01010038 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
B U I LDING ADDRESS! PERMIT NO,
7550 NEWCASTLE DR 01010038
OWNER'S NAME: APPIACAI'[ON SUB DXIH
PARK HEE Y 01/09/2001
• PHONE: SANITARY NO. CONTROL NO.
❑zz ARCIII I EC'TIENGINEr;R: BUILDING PERMIT INFO
woo C BTDCi ELECT Ili.IJMMFIliCll
W IJ I_I ftiI{� I
LICHNSED CONTRACTOR'S DECLARATION Job Description
O I hcmlhfihy al Iha 1 Intl IirenncA nndl p of lime I Clmplcr 9(commencing
with Sermon 710X)of Division3 olme Bminess and Profcs,ions Gtcrndnty licence
y5J
in full mrecind erred. WATERHEATER
z w 6 Liccn,c Class hies a
n O Daae Contractor
aj 3 u. AREni r iLT's OECI.ARAIION
Ca ; I undcrdmal my plans.,hall be o,ell un public records
d>
d S o o Ilanned rromndomd
OWNER-BUII.DER DECLARATION
so 1 hereby aRm,mat I am csnnp.fair.Ire Caram,un s License Law fm the
loll acing reason.(Section 71315.Ba.inahs and Ptotcs,ion,Gmw Any city oreoanty
F 2 0 which requires u permit m amclmcl,tiller.impmvc,demolkh.or repair any aloicaue '
i 3� pno t a s I. yu th ppb tf hpc a fl s d:neacm
matt 1 : Ip art lo the toweion, ,nhec meson's I 1 (cmlpw,9 Sq. Ft. Floor Area Valuation
(commencing.oda section 1001)of D'va n 13 f he Bu.i.c,a u d l f sol .Colic) $1
or that he in eIempt,hercfrom and the basis(or the alleged csemptinn.Any violation /
of Section 703 1 5 by any applicant lot a premia Ithjhnx me:applic.aal In a civil penalty
ar m,t ti„re mea r.e hundred doua:(55an. A PN Number Occupancy Type
Z „nhemnpit,.... myeo,loyce will,walalc'a-1..m...lo,ati„n 36617017. 00
will do the work.and the shuaure is not intended or offered lin.sale(Sec.7194.
Business and Pooles,ion,G.le:The Connector's Ticeme Law does not apply to an Required Inspections
owner of property Who build.or improve,mean,.ass who does Inch work hineelr 106 — SEWER & WATER -
tit through his own cn,ployee.s.provided thus such improvements an,not intended or
..Bared lot till,.Ir,m,wa.c,,in,building or improvement is sold withi„one year of 202 — UNDERFLOOR PLUMBING
completion,the owncnhuitcr will have the harden of proving lied he did not build m
;mpnq orpum orale.). 301 _ ROUGH PLUMBING
a, netonheproperty.amexclusivelycontractingwithlicen,edea:,oneIis1 302 TUB R OR SHOWER
Ye
wet dhc rojec,(Sec.7(94.Baines and Pmrc,sion,Cods:)The comraemr's
Uctmoe Law does an apply to an owmer if proirdy who band,in improve,mu¢mn 502 — FINAL PLUMBING ENERGY
and who comrmts Por such project,with a contact(s)licensed pursuant to the .,
Sam ll c a1 sv 506 — GAS TEST
❑lam enean •s6a. B&rC ln,ho—...
Gwne me / )'/O / 507 — FINAL RLUMBING
-WORKER'S COM or SNyin, lCLliallo ION ,
I henry affum under penalty of perjnry one of Lhe lidlowing did amtinns:
❑ I coo tilt will n,orided I,Ceai bean of Consent m s Tabor for Worker's
ComalmorC n, is alk in,, hr by Scainn s i... of Lhe haMr Gtc, for the
perfornunee of the work for which this permit i.ismeJ. ,
O 1 h.oc and will main:ion W..fit's Compensation Insneaco,as loaded by Section
37W at the IaMn Coe,for the rerfonnrnce of the wink for which this permit Is /O/
i...ed.My Werkir,Compsn
en,mlon Inrence carrier and Policy number are:
Cartier; Fall,No.:
CERTIPICAI'RIN OI;EXF,hf PITON FROM WORKERS'
COMPENSA'I ION INSURANCE
(Thhaanian need nm he Complcled if the permit is for one hnndmd dollars
($dd)nr less,) -
I ccAfy that In the Wrrnnn:mce of the work for which mi,permit i.issued.I
shall not employ any,.,nice in any manner In an to ,c nim subject in the WarkeN
Cominnsvion Lbws of California.Use ”
Applicant
NOTICETO APPIACAN'1':Lt.Muer making Ilii.Cerilic:re of 17aanpdon,you should
Manna subject o the W'orker's Cnngxn,mlon provisions of the IaWr Code,you must
C) tonlawice comply whuhmchp....monsar l his permit still IMlocated revoked.
Fr_Zi CONSTRUCT ION LENDING AGENCY
> I hcrehy allinu mall I nac as a conwvction leading agency fill the penoahhaam
W of the nark for which this permit is issued(Sce.XN7,Civ.C.)
G A Lender'.,Name,
Z Iwnder'v Address
V 1 ceniry that I have rend this application and state that the chase information is
comm.I agree to nnah,wish ill Illy mrd county ordinances ant same laws trialing
C U to Moldings construction,and hereby authmis,representative of this itym enter claimma:multi.......onai,..open,for itwpeaion pur,sorl.
F' y (We)agrcnnsivc,indomnily and keep hamdcssme city of Catarina,.,alna
(Z) liahilities,judgmems,crisis and expenses which may in any w-ry aaore.,am,.said
U z 42%;
.. ding ai mix,.,Bold.
^ SAND Issafdb \ Dates. y'n hRe-roofs
.P.HUOIIs oldmg(1AIS Uder,or URE
Will the tram n,nature i,a)co he.Clar dare or ranine ha.mdnraa alcrSale,, Type of Roof
as detmd by the 32o)?no Munich,al code.Chapmr 9.12.unJ the Heahh and Salcey
Colic.Section 255121.)!
wee ElNo All roofs shall be inspected prior to any roofing material being installed..
Will the applicant or more,budding ovcop,Tm use equipment or deices which If a roof is installed without first obtaining an inspection, 1 agree to remove
emit hmardnus air conatal nvms a,defined by the Buy Area Air Qualhy Marag can
Di,„ril.9 all new materials for inspection. Applicant understands and will comply with
Cl y- nNo all non-point source regulations.
I have read the hazardous materials requiremcros under Chapter 6.95 of the
Cale Broin I Ia;Am a Safety Cdc,Scutlon,25505,25531;md 2551;1 understand ttnn
ifthe building does not currently baro a Learnt,that it is my res ,mihilidy in notify ahs
ace P f 0•amantart,which mus,be aha prior to...mine off a Cenificate or
Signature of Applicant Date
goal T” naoa All roof coverings to be Class"B"or better
OFFICE