00060142 CITY OR CUPRRTINO
11OII.nING DIVISION PERMIT CONTRACTOR INFORMATION:
ItUI LDWG ADDRESS: PERMIT NO
10321 STOKES AV ATLAS HEATING 00060142
'ER'S NAME: APPLICATION SUB DATE
EAVITT 155 SAN LAZARD AVE 06/21/2000
MPPONE: SANITARY NO. ' CONTROL NO,
(408) 739-0516
C se z ARCHITEC(ENGINEER: BUILDING PERMIT INTO
ItLDG ELECT PLUMB MI[CH
n
LICENSEDi RACnON'R DECLARATION
Job Description
Z b 1 hrony offnnmc,I.,it fiermed under Orovso Cha ter 9lcammencin
Oi_„
p=roYf_-s- with Se( ofoninfthe Businas and PndcssiunsCodain,license
is infnllflumeand euect.
ADD AIR CONDITIONER
5:.. Lccase
Class Lic.a
Cca a h Dam Iu'rECfContractor
a O<
I m shARC 'S DECLARATION
understand my Alaall he used as public record,
se .
'- ce p O Licensed Professional
a o UW'NER-HUILn17R IIECLARAI'lON -
1 hurehy adlirn,Ina'I un,eecn,pt Toro,the Contractor's License Law for the
Z< following mann,.(Section 7031S.ILesiness anA Prof I—oro Code:Any city or county
S C Which requires a permit m con num.alta.In,pn le.detnnlM,ur repair any ntrucwrc
x3°"9
Pit oru.is iseuantt.:d.w rcquim"Ite`pplicant r—amh Will file asigneddlusment'
mut he is licensed purtnn m the pr of C"allals"Licmnna La,(Croke,9 Sq. Ft. Floor Area Valuatio�ll
(commencing with Section 7100)of us n 3 nftbe Itusinds and I'ndession,Cude)
or that he is exempt tbcacfroand due e name for the alleged exemption.Any violmion
of Section 9831.5 by any applleant lora'IOil nabiolk dm a r,liemu it,a mivll penalty
(If nal a nil,loan five handled dollars($500), I APN Number Occupancy Type
❑Lasowns,onhapropany,"myemnloycexw,In wagmit,Ihci,xnh,comPenaahon 32647040. 00
will do the wink,and tire structure is not immiadcd or rifled Ga sal,(Sec.71144,
Business and Prore,sindo C"mrrhe Cmamctnr s Limenxe Law does as apply to an Required Inspections
n of pmperty Who hadds or nnprw a..mamm,.and who doe,such work loneBlf 303 — ROUGH MECHANICAL
n through his own en,noyrm.pn,vlded had sumo httprwemems am nut intended or
oHced for ode.ll:however.the huildng or inq,roven,ent is sold within one yea,of 3014 — ROUGH ELECTRICAL
completion,life owmchuilder will hall,the burden of proving that he did an build or
n"anemrpuru"cnf.°1a.)' 505 — FINAL ELECTRICAL
❑L as nwneroflnn pmperty.art exclusively contracting With Eccnssd corra ors n, 508 — FINAL MECHANICAL_
rowan the pnjoo see.7194.Business and Profesdons Cdc;)The Contmnor's
License law docs not apply a,an owner ofpmpeny Who builds or improves thereon.
and who cormwI%for such projects with a comrectort0 licensed pursuant to the
Cmarae,or.v Licemc law.
❑I am exempt under See. .B&PC for this meso ,
,ties rate FINALED
WORKER'S COMPENSATION DECLARATION\ 'I Iherebyaftirmsunderpenaltyofperjuryoneofthefollowingdmlamtlons: MAY 3 O 2001
.] 1 have and will maintain a Certificate of Consent m self-insure for W'orker's
Compensation, us provided for by Section 37(0 of the laser Cde, for the
perfommnce of the work for which this Timor is issued. BUILDING
❑1 have and will maintain Worker's Compen ation Insurance,an required by Section
370D of the Llan Code,ror the Wrt'onnance of the work for which this permit Ls
;,sued My Wnrke,I Con3tian Insurance carrier and 1policy number am:
Carticr�Cl, .1'ISsnJ(!nD.IUNk'lullXl!M111'tl ION`FROM�`t�KERS �
R COMPENSNI ON INSURANCE
(This section need nut be coniplemd it the pern,it'is for one hundred dollars
($100)"tell,)
I send, hal in the "d...msmcu of aha work for which IN,pear is issued I
shall not employ any person In any noun.011 w tyz/,fye icct to the Worked
C.oanpcmatlnn lox ( orn nue_,.
Anphcaat
NUI'ICIi TOA'PLICAN'1':II,vRer nankin IhixCmllicmc of Exen,nfinn,you should
her nine>nhject to the WoAcr's C....lWnaallon pnrvi slabs olthe labor Code,you ram,
'Q Q lordWan comply wid, ud,provisions or this Permit shall be demnsxl revoked.
F ^ CONSTROX71 ON LRNDING AGENCY -
Iz > 1 hereby aHinn Nat mere is a canalm,flon lendh,g agency for the prronnanme
If the wink for xhieh this lnrmit ix issued(sce.3097.Civ.C.)
La
C'. p Lenders Name
.7. z Isola',Address
V Q 1 cenily the I nave read this application and aura tem the.leve information i,
Lts E.. correct.1 agree m comply will]all city and county ordinances and state laws mining
Q V to building cons,mnian.and hereby munrire represcmatives ofthis city to enter upon
the aMve-mentioned property fill invpenion purryses.
t,., 1 IW'e)agrecrosuve.indannify anA kttpharmles the Ci,yof Cuperinoagain.ct
Vi liabilities,judgments,costs and exlwaews which may in anyway anile against said
V Z City in consequence of the gating of this permit.
APPLICAsA'UNDERO7ANDSANDWIL COMPLYWRHALLN ,N-POI Issued by: - Date "/Z•%OD
SOURCrI, GULATIONS. LP y'
Signature of npplic,muc direct (L Date Re-roofs
IL\PnRDOUS MAG AIS DISCLOSURE
l the applicantfuture Ia ilf. sauna stone,,handle he a,don,mammal Type of Roof '
as Acfined by the Cupertino Municipal Code.Ch per 9.12.and the Health and Safety
Calc Section 2.5532,a)? \ /x
�Ye• N/wAll roofs shall be inspected prior to any roofing material being installed.
Will the apnlicnm nrfomre building uccupant nor cquipmem nr device,which If a roof is installed without first obtaining an inspection. 1 agree to remove
mil hazardous air eontaminams ax ddincd by the 10,,Area Air Quality Management
,Diarist? all new materials for inspection. Applicant understands and will comply with
❑Ye, un all non-point source regulations.
1 have read the hazanlonv anmeeiulx requirements under Chapter 6.95 of the _ -
Cnlilurnin health K Safety Code,Sections:550.5,25533 and 25534,1 understand that
II'tIt,IN II nlnev nal eurrvuty lin...abrnun1 (1,;1 it is my I'Ponxihilltym notify the
ceupnm, aha regnlmnwnts cable a n t rte met p'lur ea Ixxunner of a ram ill'
°"°1'° /q//W���yq� (gI,,o 7J Signature of Applicant Date
ow— hamarlv.elz'ru' ��igcnt ��nl`�"" Wlla"te All roof coverings to be Class `B" or better
OFFICE