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03050143 CITY OF CUPERTINO BUILDING DIVISION PERMIT =CQNTIAC -9 INk'.ORMt1TI( N . rf'.YN�. BUILDING ADDRESS: BAY AREA HAULING & BOBCAT 2ifti ""03050143 OWNER'S NAME: 1151 SPENCER AVE . 9/2003 N-YAO LIN jP"E; (408) 592-9755 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER; BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 300 LICENSED CONTRACTOR'S DECLARATION O O O O wI hereby affirm titan I am likensed ander proWYons of Chapter 9(commencing Job Description u with Section70t1o)af0ivision Serine Bumseasand Profaaslam Code.and my license I. �, p n � in full force andeffen DEMO .SWIMMING POOL FQN. � : - j Z Lieenso Class he.g DMA_e- DCmocanMm DECLARATION JUN i 9 2003 ARCHITECTS 1 understand my plans"I W used a public records G Licensed Professional 5w OWNER-BUILDER DECLARATION J�1 I hereby affirm that I am exempt from the Contractor's License Law far the BUIL •1.:bg 4�•+� O O following mason.(Section 7101.5,Business and professions Cade:Any city or county s$ which myulma a permit m construct,slot.improve.demnllah,or repair any stomtum poor m its issuance.also requires the applicant for such permit to file a signed statement FF`? Net to is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft. Floor Area $4N$b1®tion 3 $ (commencing with Section 7")of Division 7 of NC Business and Profwion&Code)or ' 3 that be la exempt Mondrian and Ne basis for the alleged exemption,Any violadon of Section 7071.5 by my applicant for a permit subjects the applicant in A civil penalty of erO 0 Occupancy Type oat more than five hundred dollars($500). ❑I.asowner of the pmpmY.wmy emPloyem with wagmasthelr role rampewnon, willdotW rk.mdtheatructumbwtint dwoffe forsab(Sec.701•a,Butlmss — and Professions Code:The Co mictork eco law does not apply b An ow.of 102 - PIERS d Inspections property who bas I Ida lir tmprows thereon.end who dam.tach work himself or through h4 own employees.provided that such improvements are not intended at offered forsele.If. 103 — UFER however.the building or improvement is sold within oro Sear o(cnmpleon,the owecr- builder will have the burden of proving that W did not Wild w improve for purpose of 104 - REBAR - ale). 105 - ANCHOR BOLTS 26 as owner of thtungsten,am exclusively connecting with licensed connacmrs a 106 - SEWER & WATER natnot Ne Project(Sec.7614,Business and Profmalons Code:)The Commemr's Li. cense law dons naupply to eco..ofpropeny who Wilda or improves demon,And, 202 — UNDERFLOOR PLUMBING who contracts for such projects with A conlnetor(s)licensed pursuant a the Con ractor's License Law. 203 - UNDERFLOOR MECHANICAL ❑l amcnouptundersec. .B pemrthlsmxmn 204 - UNDERFLOOR FRAME owner GiQ 205 - UNDERFLOOR INSULATION ` WORKER'SCOkNSATION DECLARATION Ihimbyafaresonarpew of perjury one of Me followingdeclammm 301 - ROUGH PLUMBING I haw and will maintain aCe rai .mafConsentwself.insumfw Worker'sC=mn- 302 — TUB & OR SHOWER anion.as Provided for by Smtion 7700 of the Labor Code,for the performance of Be, 303 - ROUGH MECHANICAL work for which this permit is issued. 304 - ROUGH ELECTRICAL Q 1 have and will maintain Worker's Compensation Insurance,as required by Section 305 — FRAME 5700 of the Labor Code,far the performance of the work for which this Formula issued. My Worker's Compensation Insurance eania and Policy number am: 306 — HOLDOWNS Carrier: Policy No.: 307 - INSULATION CERTIFICATECOMPENSATION7ON FROMINS RANCEORKERS' 308 - SHEETROCK (Thlxacetian need not becompbted film permit is fmow hundred dultars(SIM) 309 — EXTERIOR LATH 310 - INTERIOR LATH I certify that in the performance of the work for which this permk Is issued,I Nall not 311 - SCRATCH COAT employ any person in any manwr so as e become abject to the Workers'Compensation Laws ofCalifornia.Dam 313 - ROOF NAIL Appllcanl NOTICE TO APPLICANT:IL after making this Cenificxte of Exemption,you Mould 501 - FINAL ELECTRICAL ENERGY become subject in the Worker's Compensation provisions of the V lmr Coder.you moa .JZ forl comply with such provisions or this permit Mail W deemed revoked. 502 — FINAL PLUMBING ENERGY O CONSTRUC`nON LENDING AGENCY 503 — FINAL MECHANICAL ENERGY [.ate+ Ihereby affirm that there isaconawctionlendin{agency for theperfurmmmuf 504 - 'FINAL BUILDING ENERGY LL'> the work for which this permit is issued(Sec.3M,CN.C.) Lender's Name 505 - FINAL ELECTRICAL W Q Z Lender's Address 506 - GAS TEST U O I«nify that I have rod this application and state don Ne Move information is 507 - FINAL PLUMBING W F anew I agree to comply with all city And county ordinances and state law mistingm OU building construction.and hereby Authentic reprousentatins of this city to enter upon fee FINAL MECHANICAL r W Move-mentioned property for inspection purposes 0 9 FIN py (We)agree a ave,indemnify ad hep harmless the City of Cupertino against I G byliabilities judgments.costs And A.M.which may In my way sums a{ainstsaid City U in consequence of the panting of this permit, ^ APPLICANT UNDERSTANDS AND WILL COMP WITH ALL NON-POINT Issued by:51 WORKS Date SOURC RE ULATI S. Re-roofs Si{nuurc of Appli HAZA toUS MATERIALS DISCLOSURE Dem Type of Roof �® �9 - 0 3 Will the applicant w future Wilding occupant store or handle haallous material As donned by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code, rivenzss7z(,)7 All roofs shall be inspected prior to any roofing material being installed. rives ❑No Will the applicant or forum building occupant ata oyulpmcnt or devices which If a roof is installed without first obtaining an inspection,I agree to remove it hammous air contaminants As defined by the Bay Arta Air Quality Management all new materials for inspection. District? ❑Yea 0 N I have maJ the harardtwmaterbls reW irtnonts under Chap¢ri95 of the falifor- nixHmlth&SafetyCode.Savom25505,25577sud25534.1under thatiftho Wilding dam not currently baa a tenant,that it 4 my rmpomihill b nodfy the occupant of de require nu It It bemetpriortoiauzTesc M:eofoccupancy. - Signature of Applicant Date caner or.uthorixd ages Date All roof coverings to be Class"B"or better CITY OF CUPERTINO DEMO 0 3 ° ° Y-,3 CIT O �© CUPERTINO PERMIT APPLICATION FORM APN# Gt C) 13 Date: s_ Z q _. 03 Building Address: 203 B Si � 1/�Yo..c�o .4 Owner's Name: Phone#: Contractor: �r License#: Contact: G l A�jl_ ,S vL1�0 k L Phone#: /�So� (o 6 Applicant/Seataetac: C 1 51 Bitilding Permit Info: ld Elect Plumb Mech S Description:Job - — - - -- . P Residential: V Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: Valuation: © Type of Construction: Occupancy Group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILIDNG BSEISMICOM Seismic Commercial BUILIDNG BSEISMICRE Seismic Residential BUILIDNG BPLANCHK Plan Check Fee BUILIDNG �� BUSLIC Business License BUILIDNG