00060088 crry OF cUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
I
BUILa, PrRM1'I'NO.
I3ING ADDRI!SS
OWNER'S NAME pAfPLICAWVWN
765 'STENDHAL LA l `v 3(4. "I� 88
SAIIIII NP/1 4/'n— ft No.
"DE SILVA NIHRL AND EIKO lilt] BILI SLI ILf
C K z ARCI if rECUENGINHER RUIL11IN(I Pn:RMi'IINFO
O C RLDT FLECr PLUMB MECH
y_
I
h< LICIiNSED CON'fkACTOR'S DI?CLARAIION Job Description
^` hcmhy tJ'firnn n,I:un liccnmd undur provision,of Chaplet 9(cmmncncing
O 4th F aa with Scc,iau 7(Y)0)of Division H of the HudneC.mW I'mfcssinnx CnJu,send my license
is In fullence
lorcc and clracr.
Contictnr
I'S -
�a LLL nRfnfrl!cUECLA INSTALL SKYLIGHT c
(_ to
aj ]understand n,y Plato,null be n,ced nn public rceonln F 1 N A L E D
u,C C�O Liccwcd Poin,sionel
m a OWNFR-BUILDER DECLARATION
I hereby aRno Inn,I ran exempt from the Contractor's Liccnx Law lar the MAY 1 5 20 01.
ful w ng netn.(Section 71315,ituxinc„and Professionda,,CuAny city or un,y
`Fc efud I p 1,.cou'umo.'h 1' denroloh.nr repair any:t ,alure
wCam prof t I. 9 (lie tf hp,ml, 11 g m
signed
c. Beithe is Inevricede : rt th pro,oum,ofheComeau, e,Limma,Law'(ehafne,9 Sq. Ft. Floor Area BOWING oven... nl ng wish se „ m
a na 71XM0 of D,n,nn 3 if Ru,ncand srofas, n,Code) BWggrI IV
or that he is eta Tu thcrctinin and Inc basis:lin 0m ndleged eatuTnion,Any viol.is n
of Suction 70315 by any applicant fm'a"cont 11bjcan,he:9,plicmt m a 11111 1111.11Y
nim,nmmthan five baaireddouax(S5001, APN Number OCCUP:1 T0ypc
111.a,owner of the pou,noy,or my cnnployccs wish wage,nx,nen,o t,urmpenution.
will do,he work,and the amcmro is not intended or oilcoed for sale(Sec.7f"4.
1Las ess and Prom—ions Code:one Contractors License Law don,not apply ton quired Inspections
p
Anolwn,Wl baild,orImmvc,manon.aid woo doe.,amworkmm,<H 37542039. ON '
or through hi.,own employee,,provided that such improvanenl,arc not intended or
olicred for sale.IL bnw'c.xr,the building or impmyeraent is cold within one yea of
mnpletion.the ownern
builder will have the burden of proving that he did or build or 101 — FOUNDATION
Improve lin pnga,xc of,me.).
❑I,m owne,of the nop,ny,ora e,cls,ilaly ctmmctin,suit lieemed arntnat„s,o 1012 — PIERS
Lone,the pmjcct(Sec.7194.Business and Pmfexann,C m,:)The Comrac"'r" 103 — UFER
.aroicense Law doe, or apply es an owner of pmpeny who Wild,o,improve,rhumon,
and who contracts for such projects with a cam,mnmp)licensed pursuant to the 104 — REBAR
Coulraam'x License Law.
