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02060171 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 6365 CANDLEWOOD CT 02060171 LOWNERAPPLICATION SUB DATE HARWOOD G AND WILLOW 06/26/2002 PHONE: SANITARY NO. CONTROL NO. s O O ARCHITEC'VENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH r—i u u 1u sa.. LICENSED CONTRACTOR'S DECLARATION "LEIhereby efforts that Iamlicensed uMe,provis.mIdChapter 9fcommcncing Job Description with Section]000)ofDivision 3or the Business and Profeaiotu Code.and my license REVISION SUBMITTED FEE $222 PAID. is in full force and effect. 3 5 ate License Class Lac.If ORIGINAL #01010017, NO NEW PERMIT ISSUED. DCranston, t• O to ARCHITECT'S DECLARATION g 1 understand my plans shall be used as public records Y an O O Licensed Professional a' OWNER-BUILDER DECLARATION 1 hereby M.that I am exempt from the Contractor's License law for the I-Z< following reason.(Section 7031.5.Rosiness and Professions Code:My city or county which requires a Permit to construct,alter,improve,demolish,m repair ony stmcwre. Prions its issuance.also requites the applicant for such permitao Ne a signed statement that hh,if licensed paobatto de provisions of Ne Contractors License Law(Chapter 9 ,Sp pt-Floor Area Valuation (ronnmrn;pgwilh Seclioni70I of Division 3 of the Business and Prpf,sions Cnde) i' 1 ss^^C7 f t�- j.a' y/Y or that he is eienirNemfromand the basis for the all): '-�A+• 1a.'•:a•- dLjA'. ti4:t"t..i .j..:f� f.5-. +: p gut e6unpdno Anyviolation of nor mar 7031.5 iv any applicant fora Pertain subjects Nc applicant m a evil penalty, of nor more than five hundred amlatr lssony urn er, i e! Occupancy Type 01,as owner of the progeny.or my employees with wages mlheirsme compensation, i ni _ will do the work,and'the'swcture is not Intended or offered for sale(See.70441 - n -Businessand P f Code The contract License La does t apply to an 102 — PIERS Required Inspections owner of property Who builds r impiove.s thereon, d who d c s ch work himself or offered through h' cowl yrs.provided th t himprovementsa t trended or 103 OF ER completion, o ler -le tt however,ldNebuilding arip emsold wuhm one year of -" l O 4 — REBAR '• /r improve m pl uarImo ter buena willhave ine burden ofproving Ne he Nd std bund or 1' V tap errpuryouarale). 105 - ANCHOR BOLTS ___ _ --C1 Lim a pNepropertyantexclusively- own contracting 106 - SEWER &--WATER i '�-� ✓ co w t he Project(Sec 7044 Business and Professions Code)The Contractor's ,,..) ,, - License Law does not apply t nowner ofproperty who builds orimproves thereon, 202 - UNDERFLOOR PLUMBING and.who eontracts.for such projects with a contmea (s)licensed pursuant to.the. '___. ....-.._. Contractors License Law.,, 203"' UNDERFLOOR MECHAN3CAL' 'ZI ameumptpaunder s,,v.' ,B&P C fonhis reason 2 04 - UNDERFLOOR'^'FRAME'' over (,�yp� A D�,te�j b^'AG^�'�• 205 - UNDERFLOOR INSULATION �WyOkKER'S COMPE.IQATION DECLARATION 301 - ROUGH PLUMBING I hereby aRnn under penalty offptper'jury one or the following declarations: 302 - TUB & OR SHOWER ❑ 1 neve and Will maintain a Comficn¢of Comcnt to self-insure for Worker's 303 - ROUGH MECHANICAL _ _ Compensation, aro provideddor by Section 3]00 of the Labor Code, for the -. _ _ ~''. Performance oftheworkforwhichthis Permit isissued.; 304 - ROUGH ELECTRICAL _ D 1 tnm4 and will maintain Worker's Compensation Insurance,as required by Section 305 - FRAME 3700 of Ne Libor Code,for the performance of the work for which Nis permit is ' las ed MyWorkers Compensation Insoranc mer and Policy number are 306 - HOEDOWNS .. - .........