01100085 OF
CJ BUILD NG DIVIISSIIOrvNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7524 WATERFORD DR SHOWCASE KITCHENS INC 01100085
APPLICATION SUB DATE
° V9alu7 ROBERT W AND LYNN M 12333 SARATOGA-SUNNYVALE RD10/11/2001
PHONE: (408) 253-0412 SANITARY NO. CONTROL NO.
BUILDING PERMIT INFO
O O ARCHITECr/ENGINEER: BLDG ELECT PLUMB MF.CH
8Ny
S a LICENSED CONTRACT'OR'S DECLARATION Job Description
22
;i_� Ithereby 0)of thxln 3 of
licensed under provisions Prons of Chapter andinyencise KITCHEN REMODEL.
wCm with Scaion]a0a)of Division 3of me Businasend Pro sC c.end myliccnu
is in Bina force and effect s�j REPLACE DOORS, GAS LINE, 8 OUTLETS,
i K 6 Li..,Class Lic.p
oro Data
Ia_x__= - l cnnmmr 8 LIGHTS & 2 CIRCUTS
LLO« ARCHITECr'S DECLAR O
5 1 understand my plans shall be used as public records
T
i p O
Licensed Professional
-n OWNER-BUILDER DECLARATION
t� 1 hereby aff nn that I am exempt from the Commcmr s License Law for inn
C?a following reason.(Section 7031.5.Business and Professions Code:Any city or county
��o wo,h requires a Permit m conatma,alter,improve.demolish,or repair any stnsctum
$ -prion ts' «e.elaorequ the pPlieant r«such pemmuofl geed xammem• -.. ..._ _ .._ .. ._.__ . ... ........._ _ __ _ --.__- __
e 3-, thatitn a l nicd'Purs•.vtg to the pm sons of ube Contm<wls tatt La (Chnper 9� -i f,^. yes Et-FUo0 r-A ea w s k 2 C,Q RaDOR
Ire g do sects ]uo0) rovemn3onne Basm<. dPror..mn,Clue) S_ulti ^.. k4'I Ci.a. + .d. afF�i_s $
.,,but he is exempt thertGbm and the basis for the alleged cxtmption.Any violation
of section 7031 S by any applicant for a permit subjects the applicant to a civil Penalty-
ofn«morelhanfivehundreadollam(S500). 366"i%'b11UP°h90 ' Occupancy Type
p I,aownerork, pro geny,tarmyemployeeswith or
roestheirsolele Sc.lion,
will ne the work,and the orke:Tontrure is not cou', d orae Lawered for sale(ser. to ri, 101 — FOUNDAT](GAbired Inspe
-Business nM erty Whir Code:The con,them s,and w o d dues not apply m alf 1q �/�'L E
owner of Pmpcny Who builds m improves tMreon,and who does such work intended
or ! r, v P�
or through hu awn cmploy«s.providW That such improvcmcnt are not inundetl or 10 2 — _PIERS__ _ _ _• _ _ - _ _ _
...pf=Bx sale.If-howeveCme building or improvement is sold within one year of _.. . 10 3 -- UFER . . . ... . ... . . q.O q
OZ.
completion,the owner-builder will have the burden of proving that he did not build or.
improve for purpose of min.). 104 - REBAR FEB 22
oi;'a:ovne,or the pmp<xr.om�srhaivelrrtrenire with hrenaed rontiarmra to: -. .. 105--- ANCH6R BOLTS.
:.
construct the Project(sec.]Baa,Business and Professions eadraThe Commcror's 106 — SEWER & WATER ^ 'BUILDING
- License Law does not apply to an owner of Initially who builds or improves thumn,
and who runners for.such.Imiects with a contractors)IivenI In don -- 202 — UNDERFLOOR PLUMBING - . . ..
- Conoaaofs licensc Low, -r,�•r
01 norex<mPthnderSec. BaPer«ms ane' 203 — UNDERFLOOR' MECHANICAL
204 — UNDERFLOOR FRAME
°•"'"` W°RI WS COMPENSATION DECLARATION 205 — UNDERFLOOR INSULATION
1 beach, M.mxcf Irnahy of perjary cine onhe f Alossm,declarations: 3 01 — ROUGH PLUMBING
❑ 1 have and will ammuln'a Dc'mBcme of Consent to self-insum for Worker', 302 — TUB & OR SHOWER
compensation, as provided for by Section ciao of he Labor Coda for the 303 - ROUGH MECHANICAL
Performance lithe work for which this permit is issued.
