01030089 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7936 MCCLF_LLAN RD DRAEGER CONSTRUCTIOIJ INC 01030089
WNP:R'S NAME: APPLICATION Suit DATE
CAMPBELL_ ASSOCIATES 605 COMMERCIAL ST 03/16/8001
PHONE SANITARY NO. CONI ROL NO.
(408)536-0420
❑z Z ARCHI FEC ENGINEER: BUILDING PERMIT INFO
00
E� LIIG .ECP 'LUM H I
I_ I_ 7
H= LICENSEDCONTRACTOR'S DECLARATION Job Descripti l
a, m IhembyaRm,thallam lmenxd muter prorisinm of ChaPtcrH(commencing
�ml–w with Section 7(XId)nf UivisionJofrhe Business and Pmtcd,i...Cude,andmylicenw
x hu hr anaelreCt. _vl7 CZ FIRE JOB REPAIR
n a Lica„sa cis,.: l.m.a
He. Dom Conmmo
ARC111'IEC'I'S DECLARATION
F t= g I understand any Plans.hall M used m public rramk F 11\I A L E D
ac W�Y
p p LicunsuA Profasiawl
(hat I a -cl1 rope i t or CLARKI e Contractor
JUN U 5
d hammy,(brat.but 1 1. .lw'ad fn..m me Cssivn a of License c latw for me 2001
se>< fodnwing tansy IScctint 9ro 5, t.alter. end ve,dsinn.,Cdc:Any city ,% ucmy
'FO wh<h 4 m Pc tt t t h P J LM1 p' ya nurc
ac poen w I y he,applicantf eh pe nn fl gd.ttmem
hath :I licensedFormula n they s of C t t License La (Chapter9 Sq. Ft. Floor Area BUILDING'°matiDn
(commencing wth Sut m 7HXp of D'v,in,J of the Ha,unts,and Profe,a on.Code) - $ uation
or hw he i,cxcmPt mcralrnn,and toe lealie Pur the all,cd emnPtian.Any violation
100000
of Section 7031.5 by any applicant lar:,Penni subjects Inc arphcant m a O,iI penmty
of not more than Five handreJ dollars Will. APN Number Occupancy Type
❑I,as nxmcr ofthe progeny,or my employees with wage,os their sole comrcnsaaon. 3621 2001. 00
will do 0e work,and he.tectum is mil Intended or offered for vale(Sec.76W.
Baine,anti rrnfe,im,,code: The Contractor,License Law does all,..pply to an Required Inspections
own,of pit,”,wen builds or I...pa,vc,.lo,.W not who docs sant,work h'mr,elf
,r through hi%own ca,loycc,,provided that such hnpmvemcm,arc no,intended or 101 — FOUNDATION
Red for dale.If.however.he budding or improvement is sold within one year of 10'2' — PIERS
omplednn,the owner4suimer will have the harden of pmvmg that he did not laid or
mpmvefar porw,scor,me). 103 — LIFER
'❑Iter nwncr of the uchnisel.em,tmnin,will,rcunwd en.nmrinrd.n 104- — REBAR .
L,naruct the Tricot(Sce.7044,B.,inesd and Pmfcs.inns Com,)Toe C-lunacmfv - '
icense law does not apply to an owner of property who builds or impose.memnn. 105 — ANCHOR BOLTS
and who contracts for such pwjmly with a contanogM licensed Pursuant m the
Contractor%Lieen.elaw. 1.06 — SEWER & WATER
❑lam Mai under Sri. .B.K P C for this maum
202 — UNDERFLOOR PLUMBING
Date
WORKER'S COMPENSATION DECLARN'[ON 203 — UNDERFLOOR MECHANICAL
I hereby affirm under Penney ofpertry one oftoe folh,wing declaratinns: 204 — UNDERFLOOR FRAME
❑ I nave and will maintain a Certificate of Consent it w1kirmne lar Worker's 205 — UNDERFLOOR INSULATION
Compn.,.mio.,. us provided for icy Seedon 3700 of the Labor Clete. Lo, Inc
permnnameofthe work lot which mi, emit i,issued. 301 — ROUGH PLUMBING
111 have and will meimain Worker',Compensation laurenoe.as requimd by Nation 302 — TUB & OR SHOWER
37(X1 of the Labor Cale,for the performance of the work for which this permit is
L My Workers Coil })„,doe Insurance earner anti Policy mber am: 303 — ROUGH MECHANICAL
ey so
c:,rd,r:_j36Pj ' Kra! rnncyN,.: .(411s 23o�'� 304 — ROUGH ELECTRICAL
CERTIFICA'f10N OI'EXEMPTION FROM WORKERS'
.I COMPENSATION INSURANCE 305 — FRAME
jBi section need nm been,npletarthe Permit isfor one hundred dollars 306 — HOI_DOWNS
($10f 'rle—) 307 — INSULATION
1 cemly mat in me pedmorcrec niche wink to winch osis permit i,i„sed.1 308 — SHEET ROCK.
