03050052 CITY OF CUPERTINO �Vl X
BullDt"c DIVISION PERMIT x CONTRWGT:OR INFORMATION:
BUILDING ADDRESS: WEBCOR BUILDERS PERMIT"DO 3050052
-R'S NAME: 951MARINERS ISLAND :BLVD PERMITIssfsn9/2003
_EVENS CREEK APARTMENTS
P"O"E (415) 349-2727 SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
= t� o
.06 LICENSED CONTRACTOR'S DECLARATION
�r 0 1 hffirm
erchy athat I a der licensed unProvisioProvisions; mmcinJob Description
von;of Chapter 9(coen
g P
NN Section 7")of Division Sof the Buammem and Prefommum Coca.mud my license e
orfullrolual rtect TI--REVISION TO COMMUNITY RM A
naZ License Clan Contractor
C-
Dau cdnDECL ORIG. #01070021 �\
ARCHITECTS DECLARATION
9y 1 undersand my plans shall bo used a Public records ,C
D V
G Licensed Professional
5 Oat I am exempt
from
DECLARATION
Com ION \
S 1 hereby a1Rrm onn 1 am esusin fret the fismo mors License Law for Inc
0 o which
fou does,..(Section 7113 t.5, r,Business land sae.&ore Cade:My city or cs,ume, -
$ which dquims a issuance.
to consumer,alar,tit fmve,h surnsh, fie asir any structure
tat,Hohei uicnaudprsuant to the nnovisioc of for sucharmilm nesse Law(Chapter
meal
(c romancing cdpuwion70 cpmvialomnlNeConusbarem Li¢melsiw(C Code)
Sq.Ft.Floor Area Valuation
E $ (cot he is romancing with Section nd NDiasis f r th the alleged
eaand on.PreAny
Cede)of $50000
3� Net he u exempt therefrom and the baso far Ilw allcgW exemption.Any violation of
Section 7031.5 by any,applicant for a permit ubjects the applicant o a civil penalty of APN Number Occupancy Type
not mod Nan five hundred dollen(;5011}
36901029 . 0 0
[JI,u owner of the pmperry,or my employees with wages as their sole compensation,
will do the work.and Neswnuta is not intended or offered for ash:(Sax.70th,Business RRrr^^ d Inspections
and Prefessiom Code:The Consomme,U.Law does.1 apply to on owner of 101 - FOUND_A_= P
prepeny who builds or im proves thereon,end who docs arch work Interstellar through his
..employ.,presided dam uch improvements am non Intended or offered for We.If. 102 — PIERS
however.Ne building or improvement is sold within one year of completion,the owner,
builder will have the burden of proving that he did not build at improve for purpose of 103 — UFER _
21O5al`" 104 - REBAR
h u owner of Ne propeny,am exclusively contracting it lludnd.macton to
— ANCHOR BOLTS
met the project(Sec.70".Business and Professions Code:)The Contractor's U.
come law does not apply man owner ofprepeny who builds or Improves thereon,and, 106 — SEWER & WATER
who contracts for such projects;with a canuactor(m licensed pursuant to the Comractoes
LiesLaw. 202 - UNDERFLOOR PLUMBING
❑lam exempt .B&Pc-fa�thgla dpn�.y 203 - UNDERFLOOR MECHANICAL
a.COMPENSATION DECLAN�'7'"`�- 204 - UNDERFLOOR FRAME
bomb under penalty of perjury one of the following decimations: 2O5 — UNDERFLOOR INSULATION
❑Ihave and ainWn aCeNricate of Camel to selfdnsud for workers Comped 301 — ROUGH PLUMBING
amid.,u provided for by Section 3700 of the labor Code,for ft Performance of the 302 — TUB & OR SHOWER
work for which this permit is Rmed. 303 - ROUGH MECHANICAL
❑Iban and will mai.uin Workers Compensation Issuance,a required by Section 3O4 — ROUGH ELECTRICAL
3700 of Ne Iahorcode,fm Ne perform..of the work forwhich this permit a Issued.
My Workers Compensation insurance easier and Policy number art: 305 FRAME
Carrier: Policy No.: 306 - HOLDOWNS
CERTIFICATMPENE OF EXEMPTION
ORKERS'
ATION INSCE NCE307 — INSULATION
(Thlsactiw need not W omoulmol time permit 4 for We hundred dollars(SIM) 308 - SHEETROCK
or bas.)
309 - EXTERIOR LATH
1 unify Nan in to performance of Ne work for which this permit is issued,l shall not 310 - INTERIOR LATH
employ any pend.in any manner an u m became subject to the Workers'Compensation
Lawsof California.Data 311 - SCRATCH COAT
Applica
NOTICE TO APPLICANT.If,after making this Ccnincam or Exemption,you should 313 - ROOF NAIL
become subject to the Worker's Compemotion previsions of the Labor Code.you mum
.JZ forthwith comply with such previsions or this Permit shall Im doomed reroked. 501 — FINAL ELECTRICAL ENERGY
?O CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY
H 4 Ihadby.trim,ft.uemlaacammutionlending agency for she performance or 503 - FINAL MECHANICAL ENERGY
Cr, Nework,for which this permitaissued(sec.309'I,Civ.C.)
Lenders Name 504 - FINAL BUILDING ENERGY
{r3 Q
a z Leader'aAdd., 505 - FINAL ELECTRICAL
U O 1 certify that 1 haw mad Nis application no sum Nam the above informnlun Is 506 - GAS TEST
IT.F correct.1 agree no comply with all city and county ordinances and sou laws robust in
CU
building corcusurflon.and hereby motodue representative,or this city in enter upon ft FINAL PLUMBING
above-mentioned property for Inspection purposes O 8 F I N L
a (We)agree be ave indemnify and keep hormion the City of Coconino against
In liabilities,judgmcnu.c andapevm which may in any wayacreemasm said City I
t„)7 O'contequ ceof gnnungur Ni a permit.
r1• APPL r U ERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:5 NG Date
/;
50 R `G ATIONS.45114t*I _
1� _4q7Re-roofs
S' ave r IIc.VCasummer ou
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
a pliant dr I.I. uildingauupantnomorma Ichaallousmaurial
d,f b CupeNno M."M l Code.Chapter 9.13,and the Health and Safety
:.Sc M32(an ft(1�.` All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building ouupanl on equipment at dcvima which If a roof is installed without first obtaining an inspection,I agree to remove
emit hexardnus air conuminen a defined by Ne Boy Arca Air Quality Management all new materials for inspection.
Diatrin?
❑Ym Nu
I be.ocildiffl, Mous materials dquidmcnu under Charter 6.95 of the Califor.
nice I &S .Sea..25505.25533 and 25534.1 understood lit lM building
ave a unapt.Nat I'M
my dapomibllity m naify the dec.p.m or Ne
him mum be met ptlormisw.cc ar.eeNEea of Occupancy. Signature of Applicant Date
wane authamcaesem All roof coverings to be Class "B" or better