01080011 CI
um OF DPERTONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
20300 STEVENS CRK # 100 SAN JOSE CONSTRUCTION 01080011
OWNER'S NAME: APPLICATION SUB DATE
CANAL PLUS TECHNOLOGIES 1210 COLEMAN AVE 08/02/2001
PHONE: SANITARY NO. CONTROL NO.
i (408) 986-8711
OPV ARCHITECLENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONGRACTOR'S I�—a� O LJ IJ IJ
. RATION
v Iherebyaffirm @mIaamliensdunderrproov ions ofChaper9(commencing Job Description
'LLiii wimSection Tboo)nfDiv�ision39fmaeasi�samPmresunn.Cwe.aadmyIt. TENANT IMPROVEMENT.
x25 is in mu force an Fact. cm
3
o ce u Liwer a Lie. mr
f I ARCH I I LCT'S DECLARATION PINALED
1 nalar ,and my pIam,hull w used os public records
M o Licensed Professional SEP 17 2001
OWNER-BUILDER DECLARATION
u, 1 hereby orErm that 1 am exempt fru.the Contruaor'a License Law for the
t z a lolmwing r<awo.(section 7031.5,Business and Professions awe:Any city or sorely $500
0 0 0
E s p which requires a permit to connuoct.alar,improve,demolish,or repair any suucmrc
so3m nort t arcus,also req the mm
applicant for such pern fRe, d u
&tieiactri
P
P i liceirsedpuisuanllotneprovivonsoftheCmurniLc Law lChaprer9 r Valuation
team g ,m seer n ngxq rD is on a Orme Bas nes.and Pr fessions cods)
i
or that he s exempt inncfmm and the basis for the alleged exemption,Any violation
of Semon 703 I3 by ar,applicant fora permit sub(«u the applicant m a civil penwty
•ofnmmnrethan.five hundred dollars(s5w). 1O]�PNgV8tffDATIONi Occupancy Type
D 1,as ownthe er of pni m my employees van wages as their m
sale cm pealion. —
will do,the work,and It structure is not intended'or offered for sale(Sae.]0W,-
Rasinaa and Pi6resdon,code:The Continuo's ueense Law does not aPplr to an 10 3 - UFER Required Inspections" ' '
owner of p.,.y Who builds or i.pri thereon,and who docs such work himself
or mron� his own employees,provided that such improvements are not intended or 104 - REBAR
offered fur vie.If,however,the building or ire mvemcnt is sold within one f- BOLTS —
p O 105 - ANCHOR
completion,Ne owncr.buuder will have the burden or pmving that he did not wild m
improve for purpmaofsale.). 106 - SEWER & WATER
o'1.a owner o"fthe pmpany,amesdnvivelyconGLLiingwithlicce-Ko.raamrsto -202- - UNDERFLOOR—PLUMBING _;iv-i
canton,the pmiect(scc.70M.Bashes,and Professions Cored no Con.m*a 203 - UNDERFLOOR MECHAN-I CAL r'r a :I
License Law dos am apply to an owner of property who wilds or improves twreon,
and who contracts for such .wdtb pmiccsa contmcmsaam dsr licensed.putto the_ 2 04 - UNDERFLOOR "FRAME- -
01 a a. License Law..
❑lam<aemw under, "' aPefor this reason 205 - UNDERFLOOR"INSULATION
own`Cl, " Data 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER
Ihereby affirm under penalty ofp<rtiryone onhefollowing declarations, 303 - ROUGH MECHANICAL
�. D 1 have and will maintain a Ceriirc lc of Cr km lu sel6lnwm I Wofl rra 3 04 - ROUGH ELECTRICAL
Compe...him,-as Provided for by Section 37W of he Labor awe, for me
- 'pirromsaneonna.mkfo,wnirnmi:p<,!pit.isissfuni— , 305 — FRAME
�f13oe'and will cis inmie Worker's Compensation Idwruiti as required by Section 3 06 HOLDOWNS
37W of the Lahorclidc,for the,performance of the,work.hor which this-penmit'ts 3 07 — INSULATION
mined M W flees Compeowuon I wrp c"cam<e and Policy counbe,me,
308-,='-,S$EETROCK
cat'„ t vr,lu.: it.
