03070053CITY OF CUPERTINO
""^�'°' 1 n3 •' " '�' ' ` •° "s"'''
BUILDING DIVISION PERMITCONTRACT.OR�INFORMAPION:
BUILDING ADDRESS:
HOWARD WRIGHT CONSTRUCTIO
PF nT. NO. 03070053
OWNER'sNAME:
PIER 9, THE EMBARCADERO #111
ITISSUEDAM
E:
(206)447-7672
SANITARY N0. CONTROL N0.
ARCHITE MNGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
i0
rF
LICENSED CONTRACTOR'S DECLARATION
Job Description
mencing
1 hereby efOrm that 1 am licensed u 1 provisions of Chapter 9 (com®
with Serono 7MM )nf Div' ion Sof the 13 e' exand ufesxianx Code, and my license is
in rens
0.,,f n «act.
FINALE
FINAL`®
13
C) L
Cl Lic.
TENANT IMPROVEMENT
ip
rNraa�� s,4
Detc ARCHITECrSt tgj;{10kRATI N
SEP 0 5 2003
1,
U
1 un rad my plans shall imuud u public records
it;
s3
Licensed Pndeuional
OWNER -BUILDER DECLARATION
1�
BUILDING
I
I herchy mTom that 1 oro exempt from Ne Contractor'. Law for the
)0
(allowing ..at. (Section 7031.5, Business and Pro(eaaions Code: Any city or county
S
�}
�<
which requires a permit in construct. alter, improve, demolish, or repair any structure
pd. toots isiunee,also requires the applicant(orsuck permit to Me asigneda.tnment
that he is licensed pursuant to the provisions of the Coal ... fr's License Law(Chaptm 9
Sq. Ft. Floor Area
Valuation
•0
h $
(commencing with Section WIND)of Division 3 of the B usinars and Professions Code) or
that he is exempt therefrom and the bub ror the alleged exemption. Any violation of
3 690 jp2n nn
APN Number
Occupancy Type
Section 7031.5 by any applicant for is Permit subjects the applicant a a civil penalty of
not come than five hundred della. ($5W), \
❑ I. as owner or the property, or my employees wish wages in their sole compensation,
101 - FOUNDPA[e�@Aid Inspections
will do the work, and the swaum is not intended oro(fcmd rot ask, 7044, Business
and Professions Code: The Comm ctoei License Law docs not apply to an owner or
property who builds or improve Nercon.and who doessuchwork himul(or Nmugh his
102 - PIERS
own employee, provided that such improvements are not intended or offered for nit. If.
lO3 — UFER
however, she building or impmvemem Is mid within am yeu of completion. the owner
builder will have the burden of proving that he did not build or Improve rte puryau or
104 - REBAR
ole.).
105 - ANCHOR BOLTS
01, as Owner of she property, am exclusively contacting with licensed contractors to
canslmcuhe project (Sac. 7044, Business and Preparations Cade:) The Comncmr's U.
10 6 — SEWER & WATER '
cram taw does not appy to an owner of property who wilco or improves thcteon, roti
d o the Comraetofa
who contracts for such projects with a emttrumr(U licenmpromisor
2 O 2 — UNDERFLOOR PLUMBING ,
License Lx -
203 - UNDERFLOOR -MECHANICAL
exempt
I am exempt unser sec. . 0 P C far this moon
&
.204 - UNDERFLOOR FRAME
Owner Data
205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penally or perjury ane of the fallowing declarations:
P,
301 — ROUGH PLUMBING
,I have and will mainmin a Ccnificate of Camm�t to setWoute far Words,'.Comper-
302 —' TUB & OR SHOWER
cation, as provided for by Section 3700 of she Tabor Code, fm the peRormance of she
3 03 - ROUGH MECHANICAL
work for which this permit is iuued.
3 04 - ROUGH ELECTRICAL
0 1 nave and will maintain Worker's Compensation Insurance, as required by Sectio
37M o(thc labor Code, for the Performance of the work for which this permit is issued.
305 — FRAME
My Worker's Qom nsetian mxu.nee ca 'er end Policy number am:
hi J1�
3O6 — HOEDOWNS
Ca r; CE FICATEOFEXEMPTIONYFR M W14
ORKERS
307 - INSULATION
COMPENSATION INSURANCE
308 - SHEETROCK
Oils section need not wwmple¢d iftbe permit is (.a. hundred dollars (11100)
309 - EXTERIOR LATH
or Ica)
I ccnify that in she performance of the work for which this Permit is issued, I shall not
310 - INTERIOR LATH
employ any person in any manner m u to become subject o the Workcas Compenmtion
311 — SCRATCH COAT
Laws of California. Dam
Applicant
313 - ROOF NAIL
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
501 - FINAL ELECTRICAL ENERGY
become subject to the Worker's Confirmation provisions of the tabor Coca. you must
forthwith
,Z
comply with such pmvisinnstothis Krmitshall Ix, deemed minded.
