01030171 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
FENCING INC 0103017.1
OWNHR'S NAME APPLICATION SUIT)ATE
03/29!2001.
ZONE: SANI'T'ARY NO. CONTROL NO.
0zi ARCHI FEC'E/ENGINEER: BUILDING PERMIT INFO
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BLUO ELECT PLUMB NISCH
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1-N LICHNSIN)CONTRACIOR'S DECLARATION Job Description
0 1ncrcnr mmonmal I nm Inarrod nmlcr prnvi on Chapter 9 tn•mmcncing
0 o,f-O with Section 7001 of Division 3 of the Bucinl and lesionGrde., Iny I"cusm
ay^� is in full force and e
Lie.gel
/ 2ND FLOOR BALCONY REPAIRS
a.406.N Date a� DECLARATION
lnf
rator
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DEr:C fIONr
C u I T[g 1 understand I,,2 Trans sbull Iso used as Traffic record,
am, p O Licensed Pn,fc,sltlll II '
XOWNER-BUILDI!It HECLARAI'ION
W=m
hereby
add....tem m xenrpt tomo the Cn on'ter r'n License Law I the
F'z folkes ng re.snn..Seelion 7011.5�Ru ors,and 11..fellinnx Code:Any city nr county
E F p which requires a permit to construct,alter,improve,vemolist.or repair any incarnate
an Cam prionoiu iz umce,ubo nyuircn the applicnm fur such u
pcnnio rile a signed stmemcn
that he is believed pursuant to the provisions of tho Contracrobs License Less(Chapter 9 Sq. Ft. Floor Area Valuation
(commencing with Sorbian 7(gM))of Uissinn 3 of Ire Business,and Professions Code)
or that he is eaerapt tberarom and the basis too the alleged exemption.Any violation
of section 7031.5 by any applicant rot a fiction.omen.tee nppliwnt u,a visit rclndty
IT Inst Irmrc than bee emrdred dollar,.(S500). APN Number Occupancy Type
O I,u,owner of the prapeny,or toy"I'lloycce will,well'a,theirsale con.pmrsalion. -
.ill do the wmk,amstructurex
I the structure i,our intended nr uttered for vale(Sae.74. -3621
00
Bu.sine,s and Pmm.,irmn code:Tec Contractor,License Law dire.,nor apply In air Required Inspections
owner of proPemy Who builds or improves Thomson,and who docs such work himself
or through his own employee,provided that such improverrrents ate not intended or 101 — FOUNDATION
uftered for sale.If,however,the building or improvement is sold within one year of A
completion,the oil ncr-milder will have the burden of proving that be snort build or 1.02 — PIERS
improve for parlow nt aclasis
El1,a,own.rofthe pm 'ry,iIrsclmivelya,mmetingnimncemxcdCvmm.I„IF to 103 — 'UFER
hnrlmct It.project(see.710.4.Rmin...and Prol ..ions coat.:)The C...no"on, 1.04 — REBA R
icenm Law doe,ten apply ,,na owocr of propevy who solds m improves there....
and whonnrrna,.An.such proect,,wire a.mr.mmmr@)licensed pu roam m he 105 — ANCHOR BOLTS
Contravenes Live...low .
❑1 am caernpt trader sec. .B&P c fin,hi,reakm ].06 — SEWER d WATER
C,nor Date 202 — UNDERFLOOR PLUMBING
WEIR KER'S COMPENSAI[ON DECLARATION
WALE[Y03 — UNDERFLOOR MECHANICAL
1n.rmy:nnrrm under racially otp.riroy Disc of nr.ldnswing d..lm;nir,nu: 204 — UNDERFLOOR FRAME
1 I have and will r dnmel u Ccnincuo,of Consent I,) olt-i n,ure for WwkerMAY x 10
2001 loorroaation, as pmvWed for by &enter 370() of doe Labor Code. for the 205 — UNDERFLOOR INSULATION
,ifnmranceofinennrkhnol
whichtbrxpennhisaed. 301 — ROUGH PLUMBING
7-�(/have and will maintain W'ader's Compen alion Insurra ,as required!by lection
Rh of me Labs Code,for me performance o1 me work for whim mi.permit is 302'x02 — TUB OR SHOWER
ill dM Wnrkcr.emn, "no Insurance carierand Pnbcynumberare:
303 — ROUGHH MECHANICRL
Ca "��GL ��L"y Nr"�-N�` �'d 304 — ROUGH ELECTRICAL
1 I<I IJ 'AUON OP E%CMI'nON P UN W)RKERS'
COMITENSSHON INSURANCE 305– — FRAME ..
