02040114 (2) CI eun DING o ERTINO CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS: PERMIT NO.
10685 JOHANSEN DR. ROCKWOOD CONSTRUCTION CORP 02040114
OWNER'S NAME: APPLICATION SUB DATE
EREIDOON GHIASSI 248 BELDEN DR. 04/22/2002
rrfONE: SANITARY NO. CONTROL NO.
(408) 227-7999
0 i ARCHITECT/ENGINEER:
u O O BUILDING PERMIT INFO
BLDG ELECT PLUMB MF.CH
0 O N= LICENSED CONTRACTOR'S DECLARATION frrB.I1A C 6�, �I E
O Z-G 1 hcrcby affirm that 1 am licensed under'S DECLARATION
Chapter (commencing Job De Ya
F'_^tw with Section](1110)n1 Div61ao3of,he Bminessand Professions Cale.and my license ADD 1028 SQ. FT.
�x�st LcenseCln full assandeRen DEC 2 3 2002
s m a Litems Class Lic.x
3 a O Dam Contractor
�+ ARCHITECT'S DECLARATION
O 5 I mold-Itiod my plana shall be used as public recmNs
ic
o Lmenaedprort:atanm BUILDING
OWNER-BUILDER DECLARATION
1 hereby orf rat that I am tsempt from the Contractor's License Law for the
E_?a following.aeon.(Section 7031.5.Business and Professions Code:Any city or permit county,
F o which regwres a peit m 1,moue t,.111r,improve,demoli h.or repair any structure $140000
i 3 n ,poo to its ca also q them applicant for such pert t fl signed statement
thed he inlcenwi pursuaa Chep 'a s of the Coanrettor,LicenseLa (Chapter 9 ValLLflllO❑
hn,nnionicing w id,Sen on]Odd)of ' aW .
slon J of the Business P of code) ]^�'3;/,-U�Y; ,e V y ppt'I-(•Fes ,
onha he is exempt therefrom and the bass for the allegeb e n plwa.Any violation )tk .l:��L_..
of Section 703 IS by any applicant rot a permit subjects the applicant to a civil penalty
pI not mom than five hundred dollars(s5a11. 101APN 15ATION Occupancy Type
-
0 owner or the propry y ploy tl stages .tn - penatiot. _
will do the work and the'strut notintended o Offered for (Sec.]Dii - - -
Baalne.a ana Ptareaao cad Tn cram r c< L a an apply to an 103 - UFER Required Inspections _.:It it
owner of propeny Who builds or'mprovss thereon,and who doe such work himself q p
or through his own empl) p sided that n p to hots are not intended or 104 - REBAR
offered fro-alt 1p'loosever. he building or-' po m is said wild.one year of -- _ '-'- -'" '---- - -- - --
comple{ion the owner-Wilde,w-Il have the burden f proving that he did not hu;W or 165 — ANCHOR BOLTS
;mpmve run purpose of.ale.). 106 — SEWER & WATER 1
�l;ac owneTor ih.__. .
p pe y, and oan; itual Es:)The nvaciorsm 202 '-`UNDERFLOOR- PLUMBING __,M7__
203
-
- - sewn the pmjcn(Sec.]oJi,Business and Pmkssions Cods:)The Contmcev's � " L I'-'
License Law Jucs not apply to un ownend properly who bums or improves m,rcnn. 203 — UNDERFLOOR MECHANICAL '' : " •''
.. ,and who contracts for such projects with.a crcurctor(s)licensed purami the
cont t .Lc,naeLow ..... .__. 204- UNDERFLOOR--FRAME
bl e pt oars ',Bz'Pee,rrni.r<aann 205 — UNDERFLOOR"'INSULATION
` •_9W net Na Date T70o2 301 _ ROUGH PLUMBING
ER'S COMP5VATION DECLARATION 302 ROUTUB H 0R SHOWER
IM1ercby alarm under penalty Of pc�mry one ossa following declamations 303 — ROUGH MECHANICAL
❑ 1 have and will'mainmin ti Ccnircate of Consent m self-Insure I'or Worker's 3 04 — ROUGH ELECTRICAL
CompetemLah
ion, as provided for by Section-37W of the r Cods, for the
- _- Perfnnm,nee-f me walk mr which mix permit is kt,acd; , . 3 0 5 - FRAME
o I b-a and will maintain Worker.Crrm,=n.atien mmranct.'as rcgaircd by Section3 0 6 - HOLDOWNS
3700 of the Labor Code,for the performance of the work for which this permit is
issued.My Workers Compensation Insurance carrier and Policy;nynmerare: 307 — INSULATION
c er t. PmmrNo _... ; ` 3.08" - tSHEETROCR____ ...-... .-..„. ......,. . .. .. _.__..__..
