01030179 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PIERMI'r NO,
7966 MC CLELLAN RD # 2 PSG FENCING INC 01030179
OWNEWS NAN117: APPLICATION SUB DATE
CAMPBELL ASSOCIATES 1133 N 1.01-H ST 03/29/2001
do ZONE: SANITARY NO. CONTROL NO.
4089953397
w0_O ARCIII I LC`UENGINEER: BUILDING PERMIT INFO
BLDG ELECT I•LUMIi MECH
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LICENSED CUM uncroes Dec1.3RnnoN - Job Description
O �, 1 hereby affirm ohm 1 an,liamed under provision.of Chapter 9(commencing
wish Section TXXB of Div Jnt mnBwin,..and fevvms Coxle,:mA nry licenx
roBf.reeandml 2ND FLOOR BALCONY REPAIRS
m 3¢ i.i,cnse CP Lic.H .�. .
w 3 a m Dam_ =.�= Cmnndnr_ .
ARCIiI'I'IiCI"S ULCLARA'i101'
C vi 0 g 1 old...land Amy'Into.hall be aloof a.,public men&
f
zea:
w O O Lian.,eJ I'mfcssional
uh m I berth}ilium that 11. ,Burin fn,m the Contractor's License Inn fin the
1–Z`- which ire maw n.section 7loI 5,Bushes,andimprove,
vet de o demolish.
C.ne:Any city or icounty
O
which requires iisaapemso to reummue applicant
for such
colic it or repair envmmnue
a.3a. prior t vane q :m ppl t r r'u h a.mm t 11signed.,statement
mann licensed pursuant t m p i nn Contractor's,, on Calk) Sq. FL Floor Area Valuation
or h , g ams m Heal na' ti 3 nn alleged�. dP r:: .canal $3500
ar me he;.31.5 b Ih,,a ,li.und or neer.rnr me cihe ppl np,...o Any v penally J
m1'Smany703un vany.rlidolteraponNn Iuhjccd thenPPlicum n,u ulvil puma((}
.f m,.Im,r,n,an tion nhhmfmd di11a;.(sslal. A PN Number Occupancy Type
❑1..., y roflhepr.peay,o myen,ployo with wages a.heirvdec.mpensomp. 3621.2001.. 00
will do,hework,and the.wmurc is nu,intended or.Bend lite sale(Sec.TtW.
Busmen.and Professions Coca:'ric Contractor'.License Law Jaes not apply no an Required Inspections
.,ownerif property Who builds or improves memo.and who does such work himself
. ugh ensowmemployees.provided mat au,b lmpmvemens eJ �E® 1.01 — FOUNDATION
.Bernd for vote.If.nnwe.er,me building.r improvement is alt1 � e 102 — PIERS
iomplanon.,nc ovale,holder will have the buNen of pruving Ill.,he did not Ing or
mpro a for pm,m,e ir.:de.f, 103 — UFER
01.a.^x,me .fine pr.penw.Inn emlusive,y emnmen,wire w,m.,dM ya.1 D 2001 1.04 — REBAR
L ........I licp J 'I(See 7044 B v uld I f o,C,,,],:) ]h ( ....eters
cv Lou,doc,00l al ply( ri11I nY h^IId. p hemor, —
,id 1 no h I will a B r 10 5 f ANCHOR BOLTS
C orcaLaw.01neempi mdcr Sec BUILDING 1.06 — SEWER & WATER
Ihr.r
unmm Dam 202 — UNDERFLOOR PLUMBING
WORKER S COMPENSATION DECLARAI ION 203 — UNDERFLOOR MECHANICAL
Iblanch,moon under pNruk,ofpe,j.,ormofthe follow in,ciccearmiom 204 — UNDERFLOOR FRAME
Q 1 nave and will In:Jntain ;t Cemhca,of consent to.eh-inure for workers 205 — UNDERFLOOR INSULATION
Cmmpcnovlin, as provided bar by Section 37(p of the I.an^r Code. for the
pe,b,m,an.cormeworkforwnienmi.pnoliti.i..^ed. 301 — ROUGH PLUMBING
❑I h..,a and wiu nmaam;dn W..Im,n c.lnpea.:lrloo In.moanee.:u recoiled ny Swum 302 — TUB & OR SHOWER r
37011 of file LaMu CIna,for on,Ilerfinnan,e of,he work for which hi,p^rlain i.