(This section need not becnmplcled flhe pennit is forom hundrcddollurn 306 — HOLDOWNS I
Ibllgl nr least
I cenify mat in the Iwrfonmrne,of the work for which this permit i,t...ed.1 307 — INSULATION
,hal or employ any pemun m a
any benem r-1 a. become.abieet to the Workers 308 — SHEET ROCK
n,
Crmrpaadon Laws oreal fsrnla,Date
Affiean' _.309 — EXTERIOR LATH
NOTICE TO APPLICANT',If,after making Ihia Coltinaam of Caanpllon,you should
Z Iwoome subject is rte Wliker,Corr ar,anom pro liars.,unee Lthor Co le,unnoto - 310 — INTERIOR LATH
O Ofind llwirll mnrply nb11,such provisions or This renua.arae be decmcd rwakrol
Z _ 311 — SCRATCH COAT
FCONSI'RUCTION LHNUI NO AGENCY
> Ihereby add..Oloathemi.aermined mrlemhngagency f..beledsnrran _ce 313 ROOF NAIL
ofine work for which this permit is;awed(sea.3WO.Civ.C.)
y p IendernName 501 FINAL ELECTRICAL ENERGY
z LcndersAddres.
Uw OH dor t 1 evillyII III Ithis c"l I ndoba E tat h f nim .
502 — FINAL PLUMBING ENERGY
1be I ly ,n llly I y rr ' Ice 1' elat g
503 — FINAL MECHANICAL ENERGY
OU obld'rB an ranar rand moby arlro R n pont aliva.rlm„a'ryl lit r ayon
yrw nor•abs.r-rued....edpmwri,f.rin.peeaonp —
arpowFINAL BUILDING ENERGY
CL. (We)agree tenave.indemnify and keep henrless'he Cir,of Cupenmo nonno
Z liabiliticn,judgmerm,costs and estw re,which may in any wvy arc.,against said 50 FINAL ELECTRICAL
r, Z City in con.wigencer of The gmnring of this permit.
APPI 'ANT UERSTANU. WILL COMPLY WITH LL NON-POINT 6-�GAS TEST Date l�
sO 'E I n nn rvs �_U I Issued by:
eum of A"l'a" Conrme, Dare Re-roofs _
zARDouSMATEItIALS)ISCTO URE 508 FINAL MECHANICAL
will Ilieapphcanlo,lirlure M:ldmngna........loall,bnmma lra,atdo:....... nal Type of Roof IS09 — FINAL GRADE
ab def ed by the Cnperlinn Municipal Code.Chapter 9.12,and the Health and Safety ter NA pA�I �T����((�`.
c.da Scotism zss32m)7 •�� 511 Fr'bW' )P A IRraiCr g
❑lies k`Jrl9n All roofs Shall be coed n an lal being installed.
WiBme apprcant or boom wilding occupant tw equipment nr reef...which If a roof is installe5f without Fir;1N(a1fIi"RJ&i .Iipeyppi,lfvGgree to remove
carit hazardous air contaminants as defined by the Bay Area Air Quality Management
runnel, all new materials for inspection. Applicant understands and will comply with
❑Yes Nr' all non-point source regulations.
1 loor mad ore ha-rd... r.aroa1,1 er,ormuncrus order chapter b95 ,1 Ire
callfumia Hreld,&Safcry Clods.Sr,lions 255115,255)3 and 95534.1 undcnlmal rwI
It the hulldiagdawn lull courant,have a mnanr.11ra iI In Iny rc,pon"billly m nosily the
x4i
ntn whim I t be reel pr4.t Ice of a Cenifca a oI
a Z �Q. Signature of Applicant Date
t Him
All roof coverings to be Class "B"or better
OFFICE