Loading...
04080039CITY OF CUPERTINO "`� _'� e BUILDING DIVISION PERM *GONTRACTORINFORMAN x .s „ yy:,'s TY"&„ BUILDINGADDRESS: NOVO CONSTRUCTION PERMIT NO. 04080039 2040 OWNER'S NAME: PERMITLSSUEDATE PROMETHEUS S NE: SANITARY N p OL NO. 65 70101 ARCHITECT/ENGINEER: BUILDING PERMIT INFO B MECH EKM' PLUMB LICENSED CON ACTOR'S DECLARATION Job Des Ip 1 herOby, Bnn Um I am licensed Under p ons of Chapter 9 (commencing Seeri�of Divixion 3of Oe Bminmsan P,fcssinns Code. and myliccnse is with in full ro a erMct. "Z '! 11' (' �2 v License Class see.« l Z TENANT IMPROVEMENT � Dam Conmcjor"d CJO AR HITECTS DECLARATION a,,,� IundcroanJ my plans shall he used as public recordsL® �'ra fcssiona Licensed Pml DECLARATION Oat 1 hereby ¢(sere that 11. exempt from the Contractor's License Law for the I am exempt from i following ¢moa (section 7(5 1.5. Business and P Calc: Any city nr county . dernm which mqusm a permit cat cnrtswd nitre, impmw. demobh, or pair any swmum e cm ? pdonnslicenedpUrssumquithe theapplicantOf for such Contrarminoicenssigned state(Chapter Sq. F[. Floor Area Valu¢ion ,(that he commencing wit Purstion70bc of Division 3 the eBusinur'snd Proclaw(C Code) (commencing Section W00) or Division r of the iter t Business and on. Any vi Coda) car that M inc Net K i exempt IbemOOm and the basi for the alleged eumption. Any violaron Of 3ARN M(blXr 00 Occupancy Type Section 7031.5bya1 applicant for a permit subjects the applicant to a civil penalty Of not more than rive hundred dollars (Ssw). 0 1, as Owner of the proper, or my employees with wages m their sole compenution, Required Inspections will do mewods. and the awctute is not intended mothered tonal, (Sec. 7044, Business and Professions Code: The Contractor's License law does not apply toan owner of property who builtls,r improves Ucreon, and who docssuch work himself or through his own employes, provided thmsuch improvements are notinmrded oraRered forsale If. however, the building or improvement is sold within one yearof compledon. the Owner, builder will have the burden of proving that he did not build Or improve for purpose of sok.). 1, as Owner Of the property am exclusively contracting with licensed contractors to - construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li. _ cents law does not apply tO an owner Of property who buiids or improves themon, and who contracts for such projects with a emproctor(s) licensed pursuant to due Contractors License law. ❑ I am exempt under Sea, , B & P C for this reason Owner Dale WORKERS COMPENSATION DECLARATION 1 hereby affirm under Penally Of perjury one Of me following declarations: 1 haw and will maintain a Caniricate of Consent toself-imum for Workers Compen. sation, az Provided for by Section 3700 of the Labor Code. for the pedurmanee of Ue work for which this permit is issued. ❑ 1 have, end will maintain Worker's Compensation Insunna, as mluited by Sccron 3700 of rh, labor Code, for the performance of the wgrkDr which this Permit is�issurd. eric a d Policy number ChnMCom,somatin'(I3nsurance`a l�ofr/ uaPNoW✓EICATEOFE%EMFTONFROM WORKERS' COMPENSATION INSURANCE (This section need not he completed if the Permit is forme hundred dollars (SIM) r Mss.) •1 certify that in the performance of the work for which this Permit is issued, I shall not employ any person in any manner so m to become subjcm to the Workers Compensation hwa of California. Doc Applicant NOTICE TO APPLICANT: If, arm, making this Certificate of Exemption, you should become subject to me Worker's Compensation provisions of me labor Code, you must forthwith comply with such Provisions or this m mit chall he deemed mvnkcd. D CONSTRUCTION LENDING AGENCY , 1 hereby affirm that there is a construction lending agency far the performance of the work for which this permit is issued (Sec. 3097. Civ. C.) Lender's Name Lcndcr's Address. - > 1 ecoiry that 1 have mad this application and sure that Uc above information is ' conem. l agree to comply with all city and county ordim mutt and some laws miming to Wilding construction, and hereby authonre mpresematims Of this city to mom upon the U above-mentioned property for inspection purposes. 