02050052 (2) CITYBUILDING DPERTON PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO,
7893 ROBINDELL WY BB CONSTRUCTION 02050052
T5� 'flUGO E AND E-PING S 3535 ROSS AVE . STE 105B APPLICATION
05FW 2002
EARCH=ffiNGINEER:
SANITARY NO, CONTROL NO.
p (408) 266-6266
O O < BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
f° LICENSED CONTRACTOR'S DECLARATION
0 !2 E Job Dg cri IT.O El O 1 h by farm that l am liven unser..torr,provisions of Ch.pmr 9(commencing LIVING SPACE 2 9 31) S U.pion
/
<yf� with Smion]o9o)of Division eB cs and Pm(essio C e,end Hot.
iamrmlrp�gno<"C's ��� GARAGE 452 SQ. FT.
rc npaU Lic seCAs
a". mr
aLL� R x1 RA o 8/
oo
1 uneersmn n Pla h c pub' N..
to-O O Licensed Pmressi
S o ER LOER DECLARATION O�
v 1 he affirm that 1 a .amps from tn<Contractor's License Low for the
Fad following reason(Section 703). ,Business ane Professions Code:Any city orcounsy
-,F S€O wh ch req rcs a perm t ro c mon alttt mpmve,dcmoluh,or repair any swcmrt
3$ pct s ui nenaiurtg theaslonsof Contermitm==Uw(Chapt
thai he is l'nnacl pun olio Ue pmvrsfons of Ne CinBusinsanruelnw lChopttt9 r,1.,s S Eta F100r Area , ii1 Valuation
(comm cn6 thSecs{..7000)ofDvision3ofsheBusmesganaPrpfmvomCode? s rf. E'yJyy�9,' nig a!11's4Is,. 5`sE1(:1`s ' '
or that he ig exempt thercf7om and the bass for the alleged exemption Any violation 6 21 9 O 4 . O O
-of Section7031 5 by any applicant for a permit subjects the..plica...to o nvtl revelry' Occupancy Type
of no marc than five hundred dollars(5500). APN Number :�:ar..,n
❑Lasrofthe property,or mwags y employees with was as their sole compensation, 101 - FOUNDATION
-wl11 au the�wnrk.-end the structure is a..,intendedornfrenal far W.(Sec-]044- 102 - PIERS Required Inspections
Business And'Professions Code:The Conwcmr's License Law does not apply is an -
owner of property Who builds or improves Merton.and who does such work himself 103 - UFER
or through his awn employeea.provided that such improvements art not intended n
-otteied for nlE If.Rdwevtt,tfie building or o v improvement is sold within on-car of --
. . g mpmv t a
comp(. Neo herb Ie..willh eih buJn (progNth did sbulla or
improvemrp ryo.e..rsale.). 105 - ANCHOR BOLTS 1
_ _ -
106------SEWER.._&..WATER --.
O 1,m rwvntt nl ihnpml any,am exclusively contractingw ih licensed m . 1,:.!Irconstruct ^
,t.
construct the project(Sec.]040,Business and Profession,Coda:)The C.mant r'a 2 O 2 - UNDERFLOOR PLUMBING
±; License raw does not apply to owner of property who builds or improves Nercon,
and who contracts tor_=a.n.pmjnrs.whna can a mrt=LRnn d.parswna. .N --- --- _. _..2 03-.__..UNDERFLOOR-MECHANICAL:-.-----..
C.n.c,.,'A License Lew. .
❑I am excm :.:,,.t'.i,.1 L'1 i- 204 - UNDERFLOOR%,FRAME;or
p under Sec:',' `;B'6:P C for this reason
='?
1
wn2t oau, 205 - UNDERFLOOR INSULATION
WORKER'SCOMPENSATIONDECLARATION 3O1 - ROUGH PLUMBING
Ihereby affirinunder penaliyofpe0LOY line,Ori n followingenl,midods: - 302 - TUB & OR SHOWER
l`)`' ❑ I bodes and will maintain a cenifcete of Conscm to self-iruum for Worker's 303 - ROUGH MECHANICAL
Compensation, m;providod for by Sccuan 37M of tbnlabor Code, for the 304 - ROUGH ELECTRICAL
perfo e c f the work f r wMch erm Nis pi is issued.
