01040106 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS, PERMIT NO,
10599 N. STELLING RD. 01040106
OWNER'S NAME: APPLATION UB DATE
STEVE NAN 04f20�2001
PHONE: SANITARY NO. CONTROL NO.
p,e z ARCHITEC(ENGINEER: BUILDING PERMIT INFO
&st O O BLDG ELECT PLUMB MECH
<�� LJ C_J I-1 LJ
Gas
LICENSED COM'ftALTOft'S DECLARATION
z z ✓- 1 hemb affirm that 1 am licensed under ions or chat 9lcnmmenein Job Description
p z`-'p Y provisions Chapter g
Hew withseninn]oomarpi�ismnJnfthe BndnessandPmlessinn.cnae,awmyrcwm NEW SINGLE FAMILY HOUSE.
<-F_ is in muroncea,weffect. 3731 SQ. FT. LIVING SPACE
re z e a License Class Lic.of s
of 3°,v Dam Commeim 518 SQ. FT. GARAGE .
ARCHITECT'S DECLARATION
ol
1 undeniand my plans eM1ull be used as public recorJs `
a DIC'®' tlV
i a p O Licensed Professional
�
z OWNER-BUILD ER DECLARATION kp�p�
' n 1 hereby affirm that I am exempt from the Contractor's License Law for the
1-z following reason.(Section 703 S.Business and Professions Code:Any city or roomy- II/f a,
Y€p which regulate a pc.is to consuun,alter,improve.Jemolisb.or mean any swcmre ///,(�
i 3 ce _prior to its issuance,also requires the applicant for such pmunirill file a signed somment
that he is licensed pursuant to file provisions of the Contractors License Low(Chapter 9 S Ft. Floor Area; - nation
(commencing with Scown,]")of Division 3o fine Business and Professions Code) q , , t ,..;' ,..._'.' -i. , $37
or that he Is exempt lhcrefrom and the basis for the alleged ekemption.Any violation -
-of Section]831.5 by any applicant,for a permit subjcets the applicant to a civil penalty
Iof nm one than five nandred dollars S500). 3266916Ylmb49rn..R:a.. . upancy Type
❑l•as owner of the property,or my employees with wages as their sole compensation,
willdohe d No and the nmmum n nor intended Li ore Law roc amoappl]tau. 101 - FOUNDATIIWuired Inspections' "al
Wine,of ,.�Pny Who
Code:The Cots herf s.and w law J«s nut apply ie,aif
Wine, his ow em builds or hvided that
such and ve entsare n work nied or 102 - PIERS '
or through his own employees.pmvidcd that such improvements
ensn t int said
are not oncmlcd or
ow-vei the huilJin- -.i-_� i in sold within ono eai o! -- �-- -- - - -- - -'-'-'----'----------------'"------------- -' ---
complefon. e7[b a gw burden
r 103 - UFER �Ad:-or cl..r:.gyp ;.o
completion.necrose rvbmWer will have file burden of proving that he did our nand or - i --- -
imprnvc purpmm�rsam.k 104 - REBAR
- - - - - edcont._----._.._. . 106 SEWER & WATER ---.._._..-- --
- —... -
•: > .uawnecnf the Pmpeny.am exduxivdy con,racting with littnseJ contrucmrsm _ 5_.-___ H ._ ____, Pl_,1.-,'I b.A`!,I p:
construct,he project(Sec.944,Business and Professions Codeq The Contmcmr's - i. P'. [ - t
Urcrem Law does not apply m an owner of pmpeny who builds or improves thrown.
'-
and wno.wntme"fil pountswith.a rommemresLe«msea-pursuamao the -_.-- -. 202---- -UNDERFLOOR--PLUMBING --' - - - — ---'--
cnntmdn's License law.
qr re al am axcronu d„ee. `""" `".e'&re,tbrmis roman 203 - UNDERFLOOR' `MECHANICAL
u5t= 204 - UNDERFLOOR FRAME
er
- WORKER'S.- MPENSATfONDECLARATIOd 205 - UNDERFLOOR INSULATION
-
Ihemby liffimn undler pcnaBy ofperptrym,eufM following d 1 roma. 301 ROUGH PLUMBING
l have w will fountain a c r rcme ofoL Consentt f workers 302 TUB & OR SHOWER
C
Con p m p ided f n 3]IXby S I f the LVW Code for flat
'permm,ana none Irk.rnrwn=h tnis pe„n;,. J 303 - ROUGH MECHANICAL
❑1 have and will maintain Worker's Coin,no,41 on In6mnce.is fir,-fired by Section 304 - ROUGH ELECTRICAL
- - 37N)or the latburcoee:for the p irfpm,a«e or the work for whim this perms is 305 - FRAME
ssu a My W k rs compensation in,iffiew,bartmr nil Pult Y ca rte --
,,.., --- ' 306-'— HOLDOWNS"
•Pony N' ) r. c.