4 (We) often to aave indemnify and keep harmless the City of Cupertino against liab" 'utlgmcnu,cosunex pens es which may in anyway accmc agarmisvd City > con of me graining, Of thispermit. PP ANT N ER ANDS AND WILL COMPLY W)H ALL NO POINT Issued by: Dat S E L 15. Re -roofs ILL Signawrt of ApplicaHAZARDO ate HAZARDOUS MATERIAL$ DISCLOSURE Type of Roof Or handle Will theapCu Oor fummbuildinge.c althamaterial hainstore az defined by the Cupertino Municipal code. Chapmr 9.12, and IM Health and Safety Health Code. Sections 25532(a)? ; ED Yet E] NO All roofs shall be inspected prior to any roofing material being installed. will mime ildin If a roof is installed without first obtaining an inspection, I agree to remove thea applies or oats ant cast a quipment or devices which PP Dor g emit nus air conmminan¢ tkrincd by the Bay Arca Air Quality Management e all new materials for inspection. District? Dixtria? ❑ Yes 4. Ih eharardous materials requirements under Chapter 6.95 of the Cali for nix Hal &Sofcty ode,S cthm8505,25533and25534. 1 undcrsundthmifmchuildmg doesunrcroly Manan partiblktyunOory me. y�FnntIntthC ^thism mqu' aw6 hMust ssuaneeofaccmra5coa0Scupan,Mr, / Signature of Applicant Date IP All roof coverings to be Class "B" or better Owner Or au,h,id=gent me • n U • �Jov4i „n�_�, • NNW August 6, 2004 Greg Casteel, Building Official City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 Re: Cupertino City Center 20400 Stevens Creek Blvd. Common Area Restroom Countertop Height Compliance to ADA Standards Dear Mr. Casteel: Per our previous discussions over the past several months, we are requesting permission from the City to leave the existing non -conforming countertops in the common area restrooms at their existing heights. The issue brought to our attention during tenant improvement construction is that some of these countertops are up to %” higher than ADA standards. At the time of construction these countertops were approved and code compliant. In the fourteen years since the building was occupied, we have never had a complaint from a tenant or on-site visitor as to the height of the countertops. We understand and agree that should this issue ever become a problem for one of our tenants or visitors to the building, we will take action to bring the countertop height into compliance with the current standards as required by law. If this is acceptable to you, please indicate with your signature below. Sincerely, 2Lope Senior Portfolio Manager CC: Rod Standard, Vice President Prometheus AND ACCEPTED: City of Cupertino, c71 DQ 20jG4 CITY OF 20400 Stevens Creek Boulevard, Suite #245, Cupertino, (A 95014 Telephone: 408.873.0121 facsimile: 408.873.0122 www.prometheusreg.com n u • J 0 0 City of Cupertino Plan Check Transmittal Permit# Project Address Owner 04080039 Control# 13476 Plancheck# 1 FileDate 8/5/04 TENANT IMPROVEMEN 20400 STEVENS CRK #750/7TH FLR PROMETHEUS Description 1 Plan Check Status (attach comments and return to Building with plan set) Dept Plan check# Date Due Date Staff Comment Date Appr al? BERRYMAN 1 8/5/04 8/19/04 B R YMAN Planning 1 8/5/04 8/19/04 e $ a Q Fire 1 8/5/04 8/19/04 Sanitary Additional Plan Check Fee U Hours Planning Fees Housing Mitigation Fee Amount Heart of the City Specific Pian Fee Amount 1 8/5/04 8/19/04 Assessor 1 8/5/04 8/19/04 Additional Plan Check Fee U Hours Planning Fees Housing Mitigation Fee Amount