00110073OFFICE
7BUIOFNG
CONTRACTOR INFORMATION:
DIVISION PERMIT
PERMIT
BUILDING `> WLSTEVENS CREEK BLVD
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'dd1 1.0073
OWNER'S NAME:
AI'PI.ICA'1'I( UU Ali
l2�00
STEVENS GREENS OFFICE CENTER
AS
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�IDNE;
SANITARY NO. CONTROL. NO, c
p C >
ARCIII FECUENGINHER
BUILDING PERMIT INFO
100
L 1E 'LU i L
w'1_
7 I_ L L
.20
Poe =
IJCIiNSEU CONTNACTON'S UIiCLAHATION
Job Descriptio
1 berehy A'tinn Ihal i um Iiecnaal under pn"isirn, of Chapmn 9 (mnancneing
'--h
xsmsmtion7aMnoIDivi,i 13onhcUr,inc,smhdPmfc,siomCode. lmyhscns`
in full fort ndr I.
".icclh,e{:1,, ueh �% $
�r/p'nu
VOLUNI"ARY URGRRDE AND RENOVATION TO EXI
sd
/j/ conhrmctm - -
ale _•'f-1-f—f O-
TOILET
ROOMS
O'F)'
<
J
DECLAIM
1 AHCHII'Le I, v,uhheN
I unJcnlunJ nhy plan, [,all M used x, politic Ie]ONs
,
3r5
R
OIVNiiN-ItUIi.D1iH UIiCLAHAI'ION
I hereby mlimn mat I am coma, from rhe Contractor', Liven. hw for he
Iblltwing re t. (Section 711.11-,5, bruin, and roam, , Cu 1, Any city or counry
j F o
which AWmfaa a irrntil to conrwel, alter. improve. Jemnl la, or repair any oruaure
jam
prior to its issuance, also require, the applicant for such permit to file a signed aammem
Sq. Ft. Floor Area
ton
• that he is han,ed paonnn In the pm,nnus or the Coorac,or, Liean,a I.tlw (Chapter9
lanamencing with Section 7000) of Division 3 of the bu,inecs and Profession, Code)
a that he is c,mnpl therefrom and the na,i.s for the alleged esnaption Any violation
I,[ Semon 70113 by any uppl anal for u po-n.it "Trot, dm uppl leant m a civil penally
APN Number
Oce'pa c'
of not more than five hundred dollar, ls500r.
pe
❑I, as ownerof theptnper rimy employes w,if wag es as dmir od, arri on,
JG 32
." ,.r. M-0
Required Inspections
will do the work, and the structure is not intended or oficrtd nor sale (Sec. 7044,
wuine,, and Pnd,asion. Cale: The Contractor'. Liam, law does not apply to an
owner of property won bard, lit impnaee thereon, and who does sods wok I ..... III
or through his own employees, provided that such improvements art not intended or
'
or
offered to, als. If, has r. he building o mph cot is %old within one year of
101 —
FOUNDATION
,....Ir Irian. tha owner. hu ldar will have the or pno rr, bran he did n n bu ld a
Improveaawrn'•enf,ale.).
102 -
PIERS
❑ I. a,ownerof the pmprny, on cods ivcly contracting with licensed u amulo.n,
103 —
UFER
mss mer the project (Sec. 7144. Rusinros and Professions Code) The Comrmmr's
cons
104 -
REBA P.
aw doe, co apply m air issuer m property who hadas it improva, thereon,
and who contract, rot such pursO, with a commctras) licensed pursuant to the
1 d5 —
ANCHOR, BOLTS
Conlmeor', Liccn,e Law.
O l stn ena,up, umlan5cc. .B&11C For IF,, re'"'+"
1.1716 —
SEWER R WATER
°soot
202 —
UNDERFLOOR, PLUMBING
E1vS
WOIt KEit'S GDnt1'DN$AfIGN UECLARAI'IUN
I—
203 —
UNDERFLOOR MECHANICAL_ .
IherehyarhrmUnderpenaoyoflerjmynoeonhehnowingdeclarations
204 —
UNDERFLOOR FRAME
I have ane win maintain a cerifiram or con nI to re u:ir,arat Worker's
coohp„nsahmr t„ ...... act for by Salon 371ID or he Loth... Cale, for. be
205 -
UNDERFLOOR INSULATION
ceal the ich i, i,nm,
raker'.
