00050093 .. I,PtJ C41—` •a .
CITY OF CUPERTINO
BUILDING DIVISION PERMIT 'CONTRAC,' R INFORMATION:• '
� p,vw
BUIL'0I4fas5DRT.TPTOE LA PMMITN(6 0 0 5 0 0 9 3
IP�DL APPLICATI"IIAP'g r/2 0 0 0
PHONE. SANITARY NO, CONI ROL NO.
ARCHITEC'UENGINFER: BUILDING PERMITINFO
BLDG ELECT PLUMB MICH
wOp LICENSEDCONIIRACfOR'SDECLARAI'ION O O O
P 1 nerenr mfirnt mm I am banee sneer Providans or enalner v mnmmenemg REMODEL AND AdB l'gi?lion
<ZW with Section TO))of Division 3ofthe Business and Professions Coale.andmyliceneis
<a Blufonceaodmfat 10/01/02 PER GREG EXTEND PERMIT 2 MONTHS
zov'a_ gat EXP ZES 12/01/02 .
2 License Class Lic.N LTJ
Dale T'SConDECLtorARATION
r�11 n r�
OZ;:,
ff ARCIIITNCTS DECLARATION �Li kS.
�0¢< lundcrsunJ my plans shall be used as public rcbords
dOyU
HLLa, Lmeit.d Prnfcssiuml L OCT 0 3 9002
y OWNER-BUILDER DECLARATION
� v C
Y 8 1 hereby It,.that 1 am eaempT from the Contractor s License Law for the
w a n O folluwing reason.(Section 7031.5,Business and Rnfessinns CnJe:Any airy lir county
which requires a permit m construct,alter,improve,demolish,or repair any structure
Fig•
prior In its issuance.also requires the applicant for such
perminn flcasigncJ smmmcm
££SS<O that he is located pursuant to the pmvisionsOfthe Contractor's LiccowLaw(Chapter Y q. t. Floor Area $33Vatt�tion
yF (commencing with Section 70ko of Division 3oflhe Radius.,and Profcsslons Coal
ad 3 that he is exempt therefrom and Inc basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant m a civil penalty of -3 bAW9&'AeP U Occupancy Type
not more than five hundred dollars(S500).
❑ I.as owner of the propcoy.M my employees with wages u their sole compensation,
will do The work,and the stricture is not intended lir offered for sale(Sec.70a4.Business
and Professions Code:The Cioneacmr's License Law does not apply to an owner of 102 - PIERS egwred Inspections
property who builds or improves thereon,and who does such work himself or through his
own employe.s,providedthatsuch impmmorms arcnol imenoro
dedRered hassle.If, 103 — UFER
however.Inc Wildingorimprovement is sold within one year ofcompledon,the owner- 104 — REBAR
builder will have the burden or proving Out be did not Wild or improve for purpose of
sant.). 105 — ANCHOR BOLTS
p 1,as owner of the property,am exclusively contracting wit licensed contractors b' 106 — SEWER & WATER
nsuucl the protect(Sec.704q Business and recessions Code:)The Contractors Li.
ceme law does not apply loan owner of property who builds or improves demon.and 202 — UNDERFLOOR PLUMBING
who contracts for such projects with a contractor(s)licensed pursuant in the Contractors
License Law. 203 — UNDERFLOOR MECHANICAL
❑l am cacmpt under See. .B&PC for his reason 204 - UNDERFLOOR FRAME
Prier Dat 205 - UNDERFLOOR INSULATION
WORKER'S COM PENSATION DECLARATION 301 - ROUGH PLUMBING
I hereby M.under penalty of perjury are of the following d«laaticam: 302 — TUB & OR SHOWER
1 have and will maintain a Cenificate of Consent m self-insom fo,Wm1 crS Compere
station,as provided for by Section 37M of the Labor Code,for the performance of in, 303 — ROUGH MECHANICAL
work for which thus permit is issued. 304 — ROUGH ELECTRICAL
D 1 have and will maintain Worker's ComPemation Insurance.as required by Section 3 05 - FRAME
37011 of the Lahur Code,for the Performance of me work for which Ibis permit is issued.
