03020122 CITY OF CUPERTINO "+> ,r{R '• 9"" x- '�".�>� .- _
BUILDING DIVISION PERMIT iiCONTRACTQR TNF..ORMATION. '
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' BUILDING ADDRESS: PERMIT NO.
11244 TERRA BELLA DR 03020122
's NAME: - PERMIT ISSUE DATE
TURNER MICHAEL K AND LORRAI E 02/27/2003
PHONE: - SANITARY NO. CONTROL NO,
ARCHTIECrIENGINBER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
pp 0 0 0 0
LOp LICENSED CONTRACTORS DECLARATION Job Description
u I hereby affirm that 1 are Rcouedgnddr provisions of Chapter 9(commencing .
m�� m ma force with Section]0111I)orDivision 3 of the BueiAamd ProfeulonsCode,md my license Is KITCHEN/BATHRM REMODEL -
5�3 pgmm cidacre, gla
anu.amr SPECTRUM FINE HOMES - Puri^4-F.rj '
9 / HITEcrs A 1 N I�lgMt .
?@ undersand my plau shall he uwd apuBMh mcords JUL
UL 2003
rG Licensed Pndauicuml
.�m OWNER-exempt 0.m the C AT10N
0 E I hereby a(Rnn that 11. exempt from the ConlnnCo License Law for the - - �UIL:DtRiCa
o D following moon.Permit
t 7(G 1.5,Business and Professions Code:Any city m runty
s,S O pooch require,n permit m construct,a@r,impmrc,dcermit t ri mash any igned tatement
FE�, pdonnits lused Issuance. to also the
pre inions of for anchpermiuuies Low(Chapter
g < ('hat be CommeeccgWithSection
rsuammth)ofDivmnanthe oftheStrmms,ueerp.aw(Chapmf9. Sq.F[.Floor Area Valuation
$ (cat he Is exempt Se efrem and the
basis f r the
the aged axe and Proon.Any
Code)of - $200000
Ionto Is campy therefrom and or buil for the alleged emanon.Any violation of APA N N
Section 7031.5 n any applicant fora permit subjects me applicant to a civil penalty of 3 5P6 21 bBlgr 0 0 Occupancy e
nor mom Nin aw hundred dollen($500). P y TYP
O 1.u awnu arde pmpwy,m my cmplayeu wird vnge+u Noir wk comN=tlon,
will da Ne work,and the suuctum isfiat intended orofrered tat ule(Sm.70N,Budrcss
Th
and Professor.,code: e Consomme,Llnrce Law don not apply in an owlte,of 101 - FOUNDS Inspections
propertywhobuRdsoeimpromsmereon,andwhodee,euch work himselfarthrough his __ . . 1.0.2 . — PIERS
own employees,provide
d thauueh Improvements me not intended m oBared for sate.If.
however,me building orimprovement is mid within arc year of completion,the owner- 103 — UFER -
builder will haw the burden of proving mu be did not build or Improve for purpose of
tis.). 104 '- REBAR -
0 1,as owner of the property,am exclusively contracting with licensed contractors to 105 — ANCHOR BOLTS
camuun the project(sew 704E Bmineu and pmefexsions Code:)The Contractor's Li.
cera law does not apply to an owuer of property who buildx or improve thereon,and, 106 — SEWER & WATER
who counters for such projects with a emnmmrtG licensed pursuant m the Conesacmes
License law. 202 UNDERFLOOR PLUMBING
'
am nem plunders= ,B S P c for this reason 203 - UNDERFLOOR MECHANICAL
Data 204 - UNDERFLOOR FRAME
WORKERS COMPENSATION DECLARATION 205 - UNDERFLOORINSULATION -
Ihereby.mtmunder penalty ofped nryamorthe following dee6ration,: 301 - ROUGH PLUMBING
0 ban and will maintain a CwhicaaafcansenuoselFnuum forwodon"Compcn- 302 — TUB & OR SHOWER
talion,u provided for by Section 3700 of the Labour Com,Cofor the performance of dm
work for which thisporait[aianed. 303 - ROUGH MECHANICAL
01 ham and will maintain worker's Compensation Insurance,as required by Semon 304 - ROUGH ELECTRICAL
3700 of me labor Code,for me performance of the weak for which this permit is issued. - '
y Worker',Compewtion Insueana nmicr and Polity number am: 3 0 5 — FRAME
Cpoll — 306 - HOLDOWNS
CERTIFICATE OF PnON Wh Ofg307 - INSULATION
COMPENSATION IN ANCB
(This.[I.rcadnot he completed ifthe permit is rorom hundrers(
ddullaS1011) 308 — SHEETROCK
m
tu ") 309 = EXTERIOR LATH
I Certify that In the periaro mea of the work for which this permit I,limed,),hall nut 310 INTERIOR LATH
employ any perean in any manner an as to became ubject to de Workers'Compensation 311 — SCRATCH COAT
Laws of Cdifomie.Data
Applicant
NOTICE TO APPLICANT:If,after making this Cenificam M Exemption,you should 313 — ROOF NAIL
become subject m the Wohm's Compensation provisions of tie tabor Code,you mut 501 - F I NAL ELECTRICAL ENERGY
`Z forthwith comply with such proviaiou or this Permit shall be domed revoked.
y O 502 - FINAL PLUMBING ENERG
W CONSTR UCTION LENDING AGENCY 503 - FINAL MECHANICAL E R Y
,rr Ihemby elErmthnthen iso conswninn len0inpgcrcy fur the permemance of
the park fur which this permit 6issued(SecJ097,Cho.C.) 504 = FINAL BUILDING ENE GY
W Ca
Lenders Name
Lcnder's Addmu 505 FINAL ELECTRICAL
0.r
UO I ceNry mal I ham real this applicuion and ma that the above information Is 506 — GAS TEST - -
V, P correct.l gree 10 comply with all city and county ordinances end sate law,existing to 'J — FINAL PLUMBING
p building convection.and hereby Wthodm representatives of this city to enter upon the
W ahove-memaned property for inspection purposes. 50 — FIJOING
ICAL
(We)agree m save.Indemnify and keep harmbs,tie City of Cupertino against
s,v y Imilide,,judgmanu.ensu andexpcues which may m my way amus against said City 9 I
f, In consequence of the granting of thi+
^� APPLICANT ERS kNDS AN WIL COMPLY WITH ALL NON-POINT Issued by: 5 at
SOU S.
a Re-roofs
SI aura SiMppIRSuffe6fillfinstor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant more or handle haurdou material
Iftlnod by the Cupertino Municipal Cade,Chapter 9.1 i,and
the Health and Safety
Section 25532(1)? All roofs shall be inspected prior to any roofing material being installed.
OYeswo
Will the appucanl r pan building aoupsal um equipment or dcviw which If a roof is installed without first obtaining an inspection,I agree to remove
trail hazardous air ronuminmu u deflea by tie Bay Ara Air Quality Management all new materials for inspection.
District?
OYcs T]I No
Ihe.mrd the haxerdmser4hoal,mquhements under Chaner6.95 ofthe Califon ,.
nit Health lbs,fety Code,Sections 75505 533 wu18534,1u"comod muifthe building
dam not comenti have a moan,the +n rceponsihility b roti' 1M m Gant of the
mquimmc n , a Ipd feels IamcanCcnina,maf. •y Signature of Applicant .. Date
2
u odycd,gent VD„ All roof coverings to be Class"B"or better