00090141 (2) h CITY OF CUPERTINO -
BUILDING DIVISIONPERMIT . CONTRACTOR INFORMATION:
BUILIIING.ADDRESS�
. '. PERMIT NO. F
a7 00090 14•g.
OWNER'S NAcgE r321 S DEANZ9 BLYU • - ,. - APPLICATION SUR DNIC '
2/20
PHONE y `HILLS REALIOR 'R- L . - a .. SANITARYNO. ': CON'I'ROLNO. -
O s Z r ARCHITECIIENGINI RR. - - BUILDING PI:RMI 1INFO
wF y F REDO ,ELECT- PLUMP MECH '
=Z LICENSED CONTRACTORS DECLARAI ION 1 {
z H Job Descrlp'tPon l
�Oz_G Iheahy Rttuh tlnl'licensed under '.t ICh pivJ(conncnmigy _ '..t
re t•w wihS t ]000) rD' iuf theBm e a IP f:' n.Cde.anJ my l' eocu �;'* r ,_
si fill force dffet.
Liedaw Class L' W
°ads Dol c hard, 2- E, G;'.MECH IN ATTIC - _"
ARCHITECT'S DECLARATION
f5= I ndarvrnnd ny pr , HIT beuac l p"hR • - -
so
awwif
i 6 p ce Licensed Pmf n'el { gas-
to
/
a, OWNER-BUILDERDECLARATION
i- m ng hereby vlfnn onthat I 7031n5 exe npr from the Cont'a 1'Any city I rll i t {
FZQ foil greason,(S it ]On15 BusinessJI f.. Cd :AY .ty 'crop
e w which e3m pa - t f construct,trial, P derrolisiWor r6porY ane
prr at Ib ppl rl h 'Ir file statement
that lie I rap r(ofthe mosisionsol n cri L (cbapNr9
-
S �Ft.,FloorArea Val tion
• (ca nene agwth Sut ]WO) fD'' � fth B dP f:.' .Godo) - q' � Q.
orS at he's aapt any
apo nd for accord
nonoo Anyv'r Inion " -
nfSection,(Iran by any lap doll fortipencil subjects the vpplicvntmucivil penalty cu
on�ot imam titan five ltndtm dolmen ts5lk,)., APN Number— � 'Occupancy Type
❑Las owner of the peoputy,or my employees as`ith wages as their vote v,mpemmfon. a'
art]do r k 1 Ih a t t i amended offered 1 I (S .7044,
r Fro dP r:o Cd The C l 't I' I' I t apply to as R tllred Inspections
count of propmy Wh h Id' inpmvv therm.and who does.ach wo k h n,tit
o`tM1 6h his own employees p d d that 1 p c s t' I aded'a
offered f If, t Wilding or ImproVereents Id within one yrnr of 1.01. •'— FOUNDAT I ON _ -
conpltinth wnerb llderwillhnGalhhunletf paving hot Eed'd not build or _ -
i.,r I' p ,aeu,df ) . .t._ •• - 1.02 - PIERS . {_ ..
01,to coner oren property,am exclusively catiaractiag withr at rterstd 103 —' UFER
Lcot tIh project(S 7044 Patients dP fc.i n Cm )Th Cnu cmrs -
enellwd I applyl 'n oducrofproperty he Hill:a,i P tle,m 1,04" '- 'REBAR
-
and h sources f .all em with nnacmg)I' d personal to he
col t -
-
105 — ANCHOR 'BOLTS
-ol an,ecri add,See B&PCfar this.,,,a 106 _ SE14ER 4 WATER
°u r�—A�s� Pe sAT1/�cN 202 UNDERFLDOR PLUMPING
thembyarndaide,pumlryof"' ryt,eaemeEdlewitgdeclarminds:� - 20.3 r, LINDERFL00R-MECHANICAL '
Cl1 n a n mutation ce n c r . r Work,,,, r:04 — UNDERFL-OOR• FRAME
Ci p f . F ild f by Section 3700 r 11 [..be, Code for the,,
performances, fdhe akl off OF Imp anI,bond. 21715 UNDERFLOOR .INSI_II_Al'IORI
;e to
O 1 have and sell
eirritation
Worker's Conifers arm In. aacquired' I' r30t —
ROUGH-'•PLUMBING "
3700 LontorCnrmeneann' t, rrmewor:r which m.permit
i
i„1.1d.Mywalou Carmensannn laurncecarier and Rbe"nmlar are302 — TUB &' OR 'SHOWER
. .
