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01050052 CITY I BUILDINGUDIIVIISSIIONNO CONTRACTOR INFORMATION: ' PERMIT BtJIIj31f'C�A4DDRFSSs'-S,TA DR-CARPORTS PERMIT NO. 01050052 °11�UUp Wit IINLO COMMUNITY SERVICES AeP�c Tfo s)$Q161 PHONE: SANITARY NO. L tJ U CONTROL NO. l. q p zO ARCHITEC-DENGINF.ER: BUILDING PERMIT INFO w BLDG ELECT PLUMB MECH 6, ' LICENSED CONTRACTOR'S DECLARATION Job Description IherebyaRof Db that oftheeduMcr pndI'mmofns Code.a(commencing CARPORTS /� y2_, wiNSal frau c(rmdl Division3 of Business and Pnffcssions Cole.and mylianse � LED - Lcense (lace nna eRr �'� 3 rc w a Dole Class Lic.p u u Dam Conoacmr �) �] _tv y i AR Hall xu a DECLARAec APR R U 2 2003 1 underrated my plain shall he used as public rccnrds p;0 Licensed Professional o OWNER-BUILDER DECLARATION •- LUG 1 hereby all mat I am exempt fmm she Convector's License law foe B the 'LO — t?< following rennin.(Section 7031.5.Business ad Professions Code:Any city or county Y O which requires a Permit to construct,alter improve,demolish,or repair any struaurc ma _ -pr t t e,ulsrcg stlrcaplt fm xuchpern'sUlnsngne(Ch.plain ------ ------- V -- -- --- ---- - , commencing mer lr dpde l n Chep Dain nn the usins and dPrlawonsCor9 Sq. Ft. Floor Area. r .. ky Valuation (commw cnimptsh emmnvin0a The bas Division Business ex mpion.An vi Coats) y 'Q al Y:.,�'; or Nn Section is escmpt fhcrtGdm'and The basis for bj cts the eaempnt to Any l penalty ` of.. am sanYapplicants o[]far aPermit subjects the applicnnnoaevil penalty arnm mate roan five naoarca aanare(sSao). l O lARN IFQII]RgDAT I ON Occupancy Type 111,anroffle pmpcny,or employees with wages us their sole compensation. 102 - PIERS will"do�the�work.'eadlhe cuuction is not intended"lir ntfrmd'for sale sec.7614, 103 - UFER - Businexs'and Pmfasiom Code:The Contractor's License Law does not apply to an Required Inspections owner ofprapanyWhoWildsatimprovesthereon,andwhodoes.vahworkhimalf 104 - REBAR or inmuh his own employees.provided that such improvements am not intended or offered F,r sale:If.ndwever,the budding o7 improvement m sola within one year of .. . .. 105 -- .ANCHOR BOLTS -- mpletion,the owner-budider will have the burden of proving that he did not build or l improve for purpose ofsmel. 106 - SEWER & WATER - ng with liccnscd c --' 202 - 'UNDERFLOOR PLUMBING_--- ' O 1,as owrrcr of the prnpcny,a xdusivdy comraniontnmon to consumer the project(Sec.7114,1,Business and Professions Code:)The Confiscates 2 03 - UNDERFLOOR MECHANICAL License Law does not apply to an owner of property who Wilds or improves themon, 1:[ and who contracts ensefor.Such.pmjecuamran .with a.corrs).icenud.pursuant m the ...__. ..... .2 04- - .UNDERFLOOR- FRAME -­ 0 NDERFLOOR-FRAME _.. _ _ . ..._ .. _.._. ........__._ -._ °I Ain exe pt undo See. ",B&PC for this reason 205 - UNDERFLOOR INSULATION owner Date 301 - ROUGH PLUMBING 0 WORKER'S COMPENSATION DECLARATION 302 = TUB & OR SHOWER -khereby aif,.unclerpedultyofperjuryoneofthe following declinations: 303 ROUGH MECHANICAL ° 1base and will mainmia d Cerificate or Consent to self-insam for Worke a 304 - 'ROUGH ELECTRICAL Compensation, as Provided for by section 3700 of me Labor ease, roe the 305 FRAME performear of fM wink(or which thin permit is issud, °I have and will mu ident Worker's Competuvion Insurance.as required by Section 306 - HOLDOWNS 3700 of the labor Code,for the performance of the work for which Nis permit it 307 - INSULATION. - issued.My Workers Compensation Insurance artier and Polity number ere: - 308 - '.SHEETROCK c'miec(r CERT�CXF.MPI'ION' R ORKE9S/1G/ 9?' -1309. - v'EXTERPOR 'L'ATH", .