i CERTIICATIOY OF LXEMPfIOY FROM'WORKERS' ' ,, V r" 1309 -
s — `F s 2•• { s g s s ` ., •t
co�I _ ..SATIONINSURANCE• - 3EXTERPOR' LATH a
-' -31'0'
- f'-_'
INTERIOR-LATH
(Thrs`u,cti6n'need not he completed if the permit is for nne hundred da Ilan
6lgn ries'.' 311 — SCRATCH COAT
-
b I tlyttrr' m parr t aim kt nchd permt -..aa i -- -3`1'3.-:.- -ROOF- NAIL-' --
in y . as to become to the Wnkm ..._.::_ ..
co°pe` tp�Iiawaymcli nm.Ume n` 501 — FINAL ELECTRICALy ENERGY -
-Appinnum .•
NOTICElOAPPLICANLe.mtermaktngtnereenut<meate..empeon.rou,name. . . ..-_. ..502 -- FINAL -PLUMBING-ENERGY- - -------
become
Z subjecuotheworkefsCompenwtionpldvisaonsoRheLaburCode,younmet 503 — FINAL MECHANICAL"ENERGY
a '•"t
Z , mmplywiln.a<nprnvi.ran,or,his permdnh-R be deemedrcvokea. 504 . -._.FINAL BUILDING_ENERGY._ .___._.
O O e,nn n
CONSTRULTION LENDING AGENCY - - -
�. } In by Fra that n consuun' I d g agencyr,the performs _ 505 — FINAL ELECTRICAL „
,ran okf which vex .I t•
.. -p t Its ,on Ga.c.1 _ ._..._ ._ 506._-.-. GAS TEST -
y'c Loden Name
..Z one
Le 507 - FINAL PLUMBING---------
Z
UO -
cL batlna pl'cat d at n tth m f r nix 508 — FINAL MECHANICAL
F cpnen I agree a comply M all city sad county ordinances and state laws rcladng
509a O.0 to bolding coosumction,and hembyauuhmiec rcprcsenutivcsof this city to ac,a,. on - FINAL GRADE
the above-mentioned Amite t,for insp tion purposes.
(We r.,mamasve.Indemnityaadkeepnarn,l<.:h,City ofaperdna,gainat 510 - FINAL PLANNING-
: UmZ liabilities.judgments,costs and expenses which may in %myaceto,noca oras 514 - FINAL PUB C WORKS
in mnaqucnce of the granting d mss penult any
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALLSON-POINT
SO,Ir er .i;. Issued by:
0 Date
n' \ d UC mmao - •;
�fH VARDOUS MLSATERIADISCLOSURE Due Re-roofs
-oto foansbdmld¢gc p t t or nandle Health
natenal Type of Roof_
'del evl by Cupertino h1 "p ICWv Chapter Y.I admeH IN and fry code.Se t 2557 1 1^. s } ..... .,..>. ...,.-... -....
❑Y airily 1 ✓i : i •'i •,
0. All,roofs shall lie nspec[ed,prior to any roofing material being installed,
w n ri airalcic t future building' ,< p t - If a roof is installed without first obtaining an'inspec[iori, I agree.to remove
it haw d contaminants 4 p m d which
nK as JefineJ by the RyA.�i rQ Quality Manegem nt
D'tra all new materials for inspection. Applicant understands and will comply with
all non-poinfsoiirbe regulations. -- - - - -
I have ad the'hazardous materials under Chapter 't
6.95 of the t' s '
C fma From h Safety Code,Sections 25505.25533 and 3553' 1 undcritandthat
-if th b tIdifndgr d ngti rtt mertnets which
h th mumst be
met
t prior
to issuance rc:Po.'ohr'Ia'ryCt atcfye mue(Ouw - _
7.79 -
=" t nature
Dale _
_. ._ -
"' " I rate All roof coverings to be Class "B” or better
-r f.,... .: . . . _. . .. t . _..OFFICE. . ......