-, rt }CERTIFICATION OF,E%EMPTIONIROM.WORKERS,�• a 'f3O'9 "--'EXTERI'OR'•LATH'
_n COMPENSATION INSURANCE;
-"-"3,10-,-.,--(INTERIOR-,LATH__ . ._.
(Thsamonneed not w complaiad fthe permit is boom,hundred dollars _
rslwrntless.) 311 • SCRATCH COAT
1 can rr our n th pedbrrn, enon,un y myon m<- rk f b q«t r me workers _313- ROOF NALL. . . .
i, which this perm t is t,wed;I t
`C..'App,san 'employ
`y v'//H iIn` 502 FINAL PLUMBINGAENENERGY
M[�p� /°�9'�Y.
NOTICE TOAPPLIT If,after - ` - - FINAL :ENERGY ._..... .. .. .
maki h s Cemneme of E< pt on,you should '
Z become id,peoltotheWadae:CdntpemaaonPm.i,imtanfine borcoda.yo ma 503 - FINAL MECHANICAL
Z O forthwith comply with such previsions.,,his permit shall be dcnned revoked. _ FINAL
505 FINAL ELECTTRICAENERGY .
.VJ `• it ' ' CONSTRUCTION LENDING AGENCY — L
a ; I herabi which
that(her t construction lending a.C.)Y f th peAurmarce ;
a the"Is or m knoll a(s '3o97c c) 506 — GAS TEST
W Z ,neer',agree ahem r.a ._. - ... - - ,.. ... .. .- -.
y ❑ Ispde Nm 507 - FINAL PLUMBING
Z Lend< AJdrt, �.,,It
U � m readlli pplict dMturiwmaaro f mints 508 - FINAL MECHANICAli
Rr F.t ply with all city and county ordinances and state]a%xminng 509 - FINAL GRADE
O..r) to Wilding .visci on and hereby mbar ze repmn
emti es of this city t ter upon
p m he wr al yr, .peed pram,. 510 - FINAL PLANNING
F' Q (' W) gra toMs a neemtif5dA ph I ry theCfCupe n Against
m . Rab,lt . eta IM acn n y' any ayMCNCagainst send 514 - FINAL PUBLIC WORKS
O.� City in mcquence of the granting
of thihi s permit.
S PPI( AWj1NDERSTAND NDW'ILLCOMPLYU'iTHALL�ON)•O� [sued by: Date ��V
/.Gr/// �GL//!�'\ •. tDate
signmurcof Applicury oartwon 1 '� ' ' � 1'•,,:, Re-roofs
Code Stoma 25 HAZARDOUS ATERIALSDsure ca URE
wlluteaitpHA ff w'Idmg punsSCLOSUEn,�fd 1�t�1 Type of Roof.
as def ed b thus Cupanm M c pal Cod Ch pt 9 13.and theHealth d Safety
{�6 t•n 'f" kris, 7 E [p{`:'kt °..1,' ' •s : ,t[ t r..
D Yes 332(n)PN �,'\ .t 4. ;q', •�•;•a All roofs shall beinspected prior to any roofing.material being installed. ,. _..
- iWill meapplicam orftture baddingocc....I use equipment or devices which If a roof is installedwithout first obtaining an inspection;I'lagree'to remove
emit h rd . ,cum nt defined by theBay A A' Quality M nagement
Dista v/ - all new materials for inspection. Applicant understands and.will-comply with
El yes L - all non-point source regulations. . , • ; ,,
'u I haverread the h lard u..momtiids onRitamena under Chapter 695 of the
Calf 'aHeilth&SafetyC d 'sedans 2550525533 and 255341 understand that
if the Wildingdos not currently haveate t that tin yrespo_ bllyt tify the f ,
occapam f req.tomwot. which'mu�y w t Pno I ia,an. f Cenificmt of
Y,
q/; q Signature of Applicant Date
Owner pro thonzad agent D, e All roof coverings to be Class `Bos or'better
-OFFICE --