02030086 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATI(O
BUILDING ADDRESS: PERMIT NO.
1133 STAFFORD DR JONES MASONRY 02030086
OWNER'S NAME: APPLICATION SUB DATE
ERIC WONG 1058 DELL AVE 03/19/2002
i sPHONE: SANITARY NO. CONTROL NO.
4083777512
O O ARCHITEC MNGINEER: BUILDING PERMIT INTO
u BLDG ELECT PLUMB MECH
IJ LJ L,
LICENSED CONTRACTOR'S DECLARATION
S r? EN
1 hereby affirm that 1 em licensed under pro isions of Chapter 9(commencing Job Description
',-° REBUILD BRICK CHIMNEY FROM GROUND UP :
—t c with Smtion]0007 of ivision 3 of the B�ss and Pm�siom Code,and my liana
:mi3 stns( aama em. 5 'lTJ
:sa.a Lien ns_ x
ILL°`" 1y SD ` r FINALED
a ria J- ARCHITECT'S D RA
,� 1 understand my plans shall he used as public records
3_,c Licensed"°(estional z MAR 2 12002
OWNER-BUILDER DECLARATION
='an a I hereby affirm that 1 am exempt from she Commemr's License Law for the
(_? following mason.(Section 7031.5.Business and Professions Code:Any city or county $5500
as,Y A o which requires a permit to construct.titer,improve,demolish,or repair any structure
�
3� Prim soiu issuance,also rtquinmthe applicant fm such permit to Rlc amigved...semean BUILDIN
..._
Nathe slicensed Panuon(so the provisions of the Contractors Liccnu Law(Chapter 9 �`p f.p}�pr Valuation
(commencing wird Sectiom70(0)of Division 3 of the Business and Professions Code) y ;3Cf;d�17,U,1.-Y•, UV ; 'I'.
or that he ii exempt therefrom and the basis for the alleged eawption.Any violation - ,
of Semon]0313 by any applicant fora proms subjms the applicant m a rivil pemlty
of notmom than five hundred dollars 550(p. 1014PNDATION Occupancy Type
❑h ns owner of the PropcmY•of my employees wird wages as their role mmpeassion. STRAPS
will do the work,and the swaure'is nut'imeMed or offend for sale(Sec.7044. - - -
Business and Professions Cade:The Contractor's License law does not apply to an 514 — FINAL Pt$, Z&O 111,1PR96 is
owner of pmprny Who builds or improves thereon,and who does such work himself
or through his own employees.provided that such impmvemems amwithin
not intended or
e offeietion tile.wma-WBer,Neb have the
r irden of
tis ngsoldthat
he did not Wild
of
completion,the awnenb ale).will M1ave Ne burden of proving thn h<did not build or
improve!or puryou of sale).
- with licensed contractors m
❑k ers owner of the progeny,a .Business
ively contracting `
construct the project(Sec,]044,Business and Profusions Code:)The improves
Contractor's
hemon,
License Law docs not apply to an owner of property who builds or seimproves therton, '
: arM.who r"Lice t for.inch projects wird a contractors)licensed pursuem m be,
Col amexempt unu Law.
❑lam exempt under pec:., ,,. _ .08PCfor this mason '
chibrio Data .
WORKER'S COMPENSATION DECLARATION
!!! 1 hereby aRrm under perahy of perjury one of the following declarations:
❑ I have and will maibuin a Cinificam of Consent m self-iti um for Worker's
Compensation. u provided for by Section 3700 of the Labor Code. for the
performance of the work for which this permit is issued.
❑1 have and will maintain Workini Compensation Insurance,as required by Saviors
.. 37W of the labor Code,for the porfommem of the work for which this permit is
isme .MMX Wmkelm Compcnsesigp11nsumn .
:a carrier md5 Policy ntlmbsur
er 9 min Iiry No. :,..,, ... .. . . ... .. : . ... .. _. .
"rt`.'CERTIPTCATION OF EXEMFrnO OM WORKERS'.' V .. .'.J t. t - I: r,i: .•.
COMPENSATION INSURANCE"`
rThis ia<liou need not Is,completed if site Permit is for one hundred dol Ws _.
($Iw)or less.)
1_1. 1 cempl that in Na'n in my. o isle work for which this pemdt a issued,I
shall not employ ono person in any m ns to become subject to the Workers
compensation laws of California,Dann
Applicant mgt
NOTICE TO APPLICANT:IL afarmaking this Ceni&ate the
Uttar od you should
z 0 become subject y the Worker's Compensation Provisions or Ne Labor Code,you most
foMwitn comply wird such provisions or this permit shell M deemed rtvoked. I
a CONSTRUCTION LENDING AGENCY
.7 . I herby aRrm th..Nem ia'a constmetion lending agency for the perf.mimince
W,r of Ne work fins which this permit is issued(Ser.3097,Civ.G)
Pn Q ..Lmdari Name.:.
a z Lenders Add.