502 - FINAL PLUMBING ENERGY
O
CONSTRUCTION LENDING AGENCY
503 - FINAL MECHANICAL ENERGY
I hereby affirm the there is construction lending agency for the perfarmams nr
504 - FINAL BUILDING ENERGY
Q
she work for which Nis permit is issued(Sce. 3097. Civ. C.)
Lenders Name
505 - FINAL 'ELECTRICAL
Leader. Address
Z
506 - GAS TEST
Q
I cenify that 1 have read this application and state that be above information is
correct, l agree to comply with all city and county ordinances and state laws relating m
507 — FINAL PLUMBING
Vhu
bringcmrsumction, and herebyAuthoriurcpruentadwv of this city to enter upon the
FIN MEC ICAL
W
ahnvCnteriiencd pmpmty ror inspection purposes.
(We) agree m save, indemnify and keep harmless the City or Cupertino against
0 9 F I
i,,
',�
liabilities, judgments. costs and caramel which may in any way accmcagainst mid City
5 NG
in cnnuquenec of the gaming of this permit.
^
APPLICANT UNDER AND WILL COMPLY WITH ALL N POINT
Issued by: 5 C WORKS Date
SOURCEREGU
4 1Re-roofs
on reactor
mmomm
gnature ofA HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will Ne appiicant or fuurc building ocapani ume or handle hansdous marefial
u defined by the Cupeninn Municip c. Chapter 9.12, and the Health and Safety
Code, Section 25532(a)?
All roofs shall be inspected prior to any roofing material being installed.
O Yca o
Will the applicant future buil'
If a roof is installed without first obtaining an inspection, I agree to remove
or arupanwu eyuipmcmmdcvice, which
t havamnits air union, naps u ncd by Ne Bay Arca Air Quality Maagemcm
all new materials for inspection.
District?
EYcs Nn
I hevc read she huuamousmnsrials mO,immens underCm,oa,6.95 of the Calirnr
nice 11.10 & Seety Code, Secthms 25505, 25533 and 25534.1 undcrsmnd that if she wilding
dous not cI hh tenant, that it is my resprosihil ity to noOy the XrO unt of the
reyuirc m he met put .0L sateen«efaCclre of cuperay.
Signature of Applicant Date -
/
All roof coverings to be Class "B" or better
Ow , r,atna acdagent Dare
CITY OF CUPERTINO
""^�'°' 1 n3 •' " '�' ' ` •° "s"'''
BUILDING DIVISION PERMITCONTRACT.OR�INFORMAPION:
BUILDING ADDRESS:
HOWARD WRIGHT CONSTRUCTIO
PF nT. NO. 03070053
OWNER'sNAME:
PIER 9, THE EMBARCADERO #111
ITISSUEDAM
E:
(206)447-7672
SANITARY N0. CONTROL N0.
ARCHITE MNGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
i0
rF
LICENSED CONTRACTOR'S DECLARATION
Job Description
mencing
1 hereby efOrm that 1 am licensed u 1 provisions of Chapter 9 (com®
with Serono 7MM )nf Div' ion Sof the 13 e' exand ufesxianx Code, and my license is
in rens
0.,,f n «act.
FINALE
FINAL`®
13
C) L
Cl Lic.
TENANT IMPROVEMENT
ip
rNraa�� s,4
Detc ARCHITECrSt tgj;{10kRATI N
SEP 0 5 2003
1,
U
1 un rad my plans shall imuud u public records
it;
s3
Licensed Pndeuional
OWNER -BUILDER DECLARATION
1�
BUILDING
I
I herchy mTom that 1 oro exempt from Ne Contractor'. Law for the
)0
(allowing ..at. (Section 7031.5, Business and Pro(eaaions Code: Any city or county
S
�}
�<
which requires a permit in construct. alter, improve, demolish, or repair any structure
pd. toots isiunee,also requires the applicant(orsuck permit to Me asigneda.tnment
that he is licensed pursuant to the provisions of the Coal ... fr's License Law(Chaptm 9
Sq. Ft. Floor Area
Valuation
•0
h $
(commencing with Section WIND)of Division 3 of the B usinars and Professions Code) or
that he is exempt therefrom and the bub ror the alleged exemption. Any violation of
3 690 jp2n nn
APN Number
Occupancy Type
Section 7031.5 by any applicant for is Permit subjects the applicant a a civil penalty of
not come than five hundred della. ($5W), \
❑ I. as owner or the property, or my employees wish wages in their sole compensation,
101 - FOUNDPA[e�@Aid Inspections
will do the work, and the swaum is not intended oro(fcmd rot ask, 7044, Business
and Professions Code: The Comm ctoei License Law docs not apply to an owner or
property who builds or improve Nercon.and who doessuchwork himul(or Nmugh his
102 - PIERS
own employee, provided that such improvements are not intended or offered for nit. If.
lO3 — UFER
however, she building or impmvemem Is mid within am yeu of completion. the owner
builder will have the burden of proving that he did not build or Improve rte puryau or
104 - REBAR
ole.).
