01080061 (2) CITY OF CUPERTINO
BUILVING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10152 DEEPROSE PL MAM DESIGN CENTER INC 01080061
B DATE
r�QS�� `�,EY BRUCE C AND JOYCE M 1676 MONTEREY HIGHWAY AOL8�13sy2001
PHONE: SANITARY NO. CONTROL NO.
(408) 298-8668
n D Z ARCHITECTIENGINEER: _. BUILDING PERMIT INFO
m— / BLDG ELECT PLUMB MECH
gi.. / ` � L .1 L 1 -J L..I
a
LICENSED CONTRACTOR'S DECLARATION
c 5 1 hereby rrnn But 1 am Been ander Job D cription
OZ_O yn provisions of Chapter LHALLATH REMODEL.
pvl-w with Section 701 of Division 3 of the Business and Professions Code.and my license
z a IE w ism fail force and eff
u 3[I Data se Class Lichi ������®
n,y Data Cammnor
to a,0 6 R ITECT'S DECLAR
1 understand my plans shall be used as public records
5
y3` JUN 0 7 2002
a O O Licensd Pmmssional
ea OWNER-BUILDER DECLARATION
uyi r= 1 hereby affirm that I am exempt from the Contractor's License Law for the
following mason.(Section 0031.5.Business and Professions Code:Any city or count
which requires a perms to cmmsimet,alter,improve,demolish,or repair any strucmm gVKI 1L`V�i{IttiV�
poor o its issuance,also reems s fie applicant for such Permit o file a signed statement
thathe islicensed Nosy:mt lrithepmvisionsofthe Conauaors License Law(Chapecr9 6 S
(cofnnetking with Section Ot)(Knof Division 3 ofine Broamicaad Professions Cale) y 3654{;55(ft09.b0a . Valuation
m shot he N exempt thecfnfm as I the basis home alleged exemption.Any violation
of Section 7031.5 by any applicantfor a permit subjects the applicant to a civil penalty
or at mom tart file hundred dollars Is500y 10 JAPN��'DAT ION I i" I ' Occupancy P Y Type
❑1,as owner of the property,or my employees with wages as their sale compensation, 102 - PIERS
will da the work:and cal... ode:struT ,is'noCmdt con',Li ore eredLow for sale aper. m a 10 3 - UFER Required Inspections-
now will d is and Professions Code:Th,Cont intens License taw does nm apply man -
ne
r of property who btmds or improves thereon,and who does such work himself 104 — REBAR
or through ms own employehowevei.( Provided that such vemorteis sol are oro o6c yjaa or
F oll2rgdtfm sale nv hawave..the building or invent of Prot n sold hei did mon uild of � 105 - ANCHOR BOLTS
improve .meawn<r.nauaersoulweemehardenorpmemgmateidratbullaor 106 - SEWER & WATER
improv for purpose ur affil.
of unnemoprty m<aewa Ir t fig
withlicensed<om as io 202 - UNDERFLOOR-PLUMBING-
consumer me project(Sec ?A4.Business d P r aatana Code:)Th c t tar's 2 0 3 - UNDERFLOOR MECHANICAL':'
Licarse law does not apply to an owner of property who tw Ids or improves merean
and who<
ommcts.for such.pmjects with a.contracmns) licensed purumn in m<. _ .. -2 04- — 'UNDERFLOOR--FRAME
Comracmr's Licenu law,.,
_ ❑lameacmptunder$ec. '" r '.';H&PC 4n thismapon 205 - UNDERFLOOR'' I'NSUDATION
OnworDate 301 - ROUGH PLUMBING
1.' WORKER S COMPENSATION DECLARATION _ 302 — TUB & OR SHOWER
Ihereby r,rr e< pen lty feel y onear the rail ' gdecmmtions: 303 - ROUGH MECHANICAL
O 1 hose and w II mortam:Cenificae of Cement to.elf-macre for workRa 304 - ROUGH ELECTRICAL
compensztion, n: provided tar by Section-37W ofthe Labor Code. for me 305 - FRAME
_ performance of the wnrk fm
or which this perit is issued.