301 —
ROUGH PLUMBING
p salirnhrommcaa,reamnedbySaari
❑1nmcand wiu trµlmhh^wt Cour a1lht
3700 of he tomo Cale. For the peri merre m ane work for which (III, pemht 1,
302 —
TUB 8- OR SHOWER
....ae.Mh workersCnm n.ahonmaranaea mandPrhrynamnra :
303 —
ROUGH MECHANICAL
cmt`r:f�kewnacn'ioNOl�rarMyPrlo Ixu wo �
314 -
ROUGH ELECTRICAL_
• COMPENSADDN INSURANCE
305 —
FRAME
(lTi.,,Cclion neat lie be cnnhplmcJ if the pemhil i. for one hundred dollars
,d6 —
HOLDOWNS
IS II(I)nr lens)
J
I certify that is he perarmunce of the wed sur which Vide tannin i, issued. 1
307 —
INSULATION
shall our employ arty patron in any manner ,n ;is In seunttrsubject a, the Workers
30B —
SHEETROCK
compnt... kn La—uremiromm.Dale
Applicant
-1 —
30q
y
EXTERIOR LATH
:If, after this Cenificatc Of EnempliolI. yon, hould
NO'1'li-Ii TOAI'PLICANI' n
J
Maome wbjat m the Worker', Comperratinn provision, m'the Lahr Codc, you mel
`514'1 —
INTERIOR LATH
I orlhwi lh comply w'Imstir If inr, ot..... mIli, pemha,hanFar deemed evoked.
7111 —
SCRATCH COAT
Y 7
CONS IRUcr[ON LENDING AGENCY
I hereby affirm that mare is a........ mann Fending ageney for line perinnama
313 —
ROOF hlRrl_.
of thewnrkfmwhimthi,pennilisi....J(Sec.3(197.Civ.C.)
C
Ixah,'"Nn"'a
501 —
FINAL ELECTRICAL ENERGY
z
Land,, , Address
502 —
FINAL PLUMBING ENERGY
ethalmebnn
1 artilythat Ihave read eaplicatihnand ,Ima hveinfoationis
M
�*,+O
",-''I Iagr,, comply with all cit°and ..sooty tmitam I d,tata law, relating
903 —
FINAL MECHANICAL ENERGY
�:"i
mbuilding attenuation. and hereby authorise mpruxnmtivess lIII In roamer upon
y
heabove.Itenmoedpn,penyfarin,pcctinnprpose..
5114 —
FINAL BUII_DIMG ENERGY
In
Z
(We) agreemwvr. tone -andk Ihlnnnlr, he chy nrcapern, agan"I
liabilities,juh, s. I% e, ansa, achnhnav ,.an, . acme gains id
city in ml ol'Ih- r:mti .oft
505 —
FINAL ELECTRICAL I y
come permit.
AP LICA •IL I YD AN 11 V WIT I LL ')N.IIrl ,
.. 506 '—
GAS TEST Date 1
- - •r/ -rd- _�-
1 y.
-
J ` -
v
Signa e of , "heave mmnctm
DALANWUS MA'I .NIAIS DISCLOSURE
Re -roofs
908 —
F'INAL MECHANICAL_
Will the applleom or mare howdh ..<,maot slot: or handle nava fou, rearr;:d
Type of Roof -
asdmiredbytbeCupcninoMardi e. Charter 9.12. a ad the llcallhand Safety
509 —
FINAL GRADE
Calc, Section 25532m)?
0 yr, °No
All roofs shad�14N ispcct�t�piidr-toFaii�iii64�ii�fihaterial being installed. ,
Wil the apphe:nnorinmmbuhdingoer.,cmmeegndpmemordeviec,Which
If a roof isinsFalletlwithfUtlIaLoh%MgLii•idsp49!oFp',1
agree toremove
nou, air emamin am, defined by Ili, Ana Air Qndity. Management
emir haml
Dro ic"
all new materials for inspection. Applicant understands and will comply with
°Ya'` 0 N
all non -point source regulations.
1 M1mc tend rM harnman ma¢ri' requiremt under Chapter 6.95 of the
CulilmnwI ,oI k Su ay' aSccti, 25505,25 i and 2.5514. 1 minor Id I hal
if the hui ng Ua, nor ran Yhavc mount lh: Ii, my nspnnvbil yto nnuf the
'aupa roe t1 rtqui mon, whit rust pear m i„mna, u Crnlli ¢ of
Olanp
sswow
Signature of Applicant
Date,
— �aa
All
roof coverings to be Class "B" or better
ter aonho , sl, cl;,—
OFFICE