The URL can be used to link to this page

02050158 (2) OF CI uul NG DIVISION NIVO PERMIT CONTRACTOR INFORMATION: B `6ltyIPRRANZANITA COURT TECHCON PERMn'NO. 02050158 CT�WSnT PANGRAZIO 17450 MONTEREY ROAD A015C c ` GrUV2 f PHONE: (408) 778-1350 SANITARY NO. CONTROL NO. O m Z ARCHITECTIENGINEER: BUILDING PERMIT INFO uOj CO, BLDG ELECT PLUMB MCCII G 8`wZ IM1creby affinnEha LICENSED lOiconcdCumfd R'P DECLARATIONocr 9lcommcnctne GAS LINE lob Description 1ZCed with Section7")of Division 3 of the Business and Professions Code,and my license in full force m rL p ad I�imos C1las c Lie,p are �1 Canoecm�_ r,IC. ee�/a'A K a i_ ) ARCHITECT'S.true ATI Y S 1 understand my plans shall be used as public rvco CNCOJ il.W,'�sc'»Pa^. C.7a.sc2 f:' I w a t p Liaenad Prafeeximul JUN 'a v OWNER BUILDER DECLARATION ='w I hereby affirm that 1 am exempt from the Cman ear's License Law for the 1-id followingream..(Section7031.S,BusinessandProfessionsCWcAnycityorcounty � µ 1 $1000 Y O wMeh requires a Permit to construct.alter.improve,demolish.or repair my structure Bl1hL ✓^• .� ureal 3 Primo a Ira req the ypl ca t f n a it tan signed sonemem that h i n -. Valuation .. . ... .. .{dp Section Chep provisions of t Contractor rsL lir C erg r• a s (con g thSectt ]Wan ofDivisionsin 7 oftheBusiness dProfession,Code) , 1 or that he is mpi ihercfnmt and the bu.iv for the alleged cumlvnon.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than r e hundred dollars($501PN Occupancy Type ❑1.asowner ofthe prop or my employees with wages as their solecompemaeon, 301 - ROUGH PLUMBIN will do the work and the stmcwm is nm intended or offered for sale(Sec.7W4, t Business and ProfeWons Code:The Contractor',Licenx Law does not upply tui an Ull' SpeCll nS ' r of property who build,or improves thereon,and who does such work himself 506 - GAS TE S owner his own employees.provided that such improvements are not intended of 5 0 7 - FINAL PLUMB INE. -. "offered for sale.If,however.the building or improvement is sold within one year of s , iompletion.the owner-Wilder will have the burden of proving that he did not build or mprove for purpose orsma). 01,as owner of jtheec property,7(um Business a d Practing with licensee Contractor's oucmrs m ., . c License the project(Sec. to a Business and property who coda:)The improves to thereon,- Limns, co docs not apply man owner of a.cone who builds se improves thereon, .and who,°micas for.such Projects with a.cantractor(s)licensed pursuam to the _ ... ... . . . .. s.�p� ■ ._..__ .._. _ iLicense law, 01forn License ' am cncr xnnpt under Scc. ,e&PCfof his reu.wn 1 Ddner Date' JUN 0 3 2002 WORKLR'g COMPENSATION DECLARATION 1 hereby affirm under penalty of Perjury one of the following declarations: N J ❑Compensation, have and will maintain a CenlEc°m of Consem to self-insure for Worker's BUILDING Cias provided lin by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Compen.mtion Insurance,as required by Section 37W of the Labor Code,for the Performance of the work for which this permit is is I sued.My Worker, firmance carr 's Cier and Policy number are: .. .�. 1101`1$[0—O _ ... .. ... CERTIFICATION COMPENE TION INSURANCE WORKERS[{ .a1 . t COMPENSATION INSURANCE;'.__."� ' ' (This scnion need nm be cmmplmcJ if rhe permit is for one hundred emllam f ' • (b 100) I cenif,that in theBasilica .... .. - ., .. y performance of the work for which this ed to Worker l , shall en anon L any person in any manner sec as to become subject to the Workers .. . Compensation laws of California.Data Applicant - _ -. .. . . _ _ ... ...... .. . ... ... _ NOTICE TO APPLICANT:Work IC Comptaking tbi provisions f of Labor Exemption,you.you mind Q Qhecond comp to the Workers CiQue,t othis pfroulohaof the Labor Code,you must fonhwith comply with such provisions or this permit shall be deemed revoked. - ' s CONSTRUCTION LENDING AGENCY ..— Ihucby'amrrn that then is a construction lending agency for the performance ' Lender's Namc r Lender's Addor<sshich this permit is iisueJ(Sec_7097.Civ.C.) _,., ... ,-_.. . ... ... ... . . . ... . .. .......... .. L D U 1 ocra y that 1 have mad this application and sum that the above infmrnatseats k.