02060087 110009 Ch-14C.
CITY OF CUPFJWI INO --=" -- .., �, M
Ruu.mnc IV SION PERMIT CONTRACTOWINFORMATION:
Bul V(7Q@L1RRsSTEVENS CREEK BLVD SARATOGA CONSTRUCTION PERMITN02060087
qk'SNIPEM CHING 12201 SARATOGA—SUNNYVALE nLICAT0ueYR]P4r'f 2002
WE ' /a7, (408) 996-1711 SANITARY NO. CONTROL NO.
ARCHITECENGINEER: W�'/
TIBUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
a.,
LICENSED CONTRACTOR DECLARATION
,s r I hereby offrm that t am licensed ander provisions of Chapter 9 ne ntd andng C
�iw wnhSee
red
7fMMlprfDivisien3ofthe Bmiue,,and PmR,,srlln,Code,and m NEW SINGLE FAMl Q sFI�ftING
y icen.,a i,
"„ i^'^lumceandarc,. LIVING SPACE 4146 SQ . FT.WITH CONDITION
K�✓t2Z License Class Lim.# 2
�.o nate CnntraetL GARAGE 448 SQ . FT . U"�L'Pkn /,a
ARCH1ll, DECLARATION �a��99A
Or< 1 understand my plans small be used at public rcamL,
owD AUG 1q 2004
Hb�¢
Licensed Pmfcesinnal
Sy}� OWNER BUILDER DECLARATION
a w a F 1 hereby affirm that I ma carmd from Inc Commands License Law Ion the
el C 00 following reason.(Section 7031.5.Business and Professions Code'.Any city or county
K
w ire which nurtures a permit m cmerm,,after,improve,demolish,of rcpuir any structure O6.
—�, pnoan ie.oundincc,vl.sood,duca dnc applicant rnr such perminu lilcasipnce smmmem f�NSyr]Yr9�
FSCthat he is licensed pursuant In the IF vionds of the CmumcdW,License Law(Chapter 9 Sq. Ft. Floor Area $47JlY ill t10n
ttr (enmmerei ng with Section7lkNp of DiAkinn 3 OIL the Businessand Pridussem,Code)Or
i mat he is exempt Ihemfmm and me basis for the alleged exemption.Any vm au n of
Section 7031,5 by any applicant for a permit subjects the applicant to a civil penally of
not mom than for hundred dollars(15f)(3). Occupancy Type
❑I.as owner of the property,or my emplayws with wages as their sole compensation,
will do the work,and Inde structure isnot intended oroffcred hirsute(Sec.71144,Business
and Profession,Code:The Contractor's License Law does not apply to an owner,of102 — PIERS
e(IUlred Inspections
e
property who builds or impede,thereon,and who doesauch work himself or through his
Ownemployces.Omodesthatsuch impmvemeres are mol intended or offered for sale.If. 103 — UFER
however.the building on improvement is sold wiwn one year of completion,the Owner-
bar mer will have the burden of proving mat he sed not Huila or improve for purpose of '
105 — ANCHOR BOLTS
JL'cidonL,r
as owner of Inc propcn,am c olnuively weaning wire licensee contractors to 106 — SEWER 6s, WATER
met the project(Sec.7144,Business and Professions Code:)The Contractor's LI
-
LawdoesnotapplytoanownerofpropenywhoWildsorimpmvesthereon,and 202 — UNDERFLOOR PLUMBING
Lammrsuch p'ajece.wimaaontraanr(s)ucen dpursuamlothecnntaaor, 203 — UNDERFLOOR MECHANICAL
me rept under Sed, e&Pe thrsreason 204 — UNDERFLOOR FRAME
3ORKER's COM NSATION DECb�lDate lol/ a205 — UNDERFLOOR INSULATION
301 — ROUGH PLUMBING
IherchY Irlm ander penally pc jury line of the fnlinwing declarations: 302 — TUB & OR SHOWER
ads,and -I maintain a Certificate of Consent WaselLinsureforWorker'sCompen-
,as provided rnr by Section 37x1 of be Laron Code.for he performanea rf the 3 0 3 — ROUGH MECHANICAL
work or which this'rma is issued. 304 — ROUGH ELECTRICAL
❑ 1 have and will maintain Worker's Compensation Insurance.as colonial by Semon 3 0 5 — FRAME