1 eci ify than I have rtad this application and shim Out the above information is
at":[..i bi I spec m comply with all city and county ordinances and mute law sitting
O',V to WBdingc ctidn.and herebyaothoriae mpmenmsive,of Nis airy to enterupon
>s'W the above memionadproperty for inspection puryoses..
f^ dI (W<)igrte'm save,indemnify and keep harmless the City of Cupertinoagairust
V] liabilities,ji dgmen.,tins.and upenses which may in any way accrue against said
C.) rzs City in consequence of the grm m,of this marm.,
SP L AI U ERSTSND At DWI C/OyM�P WITHALL'NON-PO sued by: Date
M
�W
i. ignamrc of Applicarrruactor ." -Daft ' Re-roofs
' HAZARDOUS MATERIALS DISCLOSURE '
" Wdl she applicant or fumfe bolding occupant stom or handle hazaidous material Type of Roof . . _. ..
n defined by'be Cupertino Municipal Code.Chapter 9.12,and the HesIdn and Safety
Code Ser. 25532(gn • '
: -.; ' .
No t All roofs shall be inspected prior,to,any roofing material beipg,installed,, .. ,
call dte apph<ans furore building occupant use equipme mini de trot wnien If a roof is installed without first obtaining an inspection,I agree to remove
mit hevidous au conwmnsn.as defimd by dtc Bay Ane Air Qusltry Madagctitcm
all new materials for inspection. Applicant understands and will comply with
ave, all non-point source regulations.
I have read the'h; us'rmuiels reepiummts under Chapter 6.95 of she
California Hcaltn h Safety Cade,Scitions B505,25533 ands 25534.1 undersand that
if dic bugding doesnos cumendy have a tenant,that it is my responsibility to notify the -
occupant of the requiromms w ch mu be metnor to ianaimea of a Campeau,of
Signature of Applicant Date
caner or authoriuA erg t .. Da�l All roof coverings to be Class "B" or better
. ... .. _
.OFFICE . . ...
F R®V r D
IN PCCOh 4N E WITH THE CI Y e
CUPERTL, C DES PNOIN NC
)PTE �(/
sel c+ P ' ;nas znd it is un
•. ba kept to , cr atetat'oom
nwlul Ic �* ' ; yrn.miSsion
• ' • • ,n same vat CuPe.t,no.
C.r;
bm�', ''P n,nlspecifications
he
ne siamP.o3 °� h m P` p. and or to be an
' .LL Nl,r I - '°" t.,,n of any Provision
—a;oveI at t ,e vr..a•,-
--.., cr Slate law
4' MAR 19 2002 D
By
��kMester S&F ATTACHMENT BCP
d ffl"Nequired
leuancci „ .� 2' 37-3-(h) .
wooA hone _ Mortx Cap.
mbusUbli material 6"min.to f ace peeing. ,...,, Bond
12"fmm o g w cn mmerial pmjecting _c' •I' 824m
. Mort 0t 4f 1 each l• a l i
Above roof 2'ar 10' See .B.C.Table No.37-13.) o Horiianhl V.'tiu u Ig two tics a cxh bend in
H �ainl ng
orci vcrpcal st
pMI =l.rs Virtitol Four N - .. . .
' 1Q`0-0•' Min. I ftdl•leogth ban forchimncy.
Reinforcing to .Add two No.4 ban for
ed 'tion 40'or faction of wid
I I`. or each ditio flue.
Flashing
'- Anchor
_ trop
Mcbonge �.
Strop Vii x 1' I 11S"Alin.groat Eetrgen
Number 2 I I " 4"concrita masonry and
'Finbedmeal ln4,rchbn 12'hooked wound outer bu w/6'ext. {clay But lining
fine°to 4 jots"
D°hs WO W diameter }t Flui Lining
aeararica —
'
t1
flecti ve Due oma Md on area owed lining—yr or 30 sq.in.min, I - 6-Min.
of fireplace open Rectangulu lining—Vie or 64 sq.In min,
Unlined or lined witb firebrick-4 or too
sq. in. min. Ca t
L FlorisonW
11W111 (F�y"° ItiJ f Y I•'�� �I'�. Reinforcing Tia
V ties @ 18" O.C. tw t s @ ea. bad in
••�� !"Min. t'erticie strol. ! rjred s _I -lav,
qp qs
• r ,(f., I with 8" min.
yy
4Thick 1
Masonry ��G
6' •I 'VMlaIRginftiMin {{,, f� 'D
�L ! ni g Fout gth for ctd t
Linlol I �.. Lao it tpt' ed rP1Ar a0 wide.
I
footing dovd"JL ach eddt 4Tor1(r ,nn orfad:
Noncombustible ewat{il,' I or each ddip
/ ' I 0tor•1 —
"'-�.� l By error chlrmeys Over W,Lal I
40" wICz.
Hearth atemlo Fretxick
(hoof of ) t Hearth e•
' 16'fireplace openln <6 f FinEOx Jllrall 10"conwon ck or g•rh
aq.., 20" m 1 a firebrick
2T fireplace npening a Hearth Min. Thiet fining V Joints n firebrick V.'
I eneion aux.
:. ... .� . . ( Fovnnq idtfi
,I ti MI twnd
':;•.-' .4T i •-s ��r.' . free nding triplaa
(foxing , ; ; . . ')• . ' a ur
Thi<ktreas Y min.
•. i- . �' •'.. .� y Grodo
mb side of fireplace rel a •,' a . . • .
�'
8";n
Concrato Footing
W Square Alts"Uts for Frio
. — Standing Firiplgco
BRICK SECTIONAL SIDE BWONDCONCAETE SLAB