00080049 (2)CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDIaiSS:
PEIIMIT NO.
Soo q
0o a
OWNER'S NAMI;:
ALLIED AIRE SERVICE I14eidcA@04@60049
10643 N PORTAL AV
PHONE:
R 661 SINCLRIR FRONTRG
ANRE)L"./07/'.:P."o.
TRESSEL RONALD W AhID NANC
ARCI4I IGCVENGINEER:(409)934-8844
BUILDING ITRMII INFO
I{I.DG FLEET PLUMB MF.CH
I.I CENSI?IIamC( INTRAC'IOk' S DECLAIIA'IION
,lob Description -
I M1ereM1Y vlfil'm that 1 IledrscJ under pnrvisinn. nl Cldpter J (emntnenemg
,
with nnJnfthe Bminc,s and PmlamiOna Cak JryyYa'enx
faith haveandefect.
is in full force and effect. / S
Limine C}y�l`.� 0 —/ Lic. p
D't` �(-3t�'a-1 It
I.ANAr1. —
100000 RTU, ADD A/C 4 TON
AkClmscr%'iiil
FURNACE C/O
I undersand my It., shall W u>ul es public record.
Liccm¢a Pofcomml
OWNER-BUILDEk DECLARAI'[ON
I hurohy ullln l'but I m, l,amnpt font the Conwclor'e Licemu Law for the
following reason. section 91131 5, B.,irI and Profuk>ions Code: Any city or county
.
which rc tore, v Penni. m am. ader..1tc, intpmve, demolish or repair any structure
prior In its iauance, also requires the applicant for such permit to file a signed aatcment
mal he i,BeenyeI oustnd the prn..:on..mftire Contractor, I-ieeawI.aw(Charter 9
Sq. Ft. Floor Area
Valuation .
(c arrendug wilt Satiou 7(00t of Division 3 of the Bovines and Pml ..I I, Calc)
nr that he is exempt thercfmnt and the basis Iia the alleged a.doptinn. Are violation
of Section 7031.5 by any applicant for a permit subjects the applicant to a civil pit
APN Number
Occup®t@ETkype
of not more than rive hundred dollars
.
01, its owirer orth properly. or trY ply m 6: 'Ihear 1 pc :.inn.
will do In. k and and t n kneaded I,, olle.,al I
Btaine,, adlrfe: Cr nic c t Liesew I does nal aDd,I.an
3 1633054.0&quiredInspections
owner ofproperty Who horrorsthered h J work 7111l
or through his c pme'p den that such impl reran Included or
offered f1 If however. the building tor almovTorialt is. IJ within aric yearof
rp Posting'[lotIl mbuild 111
t t1lt a coir-n m 'in a&: .dt n .mn
304 — UNDERFLOOR FRAME y
nnprme for pumo,e of sale.)'
01. as owmer of the n am rte
property. Yld
m r, Codenwhe
301 — ROUGH PLUMBING /
ROUGH MECHANICAL
Profe C-socmn
mood me project (see. mush Busmen, rota rmre.,�mn code:) The camtmemr'e
Liaow Law due% and apply in an owner of property whn nuilkk or mtprovcs thcrcon.
Imo who <nmrmas fm .atilt lanjwts wilt :I ommactor(s) rcen>ed allema m dtc
303 — O
304 — ROUGH ELECTRICAL
O
01 am esem i under Sec. . B fl P C fur this reaam
01 a,nr>IimrudelSec
505 — FINAL ELECTRICAL
Date
507 — FINAL_ PLUMBING
Owner
woklcEk's alMrld"sArulN Decl.nknl'1°N
508 — FINAL MECHANICAL
Inerenr antro ander patchy nrrjury ane anne nalnwmg aed.mtinm,:
514 — FINAL PUBLIC WORKS
0 1 love sad will trunnion n Cenircate of Comm at self-in.me for Worker'.
Cntnpcnsatlnn, as provtdnl fur by Scetlo1 3700 mf the Labor Calc, for the
perfimnancent the work Iter which ml, pcnnit is I,,.ad.
01 Idol, and will maintain Worker's Compensation Insurance, as required by Section
3710 of the laWr Code, for the performance of the work for which this permit is
konal M I(Nj� it 's C I Itiun lny./Y/t° a .. .-11 oold polilcy amadnn�er arc:
a" (t -JI--
,
Currier:'-/n allay No,: �
'
CER I'09CATION oP EXEMIll ON FROM WORKERS'
CER
COMPENSATION INSURANCE
ffhis section need nm Is nvnplcled It nd permil is fur ore hundred out lad
IS lull) or less..) I
'
1 certify that in the performance of the wars for which this permil is i.med. l
shall not employ any person in any manner x as to became .subject to the Workers'
Ca a,dr,a i.n Lowe of Culilmd"t Date
Applicant '
NO[ ICE FO API'LICANT: lfi atIrF making thio Ccnificate of Exemption, You should
become object to the Workers Compensation provisions of the Labor Care, you must
forthwith comply with such provision or this permit shall be deemed revoked.
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CONS 'I'kIJCI'ION LHN DI NO AGENCY
I hereby ulBnn mutihcir is a eonnmednn lending agency for the p,dintrence
of the work for which this pcnnit i, issued (see. NAD, C)v. C.)
lender's Name
I<ndd, Address
1 Entity Clue 1 have ud 6+1. opplieatian I I "old that the ab"', Infimmuion ie
cored. 1 agate In cntoplr with all city and county ordinatees and stale laws mlating
l to building conswction, and hereby malboare rpresentutives of his city,, eater upon
the above-mentioned property for inspection purpose..
(We) agree Io... v, indenmifr and keep harmless the City of Cupanlno against
1 Iiuhilhics,,ral,a end, coca ;,all oxpcnsea whlen may In any way awme ngam" said
City in eonscyucncc the grunting of mi.Iurmil.
' APPLICAyy�{'U ER ANDSAN WILL COMPLY WITH ALL N�f`���OOOIy�
OURQjy4(Gt LATI S. r y/
ISSUCd by: Date
Re-roofs
stool nrnml< trcomraaar 222 Dat'
IIAZAk DOUS MAIIIIIIALS DISCLOSURE
Will the uppliam or future Wilding&cculdm smrcnr handle hamnlou,material
'
Type of Roof
It, defined by he Caperton Municipal Cale. Chapter 9.12. and he Health .ad Safety
Cade, Section 23532(u)9
O Ye, 7<�
All roofs shall be inspected prior to any roofing material being installed.
Wdlthc applicant or into. Wadingnccapanl use cynry+memor dcviec, which
if a roof is installed without first obtaining an inspection, 1 agree to remove
•mit haenrdmm air aonai niname, as &-fined by the Buy Arco Air Quality Management
District.VS'/
all new materials for inspection. Applicant understands and will comply with
'
rl Yes
all non-point source regulations.
I have lead the ra,mdous ndreriul...... re 1, under Chapur 6.95 of III,
Calimmiu Health R Safety Code. Sections 25505, 25533 and 255311 madersmnd that
rhe
if the Wilding does not currently broad tenant, that it is my responsibility at
occupant ofJinti rc ltnormenu which must W met prior to i.eoance of v C5}�fic c or
,cul+aa{c�y/'
7%
Signature of Applicant Date
All roof coverings to be Class `B++ or better
.
owns uouthunted l,at bate
OFFICE