00050161 (2) CITY OF CUPERTINO, ' ;
nmLunvc,DIVISION pERMIT :
�". CONTRACTOR INFORMATION:, " .
BUILDING ADDRESS. n PERMITNO, a
e` t
OWNER'SHA' '� APPLICATION SUB DATL
ZONE: 'ANITAR 'RN
fROi-NO.
❑%ZO ARCHITECTIE 9r. } -,: BUILDING PERMI'1'INFO
IZn❑ Aw q'� ,• f "BLDG HLEM PLUMBS -MUCH
H z w
0. LICLNSFD CONTRAC ORS DECLARATION '
z ° `• Job Descri tion
oz e In n>.m. m r „ea d p ;,,'of cnmr9(n,mne 'ng. fi
r Had ills , 7Wn) bD i fth tl d rr'• d u� yl D'+ °. -
¢¢ , InI a,.m 7 r'
5�sa L'c c 1 n
owe Dat c I" I- 358^c .LIVING. SP ,, 481' r
HITFCT s ur c x
a LL �RRAf�E.
u'O I u t r 4i t y pl .,hell be i,ul p b emtl, ,•
m
OWNER BUIL DI R DECLARATION
ad, In by ❑ In"11 DIf Ih C I , L nel f Ih - -
Z_< full g (Siarind 7031 5 11 d Potifir,stran,Code:A,cit,o,-county -
f C wh h y p nn tr, "It D d 1.1 r repair"ty'I , '
se prior to itsLs)requaresithe applicantf h drion,Infile a,i,red,lacrad, t. " ..
(but he is licensed ptl the Ians,bra.,enhe Cabriaal..LiAti Lou(Chapter 'Sq:Ft Floor AT ` Valuation
(en me,nng with Senora 7000)of DM, 3 of the Business dP les:onsCode) r
lir that he isexe npl,h ref , d he h f Ih al legal a p1 A I, , '� T
of Section71315 byduty"ppI If 1 Isufficed,Ih ppl It )'Ipt Ily -
arnolmoremanr.en a a I n (asb) - , , , ' . APN Ninberr - '+ Occu IncT
We
-
11 has of(he property, Y ply th g: Ih 1 p .m
$'3953y "
will do the work, ad the t I I infrared ,,offe,calf lc(Sue.7044, .r
Bas d Profession,Cal.Th C t I . License eL d I apply I - +r , r _R Required.lnspecti
ons
-
f lin.relly Won n Id: "p e there.there.a.and ho data:act,'avail,hianself , .. . .. -
r ur Fbu.,h his nadir - DI ye: p 'dcd that...h,'npmren sn nal mended or
offered 1 sale.If,h d bulding,r mPanemenl is: Id viahar be year of
conaple(ion,r the owner—build llh" ,thh Iy0leidIM1ld
ilar fpr f l ). - -
101 — FOUNDATION
OI as ownerf tire piuipaoY,ran exclusnelycnl T g with) used nantrunm.t n __102 — PIERS - _
m, til p 'l i(S ,7044 B .. dD I Cade.)The C I -
'nc L I I apply to ol, p,.ly h n Ia - v- m ":1.03"_— LIFER
d h toI for h parolees wl, c l 1 r(a) Ip IY ,1 the a '-
Cult I License Law. 104 — REBAR
❑I ceunpl enders ,B&PCf th,r nn ya. -
,h ' Date - '': 1�0T5 , ANCHOR BOLTS
Creat®r WORKER'S COMPF-NSAI'[ON DECLARATION 106 SEWERr R WATER, '
I hereby afrrn,ander prnmty or.pe<ivarpne of the n,Bowing denlaratioas ...202 - UNDERFLOORS PLUMBING -
o•i hava and will m ' I" ,Cer<;eeat r c nse,a to Ir Fare red let's' -.-203--- UNDERFLOOR MECHANICAL- _ _
:barber sn,an L, pnrvdea for by sn r 3788 or me I n ,-core mr me - '-204 —'-UNDERFLOOR FRAME'
perfan.suniof me workforx hch th's pan 'I' mJ. ' . .. `
❑I h a TI ,pint ur k - C p ti n I: q 'rcd by S I
205{ UNDERFLOOR INSULATION '
3700 of he Laborcad r m pry n fm kr Ilam' v t>,t e,�01 ROUGH'- PLUMBING; -
Car d M r Co pe. Insuy; �e�i�y y s -
EMPTIOF� ,302 = .TUH & OR-SHOWER
Curr e: Po -
C. TIFICATION OF Ps
COMPENATION INSURANCE
MWORKFRS - ,-303• - -ROUGH MECHANICAL.'