�I hak and will mnintain*iker':Comperariun Ins.....a'as required by seciion 304 — ROUGH ELECTRICAL
_ ! 37.of the L dWr Code,foi the pertonnancc of me work for which this pemtit n 305 — FRAME
is s d M Work els C t on Insurance mrtier end Pol eY mbar tae- ,.; _ ._....._..�_.__.... _. _..
11 306 ,; HOEDOWN$ _ _.
Cent Policy No_O"L ll 5 sOV10 ti
•' !' -CERT( 1 ATIONOF,E%EMPI'IONFROMWORKEQS"
C - a k u k `3'O7 a'MINSULATION"-1`
; ,
--
COMPENSATION INSURANCE'.;
CER 'SHEETROCK`_. ..__.._.1. .. _. ......._...- _. _-- —
11,,urse<io� lee6othecompleted ifthePermit is for onchundred d.11. 309 1- EXTERIOR LATH
IS100 len.)
310- - 'INTERIORLATH''
I Emily mai in the per+' xeonn< k r :hien m -pent is issimtla 311 — SCRATCH `COAT' `
sit II um ploy any Pe 'on y mann t be om object m me Worker'
cumpn�aaponLmvs,nfcalifomi;:oete 313 . - -ROOF .NAIL
Applicant
NOTICETOAPPLICANT..If.aftertmkingthisCernficneolit=1daayoushould 501 - FINAL ELECTRICAL 'ENERGY
become subject to the Work2fs Compensation Imvisidns of the Labdr Code,you must
C O foimwim comply with such provisions or this Permit shall be deemed invoked_. 502.--- FINAL PLUMBING ENERGY; _
rn }'I".' '., .,-,-CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY
`' 1 hereby affiim Nat there is a canawedon IeMing agency I•or,to performance
onnawmemrwmrhmispe„nisi.is�edlse<.3ov].Civ.c.) ' .';- „ 504 - FINAL BUILDING ENERGY
Lender's Name 505 - FINAL ELECTRICAL .
'Fender's Addmas `
•U O IknirymatlnavereaetmsnPpimation.ndstammanh<.boveinrormationis. 506 — GAS, TEST
"(z-E. corien.I agree m comply.with all city and county ordinances=it state laws relining 507 - FINAL PLUMBING
. :C:U mbuilaiogrrnstry<tion:aneneinbraamonaerePtnsentativesonniscityw<nt<rupod 508 - FINAL MECHANICAL
fJl me above men iogrd sp
property for incaion im"..
(Wi)3grtc io save,indemnify and keep harmless the Ciry of Cupertiooagainzt` 509 - FINAL G
F+ Z, liabilities.jdgments.costs and expense which may in anyway accrue against said
U z cry n . q a n ongorm�x 510 NA G
'APPLICA UNDTiRSA SA DWILLCOMPLYWITHALDNON-POINT' I Issued Date
� eplic Col(two Wildin8 ottuPam st 1, a 1 s
GULAno+S
M
D < Re-roofs 6
TERIALS DISCLOSURE
Sign APP(r
AZARDOUSMA
nxw Iw:maw maw,d ,Type of Roof,
as defined by me Cupen M - pal Code Chapter 9 12.and m Health and Saf ty
Cade Sectiov 255321e1 $♦ a>;. t. ! �•. s. N I !N :,r� t'q
Oyer pNo:n r, All roofs shall.be inspected.prior-to any,roofing material.being installed.
Will the applicant or Name Wilding occpat use equipment ordevices wham If a roof is installed without first obtaining an inspection' , I agree to remove
soh I becourbous air ommilmoms as Jfnd by he By Arco Ail Quality Management,
t tea] all new materials for inspection. Applicant understands and will comply with
Dyes'; oNo all non-point source regulations.
t 1 have read the h.ruldous•mireduls rer,xio memimnder Chapter 6.95 clubs
California Health&Solely Code.Sections 25505.25533 and 25536.1 undersrnd that
if th I building dors not cu- ntly have a tenant,that it is my responsibility m notify the•
ocfupam of Ne inquire n which mesh be met prior'.issuance of a CcrtiFicate of
_ °Pa"`y Signature of Applicant Date
t odzeea en 'DaDiq- All roof coverings to be Class "B"or better .
vot, t . . f OFFICE - ..