My Worker's Compensation Insurance carrier and Policy number ale: 306 — HOLDOWNS
Carrier: Policy No.: 307 — INSULATION
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 308 - SHEETROCK
onisseclion nccdnol becomelcrcdiftMpomit isfnronchundreedullars(SIM) 309 — EXTERIOR LATH
sera) 310 — INTERIOR LATH
1 cenify that in the performance of the work for which this permit is is acd.I shall not 311 - SCRATCH COAT
employ any Penson in any manner so as vo become subject m the Workers Compensation
Laws of C.11foou..Dale 313 — ROOF NAIL
canl I
Nari
NOTICE TO APPLICANT:II:after making this Ccnifieme of FsemPtiun, it.should 315 — EXT SHEAR
become suhjecl To the Worker's Cumpcmation Provisions of the Labor Code,you must 316 - INT SHEAR
OO forthwith comply withsuch provisions lir this Permit small be deemed revoked.
501 — FINAL ELECTRICAL ENERGY
z
CONSTRUCTION LE SUING AGE NCY
H= 1hereby aflinmdust Ocie a.acnnswationleading aNac,Iuthe ,furnum.of 502 - FINAL PLUMBING ENERGY
C > me Work far which this permit is issued Su.AND,Civ.C.) 503 — FINAL MECHANICAL ENERGY
W Ondr's Name
Undeer's Address 504 — FINAL BUILDING ENERGY
z le
U O 1 minify mat I have read this epplicatinn sad stale that the above inbonnution is 505 — FINAL ELECTRICAL
correct.1 agree m comply with all city and county ordinances and sum laws relating m 1
oU building conswction.and hereby sinuous,mpresentrovesOfONcitytoentermanthe 5 GAS TEST
above-mentionedProperty forimpenhmpmpo'e4' 07 FIN BG
H 0. (We)agree a save,indemnify and keep harmlem the City of Cuponino against
lishiluics.judgmen0.nasts and eapcnaes which may in any wayaccme against said City S N CAL
U in consequence of the granting of this permit 5O Date
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by
SOURCE REGULATIONS.
Re-roofs 514 -(-FINAL PUBLIC WORKS
Signature of APPlicaHAZAR O Dec
HAZARDOUSMATERIALSDISCLOSURE
Or
Type of R.�4(6 — FINAL BUILDING
Will me applicant lir houne Municipal
Co recupanl sore or Fantle hanuNous mmurim
as defined by the Cupertino Municipal GrldC,Chapter 9.12,and Inc Ilcallh and Safety
0dc.Sacron 25532hiC All roofs shall be inspected prior to any roofing material being installed.
❑Yes ONO
Will the applicant or future building Occupant use equipment or devices Which If a roof is installed without first obtaining an inspection, I agree to remove
trait hanaNnus air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
DisWct7
❑Yes ON.
1 have read the haiarcommaterials requirements under Chapmrb95of the Califor-
nia Ilealth&Safety Gmc,SeNons25505.25533 and 25534.1 understand that if the building
does not currently base a tenant that it is my responsibility To redly IM rcouPanr of the
mgmmmenLv which must he mel Phar to isezoce of a Certificate of Occupancy. Signature of Applicant Date
I
Owner or aummimd agent Date All roof coverings to be Class"B" or better
• • Jeffrey Friedl
7435 Tiptoe Lane
408-257-9513
permit number: 00050093
�g Casteel OCT 0 1 2002
uilding Department
City of Cupertino BY
COfOO.50093.
Dear Greg,
I'm writing to ask for an extension of my residential building permit, numbMy origin
contractor left the job with the work essentially complete, but apparently without c &sing e
permits. I'm told that your office sent me a letter reminding me of the open permits in May, but
for some reason, I didn't receive it. It could have been a USPS mistake, but more likely it got
hidden inside a supermarket circular or the like, and so I just didn't see it. (But since I didn't see
it, why is merely up to speculation.)
I believe that all work is now indeed complete, and would very much appreciate it if 1 could close
out the permit with a final inspection.
Thanks so much,
• 10/I102-