02090130 (3) OF CUPERTINO
CI Nut DING DIVIISSIONPERMIT CONTRACTOR INFORMATION:
NO
TIJ.D1T]DD9$$t- STA SPRING CT DRAEGER CONSTRUCTION INC PERMIT02090130
76%YWILSON T AND SUSAN S 605 COMMERCIAL ST APPLICVT'J'Nryajtn002
PHONE: (408) 536-0420 SANITARY NO.1�J'// L L CONTROL NO.
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MOO ARCHITEC)EiNGINEER: BUILDING PERMIT INFO
ptp BLDG ELECT PLUMB MECH
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a 8 y= LICENSED CONTRACTOR'S DECLARATION Job Description
o z-0 1 Hereby mrtn mor 1 am B«rise aver provisions of Chapter p(commercial, � SIDING
with Section)lllX»ys of Division l or the Busincy�(nJ Protessi°ns Cond my license
<xE°� is in full foeRecrt sj" Q'7610
3 i License Clas ,y Lit.is
u.n DEC 'ConE
C TIO
Y 1 un"crsmn"my plans shall be used as pet m records I)E C O A`2 L 2002
a s 0 0 Licensed Professional L
e OWNER-BUILDER DECLARATION BUILDING
e g''� p�
I hereby affirm that 1 am exempt from Ne Commctor's License Law for the 6.7�'Lwg.rp�O tl� $12 0 O O
t Z Q following reason(Section 7031.5.Business and Professions Code:Any city m r,munD B DIN
F s O which reclaims o permit to conswm,alter,improve,demolish,or repair any structure
teo phot t ' nim q th Pelican,foruu<h peril uofle stills swmmmt
thaoM1 s'ic2n puIn ret Jepbvi nnsonnecontractorrLteemselawlenapmrs 316&5 p lggr((Q(gea,. ,,. , Valuation
(co ng rh g¢i )Iglfllfnviron3ufthe BurimuanJ Prafessmns Cade) �l)IN3a ,:•,t, .;; 1 'w• ...al nN'4I.`��t-i•1e
or Choi rte is exempt Nerefmm and the basis for tits nllegeJ<aempdon.Any v,olauon
of Section)03 L5 by any upplicant for a permit mbjeas the applicant to v civil penaBy-
ofnot more than rise hundred dollars(5500). JOl APNI URCATION 'I°:ii'','i'<' Occupancy Type
[11.saimisherafffic phin't or M Y employees with wages as their role crouremosticat, 102 - PIERS
will doa tW work,and me rmcwre'C norcuin's intended or a Lsae 'does
sale( cc .� it tI„
- -
'Busincsi enadProfcssions Cu"c:The Comrac,or's License Inw"«s not apply m an 103 - UFER Required Inspections I"� - 1.
owner or homer,Who builds or improves thereon,and who does such work himself 104 - REBAR
or through his own employees.provided that such improvements am not imended or _ ,_ ANCHOR
..._..__' "_. ."__._"_._.."."__
16mopld for sda'o:er Wilder
baser erurden emenus sold-within one year of ----- 105 - AN HOR-BOLTS" --' .n .-L-.
'happciom,theowr rifolder will have the burden of proving that he did not Wild or 106 - SEWER & WATER
improve for purpose mf sale J.
_ e , 'o 1.atowner or the property.am"clusiveiy contracting withivcrn.md contractors to
-- - 202---' UNDERFLOOR-OOR—PLUMBING------,; ;
construct tW proiat(Sec.701 Business and Professions Coded The contactors 203 - UNDERFLOOR MECHANI CAL t5:(`: >i, nlf
j - License Low does not apply to an owner of property who builds or improves daemon,
arm who emcaets.for.such.proiecta.with.a.conuaemrts).ranred Pursuant m.me.. __204-- -UNDERFLOOR--FRAME
0Contractor's crpt adde Law,.. 205 - UNDERFLOOR,t!:I'NSULATION
❑Iamesemptunser Si' "igr"•E ;B&PCfor Nis mamn
Ow (Dote 301 - ROUGH PLUMBING
"WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
- ;•"". .Iherebymrumunderper of.perjury.od�ofithe following declaahons:- 303 _ ROUGH MECHANICAL .
a . . El hard amm5i
i will rmin a'Ckricme'ur Caroti m seu.mrna for Workers 304 ROUGH ELECTRICAL
Compensation. q provided-for by Section-3700 of the Labor code, for the 3 O S' - FRAME
'perf ret f the work f h ch th,s perm rs .ed.t,..