105 - ANCHOR BOLTS
01, as Owner of she property, am exclusively contacting with licensed contractors to
canslmcuhe project (Sac. 7044, Business and Preparations Cade:) The Comncmr's U.
10 6 — SEWER & WATER '
cram taw does not appy to an owner of property who wilco or improves thcteon, roti
d o the Comraetofa
who contracts for such projects with a emttrumr(U licenmpromisor
2 O 2 — UNDERFLOOR PLUMBING ,
License Lx -
203 - UNDERFLOOR -MECHANICAL
exempt
I am exempt unser sec. . 0 P C far this moon
&
.204 - UNDERFLOOR FRAME
Owner Data
205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penally or perjury ane of the fallowing declarations:
P,
301 — ROUGH PLUMBING
,I have and will mainmin a Ccnificate of Camm�t to setWoute far Words,'.Comper-
302 —' TUB & OR SHOWER
cation, as provided for by Section 3700 of she Tabor Code, fm the peRormance of she
3 03 - ROUGH MECHANICAL
work for which this permit is iuued.
3 04 - ROUGH ELECTRICAL
0 1 nave and will maintain Worker's Compensation Insurance, as required by Sectio
37M o(thc labor Code, for the Performance of the work for which this permit is issued.
305 — FRAME
My Worker's Qom nsetian mxu.nee ca 'er end Policy number am:
hi J1�
3O6 — HOEDOWNS
Ca r; CE FICATEOFEXEMPTIONYFR M W14
ORKERS
307 - INSULATION
COMPENSATION INSURANCE
308 - SHEETROCK
Oils section need not wwmple¢d iftbe permit is (.a. hundred dollars (11100)
309 - EXTERIOR LATH
or Ica)
I ccnify that in she performance of the work for which this Permit is issued, I shall not
310 - INTERIOR LATH
employ any person in any manner m u to become subject o the Workcas Compenmtion
311 — SCRATCH COAT
Laws of California. Dam
Applicant
313 - ROOF NAIL
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
501 - FINAL ELECTRICAL ENERGY
become subject to the Worker's Confirmation provisions of the tabor Coca. you must
forthwith
,Z
comply with such pmvisinnstothis Krmitshall Ix, deemed minded.
502 - FINAL PLUMBING ENERGY
O
CONSTRUCTION LENDING AGENCY
503 - FINAL MECHANICAL ENERGY
I hereby affirm the there is construction lending agency for the perfarmams nr
504 - FINAL BUILDING ENERGY
Q
she work for which Nis permit is issued(Sce. 3097. Civ. C.)
Lenders Name
505 - FINAL 'ELECTRICAL
Leader. Address
Z
506 - GAS TEST
Q
I cenify that 1 have read this application and state that be above information is
correct, l agree to comply with all city and county ordinances and state laws relating m
507 — FINAL PLUMBING
Vhu
bringcmrsumction, and herebyAuthoriurcpruentadwv of this city to enter upon the
FIN MEC ICAL
W
ahnvCnteriiencd pmpmty ror inspection purposes.
(We) agree m save, indemnify and keep harmless the City or Cupertino against
0 9 F I
i,,
',�
liabilities, judgments. costs and caramel which may in any way accmcagainst mid City
5 NG
in cnnuquenec of the gaming of this permit.
^
APPLICANT UNDER AND WILL COMPLY WITH ALL N POINT
Issued by: 5 C WORKS Date
SOURCEREGU
4 1Re-roofs
on reactor
mmomm
gnature ofA HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will Ne appiicant or fuurc building ocapani ume or handle hansdous marefial
u defined by the Cupeninn Municip c. Chapter 9.12, and the Health and Safety
Code, Section 25532(a)?
All roofs shall be inspected prior to any roofing material being installed.
O Yca o
Will the applicant future buil'
If a roof is installed without first obtaining an inspection, I agree to remove
or arupanwu eyuipmcmmdcvice, which
t havamnits air union, naps u ncd by Ne Bay Arca Air Quality Maagemcm
all new materials for inspection.
District?
EYcs Nn
I hevc read she huuamousmnsrials mO,immens underCm,oa,6.95 of the Calirnr
nice 11.10 & Seety Code, Secthms 25505, 25533 and 25534.1 undcrsmnd that if she wilding
dous not cI hh tenant, that it is my resprosihil ity to noOy the XrO unt of the
reyuirc m he met put .0L sateen«efaCclre of cuperay.
Signature of Applicant Date -
/
All roof coverings to be Class "B" or better
Ow , r,atna acdagent Dare