Heart of the City Specific Pian Fee Amount ��PGLARA C,OG � FIRE '` FIRE DEPARTMENT SANTA CLARA COUNTY 14700 Winchester Blvd., Los Gatos, CA 95032-1818 (408) 378-4010 • (408) 378-9342 (fax) • V=V.sccfd.org 0 PLAN REVIEW No. 04 2002 BLDG PERMn No. 04080039 CONTROL No. 13 4 7 6 PLAN REVIEW COMMENTS CODEISEC. SHEET NO. REQUIREMENT Review of plans for new partitions, ceiling, etc., for new tenant layout. -2 1 Alter the sprinkler system as needed by new partitions and ceilings. Submit shop A-3 drawings (3 sets) and a permit application to the Santa Clara County Fire Department for approval before altering the system. Call (408) 378-4010 for more information. .CBC/403.5. A-2 2 Submit fire alarm/emergency voice alarm signaling system shop drawings (3 sets) and a permit application to the Bureau of Fire Prevention for review and approval of any fire alarm system modification/alteration to accommodate this project. Call (408) 378-4010 for more information. CBC/1003.3. A-2 3 NOTE 1.8 Exit doors shall be openable from the inside without the use of a key or any special . knowledge or effort. Manually operated edge- or surface mounted flush bolts and surface bolts shall not be used on exit doors. CFC/ 1002.1 A-2 4 NOTE All portions of the building shall be within 75 feet of a fire extinguisher. The minimum size of the extinguisher shall be 2 -A:10 -BC. CBC/ A-2 5 NOTE Chapter 8 Interior wall and ceiling finish shall comply with Chapter 8. CBC/1003.2. A-2 6 NOTE 8.6 Tactile exit signs shall be provided as required to comply with section 1003.2.8.6. *FLR S NEW RMDL AS OCCUPANCY CONST. TYPE Appllt'sniNam DATE PAGE ❑ N N B I -FR Prometheus /martin H Foster 8/19/2004 1 2 AREA LOAD DESCRIPTION BY —OF—. 9,436 S.F. 139 Commercial Construction O'brien, Gilery NAME OF PROJECT LOCATION CUPERTINO CITY CENTER 120400 Stevens Creek BI 750 Organized as the Santa Clara County Central Fire Protection District Seruing Santa Clara County and the communities of Campbell, Cupertino, Los Altos, Los Altos Hills. Los Gatos, Monte Sereno, Morgan Hill, and Saratoga �Pc,LARA 000 FIRE • CWIRESY 36EPViLE 0 FIRE DEPARTMENT SANTA CLARA COUNTY 14700 Winchester Blvd., Los Gatos, CA 95032-1818 (408) 378-4010 • (408) 378-9342 (fax) • w .sccfd.org 0 PLAN REVIEW No. 0 4 2 0 0 2 BLDG PERMITNo. 04080039 CONTROL No. 13 4 7 6 PLAN REVIEW COMMENTS CODEISEC. SHEET NO. REOUIREMENT Plans are approved, subject to the above comments. OK to issue Bldg. Dept. permit. City PLANS SPECS NEW RMDL AS OCCUPANCY CONST. TYPE ApplicentNwe DATE CUP ® ❑ ❑ PAGE ® N B I -FR Prometheus/ martin H Foster 8/19/2004 2 SECJFLOOR AREA 2 LOAD DESCRIPTION BY — OF 13LD 3, FLR 7 9,436 S.F. 139 Commercial Construction O'brien, Gilery NAME OF PROJECT LOCATION CUPERTINO CITY CENTER 20400 Stevens Creek Bl = 750 Organized as the Santa Clara County Central Fire Protection District Serving Santa Clara County and the communities of Campbell, Cupertino, Los Altos, Los Altos Hills, Los Gatos, Monte Sereno, Morgan Hill, and Saratoga fr- CIT OF CUPERTINO IRCITY OF CUPERTINOO oq o 0 PERMIT APPLICATION FORM 3 I APN # Fee Description Fee Group Date: ��� 1 ' `'I Building Address: MECHANICAL Mailing Address if different from building address): AIDIAM ovvs L `Z7l� C— �mr `7 S Name: MECHANICAL BBOILER3 Phone #: Ms W\ BBOILER4 Boiler> 1M to 1.75 M Btu L -i6%— i3 © \a Contractor: Boiler> 1.75M Btu MECHANICAL License #: 0 o C� Contact: Phone: 6 0-')01-t5 Cupertino Business License#: Con. Tax for BQ Zone Fax: BCONSTAXH :ASIC Building Permit Info: BCONSTAXR Constax — Resi/Mobile Bld lect BELEC1000 Plumb 2:::� ech,a Job Description: y. �� BELEC1001 FCd Residential ❑ BELEC200 c�a� Sq.Ft.o a. - BENERGY $/Sq.F .: BUILDING BENERGYADD Ener Add Multi BUILDING Costo ro" ct: Investigation fee BUILDING Occul5ancy Group: i J Type of