-..u,..-Trac>.c..�.xavmo+•-...,.m. ..--- cathri er' ! CkTri t "Policy No, 307 - SNSUliATION - - 1 QTRTIFICATIONOFEXEMPTION FROM;WORI(ER$'t" t C4' ? + 'Yt +" k "f`s 't 308 -' SHEETROCK L ° '"" COMPENSATION INSURANCE• a' . „ - _l, ,- _ _.. __309 ="';EXTERIOR liATH __ _..._.__,�._ . . ._.t,. ISIOp) (This uMitinrneed not be completed if the pcnnit is for one huntlrcd dollars 310 - INTERIOR LATH 31-1- - SCRATCH COAT I m(y that in th'e omance of the work for which Na III is d,l - t - 4h II n t employ ony person ony mann r o as tq beanpt,subject t the Workers 313 — ROOF NAI Lc' ' Compenset n Laws t f C Date A 'I8^O A Apps= a - 501---- F-I-NAL -ELECTRICAL, NUn TO�ICAN'I If ler making the Certificate of Esempton you should z bee bjecttothe Worker aCompensation provsionsofthe Labor Code,you most 502 - FINAL PLUMBING ENERGY z 0 Innhw th ply with ch prow slots o th permit shall he deemed revoked. z _ ._,- _ _ 503_.=-EINAL-MECHANICAL -ENERGY_ .:;Vf 'r='•II' •cotthemisacoNLENDINGAGE.NCv 504 — FINAL BUILDING ENERGY 1 hereby aRmt thin nhcre is o construction lending agency for theperformance' 505 - FINAL_ ELECTR I CAL w Lead ark f hich tht ion s issued(S c l09].Civ.C) Q -Lender a-N � - - ��- �--� - - - - z Lends Addre 506 - GAS TEST Icertify that Ihave ad this application and as da.the above lurn stints 507 — FINAL PLUMBING w F concoct,1 agree to comply with all city and county ordinances and state laws relating 508 - FINAL MECHANICAL Q.V mbund ng comwction,and hereby authorize repnatrves ofthisc tyrom eerupon s:w be cba -n annw Property q,r in.pertion purpose,... 5 0 9 - FINAL GRADE -,0. [Wel agree tome,indemnify and keep harmless the Cityof Cupenido ugelnst _(A liabilities,judgments,costs and expenses which may in any way accmc against said 510 - FINAL ING ,( E.).� City 1ncommilacnceof Ne gmmm,m`1hi,,man, fr r{C/J• AP EIClsNTUNDEftSTANDy AND WILLCOMPLY WITHALLNON-p0I9T 5514 1 ' !,EA WORKS )RTE REdl .ATI NS' Issuedby: Dale Sign. 4 of App cant/CPvc<: Re-roofs r l ' HAZARDOUSWilding MATERIALS DISCLOSURE _ W IIldse npplva t f tare Laing a pS t sonam handle laureation,maType of Roof terial J as d BnW by4h Cupen M ictPal Cale Chapter 9.12.and the Health and Safety -' " '-"" "'^' `^' --• •^_ �_-_. . code s cttnns3xal f',•-o k '^ ,Fa o ye,1 r �TNo (f= -; g material being installed. Al] roofs shall be inspected poor- any WII th pylic to f mre building occupant use equipmentor deuces which If a roof is installed without first obtainingan Ingree to remove ' em t,I erdous air cunmmm t is os defined by th Bay A¢a�r Q ality Management Dianmd ' all new materials for inspection. Applicant understands and will comply with_. all'non-point source regulations. fhas'e mead the hatsobus materials requirements under Chapter 6.95 of the California q Wild,&Safety Cod.Sections 25505 25533 and 25534 1 ndersand the t —^ h dthe building does'not currently have amn then my respdnsthltyttl nmdy the occupant of the requirements which mon b ma p- r m issuancef a Certificate ser Y lldlt d V Occupancy. 6 Igo ture of Applicant bate rauthonsed agent Date All roof coverings to be Class"B" or,better OFFICE - - - -