Loading...
00020192 (2) CITY OF CUPERTINO PERMIT No. BUILDING DIVISION PERMIT - CONTRACTOR INFORMATI G //� BUILDING AD RFSS. - O Dig O �© / / f---�s Oz G/J�/IL�T��J.'r /j SANITARY NO. APPLICATION_SUgBMITTAL DAi NIC CONTROL# � PI{ON' J ❑ . ARC TECDEN NEER BULGING PF,RMI'TIN F'O �« F y i LICENSmthat C N fund under DECLARATION >-oh— In<rtbr.Rmtln.11 I enxmamerpb„:;on:Diene❑t<r9(n.mmnaing Job Description OG—p F,w:Fj i Section]Ott)a(Division dW Buimaand Ro(miom Code.admyliameis ' a Y E J null face sil effect. _ y U Li se C)au Lie.N / `� /�//)�� //� ��/fj _7w �✓ . i� p�3 a y Dun Conlralar ✓ / LV —V/,L �/1(,i, CyL�T/>E� /s].(/ ✓ F O CTS DECL elV� y I JR dusuM my It u i<rt //J�✓ G / [A/V/L �+r z ti S o ucen fe. 1 )uS_ Ell DECLARATION - "Occugpan�ciy © `I rtby (SemNall sempl from Ne Cnmradors Liana Law ror the followen tion.(Section]0 eminess atld Profmiau Code:Any city or county wltich rex ti<a.pmmit b ch,a ea,improve,demnlish,or repair any swcmre � S .Ft. Floor AreapG�priordonoreauence,also requ .applicant fore�chpemutbRl<asignedcomment C /�pant b provisionofthe GanausMs License law(CSaISW 9(commencingwishSatian] )of Diviaion3ofNc Busineuand ProfeuiomCd<)or2�0APIrj numb ype Section]W L5 by my epplicavd fa•permit subjects the appliranuo•civil pnWry of f4 /� p nod more than five hundred dollen($5f0). G ❑1,as owner of the property,or my cmwa5'ries with wag"a a mcu sole compamadem. Required Inspections w ill do Nc work,and the ewcturt is tad imcndcd a oRcrtd fm sale(Sec.]064.B uincu and Protest'.Code:The Contractor's License taw it=not apply to an owner of _ ' property wW bullae or inhproves t green.and who des such work hitmelf re through his own employees,presided that such improvements are soh intended or oRcmd for sale If.however.the building or impmvemcnt is sold within one Insured comPleuon,the - owner-builds will bass the Wrden a proving Thud be did not Wild or impose for par- poseof sale.). tJ I.u owns of the Property,am exclusively contracting wish licensed comm mors to eanstrues she pojecl(Sec.7044,Buslnm and Professions Cde:)The Contractors Li- come law does not apply to an owner of property who Wilds in improves diction.and who contracts fa such#Dimer with a contrachuds)licensed pmsuat in the Contractors Licence law. ❑Iemexempt under Sec. ,B&PCfee this ruwn � 42p02 Owner WORKER'S COMPENSATION DECLARATION . 1h.cdwalienunder perWtyofperjury one of the following orker'lom: C (� ❑{hove and will main by eCmi3am of comethtoCode.foreeperfrmiCompen- worka posited(a DY Session 3]00 of the Labor Code,for the peefosnurce of she wmk for which Intia tri nn is issued. {� ❑1 have and will ode.fon wortif Compensation Ineximence,for which h required by Section My ofshe 4Wr Code.for IW pence turner work for which Nis permit is land. My Worker's Compensation Insurance catntt end Policy number ve: Cvrriem Policy Na: CERTIFICATEOMPEIEXEMPnINN FROM WORKERS' - COMPEN'SADONINSURANCE (Thin secunn need nor be canpl<dd if Nc pcmtil is faone hundred ddlm(5100) or less.) I certify that in the performance of the work An which rhia penal is iuud,l about not employ any person in any manner as as to become subject to doe vondersCamper- t salim,fawn of California.Due APpltcend NOTICE TO APPLICANT:If,after making Ibis Certificate of Exemption,you should become subject to the Woders Compnution Provisions of the LaWr Cade,you must foMwiN comply wish such provisions or this permit sill W deemed revoked, CONSTRUCTION LENDING AGENCY Q I hereby affirm ted there iso construction lending agency for the Pe rmxncec of _ .N. the wmk for which this permit is issued(See.M97.Civ.C.) E. leaders Name y > Lenders Amau C>:7 0 I camify than 1 had,nand shls application and We that the eWV<Information is d conal.I agree in comply with all city and county ordinances and time laws relating to L7 O building construction.and Wmby amouna representatives ofthis city in enter upon use above-memioned properly for inspection puryosea. F. (We)agree b ave,indemnify and kap pe p harmless Ne City of Curtino against V luduhnetindgmenb,cram and expenses which may in any way scume against said City n consegnenee of she gmming of dur permit. 