03020108 (4) CITY OF CUPERTINO
'.BUILDING DIVISION PERMIT z s�o?s,:?9w .,�, `•tr.MO�s>if;E mh$asl. i!0ro " 0frhb
BUILDINGADDRESS: KALLIO
CONSTRUCTION PERMITNO,
10311 PALO VISTA RD 03020108
OWNER'S NAME: 1492 WALBROOK DR PERMIT ISSUE DATE
ARMSTRONG MURTAGH 02/26/2003
PHONE: —9 7 7 7 - SANITARY NO. CONTROL NO.
ITECT/ENGINEER: BURRING PERMIT INFO
BLDG ELECT PLUMB MICH
0
�oo LICENSED CONTRACTOR'S usulcvishms DECLARATION Job Description
I hereby affirm that 1 w licenced u�n�d�e�r vbiOm of Chapter 9(commencing P
with Secdon 701111 fDiWalon Sof the ppProfe Inns Code,and mylicevoh
yt�gp mi Cmulneudacmraund cmLy puna ahalllMCuLvkA gu "i"Ilermcfo�rd-a -7 yr f d � /�/� / IN
NET/WINDOW)
z mfanBATHRM REMO TI !a
Date
ffi
APR
3 LL Licensed Professional �2 2003
5y OWNER-BUILDER DECLARATION
0 0 1 Malo.Ilium that 1 1. .exemptBusim from the Conlnnofa Licence Law for the ��'�®��
0 o following noon.Permit
t ](1315.Business and are,de tau Cade:Any city m county `G
$ which Its issa a permit re construct,et.alar,Improve,demerits rie a signed
awcmn
FSS° pilar W its issuance.p also requires the appli s ut offmach per ar's Uc c rcu Law Chapatistatement
O (Commenche Is ing ad pSectio7000)of Division
of cribs Bvactofa Limn¢law(Chapur9 Sq.Ft.Floor Area 'on
Ila
(Commencing exe pthomfoun and the
Diviaionl cribs Anynvi Cade)of
Nn ha h exempt thertlrom and Ne buts for the alleged eamp0an.Any violNon of
Section 7031.5 by any applicant for a pumit Subjects Ne applicant to a civil penalty of
not mom Nan Bm hundred doll.SS300). r Occupancy Type
❑I,u 0wnu of Ne pmpeny,m my employens with wren a aleuaine compeeminn.
will doihawad.,and Ne IM COR ta IMPS nded prone do(mss apply 70an Budneu
Ndenywhana Code:TIM Cedamon, nd who IJWuchnot applylfrtoWmf iof
s 102 - PIERS equlred Inspections
propenywyees,pdaaded thamach Imprve who da uauchwmkhlmalforNmueh his . . . ..
own emplayeca,pravidnd Nat such improvements au not lnundW oroRemd(orssk.IL 103 — UFER
However,the building or Improvement Is sold within one year of completion.The owner- 104 — REBAR
bulldu will have the burden of proving that be did not build or Improv for purpose of
ASIA.). 105 — ANCHOR BOLTS
❑I,as owner of the property,am exclusively contracting with licensed mnuamn to 106 — SEWER & WATER
construct the pmjein(Sec.7044,Business and Professions Cade:)The Conmemr's U.
cmda,Law does not apply in an Owner of property who builds or improves Mccroon,and, 202 — UNDERFLOOR PLUMBING
who cantncufor such projects with a COnmalO*)licensed pursuant lithe Contrcloes
Lkenm Law. 203 - UNDERFLOOR MECHANICAL
❑I am exempt underSee. ,B&PCforthuman 204 — UNDERFLOOR FRAME
Owner Dau 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSWnONDECLARATION. 301 — ROUGH PLUMBING
I hereby a Man under penalty of perjury Ons of the following decimations: 302 — TUB & OR SHOWER
sat and vvdedfrnby 8egoonn 3700 Arcanum our Codeaia Me`performancere of the 303 — ROUGH MECHANICAL
rwnIOIt this permit is Issued. 304 - ROUGH ELECTRICAL
I Mare and will maintain Wmkces Compensation Insurance,u required by Section 3 0 5 - FRAME
3700o(the LaborCWe,fortherevermnceafdmworkfor men this permit ta Issued. 305 — HOEDOWNS
My Work Ys Compensation insurance caller and P ,,box.