,hall not employ any person a any manner s,as u,henone,.hjcc,m the Workadi
Compensation hx.ofchmmia.Date 309 — EXTERIOR LATH
Applicant
NOT ICE'TO AFPLICAN'f:If.are,ahaking this Cenilin.m nr E,mnption,y oa should 310 — INTERIOR LATH '
Zbeen re vainest to the WoU,d,Cva,clion ptovl..on—l'the Labor Calc,you mud
O O ronewith Comply willsah pmvisinmd or his permit shall The limited revoked. 311 — SCRATCH COAT
L CONSTRUCTION LENDING AGENCY 313 — ROOF NAIL
7 1 Iemby afom,thm then is a cnnwmnion lending agency for the performance
'If the work for which this permaisisdned(Sec.vrn,CimC.) 501 — FINAL ELECTRICAL ENERGY
W Q I.ceder',Name
5 7 Lentkr',Address 502 — FINAL PLUMBING ENERGY
U O 1mrifythat Ihasemadhi,a,fi.tionsad made hmthe nW,cmfonnadonis — FI AL CHANICAL ENERGY
4. [.. correct.I agree to comply w ith all city and county ordinaneed and state Inx v mlming
Of, tolmddingcr ti ntihcmhyamhorucrepreentative%ofthis city toenter upon 504 — F AL UILDING ENERGY
he abnvominationedpmpany for u,vpecolon purpose,.
(we7ngr:n,lws,andkorh'yantI keen harmless The city nfc,ennm agani 505 — -INAL ELECTRICAL
ZZl Iiuhllllos,ryJgmead..u,s1,and espcadc,which may in any way accrue again,.said ,ST
[� ,Z City in cn, permit. -
,querve,doc groroin,ol no, `�
PLICANTfONDEgSANDS AND WILL COMPLY WITH ALL NONd'OINT Issued by: G Date c9,IO_o '
a,ar �Q�•�
Sign..mm nl'npplinp,nnZA'RDOr ante Re-roofs , 508 — FINAL MECHANICAL
+ icA%ARDrum Wilding
IocAL5t mount
ou: hanE Id
wWIlic rine C.ca.nmlMatei,ml Codec Capt 4n 12.and
le Health
andSafeul Type Oof 509 — FINAL GRADE
Cdedndio he Cupenhn Maniemm c,.le.clrarmr rzlz,and me Hemet and Safety 510 �— FINAL PLANNING
Code.tiselion 255320x1".
❑Yes 0N LQo, shall blejl yectedFpQffAtalpf I launwRklging installed.
wnlheappbenmormmonadni..gnaa.pamtametlaipmemonCviCe,whim If a.rooti-rCirirt d without first obtaining an inspection, 1 : eve
mit hwanlnm or'contaminant,ns de•E.¢vl blithe if,,Arco Air Quality Management
oiddc.7 all new materials for inspect 1 ¢1}ca sand will comply with
0''es 0N all non-point source regulations.
I have tend the ha,m ,a
dous nenal,mquimmeis under Charter 6115 of he
Calilon.iu I Iexlth.4 Sel e.y Code,S.nin s 2551..5,25533 and 15534.1 undcu
nmd that
iI'tau huildingdnanotcumunllyhavea.mnunt.dr,it is my mdpoaibili.y tunmify the _
occupant of tee rey wen'cros which maw h did prior to „nape of a Cenilwmc of
aaa4. / Signature of cant Dale
owner nr.mmnrior
ptim
e d K�ent ILnc All roof coverings to be Class "B" or better
ag '
OFFICE