01060148 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: .
BUILDING ADDRESS: PERMIT NO,
10152 DEEPROSE PL CUPERTINO PLUMBING 01060148
OWNER'S NAME: APPLICATION SUE DATE
STEAKLEY BRUCE C AND JOYCE M 10297 S DE ANZA BLV 06/26/2001
PHONE: _ SANITARY NO. CONTROL NO.
(408) 283-0618
GWOO ARCHITECT/ENGINEER: BUILDING PERMIT INFO
Be m{F BLDG ELECT PLUMB MECH
I__7 L=l
LICENSED CONTRACTOR'S DECLARATION
p z y o 1 hereby affirm that I inn licensed under provisions of Chapter 9(commencing Job Description
r_3L with Section 9000)of Division 3ofnh,Ermines,and Professism,Coca,andmylicense REPIPE & WATER SERVICE &
rs in full force an
�zua uanae Glaxo --lire Lic.k Z WATER HEATER.
`e 3 uou.V nate contactor. m
ARCHITECTS DECLARATI N
undcrvand my plans shall be used as public records
or ce O O Licensed PrnPosxiould
K. OWNER-BUILDER DECLARATION
e w--" I hereby affem that I amempt from the Contractor's License Law for the
�?a following reason.(Section 7031.5,exBusiness and Professions Core:Any city or county
O
Fq loperporr I he, p d
, M1 sres,purtaryoractron
�2� r y -
tactical I I pI - fill-: 'I pe ny l dp Il6iltepr Yla til c terL w ml-I v
(c B hS uotofDiv on 3ofIbeBsn and PrnfasOini Code) S9 ,FtF1oorArea
uation
of that he is interior threfrom and he Bask for the alleged exemption.Any violatin
'
of Section 7031.5 by any applicant for a permit subjects the applicant to a civil rafty r Occupancy Type
of not mom than five hundred dallars(5500). BmbeC .,
1
011 aso he ork: ad hety,ormy employees amintwimwages
eredfsale compe,704,, _
will fit the work;and me Cola'
The C not intended a offered far sale(Sec. to
� p owner
of property
Professions Code:The Contractors License Law does not apply ro an 301 - ROUGH P s eetioi3s
owner of property Who builds or improves thereon,and who fines such Nod intended
or
though for n however IN
that such' p improvements tmlpd or .,._ 502 - FINAL PLUMBING ENERGY
chatted f I If M1owevec dm builNn o --improvement sold lA .. . .._._ .___ .....__.. FINAL
_. . ... . ._ .. .. __. _ .. _ ..... _..._._.
completion.the owner h,i Ider will have tghe burden of passing that he did not bum or 5 0 7 - F I NAL PLUMBING
improve for purpose ofsvk.). ,
O L as w..fthe
' P csus s ly omrth I sedcoalition.to
consumer the project(Sac.7 Business and Professions Cadc:)The Canonical
mi
L La does not to
a f property h b redp th
and who contracts,par sueh.prnlecta wnm a commemdq licensed pursueroto theContractors License L
�
D
t :-
❑I am exempt under See Er,
FC,fortho,maistat 0 5 2 0 01
OCTI'
WORKER'S COMPENSATION DECLARATION R
I hereby affirm d pnIty�ofp 3 y on afthef II 'ngdecliatims: j BUILDING
❑ 1 have'toom will maintain is,cartirium, of Consent to salt-insure for Worker's
- Compensation, as,provided for by Section 3700 of the Labor Code, for the
performance of the work far which this petnhis issued_,
111 have vad will maintain W.d er's Contansunitan Inamaace �required by Section
1 -tCERTIFICATiON OF E orm n of the work which this permit 3700 f the labor Cotte,f th
' is d W ker's C u rtter 'd Policy n bet are:
o1 cyN
.. X ION INS RANO
Is
ENSATION INSURANCE ....... ... ._... .... _.,.
let d f the 't Is t hundred doll '•` =" rl- j n
(SIM) ) oro prat,
nP that in the
o pent p.limit is is rl 1 .•..._ ,: _ •- .
(Tht tl tb
ype a tI m ork fn h h th
.t
'hal at ni Ip an a n r n .td becom sublet m the Woiker9 '
ComPensat on faun bl Cal Pom aDade '
Ncome subject
u j APP the Work lb Compensation s Certificate tf E Labor
Code,
mind
becomeek comply with
the such pe Compensation provisions of the Labor Code,you must
� Z forth rh Imply with h p 'cions o Ihis p omit shall be deemeit.,club
,
a=,C4CONSTRUCTION LENDING AGENCY an
fffrrr Ih by aiTrm thuh acct ct Ind gu forth,performance i :- P
Leders Address'ork for h ch th t ", d.I 3097,Cis'-'9'L ly Perfo
n
f17 Lend N > p _,,. -'9�. :
Z
I eemly mat l have read this application and nine that the abo.e information is
co pect.I agree m comply with all city and county,ordinnreas.and ser¢laws minting
tobui'dla,:onstruction:and fiamby authorizerepr Iti.arives of his city to enter upon
�'rs] th h e i dprost rt ' .pod loo,
F"Cn
(We)tgrc adamantly damntly d ep h role 5 the City f Cupertino ,aumt
W!) liabrbue judgments.costsand
pence winch may inary pay aa, ,a,rpv;t:uiA
U 7J. Cty ansegrene Ftha grml of'hisPermit '
AE E TANOSANDWILL COMPLY WfTH'ALLNON-PONT'• Date
sI CE s 2Y C, Issued by:
Sts nn,�rnppre t t -r,
Data Re-roofs
- ' HAZARDOUS MATER IALS DISCLOSURE
Will
he 5pPlid t or future bandlnsacareer.me,or handle Noncoms all rinl Type of Roof .. .......... .....
_.,..
sidefined by the Calcutta.Municipal Code Chapter 9912,amida,Health and Safely
Cod SC]cY 25532(a) f s ( t 1 t 1_ l t s 5. y r'
All roofs shall be inspected.prior to-any:roofing material being installed. . . .
Will theapplicant future building p t e eq p t d saes which If a roof is installed Without first obtaining an inspection;Pagree`tii ieinove
an lhIr d air entan t ndb m B AmeA ,Management
1❑hase read the haeardouenals requirements under chap' p pP
d_ will comply,wi(h
Y Y Q It
all new materials for inspe A licant understands an
1 all non-point source regulations:
Chapter 6-95 d the
if"be mm Health s Sal®Y Code.Sections 25505;25533 and 25535.I understand that
rf th buil dragd tit IYh -t rthtt Y P b1'ryt notify the .__ ... .. .. .. . . .... _
Oc p fth 1 e t h h ostb tP no' f' Cmf t f i '"' "
Signature.of.Applicant
. Date
Owner or cartime,nd'a,cre oto All roof coverings to be Class `B" or better
f .. .:., r ... ...
r ti OFFICE ..... .. ... .. . ..... ...
{.>:I ...