02040136 CITY,OF,CUPERTINO .
`BuiLmNG DIVISION PERMIT - ' CONTRACTOR INFORMATION:
r BUILDINGADDRESS: ": i . ._..._...... .._..............._ .. ._..._.._._. _ ._ _--.._ PERMIT NO.-_..__. ....._. ...
r 19979%99 -STEVENS CRK BLV PI`NN" BROTHERS CONSTRUCTIONS 02040136
NEWS NAME: APPLICATION SUB DATE
_-
3TEVENS' CREEK:`INVESTORS,-"INC 14'75" SARATOGA AVE"" "0"4/24/'2'0'02""
Ir PHONE:. - SANITARY NO. CONTROL NO.
(408) 252-9131
O W zO ARCHITECTE-NGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
a
5 i LICENSED CONTRACTOR'S DECLARATION
= ,1 hereby(from that i am licensed under provisions of Chapter 9lcommencing YA95•�V Sy'j"IIBS H3'al
„�<, with nfallfn]Wdiffe.vismn3onn<Rusmes dr,olasaom.eode.(ndmrlie<nae SOUND WALL
" is in full , and eRcc II'2-
c a License CI9 Lia. l
°ac� Dat — S DECLA 10� AUG 0 6 2002
i 3 u f, ARCHITECT'S UECLA coo
°g I understand my plans strait be used as public records
Y
ia.c, LiansWPmfcasional `. 'BUILDING
' OWNER-BUILDER DECLARATION
1 hereby a1Bner that 1'um exempt from the Contractor's License Law for the _
following reason.(Section 7031.5.Busines an Professions cmc:Any city or county ..C.., .,• ..),, .•-•) "-, -;$4 8 0 0 0• '
63SS p which«yusunperm nd rnlehumplotnt lot sudemo)t t ore repair any umment •" '•"
m Pno r pals eq m applicant rot suchpermnt fl 'g Wam¢mcm - -- -- • .
than he is lictivad pursuant to m!provisions of the Combustions Licence Law IChaprer 9 _ F]�� /� -
N r r a 1 Valuation
(oommenc,gw mScn un]IHM11 of DnistonJof the Raptness mProfessions Cme) ('; (Pt('l i3�tl2F1u'LnJ-.,-u�)J<.�P. t• : ��,i;s
or Is.he.ex exempt therefrom end the basis(for the allege iii mptbn.Any violation ..
of Section 7031.5 by any applicant for a permit iubjeols the applicant to a civil penalty
.Mort more than rue hundred dollars S50o1. - APN" --- r�-r• -Occupancy Type-
11 , ."�ATION"
❑Las owner ofine property,or my employees with wages as their sole compensation. 1 0 _
will'd thework,and the ancmre is not mended or offered for sale(Sec 7Ns e
Bus ss 'd Professions Cm< The Contractor a License Law does not apply to an __10 3 UFER Req IT Inspections'
own fpr pony Who bolds -improves thermn'and whorl Fwork himself . .- _ ...._.._ _ ,- .- _._... _. _.-.,_.-
tin ' or through his employees provided that such improvements are nott dW or .104 - REBAR
oPerW ficaul
If,ow er a the ll Id' g or irk en of Pass n Id emir one year of ' "-"" _
comPla on me owner"n�lair will have me Barden or Passing mat he ata not Wild or 1b5 - ANCHOR BOLTS - '
improv<ror purpoa<nrsalea' 106 - SEWER & WATER _ _
-
❑Leeownermlecp(SeenyamexdusivelycoPrunisions odenxheCo.tcmrsto 202 - UNDERFLOOR PLUMBING
Licconense the project(Sec, to r Business and erry%ho b ills or improves
Comm rson,
- Lic<nrtlawd«snot.suitor�nowmerorpropcnywM1obmlasorimpmresmereon, 203 - UNDERFLOOR MECHANICAL
and who contracts for such projects with a contractor(s)licensed.pursuarm to do, _. - 2 04 "= -UNDERFLOOR' FRAME
... Commemr's License Law.
❑IamexemIn,under Sec. .B&PCfor this mrron 205 - UNDERFLOORINSULATION
owns Dal= 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION
302 - TUB & OR SHOWER
Ihereby arfinnunide,penalty ofsc,u;yone ifhendmwmgdeclarations: 303 - ROUGH MECHANICAL
o I nave and will neaietain a c< irc.m or conxnr m self-insure for Worker's 3 04 - ROUGH ELECTRICAL
_ Cmunpensatiom-as pmiidad fv,'b, Seedoa 3700 of the Labor Code, for the
- pctfommee of the work for worm this p<.it is issued. 305 - FRAME .,
.. ❑1 have`Lha will maintain Worker's Compensation insurance,as required by section 306 - HOLDOWNS .