o t hale and will maintain warlera Cornpeasmaa m.amna:as regmreJ by Section 306 - HOLDOWNS
f m work for- n'cn m. Penn,to
Crud MyW .erN Ps �� e m and Poly rte 307 INSULATION
of Lanoecad 1 m rc 'av ( •-_O�. 308 [= ' SHEETROCK-- .•-., ,-•'. _ `` _� . ,` •.__
r CERTIFICA ON OFE%EMryI'110NhROM\ 0- `309 - 'EXTERIOR �LATH
IPECOk: .s .TION INsuRnnce • - _ , . --- 310,-,-310; INTERIOR"-LATH
':...` . (Tnaxdticanewnotbeemolleedtnhepermitisforonehundreddall—
(S I 311 - SCRATCH COAT ..
W)or less.l '
313 — -ROOF"NAIL- - -
�.. I sent that m peef - f rte k f ❑ M1 th,pe t'.isucd 1 - •,•. _ .. -- ...... - ... "
compeoianm Laway6 GlJomia Umento become ubinua the workers 501 - FINAL ELECTRICAL'DENERGY '
'Appl t- - 502 ._._FINAL_ PLUMBING ENERGY_ _NOTICE TO APIunt B fa ggm c ar t
rte be 0eWorkersC cnit on provisicans of t.I.EL--plion.you should 503 FINAL MECHANICAL"ENERGY
..
_
h C dc,yat st
Q form m c ply with such provisions or thisperm t.hall be do med rc Ica.
z,0 . . _. ... ... . ... _ 504,...-.... FINAL -BUILDING_!ENERGY__
m fCONSTRUCT ION LENDING'AGENCY 505 - FINAL ELECTRICAL
�. 1 herebywhish
ff that themawn lending ge cY f die lesfomance Lr
�y m kr 1 nm p nbra(sr3lnrC'v.c) 506 - GAS TEST
y.G 'Lend Nam 3 .. ,.z....... -. _ . . . ._. ...... ... .__.._.__.
rall Address S07 FINAL- PLUMBING.
.V .'ntw�n,le 'whishe anlad'�y ttfrtny_ty and ,mna< eaatyl rupon S09 FINAL GRADE- FINAL PLANNING... ... _ ...
v O 508 FINAL MECHANICAL '
Y ppl t t I rt t ikon W r tan is
mbuld c t ton do b ah r crc t t fth'. t tenter
,�+ W property _vetpurposes.
0. (We)agree ,indemnity and keep harmless the Ory of Cupenma against
fianihaea.julloca .co.tsand exlosses wh;rnmar;nany wayaccrue agam5tsaid 514 - FINAL PUBLIC WORKS
:V Z C'yin c.a.upoice of me gmming of mit pcmtiC'
'PI AYEGF A fh . AND W'ILLrmit. ' HALLN �-POL"T'
- . - ERecrrLAno Issued b}': Date ��
rgnamm of Apprranvcantrmmr am " Re-roofs
I; HAZARDOUS MATERIALS DISCLOSURE
Will
eppl ata luta b Idinga p to rtorh dl liwadous mammal
TypeadefofRoof.-
'Code.
I, . . .,,.. ., _i., t,," .;` _ •.,,'
S tVabSi lal ,.( aChpt 912adm H Ith andSafety
oY_ t ' All roofs shall be inspected-prior-to any roofing material being installed.
' Will m pPl ic, tort ba le. p t - cqt u pme devices which If a roof is installed without first obtaining an inspection,'Iagree [o remove
rash d t t. xd' cd by theBuy A Quality Management Dina ' uyall new,materials for inspection. Applicant understands and will comply with.
all non-point source regulations.
w d'the hamrdous..What ego ens and ek pt 695 aLthe
California Health h Safety Cole.Sections 25505.25533 and 2553+.I understand that A
":.'In an,o t eoennot"icallyhaveamnant.twtit is my msponsibilitymnotify th<
(b«upantoftheres hot emmemaN
Nha munihem m uspartbta to roofs
he ] \
z. 1
Signature of Applicant_. Date
r Owacu o am muzTu agent All roof coverings to be lass `B"or better
— -
.,m f. .. .... .. .I �. .� ,.. . .. - ._. OFFICE _ .... ...... .. - ._
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