-•.., ._COMPENSAn°N INSURANCE ..___... _.31.0_;_ .-,INTERIOR- LATH.. .. _._... . f7fhot secoiod need ma x corrindeded if he perind is far a hundred dollars 311 SCRATCH COAT ,. ISI W)ar less) ',: 1 .313 - ROOF NAIL ... _ _ . . .._,_... _.. _. _... ._.. .... fertlfy that in Tee amour;dmoe ohne work'fo,which this period is issued,r 501 - FINAL EliECTRI CAL"ENERGY ' shall nnf employ any person'in any manec marine,so or to bomsubject bject to the Workers' Campenxmmn Lawa°rcaifamia.Dom 502 FINAL . PLUMBING ENERGY ..Applicant NOTICE TO APPLICANT.If,eller maAmg this Certificate of Exemption.you should 503 - FINAL MECHANICAL ENERGY become subject to Ne Workers Compensation provisions of the Labor Code,you must C0 1 forlovill,e ply w hh'.urnprovisions or this Permit shall be deemd revakd 504 - FINAL BUILDING ENERGY toes Ruc ukNLENDwcnce AGENCY 505 - FINAL ELECTRICAL F'� 1 hereby Jr.athin thele i on.t ct on lending Lgency for the performance 506 - GAS TEST - fthe work for which thispermit is issued ISec.3097,Civ.C.) - y � unit - Namc .._ _. .�__ _ .. ... . - ._. Aum 0 <naeieAdarcss SOT = FINAL PLUMBING I ebrifshin l have re ad thisaplicttion and stun that the above information is 508 - FINAL MECHANICAL tL'O correct.1 agree to comply with all city and county ordinances and state laws inning 509 - FINAL GRADE O.V to building construedon,and hembi oulourim mpossmantives of thnsay to enter upon 510 - FINAL PLANNING ;W-W the abovcmentioned property,for inspection,purposes., gg.... y (We)agree so sans.indennnify and keep business the City'of Cupertino against 514 - FINAL PUBI,4,1 WORKS F. fA liabilities,judgment,.cosi end eepcnsra whichmays in any way scants against said V.� City in consequence of the graining affil,permit. "" 602 OF Y' NAIL APIP3LRIrC�ARM"Eff-UNDER gDDSSttAN AND WILL COMPLY WRH ALL NON:POINf Issued 0`A - Date SOL_ UL/,r� ..•. . . 1//1 d Ap/ ESS PROGR Signature of A,plitanaCmandRn, 1 Date Re-roo - ROOF - HAZARDOUS MATERIALS DISCLOSURE i': Will drt applicant or future building occupant stare or handle hamNous material Type of Roof as def Eby the 320,) n M ntcnpel Cade.Chapter 9.12 and Ne liwhh and Safety . ,a tivk, ,', Code.Section 255121e) yl'tl I _ �•; t 4 i 1'•. : °Ye _All.roofs shall be,inspected prior.to any roofing material being installed. will'he.,!ideal or fitm,Wildigoccupam use atntipmernor devices Which If a roof is installed without first obtaining an inspection,Tagree'to remove .� em t hazardous no containmanfs as defined by the Bay Area Air Quality Management _ . . . . Dimino all new materials for inspection. Applicant understands and will comply with Dyes „' �° all non-point source regulations;, I hove mad the hamadmo'mamnar requirements uader,Chapter 6.95 of the California Health&Safety Code,Sections 25505,35533 and 25534.1 atdemfand that-if the _ Wilding does not currently have a mnam;that his my fesponsibil'ny to notify the _ ace dam of 0 equiremem rch dun b mei poor to its antt f e Certircam of " - O pont Signature of Applicant- _ _ Date .: tn(AUNon ant Date All roof coverings to be Class B"or better >' :.! ;-•, -. : ,.r.. . ._ .OFFICE - .. . .. . CITY I BUILDINGUDIIVIISSIIONNO CONTRACTOR INFORMATION: ' PERMIT BtJIIj31f'C�A4DDRFSSs'-S,TA DR-CARPORTS PERMIT NO. 01050052 °11�UUp Wit IINLO COMMUNITY SERVICES AeP�c Tfo s)$Q161 PHONE: SANITARY NO. L tJ U CONTROL NO. l. q p zO ARCHITEC-DENGINF.ER: BUILDING PERMIT INFO w BLDG ELECT PLUMB MECH 6, ' LICENSED CONTRACTOR'S DECLARATION Job Description IherebyaRof Db that oftheeduMcr pndI'mmofns Code.a(commencing CARPORTS /� y2_, wiNSal frau c(rmdl Division3 of Business and Pnffcssions Cole.and mylianse � LED - Lcense (lace nna eRr �'� 3 rc w a Dole Class Lic.p u u Dam Conoacmr �) �] _tv y i AR Hall xu a DECLARAec APR R U 2 2003 1 underrated my plain shall he used as public rccnrds p;0 Licensed Professional o OWNER-BUILDER DECLARATION •- LUG 1 hereby all mat I am exempt fmm she Convector's License law foe B the 'LO — t?< following rennin.(Section 7031.5.Business ad Professions Code:Any city or county Y O which requires a Permit to construct,alter improve,demolish,or repair any struaurc ma _ -pr t t e,ulsrcg stlrcaplt fm xuchpern'sUlnsngne(Ch.plain ------ ------- V -- -- --- ---- - , commencing mer lr dpde l n Chep Dain nn the usins and dPrlawonsCor9 Sq. Ft. Floor Area. r .. ky Valuation (commw cnimptsh emmnvin0a The bas Division Business ex mpion.An vi Coats) y 'Q al Y:.,�'; or Nn Section is escmpt fhcrtGdm'and The basis for bj cts the eaempnt to Any l penalty ` of.. am sanYapplicants o[]far aPermit subjects the applicnnnoaevil penalty arnm mate roan five naoarca aanare(sSao). l O lARN IFQII]RgDAT I ON Occupancy Type 111,anroffle pmpcny,or employees with wages us their sole compensation. 102 - PIERS will"do�the�work.'eadlhe cuuction is not intended"lir ntfrmd'for sale sec.7614, 103 - UFER - Businexs'and Pmfasiom Code:The Contractor's License Law does not apply to an Required Inspections owner ofprapanyWhoWildsatimprovesthereon,andwhodoes.vahworkhimalf 104 - REBAR or inmuh his own employees.provided that such improvements am not intended or offered F,r sale:If.ndwever,the budding o7 improvement m sola within one year of .. . .. 105 -- .ANCHOR BOLTS -- mpletion,the owner-budider will have the burden of proving that he did not build or l improve for purpose ofsmel. 106 - SEWER & WATER - ng with liccnscd c --' 202 - 'UNDERFLOOR PLUMBING_--- ' O 1,as owrrcr of the prnpcny,a xdusivdy comraniontnmon to consumer the project(Sec.7114,1,Business and Professions Code:)The Confiscates 2 03 - UNDERFLOOR MECHANICAL License Law does not apply to an owner of property who Wilds or improves themon, 1:[ and who contracts ensefor.Such.pmjecuamran .with a.corrs).icenud.pursuant m the ...__. ..... .2 04- - .UNDERFLOOR- FRAME -­ 0 NDERFLOOR-FRAME _.. _ _ . ..._ .. _.._. ........__._ -._ °I Ain exe pt undo See. ",B&PC for this reason 205 - UNDERFLOOR INSULATION owner Date 301 - ROUGH PLUMBING 0 WORKER'S COMPENSATION DECLARATION 302 = TUB & OR SHOWER -khereby aif,.unclerpedultyofperjuryoneofthe following declinations: 303 ROUGH MECHANICAL ° 1base and will mainmia d Cerificate or Consent to self-insam for Worke a 304 - 'ROUGH ELECTRICAL Compensation, as Provided for by section 3700 of me Labor ease, roe the 305 FRAME performear of fM wink(or which thin permit is issud, °I have and will mu ident Worker's Competuvion Insurance.as required by Section 306 - HOLDOWNS 3700 of the labor Code,for the performance of the work for which Nis permit it 307 - INSULATION. - issued.My Workers Compensation Insurance artier and Polity number ere: - 308 - '.SHEETROCK c'miec(r CERT�CXF.MPI'ION' R ORKE9S/1G/ 9?' -1309. - v'EXTERPOR 'L'ATH", .