01090031 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
7583 PEACH BLOSSOM DR COLD CRAFT INC 01090031
OWNER'S NAME: APPLICATION SUB DATE
MORRIS JOHN R AND CAROL J 1660 DELL AVE 09/07/2001
61 PHONE: (408) 374-7292 SANITARY NO. CONTROL NO.
Goes ARCHUECTIF.NGINEER: BUa.DWG PERMIT INFO
Fi 0 O BLDG ELECT PLUMB MECH
"I—
u
w i LICENSED CONTRACTOR'S DECLARATION Job Description
lhmebyaffirmllorI licensed underproritiunsofChagcr9(commencing FURNACE CHANGEOUT.
'mt-w wish Sermon 7!X101 of Ditision Jofthc Business and Rofections Cade,and my littnsa
is in full force In R
oLOLi<inw Claw
Date Commctor d //G
ARCHITECT'S DECLA
ile u�O g undc stand at,plans shall W used as public mcortls
T
i u p Licensed Professional
OWNER-BUILDER DECLARATION
I herrhy uRrm that 1 am e.empt from tae Commaor's License Law IDI the
t K< fennwlag R,oa.serian 7071.5.Business and probe....or Code.A.Y city or county $2344
2 x O which requlm.a permit to construct,alter,improve,demolish,or repair any swmure
nam pdarto, o
ance,ab "o tin pplwant lmmchpamdmfikgrw
a.idwaa.nt.
that hd iA licensed puau Wt to th' p�visions of the Contractors License Low(Chapter i) u. r. a Valuation
as g m secyon 7o0an the
base n or t me lanae ierainimi.Any vi coam ;w't o'+•.'I �3.65�1 1 r6,
or tam he is excdihpt Mcrtrmm'tintl the oasis for the alldged eaempunn.Any violation
of Ser0715 mon 7by say applicant fm arodt pasubjects the applicant to a civil penalty
:ofnotmomthanfivehundreddnsarsls5run. 301APN]{ PLUMBIN - ..::" Occupancy Type
❑Los owner of the propmY•or my cnhployccr with w. us Neinule cumpchmtiun, — ROT GH MHCHAN it _will do work:and the structure is not intended or offered for salt"(Sea 7011; - 3 O4 — ROUGH EIH,�¢41Rdk1 act10R$"'
'Business and Professions Cada The Contractor's License Law does not apply to on
,wia,of pmpeny Who builds or Orinoco.tnerean,out who mer arwh won himself 505 - FINAL ELECTRICAL
or through his own employees,provided that such improvements arc not intended or ____
offered for rale.IL lor.'er,the Wildin or int t is sold within ossa f ... - _ - . . -._
g prove men r=mo 507 - FINAL PLUMBING t` ' ' '.rn `` -'D
�omp ve Tic the owned s ildm will has the WNen of proving tots k did not Wild m
mmoverorpom,hunrwla). 508 - FINAL MECHANICAL
-- --- --- --"-- - - - - 0 a -. .- ._.. -... _... - ....._
_U I..- of,ec propertyran exclusively contracting wit hoar:)Thconmmtntsm f. .d. . r.
c License
the project(Sec.70I4,owner
mrd Profusions Cade:)The improves
thereon, p Ll2': r!d
- - mmL.1 Law does not apply to an,wow with
property who Wilds se improves thereon,
` _and.who e,Liaas for such Projects with n contmmotls7 licensed pursuam.to the _ -_. __. ... __ ._..- _. _. - . _C_..-._ I _ _ - _ ....._..._._...___.... _._.
contractors Li«me law. if'A p',p L E
❑1 am enemin under Sea - 0&P C fonhis reason 1'• vy ora
13
"A WORKER'S COMPENSATION DECLARATION OCT L 0 9 '100'I
l' 1 hareby vffimh under n
penay of perjury ane of the following declaratimrs: la 1
O 1 have and will rainatin a Crmficote of Consent to self-imum for Worker's
Compensation, as provided for by Section 1700 of the LaWr Code. for the BUILDING
- perfarmim. fthe work for whicn,his permit is iuued.
°I huJa`und will maintsin Wmke"itCudpenautioo Iniurdnce,as o1ciret by Section
77W of the LOW,Cade for tW performance Of the which his kir is
—s ed Myy/W net C pc t Iusumtw w' e, ryO..
_ Cam I No..
-.r
4< CERTIFICATIOMPN OryF TIhIN INSURPr10N FROANCEWORK
CO ) AO _ -._ _ .v--- ..
1 (Thos ttion ctneed nm he1E
s ntplcad R thn e lessoafar one hundred dollars _- ill''CI ) t )i'
15100)nslms.l
„!,7I, n ry int- m f=R an nW mi,r r men th pe'rth, ..
trained, b' . ? 'n l
,,^2<;,'+I,
Cool n,e pl y any pero it,mann to become wbj<m m the Worseit I
Cooripchriu.n Laws of Ciflificimi,;Dote. -
Applicant
NOTICEIOAPPLICANT Ir'h ukitgth.C nificme ofE a.M n yooshould
bee6imsubj&ttothiWanerC6mpenesisonpr6iongafthclSMCode.ydumw'
Q O forth 'th' ' ply wits: h P t or th ps shall W J«mad revoked
'CONSTRUCTION LENDING AGENCY -
`�' I ba diY Rrm that thsaructiod lending spcncy for the pert idea
'W of the ork f hch Ihi4 pe w
', .uned(Se 7097 Civ C)
�
" Lc Jer's Address - ,
U 0 rte t,lI agree t comply rod ml city and io county
Sts ntrut,hand state laws
fa.cF correct l,vgree,o comply with all city and county ordinances end Seca laws relining
abovegcmmruaion;vnd lddrebyaWhuorrpO resamativas of Inds ciry,o enter upon
he b d s pony f spat P haus
F y es" Option C indemnify ser keep has l rhoCty ofC puts'iagomt
TA cit 1 f ) got d e pontes hch y n any ay a..'
!�w said
U'.Z City n DEof RST ggrmamal,otWi p=+ma '
rAPPLICA UNDERSTANUSA WILL COMPLY�'ITHALCN ONr' Issued by: Date
SOU U A O �d yQ'
S t Apphcantrc n, ao I' Dna- Re-roofs
'- d HAZARDOUS MATERIALS DI URE "
.,, Wll theippinfil fur Wldng ott pant ie .handle haraNw t o, -TypeOf Roof
mdef db theC pen tin MyttCP^I Code Chaq 9 3 ehN the H<oth md5 fry. ` .. „A, - �•... .t
Cod 5°Y n 255J2'v) s u ��
r
All roofs shall be inspected.priorto any roofing.materia] being installed. .
esu the applicants duration Wilding accpeau cgmpmentormvh«swhich' If a roof is installed'witliout first obtaining an inspectiorid, I'agree'to'remove
,.it havNouret cmumonant. tdfned Ey to Bay Are.Air Qiil,y ASenagement
Distrito all new materials for inspection. Applicant understands and will comply with _
all non-point source regulations. p;
I h...read the huvNour mmaial eats"t a W utidcr Chaptu .95 of the
Cal fa Health&Safety Code Se,ons 5505 25573 nd 25530 1 un rs.al that _
fth boIJ gd notemtl have arc tthat it is myrcpon.'Iilt t ti the -'
iccup m X,h, a, it t. h arot,lrt,n et
Signature of Applicant _ Date
n ed es t r, nate . All roof coverings to be Class "B"or better
OFFICE.-