01030110 (2)OFFICE
CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
PERMIT NO.
8060 PARK VILLA CL
01030110
WNER'S NAME:
APPLICATION SUB IIATE
ALDEN ALICE J
03/20/2001
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BONE:
SAFE rARY NO. CONTROL NO.
CHIFEC (ENGINEER:
1 UILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSE E)CON 'IRACTOR'SDECLARATION
Job Description
in
1 hereby aRmm mbar 1 um Imemed under pmntion, of Clmpm, 9lcomnencing
t -w
with Section 90001yy�f Dry loftlm Eluninasundy rsr'unr Cndc. orad lnyliccmc
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cC 03 0
C'sa Lic. JI
REPAIR BREEZEWAY AND EXTERIOR
V
Littnw
Ilam Qy)p_ Contractor
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ARCH( �ECI"S DECLAR PION
I undelon nd my plana xhnll K, uwJ ns public rccoMv
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hiecnseI 1'mby canal
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OWNER-BUILDER01..roma, DECLARATION
/
1 heT'cby aflinn that 1 cin exunyn loon me Cunmiaun s License Law for the
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26
whichim mono (Stain, 7o3L5.t. alm,.a and Any city stcounty
O
ms u permit cnmwet. ulcer, improve tlpermit t or repair any structure
which improve. laionnh. in
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requires theapplicantfor wchpermivaicensle aeot,(Clmmem
its re
mhet Min l,in,,Jt Secto lnme,m,viaiki rel the Ce Bu,ime andPrwv,im, Cter9
Beitrmlm;.awencprsu
theleedeasand Pmfonyvi lation
rhe Any
Sq. FL Floor Area
Valuation
1500
basis3of
or,lat that eisewinssea;nn on an
or that he is exempt ri y ap,m and The basis the alleged nncam I . violation
of not on 5 by mtyul9diantt Nr"pcnnir eubjemn me upplicam m u ciril penalty
APN Number
Occupancy Type
of not marc ratan Tee hundred aona,s aslul.
than
01. as owneT of pn,pen,, or my employees %ith wage% a, their sale compensation,
35610032. 00
Required Inspections
will Jo The work, and me nructm'e is no imcaded or olrcrW or tale (Sec. 7144,
Racine , and Profesaon, Calc: The Conuractnrl License Law docs not apply to an
raw 'ner ol'property Who huild, or imps scs Thereon, and who Joos .arch work himn01
101. — FOUNDATION
or enough his awn employeespoMded that sach impmVcmcals an and ;mended or
offercul for sale. If. howeveri the budding or ;mp,owmem ;s sale within one year of
102 — PIERS
mTpl vino, the ownenbuilder will have the burden of proving That he did not build or
improve to, purnoi, of a.m.l.
103 — UFER
01, as awne,of the pmper,omtalonivcly contracting with licensed contractors to
104 — REBAR
he painin (see. 7(44. Bas .nue Profen s Cod,) I tic Conmsmi,
Li,mwer
cense Law do% not apply to an ownerosfpm,crtywhoi,audsorimpmvcsmeman.
105 — ANCHOR BOLTS '
t mjeex;umnaet tuned pre Fd renam to are
ane whoommcts ]or weprc m a
Cnammtac,uanscLaw
106 — SEWER 8 WATER
0 lam exempt under see .B&PClin his reason
202 — UNDERFLOOR PLUMBING
Owner Dar.
WORKER'S COMPENSAnI1N DECLARNI ION
203 — UNDERFLOOR MECHANICAL
I hemby utllnn ander pcnilty in perjury once the fallowing Jealar"tams:
204 — UNDERFLOOR FRAME
0 1 base and xaB otaimain a Cenirtam of Comma to "ll -loom Int worker,
205 — I.INDERFLOOR INSULATION
Cion a,dan, as mo6lvd far by Section 370() of be Labor Col, for he
performance atthe work to, wh➢cnmia,emdlisismal.
