00060060 (2) CITY OF CUPERTINO, `.
euu.olNc urvtsloly PERMIT' CONTRACTOR INFORMATION'' • -
BUILDING ADDRESS w - s.y -, I" o PERMIT NO. - '
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'OWNr APPLICA'p RMe
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BIYS
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IONS: - „t r_, •y' ¢ SANT IAB .NO.
❑¢Z ARCHITECTIENGINEER'. '• - ' ° t BUILDING PERMfr INFO,
-BLDG •ELCCT "PLUMB . MECH
66 i 1.,
8-'0 1 h by aPF rCEN4FD CONTRACTOR'S DPCI ARf Ch 9( 8- ' P �
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Job Di
tion•
H e-m Id5 1 n7gH1) f0 3 flh Bu dP fese't :C d.und myl _ - •'FINALED
q .,.1 Local Il f rc J fl t - ee - _
5�K¢ License Class Lee N +
C U Dat Contractor r` SFDWL_-.' 7
F Om ARCHITEcrSDLCIARATION _ _ , 118. 2��1
WW 1 understand n Y PI shall ne wwd as p,blw records MT.
y 6
,0 Licensed P -
Xr - OWN13R BUILDER DECLARATIOY �II��D'�/�
—v Ih ff bythin ptf 0 Cmut I"e 1 f the ! i V G'
follow n6 recover (Section 7031.5,Business -d professions Clete:Any city or caparty e _ IF
,w
f x O t
which requires it permit eoustmet allel,improve,dermlid, fo y.t_cu •
pr, tits . I. q II ppl If suchP It flsigned reInamorata
' '° s
a mat n . ap t t m p m r n c t 1�r L. (cl pt r9 h Sq,Ft. Floor Area - ' ' - Valu'htI
•" (aammerr ,with Section 7as asltq of DI, t f the Bne d P f i vino Code) - v -
Irthothet,exempt m f and the h f the dirtied pf Any tut • x
'of Sect o,70315 by any applicantf phruir:uljects ficappitcant to a civil penalty, u
1 nfnmmonema,fxen dedao0are(5500) 7 • ? � APNNumber' C QypeIl
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❑las rvrme pmpey ,my employOl'wa'ges ha t-h-' :'le rum,piroatu
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will d m k d structure t m m d t 7844
Bun f r ,o Code Thec4 I Le t.pp?1.. .•..'3116^'1 700=. qR'{As uired Inspections
nspections
fproperty Wn Id. ,ma d n U h workM1 :elf
othrough In, piY tprovided t ' hp : tit Id
bloc af .nI.If.1 he n cragImprovement . sold h ra of
pt tame lm " un n burden orpm.errm nee ot hand # 1,01. FOUNDATION
patio pama,cor 102 ERS
' F
T.
/ / er of thervpertY exclusively ou ig 'm Icen d final to
Contractor's •®3 UFER
and protested,C d )Thoconstruct.the pmS 7044 B
ceaLaw _ -
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'I 1 r ppyt t l go, Iv n b la imp thereon, A OA REBAR
ancontractsf n projects w{n t . licensed rnat
Contractor,
od t I nL t 1.05 ANCHOR
BOLTS: • -
,
❑d Imo,,pN trders . - .If SI P Cf r'lu'r ,. 106 - SEWER & 14ATER- 't
' �J" R<Ea s >Mr: esATIGN DecLARn�Id 202;-„•_UNDERFLOOR ,PLUMBING <
1hooebydRm andeti,samityofpci v neat in,roll ' ger laraide,, - 0013 UNDERFLOOR MECHAN.ICAI„ • , - . rl
na Certificate f Coliwatt h in,Womers - 20,4:-, UNDERFLOOR -FRAME
C.""a'alhu, a, provided f h, S ct 3700 if theL b r C le, far the
pen acevfmcwnkfor;vhiawh',pernt ,"'ned. - "'205 UNDERFI.-DOR ' 1-NSUL,ATION' -
.El Ibase a will maintioduWarkeC,Chat l I : a q' dbySection 3!01 — ROUGH PLUMBING ,
37Bo ran Lan r c on r f n f n,, k r n ro'. p t 1..` x,3 02, —. TUR'A. OR SHOWER. • '
w f of h W rkers to pf tint Iwma e c t and Poi y 'I ido ore ^ ti ^ '
• caRe,: ”
policy No. kK 303 , ROUGH-.MECHANICAL
CERTIFICATION OF EXEMPr10N FROM WORKERS'. .304. — ' ROUGH ELECT
CORI CAL
MPENSATION INSURANCE
Chi, 1 nod ran be ipletcdifti p iLdmr�arehuadietdollars x' 305 —,FRAME..