WMPENSAT'IONINSHRAM10E ` ' ' -• '
r need a.,net,mpleted ane ,r l,i'n 'e nand rdagnar.. 'r ' 304 —"ROUGH "F_LECTRICAL .
(xIoni I .L - - r 3$5 `--FRAME ' -
a
�a I cendy that'arrhe l"afairdiance ofore vvnkl beh this peort"esud,1 '306 HOLDOWNr'j-
Ana r Applicant ,pl es of'periodr ,to nenam,. anreet,o inn wark - ,�� r . :, 307 '.INSULATION" «,
Comp , "II . fC if able -
NOTICETOAPPLICANT If, fl - k' gthl Cent "I fL InpO n.y h Id r;308- •SHEETROCK
become sr to tire Workers Compensation p 'nn Labor I y t
bIh errantly nnh h p v onl p�rn,mall be dnd revoked ` X309 EXTERIOR' LATHQ
-
CONSTRUCTION LENDING AGENCY t "310,•,-n INTERIOR 'LATH
R
.� � I h r by r n th l lh re s a v 1 ding igen y f th p rior ounce [ a', — n n I ^
'offs kf h;cl thl pe I. u.med(Sc 3097 Cie.C) - « -;l - 311 SCRATCH�COAT.I F t
Lend :N me •,!
D z Lender Add : _+� 313' - ROOF^„NA'I•L'" , .- -
fyl llna dlh ppb I nadil, mtl b f ar 501 — 'F.INAL, ELFCTRICAL ENERGY
"•w'H,
colueetr I ii,rout ply vvidth all ait, ad contact, d " dt t la .rel Ing -
I" r, tohardaigcoo,tnc(nn ndherebyan,ner preeaw�,e,arin,e'piacnlerap'ai • . 5021 — FINAL PLUMB
•�y �] ,the of onuonW pmi n.
peny for petis prp s - « "` 5 'kF
Q,I 9 (Wedag t '" e" d fya Ikep haml .s theCty fCpert a eirst , .. r
Vi habil t o rdg I: .I d ...
p n .which
an ,any y g iau - d -
V,� City 1,cons neof the
g nYng
Na, APPLIC T D. NFf COMPLY WITH L T .« •I -
•SOUR RE I
S.
Issued by _ Date_ _
'sign A pl a oc n,a t .. Re-roofs " - . -
HAZARD ATIRIALSDISCLOSURP � 504 F'INR"INHL:"BUILDING -ENERGY E ppl "m r r I n'Id g p Lt n hI m'n -''[ype of Root`. _
„del dbytn epLa ,Mu,apalCoa Chapter9,12,and, Health and Safety 505 — FINAL 'ELECTRICAL
'r Cod Scraticur 29532(u) ,t. Jw •r _ .- `'
°Y All roofsc"FA
shaMingj ericTF Tny roofing material being Installed.
wit d appy t , I al p , c,.i t a •M1 n if a roof is in�l5@*�rZ�tfd witFoENAkt oPlubmiiiiNfropection, Iagree to remove --
nlh' . I t t I Iby 11
Bay A A Q IIYMge t Wlrl�l 0Lt
all neve mate ocin p A*J6 RMNdk@Atands and will comply•witli
all nq_n poun_"yei.Le9W1 L GRADE
a a d the d later I l e I: a Chapter fi95 of Be
-
calif &s,r ty( ae S assns 5533 d 25534 1 a I d t t =510' — ,FINAL PLANNING.
Yin gd le early It t-n art,that yr,p bl, t li- Ihc x "
m•r<q: w b Ipnrte ,a ant- ed. I f " 51SF _ nlnl .'nliv-_ _ _I rr RKSS
cc an
Sign nitre of Applicant Date
-. own ora,mn,,.edas t a,e• - All`roof-coverings to be Class-,B',or better
^OFFICE.,