-F mrrea.1 agree to comply with all city and county ordinances and sum laws relating V to building con,truction.and hereby initiative representatives of this city to enter upon >, W the above mentioned property for inspection purposes tF L (We)agree in cove,indemnify and keep hormle,s the City of Cuperiiim agai nn Vl liabilities,judgments,costs and expenses which may in any way accrue against said U.Z City in comequcnce of the granting of this permit., APPLIC RSTAND AF %VLLCOMPLVWITHALL'N N:eOnT'' Issuedb r Date - SOURCE %TION,^ Y' �t � l 5ftisioti Signature of Apphcanticnmraclbr " DaRe-roofs HA9ARDOUS MATP.RIALS DISCLOSURE'' 1 Will the pPlicant or far..W lding occupant store or handle mantrokow mat al Type Of Roof as defined by the Cupen o Municipal Crete.Chapter 9,12.and the Health and Safety Cade OY 25532(a)? ... ! w ,All roofs shall be tnspectedlprior to any roofing material being installed.- Will the applicam or future Wildirg,occupant use equ porcutor devices which If a roof is installed without first obtaining an inspection;I agree'to remove emit hazardous air contaminants as defined by the Bay Arca Air Qmlity Management Distri<e ,. �,( all new materials for inspection. Applicant understands and will comply with (� w" t•: X. :• allnon-point-source regulations. .. . , �J 1 have read the hazardousmaterials requirements under Chapter 6.95 of the California Health k Sarety Code.Sections 25505:25533 and 25534.1 understand that _ lithe building docs not currently have a tenant.that itis my responsibility to notify the - occupot of the requirements which..in Be mei pfior to issuance of a Certificate of Occu �•� �� - Signature of Applicant Date ti L1 vL. _ owner in aamodae asenl Do( All roof coverings to be Class"B" or better -OFFICE' CITY OF CUPERTINO BUILDING DIVISION PERM17dik CONTRACTOR INF'ORMATi N: I�MnATRR`ANZANITA COURT TECHCON PERMIT NO. 02050158 OVTWH'8VT PANGRAZIO 17450 MONTEREY ROAD A`R15c/'r`lols nl"2 HONE: (408) 778-1350 SANITARY NO. CONTROL NO. 0Z ARCHTTECDENGINEER: BUILDING PERMIT INFO w C BLDG ELECT' PLUMB MECH tai T— D C'-1 t,-i LICENSED CONTRACTOR'S DECLARATION z Z I hereby firm that 1 am licensed under provisions of Chapter 9(commencing Job Description iN-p rat yr p GAS LINE L to with Section ircF )of Division 3 o the Business and Professions Code,and mylianse s, ifull force v s i re Liens��lxs Lie.. 33 S D'ECLo u.c. '1l— AACHITECfs DECLARAT� '�ys�'5ys�� — L r.�[G r g 1 undcrsund my plans shall be used as public mcamaeya C NC OJ (�lal?Scg�pp^, CO.SST4 i apo Licensed Professional ouOWNER-BUILDERDECLARATION w=w 1 hereby.affirm that 11. exempt from the Contractor's Code:s License Law for the $1 O O O r Z< following reason.(Section]onstr Business and Professions h,oAny city or counre to F 0 which its iisu n permit rr construct,alter,improve.h parmiit t or repair any structure a3$ that to mslimnanec,alut requires the soffor auchpemduo0leaeicense Law( hamem (comate licensedpuection7hi to NepfDivision dof a ConturactheBustors andPrLawonsCor9 P a ; Valuation (commends exng am Scerefro sag tebasisotheaBuss!ss exemption Coda , t OF that io is 31.5 b therefrom an-0 the basis for the cts shed Gumption.Any violationPety of Section]031.5 by any hundred applicant for permit subjects the applicant a civil penalty of not atom m.m five Wnarea eanars asoo). PN Occupancy Type a T,as owner of the rt m employees with wages as their sole compensation, 301 - ROUGH PLUMBIN property.or yemp Y B pane will dm the work,and the structure is not intended or offered for sale(Sec.7044, Business and Professions Code:The Contractor's License law does not applym an If se ❑ owner of property Who builds or improves thereon.and who does such work himself 506 - GAS TES e tl or through his own employees.provided that such improvements are not intended or 507 — FINAL PLUMBING offered for ade.'If.however,the building or improvement is sold within one year of completion,the owner-Wilder will have the burden of proving that he did not build or improve for purpose of sulci. ❑I,as owner of the propert,oat exclusively comranum,whit llttmed contractors to - construct the project(Sec.7044,Business and Professions Cade:)The Contractor's License taw docs not apply to an owner of property who Wilds or improves thereon. FINALEO and who contracts forsuch projects with a commit licensed pursuant to the .. Comnctore l s Licensaw. 