'•,
n
303 -_,, ROUGH MECHANICAL
Oar is - Pohey No.:
CERTIFICAI ION OFGXEMPTION FROM WORKERS' 04. ROUGH ELECTRICAL
COMPENSA'I ION INSURANCE
305_ FRAME
(T1'. section ne d r be on»P1rtm'nn per,r,r build rm aounr, w:
fbu)d) n.:.) _ 306 = H01_DOWNS .
I certify that 'I the performance of the work for'which this permit is i,vand.I 307.•u_ a.I NSULATI ON '
seal t ploy.my p y a rr so a,m become va hjact to the Works, - ,
camp n f n L „ rcah Date 308 •—,, SHEETROCK—-
NO t - - - 309, EXTERIOR-LATH `
NOTCH T< APPI. A r c Ifcl re PI y u inti t -.
O0beached h) Ito theta k .0 t F s?be LMred -y usl - ,
forthwith plrwth npravxn,arm pmn.Imined d'mvakm. 310 ..• -IN�TER�.L+OR'f+LRTH' .
�^ 4 CONST RUC I'ION LENDING AGENCY .. '3.1.1 —' SCRATCH” COAT v ,t. - ,J
s.
I nearby affirm that there landing agency for the performance ! 'kc
aA otic rk hhmp fsa
'scd(Ser3097Cie.CJ, 31,3 '—, ROOF 'NAILLad
C
Dander's Address, A 501 -- FINRL`ELECTR,ICAI_ 'ENERGY _
w F ' firythtIh thisapplication' dot thattI n information i502
FINALP_UMPTNG''ENE RGY
m,r , l r m city anti M' d.l l lawk a
O toM1 build,, e , ubh e,sl tpon S03 •FINALt MECHANICAL. ENERGY
> W pl,ha.wmanf,neapnp pr p,tt .
X04 - :FICIAL BUILDING' ENERGY
eey }y - (We)agel e t d fy dkeepbra l-sth Cry CC peru against
.. y labilid,,,didgaremb,costsd eti,crad,which are,,in an,waya runagdn,r said 505 F NAL',ELECTRICAL a-
U
City in too...unce ofd gmtnutg of this p mil. - �
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOJ5. ,TEST
SOURCE REGULATIONS F y Date �_; ( 'Lr✓rte
Sigt r of ApVrwttlC t t Dai Re-roofs. (� pA —. - r r+
HAZARDOUS MATERIALS DISCLOSURE 50TJ_ — FILIAL MECHANICAL_ r I
Will the applicant or faction buldng p r:I m or handle avaricious 'Erol .'typeofRoof-
asdeecalbylneCupertinMticip:dCoJChpter)12,adthHalmatdsafety 509 — FINAL• GRRDE.i' - '
Cod Section 255i2(') '4 .•
°Y 'e El No All roots shallSeSTkIQcted ftilyPltA4tn}Pilo rial'being installed.Will[lie plfalr titela building occupant use cN."ament or devices which ,Ifs root is•installddU4thoutFANMIaiDFN�I �t-iII�pe �Rf,R gree`to remove' .t
cant hv{ dr r.airy ma l is as deform by the Bay Area Air Quality Management - ,
District° : r : all new materials for inspection. Applicant,understands and will comply with
'O Ves r ❑No r
gall:non-point source regula ions.,.. . . .
Ih ,ad he linafaulldirl411idccalvls under Cho 695 of'ex
- -
f Calif 'H �Ill&SatelyCd Sy N:255U5255d255i1..1 d t doral k-� - . '
nifth building 0 does r currently]favor tamttti that it in' yp -'b1'tyt n flylhe .. ` ' r
ccupanr of the requirements which mast be ort F m m issuance I a Certificate of
-Oaru e, . .. ... , v.• r,
"f
SiApplicant Date
erm„n, arm m •Dole - Allroof'coverings to.be Class"B”or better',.',
"