1, APPLICANT UNDERSTANDS AND WI LL COMPLY WITH ALT.NON-POINT s f..) z SOURCE REGULATIONS. Q ns SignatureofApplicams7onlrador Dae HAZARDOUS MATERIALS DISCLOSURE Will Na ePlt or hmrc gacupantibrtor handl e naeadoanaamni m deEned byline Cuarrine Municipal Cult.Cluper 9.11,sed Ne R"IN and Safety Re-roofs Code Salon 25532(o] Type of Roof ❑V<s C3 No Will the applicandorforms Wilding occupant use agaiproemorde.iceawhich All roofs shall be inspected prior to an roofing material being emit hasaedous air continuousness m defmd by the Bay Area Ah Quality Management installed. If a roof is Installed without first obtaining an inspection . °i'"`d] I a ree to remove all new materials for inspection. Applicant ❑Yes [3 No Ila,eread the narardWamaterials reauinmemts under Chaptnb.95ofthe Cii- un erstands and will comply with all non point source regulations. persue Beald,A,Safely Code.Sections 25505,25533 and 25536.1 undersized Nil if the Wilding does sml currently Save a tentem that it is my responsibility in ratify Ne occupant or the reP memetns which must be me prior to issuance of a Cedifica,or Occupancy. Owner of ouhomaed agent Dam Signature of Applicant Date All roof coverings to be Class "B"or better OFFICE CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BU1LDING110bi t,=4 DEMPSTER AVENUE PERn11TN00020192 OWNr:R's'lVIL'AGARATNAM, MANIAM APPLICAJ I1i)8V`F2j3d 2000 PHONE: SANITARY NO. CONTROL NO. Z ❑ z INRCHITECT760irt: BUILDING PERMIT INFO BLDG ELECTPLUMY NECK y 2 l I_J 11 I_1 til LICENSIM CONTRACI OWS DECLARATION .106 Desert (lO❑ c_O I hereby offs ru thm I am licenced under pro o,bar,of Chapter 91m.ntnming r,yFu wits,aamnaunann,i,iatonnnedasine.=:rWIsfe.,ior,Coce.a,rdmylicense 1013 ADDTN, 343 S .. FT. REMDL a is in lettI ecoad crier YYy .C7 te a wClass_ Lit Z O are Conmstnr O$�/.. ' 3 G ARCHIITC7 sDECLARATION 1 undernand to,pl;m,.,hvll ha nsW u,public nxoNx • ce E p O Licensed Prafcssinnal u n G\VN[RBUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's Incense Law for the CTQfollowing¢nwn.(Sc 7031.5.Bu,ine,and profession,Coxh,Any city m county D It requites a It m vomlmcl,alter,improve,demolish,or repair ray ametre Z n3� is .,,,n,i,m;ame.alar mquire,the applicant ha.wch Permian tilt a.signul statement tn:nneI,seensedgm,namtothe provisions ofoo,Cn..tore,License l:rw(cnamery Sy. FL Floor Area $Lt�60Q10 (counteracting suit Section 70011)of Division 3liths,Business and Profession,Code) or that he is ewnnu thcrcGonn and Ilia basis fix the alleged ex=mption'Any viol pian _ of Section 70315 by any applicant lora permit adjens tnc applicant to a civil scantly of?I(,[nor,man five hundred dollars 1s51101. Aff '&18220. 00 Occupancy Type °I,uwwnm..s toe va,Wy.or my empinyec with wages m melr,ol,compensation. will do the work,and the shorten Is not intended or offered for,ale exec.7014. .- Ba,ina„arra professions Coll The Conm,cte,s License Law does not appy to am 101 _— FbuIllftyitiroiro IPspections orr of property Who milds or impnn'o theraon,and who dues such work hilut through his own etl provided mat Burnilosmo tents are not imendW or 102 — PIERS offered nor sale.If,however,the banding nen imp rnvcannot is add within one yup mI mnplaenn,me awne-milder will has,the bu dcn of forcing mat Ire did not build or 1 @3 — UFER . i.np use Iiaar ppese rr,me.)_ .. .. 