❑Ih a 'n Voait nw-k :cCmpe r I .nmdee- required by Sc6ibn 306 - HOLDOWNS
non nn I:abpr cn"e r te p=te r m work r hen w:p<r r
307 - INSULATION
" My krrC reps r- I c and Pol<y W
\� 308 - SHEETROCK-
e t t .�t-�,A ei Pol,ey 24�OCfiP f•LL „ . . .I t r CERTIFICATION OfrEXEMrI° F oM.wo�st— �- "'` ? 309 -' EX•TERIORY.•LATH4;
' COMPEYSATIO NSDRANCE .' „'-. _. __..."._-310 ;,.INT-ER30R—LA-TH - — - -� ----••--
'.ul '(TT s cu t n nee"not be completed if the permit is for one hundred dollars 311 _"SCRATCH COAT " �`•` 't` `' I _,Jt,
($10(0 less.).,
"t _.313::-_ROOF-:.NAIL.._
�mWy';haim Eei paid i hhc work f `h ch this iternot is iss J.I *, — - -
•vnuR t , pl r yea r n tohceori tdjorr ,1W'Wnkea 501 - FINAL ELECTRICAL ENERGY
cn pen dmlawrmclr Dte _ _ 50.2 .---. FINAL PLUMBING. .ENERGY__._....
,NOTICETO APPLIC\NT if ahcr rnaki gN.Ctll¢am ofEe pro you.hnu�pi 503 - FINAL MECHANICAL"ENERGY '
Z Wcmmcmbjcctmthc Workers Compcnsatinhprovisionsofthe WWr Cwlc.younina
shall bed d kcd. 504_ - FINAL BUILDING ENERGY
O forth nth comply iN etch p ovisions omit¢porn t — _
z'ti ''fO�STRUCTIONLENDINGAGENCY " 505 - FINAL ELECTRICAL
In n nulb .. . ciflending'ag syr rteperum '
it
arda, enpermit :.del(Sa: CCI 506 GAS TEST
G LendeName "507 ..
'= " FINAL--PLUMBING
find Addie..'
U,� r 508 FINAL MECHANICAL
d s,1 eerirrmati nave read this application una'ra�e mm me awve information it
lss-t-, 'cnt¢nt.I ogres.to cmmply,wlth all city and c mmy ordinances and ram laws reidimg 5 - INAL GRADE
building aonstrralbnand herebyamhoiiie icpresaioorilof this city to enter upon S O - INAL P bNGtIh _tateFop4 (W1g ioz ctdemnlr)andk pharmlaiheCity fCupemnoaginst5 - INAL BRKS
.Z Cit liabilities,judgment,cet d expenses itch y many way B.,n t and / _ I
V Z City s, q ccbfthc gin, gohh, perms r.
A PLICA UNDERST NDS N'ILLC PLYW'ITHAI.L\ONPOI\ ' Issued b ; Date
kru kr•r ,GULATIo,� .t': o Z Y
AppOe vc Nat D t_— Re-roofs
•.HAZARDOUS MATERIALS DISCLOSURE
K 11 the applicant or future builJing Occup nt stoic or h tulle '',r
'minimal .. . Type Of ROOF - - - •--+• •— � \� - - �-� �^••••^ ••^ '• ^
'a6"f d by the Cupen M c pal Cade Chaps 9 13 end the H hit rid Safety •_
Cod ❑Y s 255JI1) t N t t, t J t •e iyt. t. t x
.._All roofs shall be inspected prior to any rooffng.material.being installed..-.---_.
Will the_applficmifor.rthalJ' g p tuseeq itemm or desice.,which If a roof is insialled without first obtaining ari'inspection;I'agree''tliremove
amtM1
' u mm
Outdo? mams as defined by me Day'Area Air QLJIhy Management
all new materials for mspecuon.,Applicant understands and•will comply with
°v �" ; ; ': '' all non-point source regulations 1 ,
1 have read the Safety
Code, meter 1 requirements under Chapter 695 of the -
Cali
forma Health,Safety Crile,Section t 35505.2553]vtN 35534:I understand Nm,
f it ms Wil of
the
is a.kmaroc.bof.ty eramify
scup an�of the rtquirtmems which muni M ma pooro issuance of a Certificate of -
... Occup y.
... .. _ _ __ .. -.--,- ,.Date,.- ,
9/y �'� Signature of A ]lean[ -
antnorj:mugenrj;i All roof coverings to be Class "B"or'better ,