Construction: I Ple e" ck �s �Pif the project is a ed� s ion• ❑ Project Size: Standard ❑ Lar ❑ /m /or ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler? 100K to 500K Btu MECHANICAL BBOILER3 Boil6r> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Ener Add Multi BUILDING BINVESTIGA Investigation fee BUILDING ,:�F( z6S62- lof3 iq� //77, 72-- Q CITY OF CUPERTINO WITY OF CUPERTINO* PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfrn MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOVI Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res App liance ELECTRICAL 2of3 alffllml�t CITY OF CUPEIIiTINO WITY OF CUPERTINOS PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumb' Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING • 3of3 -V— SEP-14-2004 14:25 MARK THOMAS CUP 4082535173 P.01/01 0 0 r-7 L -A DISTRICT MANAGER-ENGINE5R MARK THOMAS a COMPANY. INC - DAVID E. ROSS DISTRICT COUNSEL ATKINSON o FARASYN, LLP HAROLD S. rOPPEL ' %JkNlr4'?.P * 14 4�1 4461 Is il flb 2.0833 STEVENS CREEK BOULEVARD, SUITE 104 CUPERTINO, CALIFORNIA 95014-2154 (408) 253-7071 PHONE 0 (408) 253-S 173 FAX BOARD OF DIRECTORS WILLIAM A. BOSWORTH DR. JOSEPH F. BROWN JOHN M. GATTO CURTIS B. HARRISON WENDELL H, KERR, JR. File: CuSD — MOP Building Dept. — Cupertino Community Development Department Building City of Cupertino 10300 Torre Ave. Cupertino, CA 95014-3202 \'�ko \(:5� NO 136 0SNW Subject: Tenant Improvement Name: Cupertino City Center Address: 20400 Stevens Creek Blvd., Building No. 3, Suite No. 700 0 APN: 369-01-028 ControtTlan Ck No. 13360 Permit No. 04060237 * Backflow may be required a Videotape and.Property Line Cleanout inspected. No additional conditionsIrequirements by thhe Dy' trict. 7 Inspector: ... ... George Santos ............................. ....... lof Date: ... 7-9-2004 ................... Sanitary Sewer Location Ole cc: Horne owner SUPRYING SANUUT SwRAGE SERvicis Fou Im OF CUPERTINO, PORTIONS Of THE (HIES Of SAUTOGA, SUNNYVAH, Los AITI)s Ano SuRRoUNDW HWIW(DIf0kAIED AREAS ww.. rana,linasunito, dij Ifict. com TOTAL P.01 CITY OF CUPERTINO �1`I .-', BUILDING DIVISION PERMIT CO RACTOR INF I',, ,. ,,,. BUILDING ADDRESS: NOVO CONSTRUCTION PERMIT NO. 04080039 20400 STEVENS CRK -7TH FTOR OWNER'S NAME: PERbBTLSSUEDATE PROMETHEUS(SUITE E: SANITARY N9. TOL NO. 65 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH Y I� LICENSED CONTRACTOR'S DECLARATION Job Descrl u 1 W Bvn Ben'am Bcenscd under p Bions of Chapter 9 (commencing with Serio�sby.I/p of Division Sof the Busiressm P fcssions Code. and my license is u.INA' � 7afa'Urb in full fortw,grfd effect. '7 O1102.�-' TENANT IMPROVEMENT Llcenm Clma Lk. a% ��� Oam ARCH �� OCT G 2004 IG I understand my plans shall W used apjrhlic mcords BUILDING Licensed Professional, OWNER -BUILDER DECLARATION I hereby ff,. Bu I am sxempi from that,that,Contractor's License Law for the following reason. (Section 703 LS, Business and Professions Code: Any city or county which requires a permit to cnnat.,. clam, improve, demolish, or repair any structure prior to its issuance. also requires the applicant for such permit to fie a signed statement Ft. Floor Area Value ion that W is licensed pursuant o the previsions of the Connector's License Law (Chapter 9 Sq. (commencing with Section 71100) of Division 3 of the Businessand Prorkso ms Code) ser thfrom and One bait for Be alleged exemption. Any violmi,on of thus he B exemptere 3 M15 N@@fir 0 O _ Occupancy Type p y ' Tl p Session 7031.5 by a" applicant for a pamll subjects the applicant to a civil penalty of come e than five hundred dollars (1300). 