01060135 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10449 COLBY AV SCHINDLER RONALD P AND AMA H01060135
OWNER'S NAME: APPLICATION SUB DATE
SCHINDLER RONALD P AND ADA H 06/22/2001
PHONE: SANITARY NO. CONTROL NO.
o«O ZO ARCHD ECT/ENGINEER: BUILDING PERMIT INFO
U,p BLDG ELECT PLUMB MECH
<i C_J I-1 I-1 CI
Z y i LICENSED CONTRACTOR'S DECLARATION Job Description 1
O Z_o I hereby affirm that l am licensed under provisions of Chapter 9(commencing
ci„Fre with Section
Se 0)ofDivision 3aftheBuslnessandPmfessionsCode,andmyliccnse TILE BATH.
is in mu force and effect.mya Littnu ClassLic.is«
To 3 e`,,h Date Contractor
a O ARCHITECT'S DECLARATION
- 1 under- and my plans shall be used.c public records
w i n o Licensed Professim,ita. U
as OWNER-BUILDER DECLARATION
^_'` 1 hereby. ,That 1 am exempt from the Conectrr'A. License Law for the
t4 3 a ffimfollowing rancor.(Section 7031.5.Business and Professions CWc:Any city or county $4000ec
k o which requires a permit to consuuct,alms improve,demolish.or repair any structure
Fei .pt t is s 'nce I5requirestit ppT tf xchproton t II dsmremca.
Tic
That lid Afn6J promormtW OAA,i.r,.fthC t .L ' Law(Chapter 9 , - --/ - -
an g smSwf ]t100)ofDiomm l,flneBusine dPrufS.ssfomeWe) ,^!' .5S.31r�2 0�1�01; 'i .i"Ti Valuation
or that be :exempt th6«f�rm�ar d the bens for,he allegd cxempuon.Any vminion j II i 1'-' I'.'�' I
-lir Section]031.5 by any applicant for a permit subjems the applicant to a civil penalty
�t�a�A�
;of no,more Than than five hundred dollars(5500). 101APN�'17C11VfJAT I ON �''''a1d-'” Occupancy Type
❑1,as owner of the property,or my employees with wages as their sole compenamion. 102 - PTE
will do the woK,`andthe'structure isnot intended or offered-for'sale(See:]Bti,
'Business'and Tiofesdons Cade:The Contractor's License taw does not apply TO an 103 - UFER Required Inspections''''
owner of property Who builds or improves thereon,and who does such work himself
of through his own employees,provided that such improvements are no,imcnJW or 104 - REBAR
tcompletion. -B P vcmcmi sold then one yea of
cio rer will
lhave 105 - ANCHOR BOLTS I �'
The ownc b lee ill have the bud of proving tiro,h did not Wild or
mp,ovefotpmwx,.f.lO)l 106 - SEWER & WATER
colas cthe rect perty tyenmmc,ingwith i d<o,aemr{m —202__- UNDERFLOOR_PLUMBING -1;,- „' --__
construct- the p j t(Sec.]tW4 tl . ss and Professions Cud'1 Th C tractors
License taw costs not apply to an owner of profanity who birds or improves thereon, 203 - UNDERFLOOR MECHANICAL”
'
c�end,who
contracts for h.prolecB with to turps)licensed p
Ermm he 204'- UNDERFLOOR
TP
RAM
tm u L
❑I na sa FO 'INSULA:-TIONB&PCf ,hid Teem.
o 301 ROUGH COMPENSATION -
--- -- - -
DECLARATION 302 - TUB & OR SHOWER
D..: Ire«nralr,maereerp<nm,yrrp<�titypg6,gnWrrnrwingaeamadrn.: 303 = ROUGH MECHANICAL
❑ l n�.d and will maimair i c&Iiricme rr Cu.wnt ro aeB.maure for Walker's 3 04 ROUGH ELECTRICAL
Compersmion, .,;provided for by-Section-3]W Of the tabor Coma for the
e.l - pwrrm,an<e lir the writ rr�wmcn mi,p<�,t,i;is ia,nea., 3 0 5 - FRAME
0 heeeo will rraimicin.Worki CompervratirOlace: regw«d by section 306 - HOLDOWNS
37IX1 f The Lobar C Je,for the perfi, c f the k for-which this Penni is
wed.My Worker x Compensation lnsurna,O=airier a ad Pory' ber am:-' 307 — INSULATION
ca Eli /'i t i • t' 308
'4e CERTWICATIONOFEXEMPTIONFROMWORKERS(� 309•`''" EXTERIOR( LATH.