❑I am a,ennu ands See. ,B&P C rot this moll° 105 — ANCHOR BOLTS
owner Dare 106 — SEWER &• WATER
WORKER'S COMPENSATION DECLARATION
Ihereby of on under punallyof periary one of the iouowms declaranons: 202 — UNDERFLOOR PLUMBING
[31 haul and win —io,nio a Cc,ar,a,e or Consent m ,en:iuomc for Wooers 203 UNDERFLOOR MECHANICAL
Co,nlKnxaaon, as provided for by Section T!W of Bre Lidnor Code. for the 204 — UNDERFLOOR FRAME
eTfonmanceofthesorkrorwhirnmispermilisissued. 205 — UNDERFLOOR INSULATION
❑1 navc and will maintain W..or's ComPematine Ireumnce,a,m,mned by Section
3700 of the Lahn,Code for the pe,turneuno A he wont rot which mM pemat is 301' — ROUGH PLUMBING
i„ued,nl,Wo let,Com,uh,almInsurance carrier and Policy aambe,are: 302 — TUB & OR SHOWER
Carrier: cI:R11FICAnuNOF EXENIfiTIONFROMWORKERS' 303 ROUGH MECHANICAL
COMPENSATION INSURANCE 304 — ROUGH ELECTRICAL
(This mcnmi mend no,M completed if tic permit is for ane hundred dollms 305 — FRAME
(51 W)at lees.) -
I artily mm in the perfunt na t the work i r which,M1i,pennir ie i,weJ,l 306 — HOLDOWNS
aau ran cnnplov/my person in o y Bat° „t� I ,m stns worker; 307 — INSULATION
Compena,iogy sus rare rro _(
Applicant f.T�PY('pt 30B — SHEETROCK
N(YDC.T 'A Lallenwking rho Cenm am of li,emp,ion,you:Would
Mcane,ubjecnntM Wicker',Compensainn pnrrisiunr of the Luton Code.you mus 309 — EXTERIOR LATH
Q O tmnhwnM1 connply with such Pnrvisioro nr this Prnnil shall he dccnmd revnkcA.
F CONSTRUCTION I.VNIANGAGENCY 310 _ INTERIOR LATH
C14 1herebyoffimn,na,hemisaconstructionlendingagencyforthesKarromme, 311 SCRATCH COAT-
faa nl the work for which,nis permit i,issued(Sec.3097,Civ.C.) —
W E Lender,Name 31.3 ROOF NAIL
M.U C Laodar,nddm„
1 c.Hytnalhave maJlnt,applicationand.mmthat he aNweinfnrmaionis 501 — FINAL ELECTRICAL ENERGY
cont.,.Iagmememnplewith.11cityandcimul,orihmnve,andsumlaw>mlaring 502 — FINAL PLUMBING ENERGY
Vrebuilding construction,and hereby amhonfe n'pnsinninec,of city In enter upon
the abolc.manth.ned p,ymcny rte inspection numoes- 503 — FINAL MECHANICAL ENERGY
FW
GWa (We)agrc,m cmc,indemnity trod keep n:vndc,,s the city or Cuperlinu against - —
rabilide,.judgments,ro,a,and usi`onws whiab n,ay m any way anemu against,aid 504 FINAL BUILDING ENERGY
U Z City in cuu,eyuenc of the gmitio,of'his pcmnil.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: 505 — FINAL ELECTRICAL Date
SOURCE REGULATIONS.
Signammof nppnatm7Conanelor Dae Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
507 — FINAL PLUMBING
Will applicant or future Wilding^c'cuWat store w handle fulecous material Type of Roof FINAL MECHANICAL
as defined by the Cupunino Municipal Code.Chapter 9.12,and the Health and Safety SOB, —
Cmle.Suction 255321x°
❑Yes El No All roofs shalP0nspecFi3py��Sr t('R Wing material being installed.
Will,hc nPPlicvn,m future building occupant use eyuimnen,or device,which If a roof is in5`<tAkIld wittfDllOYirt7l-oRki�hLt\ttlihVApection, 1 agree to remove
ani,hu11 N1.e air conmminann a,defined by the Hay Ama Air Quality Management
Di>rdcre all new materfnlL 4orinsFieElj6ifftL AP6hB8n[tuldbfQftif(d6and will comply with
IMF b Yes ONo all non-point source regulations.
I base read the MnnrJn^,mactiala min dremcon,under Chapter.6S.1 of the
California Health A Stoner Code.Sections 25505.25533 and 25534.I understand that
if the Wilding rise,Bract ally havea¢nnnt.rhos it i,my ne,prn,ibiny 1.notify the _
euupanr in enc ns m which must he ran anis isnuunce n u Cenilma,e of
i1e4 pa y r eon Signature of Applicant Date
own rnraatnoaaeaagem .tom All roof coverings to he Class "B” or better