01 am exempt under See. .B&P C for this reason JUN 0 3 2002 Owns, Date WORKER'S COMPENSATION DECLARATION BUILDING( lherebyaffirmanderperally of Perjury one ofthe following declarations: BUILDING t•O 1 have and will maintain o Certificate of Consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance Of she work for which this permit is issued. ❑1 have and will maintain Workdr's CompensationInsurance.as required by Section J]W of the Labor Code,for the performance of the work for which this permit is issued.My Workers Compensation Insurance carrier and Policy number are: carie4`C1A1i-'fUrLD . ,PmWy shsi l 1)81 0-02 CERTIFICATION OF EXEMPTION FROM WORKERS', COMPENSATION INSURANCE ' (This sithon need not be complcred if the permit is for one hundred dollars - ($100)or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Cali fomia.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption.you should 0 Q become subject to the Workers Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. •I z 2 CONSTRUCTION LENDING AGENCY 1 hereby affirm Na them is a construction lending agency for the performance Wof the work for which this permit is issued(sec.3097.Civ.C.) ❑ Lender's Name Z Lender's Address T.1 G 1cenlfy that l have read this application and state that the above information is Psi P: contact.1 agree to comply with all city and county ordinances and state laws relating C V to Wilding construction.and hereby authorize repxiemadms of this city to cater upon Y the above mentioned property for inspection purposes. f' L (we)agree to save,indemnify and keep harmless the City of Cupertino against N• liabilities,judgments,costs and expenses which may in any way accrue against said C.2 i City in consequence of the griming of this permiL APPLIC RSTAND N LL COMP LY WITH ALL N N-PojNr' Issuedb r Date SO URC ION. ` I s��.s 1 O�L y: Signature of ApplicanUComranor Date' HAZARDOUS MATERIALS DISCLOSURE Re-roofs Will the applicant or furore building necupanrstore car handle hicardoux material Type of Roof as defined by the Cupertino Municipal Cade,Chapter 9.12,and the Health and Safaty Code,'Sectian 25532(.)? ❑Yes Na All roofs shall be iospected.p-rior t0 any roofing material being installed. Will the applicant or furore Wilding occupant use equipment or devices which ami,hicardmisairemntaminantaaxdefinedbytheBayAmaAirQualityManagement If a roof is installed without first obtaining an inspection, I agree to remove District' all' all new materials for inspection. Applicant understands and will comply with ❑Yea pNo all non-point source regulations. *t" 1 have read the hizarco��,us``V1lmaterials requirements under Chapter 6,95 of the California Health&Safety Codc Sections 25505.25533 and 25534.1 understand that if the Wilding does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which must be,met prior to issuance of a Certificate of D""p ^^ 11 Signature of Applicant Date .�� l t a o' t,1 oL .. Owncrorinstant agent Da. All roof coverings to be Class "B" or better ., OFFICE } • I, � '3tFS ENE- ENEENE �� '■'.yY;Mwj I�,�■1,, s ■ N NWIFAJ INN ■■am ■� /�/ter t , MAN a> `� i. :/r!•,; .■�IRA �/�'1- .��•■/�/� 1. /� .■,b �: / � .\1"i'�� —. ��_— ��ti?•>._i..�`��11u!Illi'��Ia,.a,IyI . �:. (�, k: '��jj+ jj 1 �� .fit ■ /� • ItlI Iu16E S f�� I�►� 1 �/��t ■�`.��II�'.!•�� Cir•J.��S.11•l7:'��lait!��J�.IOai��1.Ii � 'E ��R��■ •��(: i �,/ � nliiii •�■��'�C■=��.1ii=�■es ■`L_�>t �:vr ■�-. , ��9.�11 61n• ii• ant �y •• �/" l — I ■'■/�/� ■■ ■/�/�! �,\i/� �. •. 'a�M'1��,��„,gig+}� �%Vi``;�� IIS.�.� ■■.■/�/�/� ■■. ��•-_ \, /.\, ■.■-, � ; ' I� ,�� I;}Il;}tam/�/�■•■�•/�/• � G.;.,3L....�1„�'�} � ` �` . ' ` a. .• .a�:. '�= � •,! ^ u�,t'�SIF• ,�� - ;KSI•. *<-•\'I'. • ,,%\,L.. _ 4�_+' •' iTZ1 `�\1/ice ' � w\'Ati'•�4 PANGRAZIO RESIDENCE If 10517 MANZANITA ��JJ rr • r I I .. ' ,, ,x,.2£7: ♦ COURT PLAN 17450 MONTMEY RD. MORGAN HILL CA. 95037 CUPERTINO, CA. 95014 PHONE (408) 778-1350 • • FAX: (400) 778-250