CERTIPICATION OFEXF:MPfION FROM WORKERS 1' - 30 7 'INSULATION
COMPENSATION INSURANCE- t _ _
09
. ETR K----._.----------'-------------
section need not be completed ifihc perm t is future hundred della. 3EXT
a ERI OR LATH
(M(p) 1 j .
3-10-INTERIOR—,LATH-
'r
,t,• Icrn fy fM1at''til pcR !the okf Zen thipc ,; I uad 1 ,Il•}..}.w• �• ,
hill his em In - t�.,n .. me n bjep to me workers 311 - SCRATCH 'COAT .; .
tie
Compensation law arc hf D3( -
.Applicant -
NOrICETOAPPLICANTII.after makingth Certificam ofExemption.you should 501 - FINAL ELECTRICAL 'ENERGY
't '
ODM1esome subject to the Workers Compensm n pr&ss Ws of the Labor Cade you man
rnnMWimcomply wansuch provisions nrthis permnshop neaeemmmvnked._ _ __ _502, - -FINAL., PLUMBING.ENERGY.-_____
1'�^'Vi vv� Is 'n __CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY�r'"' `
Fs 1 ho'by afftm that 1h contacted..leading agency r Ilm perr,,.a LI t
> of(he xinkfor whichth pernit,.issued(s« 3091 c c1 " ,- ; 504 - FINAL BUILDING ENERGY
y:p IsrulrN "o _. 505 -- FINAL ELECTRICAli - -
=.lZ Lans4 AJdrp .• r.1ir a:�.0 , l:il -.--_._- _ - .__
:. v o506 - GAS TEST
s I certify that 1 have mad this application and some that the above information is
i Dr. :Street:i agree to comply.with all city and county ordinances and state laws mining 507 - FINAL PLUMBING
O`V mwildingconstruction.andnembyauthoraerepmspntvtidesofthiscitytoenterupon 508 - FINAL MECHANICAL
the ann of ed D ,.y f pecti P r,ov
C. (W) fixi' dkeep lbI itheC, fConcrete,almost
V) liabilities.j dgm ms,cot tM expenses which may in any ay ace g inn said 509 - FINAL GRADE q
U.Z city c se( nrfneg in,of this fini, - 510 - NA ING
APPLICA UN 191lD AN D WILL COMPLY WITH ALLNON1POINT' ISSDBd,y„�f Date
- -
SOUR (;f ATO S. 1 .: ( �.' •�y�^n 7
wmrcor APPlicSn momicmr "' " -' / �,}i, Date Re-rot �2 - ROOF PLYWOOD NAIL
HAZARDOUS MATERIALS DISCLOSURE yp tf��of_ ROOF BATTENS
•"n W II the apphca, furore building« pant s,om or M1atWl<hecvd material - T e,
11Jfned bythe Cu,t Municipal CW Cnpter912.and th Health and sure,, 604 - ROOR,SIN-PROGRESS-
-- 'a Yon zssJzwj`t o�o.r..,,,t, ,j ,.,; _All roofs.shall be.inspected.prior.to.any_roofing material.being installed.
CSJ s •.
W'll til ppl'a, r t buiiams«a p m sc a9u pm nt rd 'ees..m ch If a roof is installed'lvithout first obtaining an inspection;Fagree'to'remove
m t hunl ois air cuntamitams as detinN by the Bay Arca Air Quality Management
Duistrict?: all new materials for inspection. Applicant understands and will comply with.
❑y ono all non-point source regulations:
I hive read the hazardous mamrinle requiremcros under Chapter 6.95 of the
Cl.build,,Ilh not cunenflyha=�tions255U5,455Uand]SSJJ.I nnderomothat
_ Y ._..... _..... _.. ... _ .__ -
'am ttht , . -Yat Pon bl',yt notify fee
.. _. ._. _ ---___ s
flee p m Of fIt 1 'rclimit M most be met prior-, su«e or Cemfiene of
Occ parte�'
o _Signature of Applicant Date
? m or Wffifmcmd.11on 7 All roof coverings to be Class"B•• or better
r pa ..
L_.
OFFICE