02010100 (2)A
Q.z
µOC
u
fn<o
n E:
'4F=
tOdL
ILLQa
i S p a
FZ>
PF[
O 2
z
CITY OF CUPERTINO'
HUD.DING DMSION PERMIT ~`
- CONTRACTOR INEORMATIn
BUILDINGADDRESS.
PERMIT N0.
822 STENDHAL LA
BATHROOMS BY REMODELING
SPEC 02010100
OWNER'S NAME:
BOYD THOMAS C AND JANE P
1422 SARATOGA AVE
APPLICATION SUB DATE
01/24/2002
ZONE:
(408)328-6700
SANITARY NO. CONTROL NO.
ARCHITECTirENGINEER:
BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
(_ 1 I_I L__J L_J
LICENSED CONTRACTOR'S DECLARATION
]Ob Description
Itiocby0) mmlamofflaeBusinesensed under pndProfssinsCodChapter 9kommpnense
in Section 7000) of Division J of the Business and Professions Cade. and my license
REPLACE BATH FIXTURES & TILE
is is full force an W/ L o �
Limenae
Gla'x // Lic. x
Dmc Contrera!
FINALE®
ARC c'r5 DECLARATI
mit l
1 understand my plans shall be used as puM1hc mcuMs
MAR 2 12002
Licensed professional
OWNER -BUILDER DECLARATION
1 hereby affirm mat I ire oempl from the Contractor's License law for the
following reason. (Section 7031.3. Business and Professions Code: Any city car county
$12442
which rtg1dM5 a permit to conewut alter. improve. demolish, or repair any sometime
prialoiuisommeaalsorequiresthea liamfor wchpermiuo fikasigned sutemem
BUILDING
- - ......
l_,\3 �`r~ pp r p,c
Valuation
that ti<u,li dre Law (ChapterCods)
pSection700)of dision the Convenors
and Pr Code)
S with and Prefectures
rcomrtren lin m Section N00) of Division 3 of she
TD 4 Z U
UZ1
of Slut Fe is a&req thny ami anj the basis for the alleged ms Any vi
alleged e. Any violation
'
pp]mpf
-of.1 Semmes d m for a500). subjects the applicom Si a evil Penalty
.. ]03 , iv any hundred
larro, mare man five nanarea aruam (ssm>.
]�t.a..sJ.��
- 10 fyaPN ' Ia[917Y'IDAT I ON
� � • ' Occupancy Type
❑ 1. as owner of She property, or my employees with wages as their sole compensation.
will do the work. and the structure is ata intended or offered far sole (Sts: ]614.
Business said 'Prof ssimu Code: The Conwcmr's License taw does not apply to an
103 - UFER Required Inspections -
owner of property Who wilds or improves merman, and who does such work himself
10 4 — REBAR
ar firou his own employees. provided eat such improvements are not intended or
- _
:offered moak. ICbowevcc the Wilding or int rov rrimm is sold within on; year of
- -- - - � _ .. , . _ _ . _.-_..._ ...,_............. ._ _.... _ .__.. _.
105 - ANCHOR BOLTS ••1'• •' -
impletion, the owner -Wilder will naw the burden of proving met he did not build or
mprwfarparPuseofsels.).
106 - SEWER & WATER
jW Property, r ew_.- ed-..__ .o,
O�L es to
xdiness romrfect with tide.)
.. .... .T
202' - UNDERFLOOR'PLUMBING" : :: _....._.-..._...
t the pr .7 no Contractor',
conawn ow project rape. moa, owner o and Prrmwhiob coda:) TM1e canthers...
License Law dos not apply m an owner o/ prpeny who builds or imprves thereon.
203 - UNDERFLOOR MECHANICAL . if
. ane who.contracla for.such projects with a contractors) licensed pursuant m the
.- .2 04' -- UNDERFLOOR.... FRAME -.-._.. _ ._....--..___.- .__ ... ....
Con mmol. Liana Law.
❑ I am exempt under See ,B A P C ra this ..a
205 - UNDERFLOOR''I•NSULATION
owner Dao
301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
302 — TUB & OR SHOWER
Iberebyof rmandrrpmidyofperjaryon, dfmpfouawingdeaamranl:
303 - ROUGH MECHANICAL
a 1 have and will maintain a Car,ibe,m or Consent to self -insure for Weekera
304 - ROUGH ELECTRICAL
Compensation, as provided for by Section 3700 of the Labor Code. for the
pertomuna nitrate wank If. whim this permit is issued.
305 — FRAME
have end will mahad. Worker's Corpensatloc insurance, asrequirM by geedon
306 — HOLDOWNS
00 of the Labor Code. for me performance Of the work'for which this permit is
307 - INSULATION
issoed.My WOAea Compensadoninsumncecarrierand Policynum.cr,=,
-...
candee:'.� par E.'.fw/l/R Bey No.: 05`6 -.'o oSo�]
..