0 1, as owner of the property, or my employees with wages as, their sets compensation, Required Inspections will de the work. and the structure Is not intended or offered rental. (Sen. 7044. Business and Professions Code: The Contractor's License Law dean not apply to an owner of Property who builds or im prows thereon, and who does such work himself or through his own emptoyces, provided thalsuch improvements arenot Intended oroBercd formic. If. however. Be building or improvement is sold within one year of completion. the owner. builder will have the burden of proving that he did not Wild or improve for purpose of rots.). 0 1, as owner of the property, am exclusively convecting with licensed contractors to conswct the pmject (Sec. 704,4. Business and Professions Cade:) The Conuactor's L6 come taw does not apply to an owner of Property who Wilds or imprown Burman. and who comment for such projects with a eonumcbm(s) licensed pursuant to the Communes License I. 0 1 am exempt under Seo. . B k P C for this ration Owner Dale WORKER'S COMPENSATION DECLARATION 1 hereby airmn under penally of perjury one of the fallowing declere0oa: 1 have and will maintain a Certificate of Consent to self-insum for Worker's Compen- sation, a provided for by Section 3700 of Be lobar Code, for the perfen once of the work for which this permit is issued. I haw and will maintain Worker! Compensation Insurance, a required by Section 3700 of that Labor Code, for Be performance of Be wprk7br which this permit is issued. My Wa Comp os d.� (II3ny..on, a `fartier and Policy number am: � � �a �S Carne(// S"F- Y tit. u Voter i� n y—IkL - CVffIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This me0on need not W completed If the Permit is return hundred dollars (1100) of less.) 1 cenify Net in Be performance of Be work for which this permit's issued. I shall not employ any person in my manner se as in become subject to the Workeri Compensation Laws of Caliromis. Data Applicant NOTICE TO APPLICANT: If. after making this Certificate of Exemption, you should Women subject ro the Worker's Compemmion provisiena of the Labor Code, you most fordwith comply with such provisions; or Bis permit shell W. deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that Nett is a connection lending agency for the performance of the work for which this permit is issued (Sec. 3097• Civ. C.) tender's Namc tender's Adtlreu. - I cattily that 1 haw read this application and state that the shove information is correct. l agree to comply with all city and county enhances and state laws misting to building construction, and hereby mthonm representatives of this city to enter upon the above-mcndoncd property for inspection proposes. (We) crime to save, indemnify and keep harmless the City of Cupertino agdnst limb" udgmcns,costs and cxpeae. which may in any way acme again. said Chty con a of the gmangof Bispeomil. ,�' • PP ANT N ER ANDS AND WILL LY ^1Y" ALL NO POINT Issued by: Dat S E L 1 5. Re -roofs Signature of ApplicmVConale HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or (Marc building occupant slow or handle levardous and az defined by the Cupertino Municipal Code. Chapter 9.1], and Be Health and Safety Cede. Section 25532(x)7 / All roofs shall be inspected prior to any roofing material being installed. ❑Yes eNo Y ' M If a roof is installed without first obtaining an inspection, I agree to remove heappiicml or acture hiding occupant um equip cut or devices which I, W.rdoua air 1 ourimmis dcfncd by the Bay Am. Air Quality Management all new materials for inspection. DisldcR C Yes I e haardaus materials requi.mcrosuadcr Chap2r6.95 of Bc Califon nha Heal &Safety otic, don 25305, 25537 and 2553d.l ondcsmnd Buif tine Wilding docs n ser out aw a te en t it u m nshbilil to nntif the occu 1 of Be req' w' It must r� asMamcofaCeniht e },,rot S Signature of Applicant Date — P All roof coverings to be Class "B" or better ' Owner car authorised agent Data