3700 Of me Labor Code,for me performance of me weak for which this pmmir,is Issued.
MyWorker's Compensation Insurance carrier and Policy rumlunam: 306 — HOLDOWNS
Carrier: PolicyN^.: 307 — INSULATION
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 308 — SHEETROC'K
(rhis,eama need not,completed if he perroir,for and hundred dollar,,(suwn 309 — EXTERIOR LATH
ones`) 310 — INTERIOR LATH
1 amry mal m Inc prrbn+nanee rf net work r when this Nordin,Word,I small not 3 11 — SCRATCH COAT
m
empl�ytiny pccsnnl '�y9lmdLn )''n bnvtnemhNG the Workcri Gtmfcnsetinn
Laws of California. V� 313 — ROOF NAIL
Appnc m
NOM oAPPueA .R:attermakingl CcOficatcafE,emp,mn.yonshould 501 — FINAL ELECTRICAL ENERGY
Zhccame s'njectrome cel'kars camperosmian mid'i'm,of the labor Coda you must 502 — FINAL PLUMBING ENERGY
fnrlhwimcorudywnn set eh provisionsmthls permit sM1all M1C JcrmcJ revoked.
Z CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY
Ihmchyan!,mmal der,rsaeanswctionlending agency In, hege,romauceof 504 — FINAL BUILDING ENERGY
C > he work In,which he' Om,,,o,mcd(Sec.3(N7.Civ.c.)
Lender,Name 505 — FINAL ELECTRICAL
a ^�
D Z <nde'sAddmss 506 - GAS TEST
UO torymm1have read ret,tyandctiunanddinerthat ndabove wsrlatingr, 507 — FINAL PLUMBING
wF wrecl.1 agree to comply with all cityaneamn aordinances and stem laws relating m
O U building construction.and hereby atmmird representatives of mi,City m enter anon he 5 rLill FINAL MECHANICAL
r above-mentioned property lou inspocuon purposes. 09 FIN
W
(We)amen to cove,indemnify and hick may
in an Inc City iv Cupensts aganss DE a5�
F' N liahilitics.judgment,case.mocauespouser wkee hayinsstheCy way ayOfCuainsl.snidCity 5 N N G
I P15
U Z in cnoaoquc Ns,of the gaming of this Permit, `U
APPLICAN'UNDERSTA S AND WILL COMPLY WITH ALL NON-POINT Issued by5.I WORKS Date
SOURCER U ATIO I l�
Re-roofs 603 — OF BATTENS
nulure of Ap cenVCOn,raclor D¢
HAZARDOU ATERIALS DISCLOSURE Type Of F4904 — ROOF IN—PROGRESS
illdea pllcaul or future building occupant store or handle haardous material
'-0ned by the Cupenrno Municipal Code.Chafer'9L 12.and the Health and Salcey
s m,section 25532(a)7 L All roofs shall be inspected prior to an roofing material beim
❑Ye, 'IKINa p p � y g g installed.
Wm mea ficaot o' chmor Welding occupant If a roof is installed without first obtainingan inspection,I agree to remove
pp y prem use ea Air Qua on Marta ement P g
s hnatmnt,lir mmnmrnaras a,dream by me nay Area Ai'Quality Management all new materials for inspection.
stdCi7
/—� ❑Yes CR No
f'
—1 have read my moon u,muNniak requirements under Chapter 695 of me Cali for-
muHealth&Safety Come,Scomm,25585.25533 and 25534.1 understand mal if the building
does nor ncmty have a amain,Roar,is my respmuihilily to of iIY the oecupam of me
ivToodmc e.wmebm card r'Imi„mmenfacenifette C cy Signature o Applicant Date
Ownma'aah usdagenl Ir All roof coverings to be Class "B” or better