`,_..ti, ._.3;0.8 ; ='; S.HEETROCK ", .
iCERTIFICATIONOFEXEMP110NFROM�' -'
{ ,.:.,
73091'= EXTERI OR" LATH'
._COMPENSATION INSURANCE"''" ""
- .._.. .
LATH --
(This icniin derd'no, W mmpletd if the permit is fee one hundred dollar
311 - SCRATCH COAT 4 1.
(SIOD)ar lost
:
313 ROOF NAIL
,1 certify that in the pedormad . of the work p, which this pcmut is i'aucda
m. w 6,yc to the Workers'
501 - FINAL ELECTRICAL'tNERGY
'bell net employ any person ma.net s} K subject
Compensation Laura lir caErrtme, /L7
Applicant. Bin Et
502 - FINAL PLUMBING- ENERGY _
503 - FINAL MECHANICAL ENERGY
NOTICETO APPLICANT: IL after nuking this Certificate of Exemptlomyou should
become subject to the Worker's Compensation provisions of the Labor Cade, you must
t
forthwithcomply'wiresuch provismnaarmi'p mitmanxdampda_Yi_kmd.
-. 504 - . FINAL BUILDING. ENERGY
" CONSTRUMON LENDING AGENCY
505 - FINAL ELECTRICAL
I hereby affirm that then is a eonswction lending agency for the performance
of the work for which this pmanit'is issued (Sec. 3097. Civ. C.) ,...
506 — GAS TEST
Lenders Name ... ..... .-. .. ... ....
..
507 - FINAL PLUMBING
LeaderaAdare':
508 - FINAL MECHANICAL
I certify that l lave mad this application and sate that me above information is
stat. l agree to comply with all city and county ordinances and state laws relating
509 - FINAL GRADE
m Wilding construction, and hereby author the representatives of this city to enter opera
the above.mentionedprpertyfor mapectionpurposes,
510 - FINAL PLANNING
(We) agree m save, indemnify and keep harmless She City of Cupertino against
I liabilities. judgments, costs and expenses whim may in my way Ware again', said
514 FINAL PUB I C WORKS
City nconsegacnce fare ranting oflhi'permiL
APPLICANT UAE 'AND WILL COMPLY WITH ALL N Nr
r`
DSn�-ro
SOURCE REG S. ��wG��
Issued b Dale
y'
Signnmrt �AppliconVConl tion, ' ' " Date
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE
...Will the allocam or future Wilding recupom alfa of handle hvzrdbus material
Type.of Roof. .. ••_. .�. ..-_.•. -_—. - ..... .
as de(md by the Cupcomes Man' Pat Code. Chapter 9.12. and me Nesta eta Safety
,
'.c ' :. •: `'
Cade, 5«uon 255J2(in, .. '.. -....,.;.Y
°Ya'` " "�"°"
._..All roofs shall be inspected.prior to any roofing material being installed....
Will the applicant or snare building recrpanl use equipment or devices which
If a roof is installed without first obtaining an inspection;'I�a'gree to remove
snit hazardous air ce. minnn as0 Bit it bY,he Boy Area Air Quality Management
)ismia7
all new materials for inspection. Applicant understands and will comply with
J °Yvs. Nr
all'non-poinfsouiceregulations.
' I have'rtad the haivdoui matcriali iequirent uMcr'Clique, 6.91 of the
-
Citifeste Health A Safery Coll:Scoti.m25505.25533 and 25534. 1 undentradthat
if the Wilding docs not cuvcmly have a tenant that it is my responsibility to notify the
T
dlcupsdm of the rets which must bc'nom prior to issuance of a Ceitif cam of
�
Occupancy.
Signature of Applicant Date
Al] roof coverings to be Class "B" or better
Owner. r am onred agent
.. -. .,.�.. ......» _ OFFICE ....
e'qFfA'*0 FLre/G Sore G/,a
•
APPROVED
IN ACCORDANCE ITH THE CIT'
CUPERTINO fODF ANNA.
TC / 4a
This set of pans aria: rpcc.iicetions MUST
be kept on the'obLt c'! times ind it is on
lawful to make any c ,_r•,;; ; or alteration'
on seme�h1 ci itch oe n.ssion from
the uUp,., City c,'„ Cupe tino.
The.tamps U .h : , n f specifica
SHALLh0I be tan:, ;:. mit ai L b, ai
• approvai of the v .1 ., any provi on
of 867.Mu Oidtn&,,.c or '.;aic I, w
Q
IA✓
p�'T0TI L�lj JAN 2.4 2002 IV
0
::,�:
...t.i.
...._..
.......
..,....
,p
n
u
uL� ■■■p ■■■■ _ o
Ii
.10