00090164urrn.c
CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS;
PERMH No.
OWNER'S NAMH:9 I I S STELLING RD
APPLICATION sl�e tQ[I�I�.9G11 F�• .
1
PHONE.
WALTERS CHARLES N AND J
I
SF_FHIN
SANITARY NO. CONTRol. ND.
09/26/2000
ARCHITECURNGINEER:
BUILDING Fi RMI"r INFO
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BLDG ELECT PLUMB MliCll
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CONTRACI OR
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undorSIyIiCLARAIIDN
IM1emby that loon licensed underpnd Profoflicense
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sz<In
-Cde.v(canon
an $cctinn 7lXXB of Uivi,inn)of lM1e Buninc,e and l'nffo,inns C+vle. and no, license
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ill fall f I've air cfficR //// /�:/S3
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I.iecnxeclaw _�CII� I.ic. N_ _—
q Cnnlmctor.�
ARCHITECT'SDECLARci7O.
REPLACE BTHRM FIXTURES
I andcdand on, plan, shall be owed or, public arcual,
-j
ce s
LiccnnN Pndc,asional
OWNER-BUILDER n the RATIONLl License law for the
I hereby that 1 ren exempt
tun ac Contras
do O
o a
tYa
mason, (Sw s cra Any city orcnunp'
hdlow ineuiresaerantnto 7(131tr B. altecseprove. ms ulboh,
zz
or
wh :y q' perant I construct. t II � I re lisbrepair'any tmaum
et Co
p ml t L I th 'Ill"' II Ips lu in g (Chapter
1 IChnpmr9
mals 1......Jp . tt ti P thefC t Chapt
S(]. Ft. Floor Area
YaL U:ltl ❑ V
e,L
Icnnmce i B.' JI f. ,Code)
eem SCn0on71XX)o
eacmpnuo
the coral the Any violation
is li and the basis for the alleged
or that he is
d rat for a permit subjects Inc applicant m a cis it (renally
31.5 b any applicant
of 4D I.5 by any p
AFN Number
Occup:mcy8�'3
ula ann
lt"d
oo+m Inorn m:Ilt Ern hombea anllwn I551Xp,
SS
ID I, m mvner of the propesy, m my empinycea with wage, as meir.mle anmpensarnn.
Ired Inspections
will do the work, and the >mmurm i.c Bol imemkd ar offered Iia sale (Sec. 70s14.
Law does In
Business and Plafessions Codc: The Contractor's License not apply an
of prulwny Whu buiIds + alpm es t,nam, and with dost torch wad hin+,clI
3590601. _)Ic:6
7 so �LIILI
his own are not uricndcd (or
loth such Intpnut
is old
oRereJ far sale. If. hu.cree the Building or impm,cnwm is old within ane year of
offered four however.cruirl,ces.the
completion, the nwncrbuildcr will have the burden ofpmving that he did nor build or
101 — FOUNDATION
mpsore Inr nurpn.c onaled.
1.02 — PIERS
❑ 1, to, owner of to pmpaty, stn exclusively cratmcdnto with livened cammenn., m
.
lce the cmncrx
project sec. mw. Bu.ineand Profensiva s eamm
,,amet the prosx,
103 — UFER
License Law d«s not appy to an owner of property who buildz or improves thereon.
and who venumcts for such prejecic with a.onmactudx) licensed pursatmt tu the
1 04 -- REBAR
Connation's License Law.
❑Inor c.cnlpltmdersee . BKpCn+rthisrc"'er
105 — ANCHOR BOLTS
Owner Date
1.06 — SEWER R WATER
WORKER'S COMPLNSn HON DECLARATION
202 — UNDERFLOOR PLUMBING
nlcrehy arnnn under pcmlty afperjory nae ol'd+e muswb+g dcclamtLm,:
203 — UNDERFLOOR MECHANICAL
❑ 1 have and will maintain a certificate of Consent to .eu.in,nm for Wmkcr'z
Cmnpemaeon, i, provided far by Seedon 3701 of me Labor rnue. ht, to
204 — UNDERFLOOR FRAME
mo nanneafinewink for stdnnm't, mat is issued.