37M Y theLabor CW f m performanceof th work for which this pq.is is .1
arria cmpn to Insurance aPm y bra 307 - INSULATION
�m�✓/Yt'S.POO � �{��1�� 1 308 SHE$TROCK ;a
CERTIFICATION OF EKEM ION FROM WORKERS t 3 0 9 }`'EXTERIOR `L'ATH
fThs«ction COMPENSATION INSURANCE`
... _...__..
'a neednmbemmpbadBribe p< nisforonehundreddollars -
- ,31'0 ;;INTERIO --LATH e , . p
311 ' `SCRATCH COAT .
! ...
3'13 —ROOF:NAIlii ;•
s, p l n fY Irr t rah p f c of the ofk(r hi<hrM1 pc t n issuN;l lc, -
ean t raptor nmy, mar
< so as a become -byes,tome woke 501 ----FINAL-.-ELECTR•I'CAL ENERGY•-' --- - - -- - - -
Com tion Laws of California
Dare
Compensation
502" - FINAL PLUMBING ENERGY -
Appic(at. - - - - - .
NOTICETOAPPLICANT.If,aftermaking!his'in"'Iof Exemption,you should '
Z become
subjcetmrheWorker,
ComsnsationProvisionsofthclaborCmgyou
ma', 503 - FINAL MECHANICAL ENERGY
Q Q forthwith cora th such provisions or this t shill W domed revoked.
z „ _ __ .., - p` 504 . - FINAL-BUILDING ".ENERGY
- • ''•
CONSTRUCTION LENDING AGENCY
'. 505 - FINAL ELECTRICAL
I hereby affirm that there is a construction lending agency for Me pcdormance
,., ofshe work for which this permiuslssue(Set.309zCis.C.) ,,.506 -GAS TEST
Q Lcader'i Nannie
Z Lender'sAddoess 507 - FINAL PLUMBING.
U Q 1 certify that 1 have reed chis.,icaion and sort that the above information is 508 - FINAL MECHAN I CAL
facF correct.1.gree to crnnplY',with all city and coonty,mrdimmces and state laws relating 509 - FINAL GRADE
r, m Wilding construction:snd hereby authonast«presanmrlves m dr,aity m enter upon
the.hove-mentioned.property for inspection purposes. 510 - FINAL PLANNING
p, (Wc)agree w s demnify and keep harmless the City of Cupci ism nguina
W liabilities judgment:cost a expenses welch may in any way acerae against said 514 - FINAL PUB I C WORKS
U.Z. City m co acre of the g of this permit.
SPPLICA UNDERS ) WILL('tOMPLYWIlALLNON-POINT Issued by: Date
IR 21PL4 7A
tgna re or icambContmcmr Date Re-roofs. /
HAZARDOUS MATERIALS DISCLOSURE A,it •-" ,
Wl11h pph2ator into.building oc pant so.6,handle hatiandran,ort al _ -Type of Roof - ... .__. _•..
as d f W by,the Cupertino Manicipal,Code.Chapter 9 12 and the Health and Safety
t
CWe Sem on 255320)?, e - ,
__AII roofs shall.be inspected pnor to-any roofing material being installed. ,_ -
-
N'illireapplicantbtfut'ure Wildingoccupantuse eauipmantordevices.vetch If a roof is installed Without first obtaining an inspection; I agree'to remove _
em t h aa,
air contaminants as defined by the Bay Area Air Quality Management -
Dismct all new materials for inspection. Applicant understands and will comply with
❑Y<s A - all non-point source regulations:
Phave mad'tee hazardous materials aequimam cls mac"Chapter•fi 95 of the -_._. .... ..... ._.. _[..:.. . ._ .. :.:.. .. .. .. ..... . ... .....
Caliromia Health&Safety Cide.Sections 25505.25533 and 2551(,1 mar erstand ma, -
'ifthe building aonnDlyh,,,,veamnant.chat it is my responsibilitymnotify me - -
actipa of the requwhicustWetpriotossuance of n Certificate of
`" "y' <f(2Signature of Applicant Date
e;,ea,gent „e _ All roof coverings to be Class "B" or better
.� _. _
>•,.z, ... .. .,
C