01060149 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
926 FT BAKER DR CUPERTINO PLUMBING 01060149
OWNER'S NAME: APPLICATION SUB DATE
PAIK MOON AND SUK 10297 S DE ANZA BLV 06/26/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 283-0618
.00
reeITIT z ARCHECTIENGINEER: BUILDING PERMINFO
— BLDG ELECT PLUMB MECH
Hoc I I I
� LJ Cl
z�_ LICENSED CONTRACTOR'S DECLARATION Job Descri tion
=� I hereby M.me,l am licensed under provisions of Chapter 9(emancncing P
Fire F with Section 7")ofDivisiam 3 ofthe Business onal PreffeasionsCride.and my license REPIPEF-M ATISM SETSCE &
<m q Is in full msec r C •� c-,r
'od oyer cm.a
Le. 10 WATER HEATER.
3LL. Dine mor MAY U 7
F m O n ARCHITECTS DECLARATI N 2002
1..&,,.ad my,plans shall W used as public records C
y
i'Y OC Lensed Professional
e.re OWNER-BUILDER DECLARATION BUILDING
1 hereby of rm raa
rthat 1 am exempt from the Comor's License Law for the
s-Z following reason.(Section 70315.Business and Professions Code:Any city or county
rwhich ragaires.,nernit ro<°nwrocl.mmr,improve,nemm'�en.°r repro say wanner
�— sia to itss I 'V ' ilppf LI Inchpe ett 11 'g d 'renem _.-._....
re:
mgtn I h dl tm]Wp nl c t 'r.L L wap erg S Ft. Floor Area, _.__.. .
m' me«ingwthSecton7lkM)ofDmn°a3ofmaBasinssmadProa,im,Code) 1 - .9� ' aluatlon
or that he is exempt thderro7n and she basis for the allege,d eaemp'lan.Any violation - •' '' ' '
of Section 703 1 5 by sea,up,]avian far a .it subjects the appl'eam ma civil penally
of nm marc than five haadrcd fosters S500). urn er Occupancy Type
❑Las owner or the norm i,�,.e
and
th y y,is o t intended
or offered
for sal (S ensaaan,
will do the work,anJ the mm�urc is not amended or oRcmd for sale(Sec.]tM,,
'Business arid Professions Cade The Contractor's Licenza Law does,not apply t°un 301 — ROUGH PLIF'949 W(Inspections' '
owner of propeny Who Wild.or improves thercer.and who dres such work himself
or through his own employees.provided that such improvements are not intended or 502 — FINAL PLUMBING ENERGY
,offered for same:If,howcvcm the builds -- i 'is sold within lrc year of ---- - -'� - -' - - - 'PLUMBING- '- - - - - -- -
campledoa,me awoerWoder win have rte Waders of proving mm he did n°t wild nr 507 - FINAL
improve f«purports,or sale.).
❑1,as owner ofthe Property,am es stress a convicting with licensed,carucmrs toLicense
consumer,rte oejen ram.]Bt,,Busters and Professions Cade:)The ves the eon, ,
License Law does not apply to of owner of propeny who builds se pars ant to the
and who convaase Le such Projects with a commercials)licensed pursuant m the
_ 111 am exempt
License Law. -
❑lumexemptundertieE - ;B&PCfonhis reason
Owner m. .
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under Penally of perjury one of be following declarations.
❑ I have and will maintain�n Ccooleate br Cm,cot in self-imure, for Worker's
Compensation, as provided far by Section 37W of the Labor Code. for he
performance oftne work for winch this permit is issued.
❑1 have and Will'mainmin Worker',C°mpar,sai°n Insurance,as rcquircd by Section
' 3700 of the Labor Code:for the performance of the work for which this permit is
,,,.cd. Y rollers yy arenami no marve center,r and Fei,moriter are: . . _ .. . ,_. .—. .._ _..._ _.._.._..._._
CERTIFICATION EN ATION I S RANO ORKW PRS.
Ot/
'COMPENSATION INSURANCE - _
(Th.:nein'need not be compincJ'f the ,air is tax one hundrtJ dollars ]
131001 rless) -
.:_. -.
awocd
I cc.stifytoy an in Person
P in any ma nee as k for which thprint 1_. orke 1
shall not ply any pc.11 any mph t becomesubject m the Warkerd
Compensation Laws of Calilomiu:Dale
Applicant
NOTICE TO APPLICANT If,after makingthis Cisions f he Lavar Co,youu me,,
Z bmome sabjcnro'he Work<r's Compensmiahpmvisions of lM1e WWs Code.you must '
ZQ fonhviith comply with.Inch provisions or this pemeit shall he donned revoked.
CONSTRUCTION LENDING AGENCY"
a 1 htneby art!.ch this
I the -cora i n leading agency for me peAonna«eof the
ry Q .,. 09],Civ.C.' :
Lender�°Nark mexfi¢h,h xpesmnss issued($cc;3_ _, -_,, .•V_ ,. ,._ - _ . _ .._ -
�,z Lander's Addrns - - -
Q 1 certify that 1 have read this application and stale that the above inforampon is
[�. comen 1 agree to comply with al]city and cmmry,fort...cx and one laws clznng
0 V mbuildiagennanuctlun.mid hercbyaumarizereprcseemovesnf lois city to enter upon
W the ah se manlioned Property for inspection purposes.
4 rWA befall(w )agree'Dios d try and keep l less the C , f C per °ago ns.
U'Z c judg ¢. J pe zit h h Y,in any > Sarna said
PP] A�fJnon
LN Le �.Tlittl USAVD WILL COMPLY WITHALL VON PO VT
C AT .6 �9 „} Issued
Slgnzmre of Appf' m aLmU mar Dole1 Re-roofs
Will the app�lic{=RDs US MATERIALS DISCLOSURE
ae' r c rfarm Wildiagaeapa It..rhaameha wammaterial Type of Roof
del Oyes the Cu nim,Municipml Code.Chapter 9.r'',and the Health and Safely -
Cod S ' 25532m) It
�'P All roofs shall.be inspected prior-to-any TOofing.materiai being.installed..,
Will th jVpl' r! Wilding' occupant se equipment ae . mien if a roof is installed without first obtaining an inspection;[agree'to remove
emit h z bcoronationcos as dyfneJ ny the Bny Area An Qumliry A1anngemem o
r D'a""'
oras all new materials for inspection. Applicant understands and will comply with,
• e �. � .'; ..
all non-point source regulations.. '
1 have'rmd the hazardous maiemals requirements under Chirper 695'of the
California Wilding
d n s Safety Cody.ave'ioav5505e'itis and 1553,,I uodemand shin
ir,ne building does i orearscurrenyhh. ,outnemetmrior mysesponsiofaCcinotary the
«cu loft req arc emu wM1ich nwzt be met prior m isswmce af,a Cmciflcum ofsa -
Y f
Signature of Applicant Date
won,.1..'a I =ant ' Dila All roof coverings to be Class "B" or better
•"1 .. t 7 - .. OFFICE - -