205 — UNDERFLOOR INSULATION
❑ 1 have and will maintain N'nrkerk Cntnpencatinn Insurance, ay rquired by Section
3701 of the Labor Calc. for the perforonance of the work for which this permit is
301 — ROUGH PLUMB I NG
issued. My Won Y�x C�Jompc�mal`iun Insurance carrier and/ Policy mourner art:
302 — TUB 8 OR SI-LOWER
—
�1M
CEN IOdCAIION OF lixFMioPirON Won K 17RS
303 — ROUGH MECHANICAL
COMPENSATION INSURANCE
304 — ROUGH ELECTRICAL_
(This we nen need not be complmen if to perms i, nor one nandred eoharn
305 — FRAME
($100) ur I...
I comity mat or me perlbrmance of to stark for, .Irish this Formar is e„vted. 1
306 — HOLDOWNS
,hall not employ any festoon in any mdnmr ,o a, m become subject to the Workers
307 — INSULATION
Coni've'.6'ra Law, of Cal l r,min. Date
Applicant -
308 — SHEETROCK
NOL'ICL'D) APPLICAN'11It. Rernmking this Cermtkam of Excmptian. yea should
Z
hecamembjegmtbc,Barker'sCmmpcnsationprnvivmeaftheLboaCotgynulnu11
this ,hall Be deemed revoked.
309 — EXTERIOR LATH
Q O
forthwith comply with wah provi,imen ur permit
310 — INTERIOR LATH
zpdN
(~ u
CONSAGENCY
� �
,r, is cun,rurvaiINGing far Ola lx'rliemm�00
Inemny aflinnthm:hcrcisa enned
—
317. SCRATCH COAT
y q
sm. 097.0 C.)
Orme work nv shirt+tis perms is inured (see 31W], sir. C.)
Lender, Nares
.
3] 3 — ROOF NAIL
O
lender's AAAress -
501. — FINflL ELECTRICAL ENERGY
U
Fcancel.
rn+n
lmm0ytatlhave read ti,appusaaoirnastate that the abavelnfoatio
I agree to comply with all city and county o din.nce, and state laws telming
502 — FINAL PLUMBING ENERGY
w
rebuilding lion,ucdan. and bomb).mlovise reforesemmives ofthk city it) enter upon
tr
heabavc"mentu+nnapmpenyfaetnpecdnnpurpose,.
503 — FINAL MECHANICAL ENERGY
F 0s
m
01 ugmc tnsuvc. Indannrfy trod keep hunne, the CllyA Cupenino nguin,t
hatdairt , judgmeat, eosin and expct+,c, which one, in raY way accrue :Igainq Siad
—
504 FINAL BU I LD T. NG ENERGY
V Z
City in co mequence of the granting of this proved,
APPLICANTD .RSTANDSANDWILLCOMYLYWRIIALLN9N-POI
Issued b 505f — FINAL ELECTRICAhate
y'
SOURCE R TIONS.%�`��
/
Re-roof's 307— FINAL PLUMBING
soy. unrnhoauntoCommcmr D.te
HA/ARDOUS MATERIALS DISCLOSURE
Wins pylic.mnrfumrebuildingacupamuomnohandleM1maNtwsneateried
Type of Roof 508 — FINAL_ MECHANICAL_
an defined by the Cupcnima Municipal Code. Chapter 9.12, and the Health and Safety
Code ScOion 25532(X)'1
❑Pers ❑No
All be�1nt' s ectet�{T'ir�.i�p�o- it Raw being installed.
Will the applicant or future htildingnttnpant ascegnipmem ardevim,which
roofs shall pmaterial
If a roof Is install Ho�lP Obtra2n9':FHJ1iN@c ion. I agree to remove
emit hmanlnm Bir rontaminanw m Alined by the Ray Art. Air Quality Mnnagemenl
all new materi.i 5fl)fdinspedtiINPApp]i1ldiRLui&rAfI61PASJ will comply with
Di,Irict7
❑Y, 0No,
all non-point source regulations.
1 hav read ac hroardsus mamri.ls requircmcnn under Chapter 0.95 of the
Culifnmiu Health & Safety Code, Sections 25505.25513 and 25534. I understand that
it the building does na currently h:we a waver, dein it to my re,rym,ibility m ramify the
ntpanl of the quiminen0 which most be met prior m iswance of u Ceniliaure of
Occupancy. 4,ej;..e1
of Applicant Date
4tVSignature
All roof coverings to be Class `B" or better
ownsr or nttmai..d asetn D:ne
urrn.c