301. — ROUGH PLUMBING
01 have and will maintain Worker's Comperartinn lourioneas rcyuimd by Section
302 — TUB R 0R SHOWER
37001 at dc Lahnr Cada, lin on, pctlunnancc of the wank fur which this permir is
issued.nyWorkiCompensationInsurancecarrierandPolicynumberam:
303 — ROUGH MECHANICAL
Carrier: Policy No.:
304 — ROUGH ELECTRICAL
CERTI IICADUN OF EX EM In ION FROM WORKERS'
305 — FRAME
COMPENSATION INSURANCE
(ThNsemanmcmall beconfined ;nhepermaisfor one hundred dollars
306-- HOLDOWNS '
51001or1e1
307 — INSULATION
I ce,afy that in But pef ..mncc of he xauk for which this permit ;s issued. 1
308 — SHEET ROCK
shall not employ any person Ia any mann,, sn as m became s,ibjv,l In me Worker,
Compensttnan1..,.1California. Date
309 — EXTERIOR LATH
Applicant
NOI'ICH OAPPLICANTtILavcnnakingthisCcnilc:dcofEacmption.youshould
310 — INTERIOR LATH
beano c sublet to the Worker's CounNo,oion pro n,iam rel"tire "bill Cask. You Trial'
> G
lanhwia,Boum,ywintinch hmvismmorhu, feran, haBbedeernedrevoked.
311 — SCRATCH COAT
CONS1 RUCTION LENDING AGENCY
31,3 — ROOF NAIL
i
1 herby allirm that there is a construction lending agency for the performance
nI be uvkfor xaid, hisnvnionisi.wed(see.11C.Civ.C..)
501 — FINAL ELECTRICAL ENERGY
❑
I.cndcr's Nano
Leads, Address
502 — FINAL PLUMBING ENERGY
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1vernOuletlhave had Bit, application and (am that henaive ;oloo.mill Iis
503 — FINAL MECHANICAL ENERGY
Y trra
v
Eva. I agree a, aon.ply with all city and room, ordinance, .,,it mate laws relating
to building construction. and hereby aamar;aerepresentatives ofIli, ,,, in enter upon
504 — FINAL BUILDING ENERGY
y
the "bove,non old properly b,r loollenom pu,po.v,
(Wc)agreeosace;nevi;myand lcepnanmess,heChyofCopertino.gain^t
505 — FINAL ELECTRICAL
'b
�z
hanll'Nes, jud,ou n.. conn and cepen,c, whmhT,my in any way alms TTguinst laid
City inemmseyaence.1theimdingnfmnpermit.
506,— GAS TEST �{
APP( ANT UNUERSTAND5AND /LW Vj/B�.�LCOMPLY WI 111
501'1 Issued by: — CTNA1 f1111M-ArNG Date /
Re -roofs 508 — FINAL MECHANICALHA.
,1 aT Date
REXllIS MAI L'fCIAIS DISCLOSURE
Will the applleanor fame building txmummumrc or handle na.anwusnunetial
Type of Roof 509 - FINAL GRADE
Tx defrod by the Cupenino Municipal Cole. Chapter 9.13, and the Health and Safety
CWe
510 — FINAL PLANNING
Se, ian 25532(.)7
Oyer 0 A
All roofs shall bed#t Wcted Rrjqj4l_anP in fpuaWdolla§ng installed.
Will he apprcard Boom build;allotcupaat use eqn;para or devices which
If a roof is installed without first obtaining an Inspection, 1 agree to remove
.it hva,ious it comminution, as defined by in, Bay Are. Ali Quality MunugemmlT
rani"?
all new materials for inspection. Applicant understands and will comply with
0i'e, 0N"
all non -point source regulations.
1 have read the ha/:niO.S materials requirements under Chapter 6.95 01 the'
Culilirz mHculOh&gamer,C'nJc. Scninns 25545, 355,1)uuJ 25514. undcr,o (that
it the limldng does not cuncnTly have a tenant that it i, my responsibility to nail, the
w Pam of me miloremans which must he met prior to issuance of a C'enilicam al
I oapancy.
Signature of Applicant Date
All roof coverings to be Class `•B" or better
nhla, undaunted agent Dam
OFFICE