(s mBl rlcoss - , • ` 3106 -
IIcvhit,11 t in he acrifteramod ofun work I,,, h h0:. prs is mccll:I 307r--- INSULAT'fON' .
shall ,or employ any.p am'n any adm so as w Imcomc hi t o 0te Workers
CompensationLawaofCarramr.Date 30& — SHEETROCK'
Appl a t 1 ,
NOTICETOAPPLICAN9It err ik'ngth CertificatefL lti yu:hall n _x•30'3"
reEXTERIOR„LATH
p nJ tt m W k Cnp t p [d Ln rC Jcy a °V
OO rnrinw th comply win 1 p sor lb+permit hill bearded or—ked - 3 — ' . . -
z y.,llZl 'INTERIOR LATH •, :
F CONSTRUCTION LENDING AGENCY_'• • ' 31..1, — SCRATCH rL."OAT ,
I h hY fr ,that there 1. canab nleading agency f the forimmm cc ? —
or the krwhichun I qtr ssued(S .3097 Civ.C) r13 ' RQOF NAT1-
q gum nndr's, ' 501 - FINAL 'ELECTRICAL ENERGY
U,O M. promo a.(.t min n 502 '- 'F-SNAh PLUMBIIsIG ENERGY
counsel,
I,.ye plr with III oil,and county ordinances and'tt laws retailing
mbadycth,nm�Iion.andGlured,andimiz,repcats :,Imscity toenter upon
-
503 —. FINAI_.'MECHANICAL ENERGY -
y r� he
F o aro C dproperty r :r i p p ,
wpbel : a rydkpnaner:mecty
ofarn agin,l 504f FINAL BUTT DING'•'ENERGY •
m Tamil l ) Ig t acro n n .y nty Iva r c agmn,t odd 509 L ELECTRICAL
'City 0 ofd m g fm 't.
APPL NT UNDERSTA D PND WI OMPLY WITH AIL ON- OINT
APL (y env s �o po Issued by 506 'F,T Date.' 2a - 06
Sigarri ofAppl ur- mnctor, D- Re-roofs L PLUMBING'
HAZARDOUS ERIALS DISCLOSURE 9^018 - FINAL MECHANICAL
t "a wu,n ppr t f t n,mmgneenp.Im,mreorn,ml n 1 . nal ti Type of Roof
der dlyo cnpna M epalcndeenap�9lz.analn a blahesalcy” 5Qg FINAL GRADE "
Coe,Sv,d o t 25532(.), '
❑Ye (:IN.
All roofsshfllM 1nspc ffill Por rKafi (Stlitig material being installed.-,
Will thppr; t 'i't n r s.'Cann t nac cgaplm ,"i'de,icessyllich If a roof Is'itFsjl Yled ailhQ7rylAgst, tphr ngpn gMptt§n, I agree to remove'
nmI atl crcmat t. dr Ibym BmyA AvQ It,M gnrcm
eDiaVcl - all new matt foi:i gra' np�Aglllbttnt�nds and,wlll comply with
°Y °Y all non poin ce req s
a m n a a' cart n.9s,;rin' i8� BATTENS; 1.•
Califrni Health&Safety CJ S t .2550525533and255341mama dttrt .=f.,04 '`ROOF IN-PROGRESS '
ifthe Indoor,dues not currently haveanomat that t: yrcsp n nrtyt many[lie t,
�<upam f the re4u e i I' h haat 0 prior t issuance of It Certificate r '-
Occ y t .. -
Signature of Applicant` - Date
t' .ramm�aaw gem , , D.e .p - '�, - `.a'k All roof coverings to be'Classa"B" or better - ..