01100062 (3) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10108 BRET AVE01100062
OWNER'S NAME: APPLICATION SUB DATE
HERB SWEATT 10/10/2001
^HONE: SANITARY NO. CONTROL NO.
;,-0-go ARCHITECTIENGINEER: - - BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
�:� 0 0 0 1 st
6 Z hereb KLICENSED mCONTRRAACTOR'S DECLARATINu9lcommcam Job Description
i N e G y a rme provisi.ns P 8
wilhSmion 7000)of Division Jofthe Businessand Prof ions Code.erW mylicrnx SWIMMING POOL.
is in run rorce and ere
C - Licenx Class .�.� — - Lis.w..1�/
il;EE Dale COntm[IOr
1 �`• ARCHITECT'S DECLARATION
g 1 .us shgl�l�u'ed qg public records
Licensed fi,�al.
+6a.g W,>6,j
Ii ONERBUILOER DECLARATION
.si=res 1 hereby Ann.the.1 am exempt from the Contractor's License law for the
I: following reason.(Section 7031.5,Business and Professions Cade:Any city or county
O which requires a permit to romwct,alter,improve.demolish,or repair Any.come, $20000
poor to its ounumee,also requires the ap=rant fasuch return rile. statement
dni hc,islisensicd NriuWai the prowls ofdx:Conuutofs Licenulaw(CuApta9 .,x'•'s t. a r •-• Valuation -
(comrrcncne'+'ith Sadon]000)0(Division J of rhe Buyiriur ani Profeµinns Code, ,:.f„f`, 1 3. 1{ s a TFS61,a R*2.S- j 0
or that he u cumin therefrom and the basis for the alleged esemptiod.Any violation 1
Daft rw more than3fi e Any
nA ed douafraa 55 )o).records wbjau the Applicant m a civil penalty 103 APN N r t. Occupancy Type
❑I;As owns of the property,or my cmploycm with wages as their sole com,cm.non,
will'do the work,and the aweture is not intended or oRaed for sale(Sec.7044, 104 REBR
Business and Professions Code:The Cammcmr's License Law does not apply to An10 7 - POOL/BO�&41Vl3d Inspections''
owner of property Who builds or improves thereon,and who does such work himself
or through his own employees.provided,that such improvements are not intended or .._. 3 O.1 _�, ROUGH..PLUMBING . '
,offered for sale.If,howcvcn the building or improvement is sold within one year of - - - r - -
completion,the owner-Ixrildcr will have the W elm of proving that he did not build or 304 - ROUGH ELECTRICAL '
improve for purpose of e.).
.- __ sal ... ._. . _ - ._ ” .._ . .. . 502 -- .FINAL ..PLUMBING ENERGY .
'-Ol:aimmrofinepmpe", mexemsiwlyconm ngwimRcenudco min - 503 — FINAL MECHANICAL ENERGY.'' '
ematran the pmjrct(Sec.7044.Bmin.,.and Professions Code:)The Conuxm:s
506
co — GAS TEST ,•.•"
License Law docs not apply to w owvu of property who Wilds or improvimprovesthereon,
d who convects for_such.projecu with.a conuuta(s)licvlud .an,m sho
Conbector.Licarselaw. 510 - FINAL 'PLANNING
'Oram escmp underSee BA,PC fr,his sewn 511 - FINAL POOL l ' -1r.
Ow¢r" .WORKER'S COMPENSATION DECLARATION S16 — FINAL BUILDING
1 hereby eRrm under Pemlry of perjury one of the following declarations:
11 ] 1 have evd will maintain-A Cenifa:aa sd Consent to self-insert for Worku'a
y� Compennuon, As Provided for by Salion 3700 of the labor Code. for the
�pe(rformance of ted work for which this permit is issued. .
qa lan aM will maiatain,W.ik s Compensation Imuran n,m required by Section
]Oo.f the labor Cade,for the performance of the'work for which this permit is
issued My Wo&ies^Comiinsadw lmut me cssnu end Pol cy numb.art_
Caner. ' ', I 'P I'rAaponcy No.,' : ;
CER. RXEMPnON FROMWONKE F• 1.x. h. �t'Y2 i tl_9s �•,r,'s.
i COMPENSpATfON'INS�NCE, �$'t
(Thin ucuon treed nal be cam relied�f the troll is for _.,-
one hundred dollen .-� •1 l..I tll;'s`
(SlpB or IessJ —
,..• 1 e'atify'tha in thepciformavice of the.work-tar which this emdl
shell not employary pawn in any manner so ss ro haome subjecpt m rh loran.
Compensation laws cf Calif.,.,Date
APpneat
'NOT ICE TO APPLICANT.If.Aft,makingthis Cenificam of Exemption,y • • j'
become subject to the Workers Compen.aion prdvisions of the labor Code, mea I —� -�' 1
cc forthwith comply with's Ich provisions or this Permit'hall be deemed rook V
-
"CONSTRUCTION LENDING AGENCY
a - 1 hereby affirm that there is a construction lending agency fo the performance
this permit is
of the I cerGu Net Ihhnve and Nis ass nmuon endux theu
Le
Lp8.f"Q nders Name
r�.sZ Lenders Add.
U •`P
lT+-ri coved.1 Agree to comply with an city end county ordinances;and sue laws relating
0'V 1.ffica ingrontion igpwyfmand by Authodurepre .., roof thiscitymemer upon
y (gt Ne abow-megiet topmpenyfminspectionpuryrrole • ,
uD (We)dgrtetosnve,mdemaify and which
the City Cupeni.lst said
CF.a� fA Iiabilitia,1Wgmenta c uuygend expenses which may�n any way ucrue egunst�uid
t„) st
:� Cityin
sequence fgnmin of This permit., •
PLICA IT p�5 fLL IPLYWITHALLNON-POINT ISSDedb
OURCE REG P.T. Y Date
tgna ofAppliCenVConvemor .f '�" Dam Re roofs '
" ' •{ HAZARDOUS MATERIA=ISCLOSURE 9
Wdl the applicant or for building acupanl some or handle hiiardous m.wrial Type Of ROOF' ( +• 4`f —' '� '/'V— '—�-- t�./ "
m defined by the CA "I. M n pal Code Chapte 912,and the Health And Safety p t• r
Cade Sauon 25$32rarr ', .vj, [ "i '!; 'Y �f if .'• '�;'
_ 1 All roofsshalLbe.inspected prior.to any.roofing.material.being.installed._.. ..__. ..
Will the applicant or future Wilding occupant use equipment or devices which If a roof is ifisialled without first obtaining an insp'eetion,'I'agree.to'ieinove
emit hootit
d... ,maminnenu As defined by the Bay Are Air Quality Management
Distrim+ all new materials for inspection. Applicant understands and will comply with
❑Ym , aNa - all non-point source regulations: , `:..(•-
;Thaw reed the hewdout meurielsrequirtmehu urWu Cheptu 6.95 of the
CAliforrus Health b.Safety Cade,Sections 25505.25533 and 25534.1 understand that
i(thc building dines o potently have s mnw4 that it is my responsibility to notify the
fe Cmin'.u.of
e q.�mcy here .r mens g n t. be mat prion la ruawae q Signature of Applicant Date
Or wlh.nxed nge -o.a All roof coverings to be Class"B"or'better "
OFFICE
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