❑I h ve and w II'miinciin Worker s Compenmt o 1 armee,az required by Section 3 05 - FRAME
3700 or the Labq'r code for the a ficin <of the walk far wneh this permit is 306 - HOEDOWNS
issu d My W kc/s C ipensdtion Insurance c rt and Pon r ndou.'e:
307 a- INSULATION-•-
.. j .. icy
a { r�:` } '308 -'�SIiEETROCK+.fix:
t i ERTIFIGTIONOF.E.(EMPT OM.WQRKERSr
ITh s section nttJ n0 h mmplertdrvf the permit
r ,
is for one hundred dollars 310"1=,' INTERIOR LATH; �•''i + '" op'
311 SCRATCH .._COAT
T -- _.z,
i c n f ah I in th K m a ce ohne u k forwhich this
y o pcwnrsts=ued'1
-Carl cans Pe n any manner as become bj n m 'wok 313 - ROOF
NAIli 1 ' -
campe lsamPlL°yrcald ma.ogle _ FINAL,_,ELECTRICAL_ENERGY,.__
eo
NOTICE TOAPPLICANT1f l gm.cnret fe pia y should'. 502 - FINAL PLUMBING ENERGY
Z Fee a subject the Worker.
o ker Can,
o pe t pmv tom of theLabor r Codyou must
00 forthwitheomplywnh such runs sonhspermit'hallb,ckmnad rAsmkAd. 503 - FINAL MECHANICAL ENERGY
'' oCONSTRUCTIONLENDING AGENCY 504 - FINAL BUILDING ENERGY
ahrtnyafBimMnh stmt and dig gerwyf the pArhimunca 505 - FINAL ELECTRICAL ")' `
of)he ark forwhich th s Pe t ss ed(Sec 3097'C'v.C)
y A 'eppeersrvam< -GAS-TEST .....- - - -- ----._-
LenacrsAdd es -
o z 50 - FINAL PLUMBING'' ° '
U O y I candy @ l h his appliceu n and antic that ab nl rmat on is 5 8 - INCL MECHANICAL
lastt.., cnnem 1 g di e comply with and county i N
y m ces Idna cite x miming
O Ci) tobuildingnmmctio and bye o rcpreeniai es ph'c.yi mnupon
W 5 9 - INAL DE
the W se e-o t ncd r .action propos
0. (we)agree lo. ,in mnifY'and keel harmless the Coy of Cupertino against 5 - I NAL /
U-h liabilities.judgment costs a eapenus which may in!.,.way acerae against said
'Z City in commit - bf e g i i milt. 514 N RKS
IAP LI 14T DP �. DWI L COMKYWITH ALL NdNP Issued by' Date
$ RCL AF P` ,. <
g aW ofAPP Cont t -rO0I5
j� „';HAZ RD S MATCRIALS DISCIASURE ,
... Wise the 9pplican t W W'laing n ram taro or handle haidadu..roman I e Of Roof.-
Re
1.
-roofs
dby the Cupe ih fu rpaLCode Chopin 913 And the Health and Safety
Type [ a
Cos. OY ..25333{ t I . . l'`:.r - , '_.i '� t P - "7 f� +' ..-.i�,.. :J..
_ __All roofs shall,be inspected.prior to any roofing materi being installed. .
Art
Wilding pat Nu . tWII the ppl¢ pmem or Je ¢exwIf B roof is instaled without first obtaining an ins action,
I a lee to'remove
emit h N e contaminants nant in darned by theBay Area Air Quality Management
carr,o Health&`sorb` .m -�:all new materials for„inspection..Appl)cant understands and will comply with,,.
..
{ �dNeb mm r i all non-point Source regulations:,;
rs c
dols req m nu undo Ch pi 695of the
le _ t ns 5505 25533 std 15534 1 demand that
-' it y natthatus yi<pun bit otifY rh
'o"ecup m of.the i immense 'm s mel pct' io re one Ce i0c t or
c _Signature of Applicant_. ,. _ Date
caner orizcd a t All roof coverings to be Class,"B" orbetter '
OFFICE-.. .._.. ...._.... - _-._ -. . _ .._---. .- -... ..._ .. _
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