00120088CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
BOILOING nUUk1iSS:
ITiRMI'f NO.
10101 N WOLFE RD
001200&8
OWNHIVS NAME:
APPLICATION SUIT DATE
CHRISTMAS TREE LOT
12/14/2000
ION&
SANITARY NO, CONTROL NO.
ARCHM liCr/ENGINLhR:
BUILDING PERMIT INFO
BLDG ELI[CIPLUMB MITCH
1=1 -1=1 =1 CI
LIChNSED CON 'I'RACE OR'S DECLARATION
Job Description
1 hereby allirm thin I um llcenmd under provisions of Chapter 9 (ctnnnxncing
w;m sechnn lata) lir Omi,inn 3 none na,ine., amt Prose:dors colic. and my Ecense
1.11 mmannJ deet'
POWER FOR TREE LOT
Lin
iccn.w Cl:,,, Lic. p
Date Cll men r
ARCHITECI'S DpCLARA'I'ION
I under m d my plana shall beused ns public record.,
'
Licensed professional
OWNIdt-BUILOI?R DECLARATION
1 namby affna Ib a I uta Caempl Bun, Inc Gmnaclor', Luno Law int the
following mason. (Section 7031.5. Bueines, and Pmfc„inos Code: Any city or count,
'
which requite% a permit to cmrwe, alter, improve, demolish. or repair any aavaute
prior In it 6,rance, also requires the applicant for such Wominn lite a signed statement
Sq. Ft. Floor Area
Valuation
that he i, licensed pursuant to the proal.inn. of contractor's License Law (chapter 9
trialin,with Seel an, 7000) of Divisim13 none lbe,mc,, and Probsnions Code)
¢1
or her, he is exwtpl thnminlm and the Ir,Ivi, for the alleged e,cnrption. Any violas..
-
of Secliol19011 .5 by any applicunr for e permit .objet'" etc applicant as a .,it penally
APN Number
Occupancy Type
lir no more than me hundred dollar, (S5kb.
:33 6200130. CIO
01. as owner ofthe property. or my employee: with wage% as their sole compenution.
Required Inspections
will do are »ore, and thesma mi, is nm intended m of staid for sale (Sae ]034,
Business Profenvino% Code: The Cnnlrnchrr, License Law docs h,
and nor apply as
issofaoltcay Who Lund.orllnpnacs thereon, and who doer. scab work hintvdf
through
304 — ROUGH ELECTRICAL
, his own etnpinync provided that .nth imp a emeats are not intended or
oflared for sale. IL however, The building or irnpeavament is .old within line year of
501 — FINAL EL ECT R.I CAL ENERGY
the owner-builder will have the burden of proving that he did not build or
inmpletion.
mprove foe porpose 9raale."
505 — FINAL ELECTRICAL.
❑ I, av ow rer of the l a ix ly, ten Cxd neivcly conmleti ag with Irx-ed v'unuaclnn to
mlmcl the pmjoo (Sec. 7044, Himine%s laid Prormvion% Co 1,)'1 he Cut hairier',
License Law docs nor apply to an toner o1 property who builds or improves thereon.
and who contracts for such Entices with a comm rmd licensed partant to the
a
Contractor's License Law. .
'
Oil icmmpl under Sec. . H k P C far lbls naso
Owner ITtc
WORKHR'S COMPIiNSAI'ION DIiCLARAI'(ON
under nahyoficate ryone
I affi
reby mcfollowffing
Workers 1 I have soil will maintain a Cenilientc d Consent to ,d lin,um lire Worker's
e and will amartain se off-insure
Compcnaneon, m provided for by Section or Ibc Lahor Ctxle, for rhe
4�
.....
perfunnun<x of the u'nIk for which this Permit ie LsucJ.
❑ 1 hate and will maintain Warker's Coarpenwrion Insurance, as required by Section
POB o1 the Labor Code. for the perrono:mce of the work for whim ihi% permit is
%
issued. My Worker's Compenwrion Insurmxe carrier and Policy number arc:
x
R�eI piney No,
CIiR'u19CA l'IDN OP Ii%BMPO 51'(IRKER$'
9
SURANC
COMPENSATION INS Uroud
is
fr colon Bad not M completed if the pennil is for one hundred dollar
'
Ibl(Xry lir Ice.)
I ccmly that in Iorf,,, mranar,c nl Inc walk or which this permit i. LsucJ, I
'
shall nor employ any person in any inner u, as lir become object It the Worken'
Compensation Laws of Cali ovinia. Date
Applicant
NOTICE TO APPLICANT: 1f, alter nuking this Cctifeate of E-roman, you should
heeonte,doemmInc Worker'. Colnpensle ton..... oro nl the Lahor Core, you lows,
immwilll roily will, wen pmvi,ien, m tela permit nhull be deemed o,,Aed.
CONS] rRUCI'[ON [,ENDING AGENCY
1 hereby after that dere is a mmam tion Icmling agency for the a fairm nce
of the work for which this pe ilii is iwual (Sat. 3097. Civ. C.)
Lender's N:une
Lcndm'.v Addre,
1 «nily,ha 1 have real Ihi, applie:nion and slate rho the atawe ill inion is
. 1 agree to comply with all city and county nrdin: rIC- and state laws relating
iostre
budding construction. and hereby authad.e representative, of this city to enter upon
the aNne-nsentioned pro, arty for inspection Proposes,
(We) agree m serve, indemnity and keep harmless the City lir Cupertino against
I'malilic, led gnntu,, nnN and expenw, wadi limy in any way aavue ap a,l .aid
City in consequence of the granting lir Ibis permit.
I � �Y
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON.I'OINT
Issued by: —�- Date —/(_i—CJ i/
y'
SOURCE REGULATIONS.
Re-roofs
Slgmarerof Apphcalnrcommeemr Dam
IIA%Alt UOUS MAI ]TRIALS DISCLOSURE
Will theanplianm or future holdlag rmctram.smn ser handle broad oa. Inweriul
Type of Roof ,
To, defined by the Cupertino Municipal Codc. Chapter 9.12, and the Health mad Safety
Cock, Section 25532bd!
''
05'°' N.
All roofs Shall be inspected prior to any roofing material being installed.
Will the applicant or ihoe hooding occupant are eelmpment or device%which
If a roof is installed without first obtaining an inspection, I agree to remove
Cn... haaardoun air umtnminanl, ns dclitied by the Buy Aron Air QmL ity M rallictnell,
siod..?
all new materials for inspection. Applicant understands and will comply with
y
0I'" Ill
all non-point source regulations.
1 Lase read the Ita,amoa, denial teproareams under Chapter 6.95 or ,he
California Heath k Solely code, Semi on, 25505.25533 and 25534. 1 undcota al Ihu,
it t he hdddiagdocn nuI ..randy hale a malml. met it is my ic,, redid.,. u, nollfy the
ccupunI oI the rat uircl ants whim mu>I hrnxt pili, to l..meate of a Cenircate it
.
°CeYpmr9rSignature
'0", /•ZY4/-�
of Applicant Date
may""' Dale
All roof coverings to be Class ,B•• or better
Ox'act err seal onaed agree,
OFFICE