i...ed.Aly 0.'n��rk�e�-� Com,cma14 L,snrancc carrier and Policy number'ire 303 — ROUGH MECHANICAL
carrier:O 1, t_ £�ei'wi,yNn.:l�i s z_� 304 — ROUGH ELECTRICAL
CEER I'1I' 11 OP ESLMI'I'IONF OM ORKERS'
C0MPENSn1lON INSURANCES 305 — FRAME
(no,scion need of be completed if the Penni,i.for one hundred dollar. 306 — HOI_DOWNS
(steal""".� 307 — INSULATION
I calmly mm,In the pedorman a of,he work to,which his cern;it Is moird,I :508 — SHEET ROCK
shall oil cr^reny any.comm i, any muter so av m baamnc wmjco b,the Worker.' .
C.;npuy,.d^nLawn^ICmin,r,ia.11te 309 — EXTERIOR LATH
A,pbeaml
Nf YrICIE TOAPPLICAN'P 11.Innr making do,Carir"ate of E.c.union.You'umid 310 — INTERIOR LATH
bo"one object on he W..kern Con"osmion provvi^m of[lie Labor Cone,you mus,
huhwilh comply with wch too, or,his permit,hall be deemed m,okcd. 3], 1 — SCRATCH COAT
f"oCONSTRUCTION LENDING AGE313 —
AGENCY 313 x item man mem is n co r,tono on lending agency for mm
e perfommce ROOF NAIL
1 h
of the work for which this permit i,issued(Sec.3097.Ci..col 501 — FINAL ELECTRICAL ENERGY
az. $
Lender's Amnczl 502 — FINAL PLUMBING ENERGY
7 Lender's Name.<
L o Iceraryw"IIlimemad do,;q,pheati.nand slam onnthe Above infurnotti.nIN To03 — FINAL MECHANICAL ENERGY
m".I ogre,to"amply with all u'ny;all c only ordi nuo,c,and Imre law.relating
O U iahoilkiageim.,mea. ad
^, ^ h,mhy anm.,l,u'repm"rnali.,,nf lhisvi;yt."Ineru,nol 504 — FINAL BUILDING ENERGY
the mu,c.ucmuned pm,nny fir Illarmfan pmpnc..
F• a IWO.,meon me.olden.nlfy and keep hamde„theCity No!Cupenmonsdrt 505 — FINAL ELECTRICAL
V] Iiubiline,.judgment.,cows end e.pens.which on,in nny way acme again.w said
U Z
Coy in e.n,eva,na none gmneng of .erten. 5P1 S TEST /
AV PLICER MBAR y,ND AND WILL COMPLY)J' ALL NON-POINT t Issued by: � n1111 Pel Ibno INGDate
s " rep ppB< moeoy„n Date Re-roofs 508 — FINAL MECHANICAL_
HAZARDOUS MAIERIALS DISCLOSURE
Will the a beam or Room holding mcnram%om or handle ha.ardou,material Type of Roof 509 — FINAL GRADE
;IN defined by the Gc,e01110 Munleirm Gale.Charter 9.12.and(he Beret,and Safety
C.J.,,,i oil25532o0! . / 510 — FINAL PLANNING
•�( All roofs shall be ugI.Ncted griyWEnypfpj ngLn:tt �lg installed.
Will nm.ppunm,or fmore holdimg occupant use eyt ir,orm or device.which If a roof is installed without first obtaining an inspection, I agree to remove
• moil haaa,Jou,air,oma ninans uo defined by the Day Ama Air Quality Management
Dim,i"! // all new materials for inspection. Applicant understands and will comply with
❑Yea 4111 all non-point source regulations.
1 have mad the ha.ardnu.mamnils malturvalmor,under Charter 6,95 of the
Calilonnia Ilcaidt&Safety Cone,Sections 25505.25533 and 25534 1 understood that
it the huildingJotsno,nmendy hove a unom.,hmo ismym,,ud,dNlity,o rood ne
ceeupam,"r' of the tic ,num.which mon he me,prior to ixsu:ume of u cenihcnle of
Signature of Applicant Date
—odn� rumen, �l Dal, All roof coverings to be Class `B" or better
OFFICE