-•.., ._COMPENSAn°N INSURANCE ..___... _.31.0_;_ .-,INTERIOR- LATH.. .. _._... . f7fhot secoiod need ma x corrindeded if he perind is far a hundred dollars 311 SCRATCH COAT ,. ISI W)ar less) ',: 1 .313 - ROOF NAIL ... _ _ . . .._,_... _.. _. _... ._.. .... fertlfy that in Tee amour;dmoe ohne work'fo,which this period is issued,r 501 - FINAL EliECTRI CAL"ENERGY ' shall nnf employ any person'in any manec marine,so or to bomsubject bject to the Workers' Campenxmmn Lawa°rcaifamia.Dom 502 FINAL . PLUMBING ENERGY ..Applicant NOTICE TO APPLICANT.If,eller maAmg this Certificate of Exemption.you should 503 - FINAL MECHANICAL ENERGY become subject to Ne Workers Compensation provisions of the Labor Code,you must C0 1 forlovill,e ply w hh'.urnprovisions or this Permit shall be deemd revakd 504 - FINAL BUILDING ENERGY toes Ruc ukNLENDwcnce AGENCY 505 - FINAL ELECTRICAL F'� 1 hereby Jr.athin thele i on.t ct on lending Lgency for the performance 506 - GAS TEST - fthe work for which thispermit is issued ISec.3097,Civ.C.) - y � unit - Namc .._ _. .�__ _ .. ... . - ._. Aum 0 <naeieAdarcss SOT = FINAL PLUMBING I ebrifshin l have re ad thisaplicttion and stun that the above information is 508 - FINAL MECHANICAL tL'O correct.1 agree to comply with all city and county ordinances and state laws inning 509 - FINAL GRADE O.V to building construedon,and hembi oulourim mpossmantives of thnsay to enter upon 510 - FINAL PLANNING ;W-W the abovcmentioned property,for inspection,purposes., gg.... y (We)agree so sans.indennnify and keep business the City'of Cupertino against 514 - FINAL PUBI,4,1 WORKS F. fA liabilities,judgment,.cosi end eepcnsra whichmays in any way scants against said V.� City in consequence of the graining affil,permit. "" 602 OF Y' NAIL APIP3LRIrC�ARM"Eff-UNDER gDDSSttAN AND WILL COMPLY WRH ALL NON:POINf Issued 0`A - Date SOL_ UL/,r� ..•. . . 1//1 d Ap/ ESS PROGR Signature of A,plitanaCmandRn, 1 Date Re-roo - ROOF - HAZARDOUS MATERIALS DISCLOSURE i': Will drt applicant or future building occupant stare or handle hamNous material Type of Roof as def Eby the 320,) n M ntcnpel Cade.Chapter 9.12 and Ne liwhh and Safety . ,a tivk, ,', Code.Section 255121e) yl'tl I _ �•; t 4 i 1'•. : °Ye _All.roofs shall be,inspected prior.to any roofing material being installed. will'he.,!ideal or fitm,Wildigoccupam use atntipmernor devices Which If a roof is installed without first obtaining an inspection,Tagree'to remove .� em t hazardous no containmanfs as defined by the Bay Area Air Quality Management _ . . . . Dimino all new materials for inspection. Applicant understands and will comply with Dyes „' �° all non-point source regulations;, I hove mad the hamadmo'mamnar requirements uader,Chapter 6.95 of the California Health&Safety Code,Sections 25505,35533 and 25534.1 atdemfand that-if the _ Wilding does not currently have a mnam;that his my fesponsibil'ny to notify the _ ace dam of 0 equiremem rch dun b mei poor to its antt f e Certircam of " - O pont Signature of Applicant- _ _ Date .: tn(AUNon ant Date All roof coverings to be Class B"or better >' :.! ;-•, -. : ,.r.. . ._ .OFFICE - .. . .. .