U0 I cenlfy 11m I have reed this application and sum that me above information is 505 FINAL ELECTRICAL
0F connect.I Agree to comply with all tidy and county oral and sum laws misting to
U building nthmed pro and hereby suthoniyerepreaenatiru of this City to tole,upon the GAS EST
W ebovomentionnd no ertysave forc inspection lacup s. 0 7 FIN `
(we)agree(.save,indcmnlfy and keep cureless the City of Cuporlin.egd it m
rr Tap Iiabllides Judgmbou,costs and expenses which may in my way accrue&Sa n&asd City 5 A ICAL
in
of dr,
of
V his rmit,
APPLICANTUNDERSTANDS ERSTANDS(AND WILL COMPLY WITH ALL NON-POINT Issued by5 Date
SOyaCERM Ly,IONS�
Sitnature IIeanVC.n -
� / �� Re-roofs 5 4 - INAL PUBLIC WORKS
ler - D&a l
HAZARDOUS MA ALS DISCLOSURE Type of Roof.
Will the&PPlicam or future WlldinS.mu nano start rehandle hanrdous mskrial
cared by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety
Section W32(.)7 1❑Yu All roofs shall be inspected prior to any roofing material being installed.
I�Na
Will the applicant or future building occupant om equipment or device,which .If a roof is installed without first obtaining an inspection,I agree to remove
it hayardnns air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
atter?Cl Yea /\L�jtf�.
I ban mW the haundnusmamridsrequirements under Chapter 6.95 of the Celifor.
ilia Hcal"Surely Code,Sued.25505.25533 and 25534.1 understand that irthe building
does not currently have a anent that it k my rosp.nablllly a m dfy dm occupant of the
requirement h test bete riot issuance or ficaa Df Occupumy.
L—, � `�> - Signature of Applicant Date
owner ..mhoriyna. ant DateAll roof coverings to be Class"B" or better