05110158 (2) CITY OFCUPERTINO
BUILDING DIVISION PERMIT CON>�RA.CTUR TNT''UR1IA,' T1� h
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BUILDING ADDRESS: BLUE WATER POOLS 1ERMTTND.05110158
10316 CR TON DR
OWNER'S NAME: PERMIT ISSUE DATE
CONRAD FREEMAN 2401 E. CHARLESTON RD 02/08/2006
NE: SANITARY NO. CONTROL NO.
(650) 864-9000
CHITELT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
309 LICENSED CONTRACT'OR'S DECLARATION Job Description
1 hereby a 11.-Nall Am licensed under provisions of Chapter 9(Commencing
with Sedian]Digi)of Dlviaion 3 of the Business and Profusions Code.and my license u
in fullfarcoondcrfecl. r GI NEW SWIMMING POOL & .DECK
a�?gDecoseClAss Lie.
L � �� DOES NOT INCLUDE TRELLIS/ARBOR ABOVE DECK
ARCHITECT'S DECLARATION
1 understand my plans shell he used as public records
U
+0 Licensed Pmrceaianel
OWNERm exempt
DECLARATION
+� I hereby aDhnt that 11. escmpl from time Canuatnms License Lew for the
`oO which ng2moa amen 7(H1.3, t,shot. and ws.de am Code:Any City or county
zs$ which requires•permit m construct,Blur,impraw,dcmnnitt meA sig any imernAm
�'y^ primmis cenenre.euommi me thovisios of fm suehperce to fit.UA,dmomem
< that MuliansW punshenuo the previsions of the Canusetors lJame law(Cheptor9 Sq.Ft.Floor Area VaIU 1600[)
Nai (canmeneing with Section 7000)of Division 3 ofthe Busircssend Profusions Code)or
.. that he Is eaampt therefrom and to beau for The allegW memptioo.Any violation of
Section 7031.3 by any applicant for a permit subjects she Applicant M a civil penally of APN Number Occupancy TI pe
Am more than fiw hundred dollars($500). 32637041 . 00
0 1,u owner of the Pmputy,or my wploycu with wgns u Nebmle compensadon,
will do do Anus.And themucem.Now intended or.111mad tarsals,(Su.70",Bushadd, ns Required Inspections
and Profestons Cade:The Contractors same Law dons out Apply to An owner of 9 P
property who Wilds or improves theroon,And who das such work himself or through his
own employees,provided that such Improvements am not intended oaRered for Asia If.
however,the building or Improvement is mid within one year of completion,the owner.
builder will have the burden or proving that bo did nm build or Improve for purpose of
Ask.).
0 1,as owner of the property am exclusively contracting with licensed contrums to
construct du project(Sec.7044,Business and Prolusions Cade:)The Contractors LI-
am,Law does not pply to an owner of propenywho builds or improv woman.and,
who contracts for such projects with•conlranor(0 licensed pursuant to the Contrsumea
License LA-
01AmexemPlunder Sec. ,B&PC for this Mason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby Affirm under peaty of perjury new of the following docurstom
I Mw and will mound.•Certificate of Comment to self-Insure for Wwwr`x Compen.
1311W.'
an,u providW for by Sedan 3700 of the labor Code,for the performance of the
k for which this permit is maued.
I Mw and will maintain Workers Compensation Imu mance,u required by Section
of the laborCode,fm the pcnonhuna ofthe wait fm which this permit Ice IuuW.
Workers Compensation Tmurentt carrier and Policy number AM:ter..'C1 n� Policy No.: 6 C�-
CERTIPICATE OF 1�P170N]FROM WORKERS'
COMPENSATION INSURANCE
(Thu rection nod not bocompleted If tie formic Is foram hundeaddollses($1001
or leen.)
1 amity that In the performance of the work for which this permit is Issued,I shell not
employ any person In any manmr an As to bocome subjot to the Workers'Compensalion
Laws of C.liramle.Desi
Applicant
NOTICE TO APPLICANT:If.after making this Certificao of Exemption,you should
become subject to the Workers Compensation provisiom of the Labor Cadc,you most
.7. O foMwith amply with such provisions or Ibis permil shall W domed revoked.
z'y CONSTRUCTION LENDING AGENCY
[. 1 hereby A@m thea them Is a Construction hummilagemy far the performuxx of
C? the work for which thts permit is issued(Sue.3097.Civ.C.)
ELanders Name
0.0 z Lender'sAaamea
U0 I certify that I haw Mad this application end sum than the show Information Is
LLI F comers,l e1Me he comply with AI city and county ordinances and mu laws noting to
O U building conslmcdon.and hereby authodm mpresenutine,of this city to Anon upon the
show-mcntiomd properly for Wpccton Purposes
(We)agree in sew,indemnify And kelp homeless Ne City of Cupertino aplot
h Ilabllides.judgmcnu.costs and expenses which may in my way seem against sold City
f�7 In consequence or the$muslin$of this permit. /J
Fl APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:9 Date
OURCE NS
S .
? � .U. -2' 1• h Re-roofs
Signature of AppllcmVConlscor �1� Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will dto Applicant m future building occupamemro or handle haurdam metarial
Alikdelved by the Cupe
❑Yes nine Municipal Code.Chapter 9.13,and the Health and Safety
e,sates 7363:(.)7 ON. All roofs shall be inspected prior to any roofing material being installed.
Will the Applicant or future building=upon,use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
wt haurdewo air contaminants As defined by Ne Bay Area Air Quality Management all new materials for inspection.
UIItriA1T
0Yu ON.
I haw read the huudmmsmauriah mquimm m underChepor695of the Califm-
me Health&SaMyCoda Scnions25505.25S33 ad 25534,I mdcmaM ton ifUc building
dose tot cunenll haw•onma"it u my mespomihility m notify the oaupmt of the
whin aRbemet P"+'uy"aar,cmutoaof Parry. Signature of Applicant Date
Owner orauchorimdagcnt Dato All roof coverings to be Class"B"or better r✓