00120080A
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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
BUn.DBUGAuuRTb675 STEVENS CREEK BLkD
PERMIT No,
00120080
OWNER'S NAAII?: I
APPLICA'HON SUIT DA'1'B
BARBEG!UE'S GALORE
12/13/2000
'PUONI?
SANITARY NO CONrR01. NU.
ARCHITECT/ENGlNId R:
BUILDING PERMIT INFO
HIADG Ii1.liC' PLUMB MECH
4 L u� F
LICENSED CONT'RACTOR'S DECLARATION
Job Description
escriptionirnt'
I Ram" 'un I ant Iicvmal under provisions of Chapter 9 (comnmacing
with Solan 91XXl1 of Finian 3 It the Ina ..ncs, and l'ndosions Cosl-,and u, limns..
:e full flrrce and offal. (,gyp -6 p
iame.�/I::., 3.I Lie a o
!J Sn—
D.,In CmtlfnClel'_`C-�LJ�-
G�'f1�/�
DECLARA �G
I understandd my plans ShARChIlECuull be usese d ns public recuNs
Licensed l'ndes'b n d
OWNER -BUILDER DFCLARATION
I hnmhy amort That I Linn csennnpl (roan ate Connacmr', Llaunw La, IiaWe
following reason. CS cdioa 7031 5. Business and Professions Code: Any city or county
which requires. permit Io ..... trout, alien improve, demolish, or repair any swclurc
pill... I, issuance, ul... m,mma the:rplicnm for such permit Io file a signal wamumnt
Sy. Ft. Floor Area
Valuation
that he is licensed purmamurtlle parwosms oflhe Contractor, Limen.¢ la,(Chper 9
lconmmm in • with Schon 7(S0) of Dlvll.ion 3 of the Bno inns,. an I rmfe �Iuas Code)
or that he 's cxemm thadn n madthe h� ni, tar the alleged campti...t, Any vicluliI
car Soution 7031.5 by any applicant for a permit subjects the applicant to a civil penally
APN Number
Occupancy Type
ernot mt,re (him live handreId..udr�Is51 ).
❑ I, as owner of the prepeny, or my employees with wage as their sole contpanwamn.
will do the work and the structure is not Immtded or onarcd for sale (Sm. 90f4.
Business and Prole.ssiea CWc: File Contractor's License Iaw dnv: not apply man
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Required Inspections
owner of pntpedy Who build.- of improves thereon. and who does such work himself
Tallugh hal awn ,n,loyva,. proviled thal Inch intprovn marts am not intended or
o,n
fcred Ila sale. 11. however. the Nulling or innpmvement is sold within one year of
completion, the owner -budder will have the human of proving that he did net build or
iurrovo for pure.- of .:del,
❑ I, as owner of the pntperty, a exclusively :laim ing with licmmad contmclots Lit
the pproian (Scc. 9044. B...i nsas and Professions Cadc:) The Cimmnor's
Lnsinnel
bs claw docs not apply to an owner of Po,Nrr, who Wilds or improve, thereon.
and who cenlmol for such projects with a'nomacmrfsl licensed puuant at the
Contrelua" U'ra o Law.
❑lana e,cmp under Sur. . B & i' C fe'doo reason/
Owner ❑ao
WORKER'S COMI'ENSAI'ION DECfARAT10N
I hemby ammo until. penally ..f Injury ane of the fbllnwing dcelarulinm:
/
❑ 1 have and will ntainmin a Certiticac of Consent to self-inwre for Worker's
/
Compematinn, as provided for by Section, 3700 of the Lull... Code, I.... the
performance of the work for which this pemtif is issued.
vc and will inainlain W'urkcr's Cnnrensatini hnwrun,c as re,aircd by Sc -tion
.1 1d the labor Coale, for the perlbnname of the work for which Ilii, perail is
.tad My Workers Compem((ntion Insurance carer and Policy ntinttit
CatrietEra<ras�/VF XXehcy Nn.: 1270
1ONOtiWORKERS'
CERTIFICATION
I 'OII
COMIENSAIDNINSURANCE
rfhi. seniors nucd not b ouni,lemd if the par it is in, one hundred dollar
.
SI(m)III' lie".)
I certify Wan in Bm Mr o m u,c of the work for x'hieh this permit is issued, I
,hull not employ any person in any namncr ao as m Maonm sahl.ct et the Worker,'
Compensation laws of California. Dale
Appleam
NUI ICE; TO APPLICANT: It. alcor ,raking Ilii, Camfi,a e of Ilse ntp..no. ,in should
become subject o the Worker. Compensation previsions of the 1- Mr Code, you rise
Ltdbwith comply with such pro owns or Ihis parorif shall he devoted revoked.
CONSI'R C"flON LENDING AGCNCY
I hcrehy umnn Ihun Wci'e is a cor,tmoion lend'mg agency ref the parfnmauve
of the vv fnr which his permit is i..uvd (Scc: 31P17. Civ. C.) '
Icndor's Name
Lender's AJdms
certify that I have read this application and.uom that the above infnnnumbar is
'
It c.. I ugmc h. an.nl'ly with all dly Ind Loamy anaran.es and state laws relating
Itbuilding conswdion, and herchy anWonte repnscntatives of this city,I enter upon
n
,
the.Nn'c-me.ioned property for inspection purpnvs.
(We) ngrcu Lit saw, Indo. d1'y Lind ke"t [I I... the CID of Cupertino ugam"
.
liabilities, judgnenls, cost, and expenses ,Inch nmy in any way III again.o said
City in vomAluence of the granting of his permit.
SCA > ILL COMP WITH AL1. NONPOINI'
ICE
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UI RE' 'Uli otiTAN
}jli.
Issued by: ✓ Date
Re -roofs
_
s.ginaIt, so , tidi irce�tla Lime
IIA%AHu(IUS MATERIALti UISCLOSaRB
Willthelueplicanlnrlumolm'ddmgoe,Chaptsmn2.'aid lehazuNnusfSatinl
Type of Roof
sed by the Cupcdino Mmticipal Code, Chapter 9.12. unW lite Health Lind S:dcty
Cldeli
CoNe, Section 25532(x)" �
0Ya' 1x"
All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or lutum building occupant use equipment or devices which
If a roof is installed without first obtaining an inspection, 1 agree to remove
emit h:v11Nous an cornu nnams a. de ed by the Bay Arca Air Quality Management
DWW"?
all new materials for inspection. Applicant understands and will comply with
°Ya NI
all non -point source regulations.
I have read the haeamwus materials mgmmmmnts oder Charter ails el the
Califnmia Health & Safety Code, Sections 35505.:5533 and 25534.1 understand than
l f the bui ldutg dote nrn c.meaul, have m.am, 111111 it is sty responsibility ,,notify the
-
twcupam o1'the "turn ian, which nmol he out prior to issuance of u Cenipicam of
` ney. /�
Signature of Applicant Date
qua
All roof coverings to be Class `B" or better'
uwnere aaW.. ed Dam
OFFICE