r COMPENSATION.INSURANCE 310 ___,---INTERIOR-LATH_—s;-' - -
';Cphiiot dn[ed not nc c irldoied f Tire permit is for one hundred dollars
a1OE.or 1pta,l ,.,,.•.,.., .. .. 311 - SCRATCH COAT
- 313 ---""ROOF' NAIL —
['r I-n ry that n the perform the work f which this Permit- us earl - --
xhan m plyad,pe y n U,Isco�n object to thawrk s 501 - FINAL ELECTRICA'I;'ENERGY
Cr pe tut La of California,Dai'' •
,Applicant, _ _ _. —..502 FINAL- PLUMBING--ENERGY __
NOTICE TO APPLICANT If aftmakingtn Cen'r ate ofE Exemption,you should p _ :`Ii, - -"
nee gent the Worker Co Fensmo p lions of Lobo cad L you must 503 - FINAL MECHANICAL
O O forthwith comply wrth suchprovisions rrthis Perim,ahaub cletermidrtvrma' _504__.r__F.INAL._.BUILDING_ENERGY
� � "'(1 at-( ' ICONSI'RUCTION LENDING AGENCYf '
C,> ;' In',ny'fr';mmttn most cf nl<ndrggse yrn mepairm,an<e 505 - FINAL ELECTRICAL ,,,
rr,he k'r nknmsce u ,aua(S }O9] e c1 506 — GAS TEST -
D.z li ae :Ace 507 - FINAL PLUMBING
�Oy.'.: he W Im<[ it dl popnyr .cord-er per
PLUMBING
U 0 508 - FINAL MECHANICA
li ions
inn, 509
- FINAL GRADEU are upon ..
S .
510 - FINAL PLANNING
F. 0. lw j grc ,o w ndem fy a keep h Ie..-the C ty f C pen`n egemst
gin.,wed 514 - FINAL PUBLIC WORKS '
U Z env = 'I Ing ,r lien
^ TPPf ICA N EYtS NDS AND V`LL COMPL WITH ALL NON Issued PGIN''TT by: Date
SOURCE I..� - .L®��
_ Segratu orAq, cam/Crntmam.. .•. 'T, - - .. ,Dap'.. Re-roofs
HAZARDOUS MATERIALS,DISCLOs URE
. whin ppl cam Wt n sea' g <uva t store or handle hGUafmus annerial - Type of Roof
usI d ed by tit Cupcn Nun c p I Cod Ch m 9.1 add the Health d 5 f ry """ ^---
Cod Sect a 25532(
❑Y f.
L K,firs ONO
I' v i . . A•. I:•t-a �~.Lsv•f, -.:: - f !fi.a*�:
All roofs shall be inspected prior to any roofing material being Installed. _
W'll,h Whelan, f t eb lined ace i equipment devices ,a, if a roof Is installed without first obtainingan inspectlofl;l'agree)to•rernove
en,l b rcom sent as df ed by tit BayAm.A cattily Mnagemenl
District? _ all new materials for inspection. Meant understands and will-comply with
❑Yea ON _ _ P - PP_ PY
all non-point source regulations. :1 .,1 _
` "•, l F ,lead the haiai man
2als ts raider Chaptc,1!i5 of the
Cxbfmn s Health&Safety Cool,Sections 25505:25533 and 25534.1 understand that
Bthcbt gJ�notcu tlyh veamn ,tAtt .my-responsibility'b'I'ry tdnmitythe .. __.._ ..... .- ,. ___. .._ ___
cOccur t Lth Aselli , itch moil F, ,p t iss a of C nifictte of
LZ Signature of Applicant _ Date
owner thr «aagem I p,� - All roof coverings to be Class "B" or bet[eY, `
c� = 7 OFFICE ..-