Q 7ATEPolicyN - � 6147- 0 307 - INSULATION
COMPENSATION INSURANCE
308 - SHEETROCK
(Thu action need mtbecompleuni lfthe permit lsfomne hmrdrWtlnilars($100) 309 — EXTERIOR LATH
Orman.) 310 — INTERIOR LATH
I cenify that In the performance of the work for which this Permit is Issued.I Shall nnt 311 — SCRATCH COAT
employ any parson in any manner an u u become Subject To the Workma'Compensation 313 — ROOF NAIL
LAWS of California.Dam
Applicant
NGT(^_E TO APPLICANT.It.aRor making this Certificate of Exemption,you Should 501 - FINAL ELECTRICAL ENERGY
become subject Or the Worker's Compensation provisions of the labor Cods,you must 502 - FINAL PLUMBING ENERGY
OZ o ronnwltn Comply with Han proNakns or that permit anon m d emcd resulted. 503 - FINAL MECHANICAL ENERGY
CONSTRUCTION LENDING AGENCY
p•,�•. 41hechyamrm that then hac0nsumttion lending agency forme performance of 504 — FINAL BUILDING ENERGY
eG� the work for Which that permit 11 Issued(Sec.3097,Civ.C.)
Lender's Name 505 — FINAL ELECTRICAL
W Q
az Under'aAddress 506 - GAS TEST
v o I certify that 1 have read this application and mut that me ahem informadua ts 507 - FINAL PLUMBING '
Correct.I agree to comply with all city and county ordinances and amu laws Mining to
rU^
building construction.and hereby AUMMIM MPMACMmIM Or this City to Coal Upon Um %8 - FINAL MECHANICAL
ab.-OnarTioned property for inspection purposeF I RADE(We)agree to Sam,indemnify and keep harmless the City of Cupertino against _ /pry Iiebilid"Judgmcnu,C09M and expeses which may In any way acme All mid City I NGr`�/,/f/v/�inconsequence of the graining of this perealt.APPLI ANT UNDERSTANDS AND WILL COMPLY WITH A ON- INT Issued by: C WORKSDate
SXU IIA PULATIO n
( ^� .s.--,—�—�� Re-roofs
nslun of ApplkanVConlncur WAS
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
Will the applicant or future building=upset atom or handle hanrdou material
as dented by the Cupenino Municipal Code.Chapter 9.11.and the Health and Safety
code. [3Y.25532(a)? y C o All roofs shall be inspected prior to any roofing material being installed.
[3 Y. [1 N
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
colt havardous air contaminants As dcfincd by me Bay Ana Air Quality Management all new materials for inspection.
17
❑Yea
I hem mW the hux4n,121 maudau requirements under Chaptar 6.95ofthe Califor-
mlaHcalth&Safety Cade,So" 25505,75533 en 125534.Iuntkrs thatl(thb building
d n0y hem a unan4 Net It h my rosponsihility u retr Occup t Or the
yui m wtich mgey��met p�'or�i�vuenm ofa Cenincau of Oce ,
_It I��-11.5(=�..� Z— l� � Signature of Applicant ,W Date
Avner car aulhorimdagent pats T All roof coverings [o be Class rrB��or better
�An�� KIft Cmetniction
:. _. 1492 Walbrook Ddve
�" San Jose, CA 95129
(408) 873-9777
,F B HIC 554785
ScoPc of WO ZV, p
cv-
262003
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�Uit.�lt>;IND.tt3 ;nit _co I�ratra�s - .
.`rJVST7ke.L �5ePf})ZAT-6 GA<-U`r. PM
o q� $JAVED GUvhTbz. OUTTLE r
JP� This set of.,p{an d speciflsatior�& ItJ�
bg,kept on the' b-at all timosnng ltds kin
aV YkAHfINPi l � I •�� � ��.'� �/Y� •v
on same withoutt(+ritten permission from
��e h.hlAln c,r) of Cupertino.
T ho
the startiping ei ttiis pion and spacifioatiors
SHALL NOT oe hold to permit or to be am
%pprovel of the violation of any provlsloW
.s
'xf Ah* City ofdlnanoe or State Law.
r
r' GENERAL ENGINEERING CONTRACTORS
O
CALIFORNIA
VALENTINE
CONSTRUCTION REPORT Date: / bL3
Project:A 2,S I-40 ,H Project No. 2-16V
Contractor: V%'l(Z,uTINE (� ek)aA-7W Superintendent: STEvc'
,a
Site Address:
- -
12�3
()Ms/ _
o.C 58 m
Exp.G OJ
J'J91 CIVIL Q�\p
• F OF CAS\FO
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VALENTINE,CORPORATION
11 PELICAN WAY•SAN RAFAEL, CA 94901 •P.O. BOX 9337•SAN RAFAEL,CA n4912•(415)453-3732•FAX(415)457-5820
1
. , PERNA JACK Valentine Corporation
111 Pelican Way
' nb 11 & Name
O N u r-tet-c- San Rafael , CA 94901
Vll
(415) 453-3732
lob Address -`-,Y
(j
- �— Date Completed
3.x,5
11 dra lic Gau a Read s in P . S . I .
I'iec Depth Pier 1 Pi
2 Pier 3 Pier 4 Pier 5 Pier 6 Piet 7 Pier I Pier 9 Piet`=Jlo
in Peet
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69 F CAU
72
Actual
Penetration ZS" /� �� �� �D 17
i.n Feet (�
Pipe Length /)
used in
vj C/ 3 2 1
Feet ll 1 (
Foreman ✓e :�1