404 — REBAR El 1,na owner of ee progeny,ono en siness a mmmmimg with licensed,cli nta to latent he oe, I(sat. 1.In Business and pert, Mittelman,edea T'he centmem�s 105 — ANCHOR BOLTS at d who Lew dtxx not.pay to vn owner of pr omm who build,ofd prn,es.h=re he at war-,License for tarn prnjeat,wnln a cont v a,qs)termed P,.rsaan, m m= 106 — SEWER R WATER Gmtman/s Lison't,Law. ❑Inn'colon tmnerSet. Basrcfor has reason 202 c- UNDERFLOOR RLUMBING Owner Date 203 — UNDERFLOOR MECHANICAL WORKER'S COMPENSATION DECLARATION 204 — UNDERFLOOR FRAME I hereby affirm under prooly or perjury one of the following Jeclamti... 205 .— UNDERFLOOR INSULATION ° I have and will maintain a Ch,Secti al Consent i 4r seLabor rid'Workers Ill ears,, he pravipr her ray se=ar 37m1 m he Labor csrda, ler me 301 — ROUGH PLUMBING Parrannraa suite ware par which this palm i,i„a.e1L 302 — TUB '& OR SHOWER °lhave rd will nal Worker:,compensation msemnca.a ragaired try Section 3@3 — ROUGH MECHANICAL . 37(0 of the Labor Code,for the perhnumme,of the work his xI,i,h iii,permit is issued,hay Won eI,Cnn nn Insurance same,and Policy nuther we: "�!y 304 — ROUGH ELECTRICAL carri=r: CI:Rn .1h,MPTiosFROM WORKhRS 305 — FRAME COMPENSATION INSURANCE 306 — HOLDOWNS . Ihi,section need not he.......holed it.he pa t is Ibr are hundred dollars 307 — INSULATION. ' IS Ipp nen less) I trend hot mme rmt,am=of ma work for.Lich his 308 — SHEETROCK chaff not employ an person an permit is issued.1 cum ti�Ly:.w,YofC.dla.. DJ;on�ser,a.a,u.ne,amesnni=ettnmaworker: 309 — EXTERIOR LATH . Panna AppBcaa' 310 — INTERIOR LATH ” N01 ICE TO APPLICANT:11.after making this Cen ill of Examoian,yon.should ' Z the amnasabttoheWorker',Cr,Panit.n.npr•visionso1do,La or Cod,yon,innst 311 — SCRATCH COAT O O mnh,bloco.Py wan,aenp.n,kilmor his p,mr;.,hall be casted revoked. _ 5 — 313 — ROOF NAIL !n CONSTRUCTION LENDING AGENCY ' a7I al afloat hat them is a cousloaction lending agency hour tile prolormance 501 — FINAL ELECTRICAL ENERGY aims,work for which thin permit is issued(Sea.3007,Civ.C.) 1 gZ LmJCL.Nome 502 - FINAL PLUMBING ENERGY Z rmer.nedtas 503 — FINAL MECHANICAL ENERGY ;aav O Iriamecerfify lhatluiply,:.dd,happy.aam.and...lyorm=mcesands„inmrmaconi, 504 — FINAL BUILDING ENERGY 0 U corset.I agree ho comply wit all dry one resixorJin;mms and stem laws relining O V mM.ilding con+.me.ien.Old hcrabyamnmircre ...... ivcx oftni,dry nren¢r apo.. - F, 9L mean..( mmrees.,apnyforrra,and nf,ma •,. 505 — FINAL ELECTRICRL F. 9L (Wry)agreet,castinndc,pyanJk Inhamayit,the City rfi,me against ne Vm I diOny ou s,judgment,asst,arra e,�,n •,whmin may m any way.este against sit 506 — GAS TEST Z city in umagn=nn• Ih32SAgoft'cperm' APPLICANT'U STANDS AN ILL P ALLNON )INT 507 — FINAL PLUMBING .. s CE 1ATo"s. Issued by: Date pdnaar - / Re-roofs a taco ZARDOUSMATF.RIALS DISCLOSURE Will me applmam or mtum buthlingoseapim,tore or handle nostril ancriw Type of Roof a behind by he Cuomihl.mici.al Code.Chrpmr 9.12.and he Health:cod safety , stirs °"°2,9532(a)?u' 0 508 — FINAL MECHANICAL_ °Y°' 'All roofs shall tip_ect Vo(MblLing material being installed. Will the applicant nen frome building occupant use equipment or devices which eCtlOn, I agree t0 remove If a roof is inst,'{�r'e withO1' obr�' n mm'S11111111 air urmumin:un<as JdineJ by ma llaY Arca Air Quality Munag=mem q,{ Aw• Dismi=" all newt r ms es,, (naafi'! An:CD{fh`� �p�7.s�'trad will comply with °Yes °"° all non-point s9ti'EF reguFad L Ip LI Ug� s P Y I have rend the hazardous.na.er;alc requirements malar Chapter 6.95 of me - - catihrmla Hugh k Sumty Code.Scotian,25505.25533 and 25534.1 understand that Ir the building does not currently hove n meant,that it is my nspmdbility line the Occurevpum of the m mens It mea h met r taar f u Cenlhute of pancy. gra of plicant Datc 0 n ,mamas. I - _ _ ales - - All roof coverings to be Class teB" or better