01050082 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING A DURESS: - PERMII'No.
10888 SYCAMORE CT SWAN P001_S 01.050082
OWNER'S NAME: APPLICATION SUB UNIT.
LARRY & ROCHEI_I_E DRENAN 4.495 S WINCHESTER I_V 05/08/2001
PHONE: SANI'T'ARY NO. CONI Rol.NO.
(408) 8E6-6893
z z ARCHITEC-PENGINEER: BUILDING 1'ERMI'r INPO
O O BLDO ELECT PLUMB MECH
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LICENSED CONTRdunderSsi6arsofClON Job Description
erne,aliinn that I Irm li,<n.cJ under pruvixions of Chopa,n Immmencing
t0 with Section 9010lnf Division Jof,he Basins and Prufc,sionn Cole.and my license
fill Toa<a"`'`f '__� Lie,„ 5�1 l4$ POOL AND SPA 352 FT RESIDENTIAL
z 6 Licenw Clus, S {_
o a�' Dlae_5_R-o Cumrxmr_S+w.v) �+1�
3 u y Ar, hall Is,u e DECLARATION
g I unJemanJ my plans hall he u,cJ as puhlic mconh !/
a 5 Licensed Professional
a yo0
a( OWNER-BUILDIIR ut the RATION
reel I re,00 sputa that 1 am exempt limn the Contractor :Any c Law for the
A 42
C which
riquiwnn.ISrunt1 '/OJLoitt.anmaanJ Prnrmsimn Co dc:Any city nrroomy
TSC wh n y p, I t c e l r pc for
d lin v' Y statement i 3 pas t t : - I y pr applicant If r epee ,in fl aligned taemem
mall th s n d p O to c l tee l 1 CIerY Sq. FL Floor Area � Valuation
«nm c g ml t 7gAn fhets J fm Bb nc dprofession,ioationAr) $23520
n-
mnlle , c5byanyf dtl h: f the11 1 pt s IIntnn
or not cone thn vanyared thrinfor apencil.omen.,me applirammacivil penally
orno roes than five numo-ed dnll,,,x fs5lgly APN Number b p Occupancy Type
❑I.ai owner of the pa,cny or Ory employee%with wages a,their side compensation. 342570"Z7- 00
will Jo he work.and the,Imclum is not irumded or ollcrcd for sale ISec.9144.
Bourexs and Profession.axle:The Contractor's License Law due,Out apply to an Required Inspections ,
Ovoitaut troy Who hatlm o,i...pmvcs merenn.;tad i does Inch wore hine..+elf 103 — UFER
or through his own employees,provided that such improvements are not intended or
offered nr tUde.If however.the mdlning Or improvcmem is sold within one year of 1.04 — REBA R
completion.the ownertwilder will have the nundco al'pro,ing that he did not build or
in,pmveforpnrmwoaale.). 107 — POOL/BONDING
❑LanowrnOfhepro,vu,amexd.ovel,Ionnacaagwith licensed contractors m 301 — ROUGH PLUMBING
Lnomas,be Poijec,(Sc,,7044•ans nJ I+n,l'es ,Code:)the Cnmracmh
icense Law tan,not apply In an Ownerof,r,peny n'hobuild.of ilnpmvex thereon. 304 — ROUGH ELECTRICAL
and wolo aun,cl, of ash Pr Jou wish u conm.nor(If lid:nwd rnLwam to the
comfaemts License Law. 502 — FINAL PI_IJIyIBTNG ENERGY
❑1 am'a"n"osier Sec. .B k P C for This mss n
naeS_g ,\ 503 — FINAL MECHANICAL ENERGY
WORKER'S COMPENSADON DECI.AItKI'ION • I ,505 •— GAS TEST
I hens,nmol undersOually of perp,,o,of me fonowing dcclarafinne ,,. 510 — FINAL PLANNING
❑ I bale and will nenimnia a Cenircate of Convent m xeff-inure for Worker', 51 1 = FINAL POOL .
Compmuation, as provided for by Section }71110 oI' the Labor Calc, for tire
lvaru,m,nnee of tire work for which min peemit i,issued. 516 FINAL BUILDING
❑I have and will maintain Worker's Co,npen,alon Insurance,as required by Seetiun
3703 of(Im LUMa Coda fur the Iwrfomtancc of the work for which this pem,il ie
Maud.My Worker's(Coope t n Insurance eanierand I+olicy numMr am:
Canier:S�gT�T�� PoBcy N,s: 318_dL��(..0 9
CLIIrIPICA TITINOESAHON INS RAMC W(IRKhMti'
COh1PIiNSAT'ION INSURANCE
This woku n,ad not he cn.nFlirted II the permit 1,fur one hundred dollar,
(SIOO)or fess)
1 cenify that in the performance of the it for which this permit is issued.I
III to mnploy any per..m in any m:mncryt usg,t ,mc object to the Waders'
CompensatinfM�Irxl1,f Cayy'firm,: Dae_7 66
oo
APPhsnm lA/Solc.Ny,T
NOTICE TO APPLICANT:IL at ic`making Ibis Certifaun nt Ilxnnp.iin.You should
liver le subject to the W'orkc/s Comrcnsaion provisions of the Labor Code,you must
Q 0 E,nhwiob,romply with such pro, to e,or Thi,penniI shall be deemed revoked.
zI
F CONS'eRUC'nON1.ENDI NO lAG ending agency
as 7 1 hereby whin,that termiss coned(Sie. Icndingagency for the perfnmancc
i-cri a wnN for which This Iwrmit is issued(See.31Y99,Civ.CJ
0. Z Lender's Name
Q Z Lender's nJJrc„
t..) Q 1 certify that 1 have read this application and smm thin the above information is
❑s P n f 1 6 u rly will, ,It it, J ly fi I t t : h i g
Q (� mbuilding construction,andn bl ardicallot representatives III this cDt t pm
rr� 0 I I I11olliay for : t 'yowl.
IWIg urinate,indearinifyix JApl yina City acus g' d
fn Ii I i ly encu t t exiles vch may m any Y ,crve ugain.a,aid
C.7 Z
City UNDERSTANDS
Ira Norr grating(if thispnmw. S-�-�/
AIURCM'RGULNIRSTANDS AND WILL COMPLY\VIIHALLNON-POINT Issued by' �� I�N�,�k �L`(.' s Date .l
SOURCE RECULA'I'IONS
Signauroof ArrlivinVCmnrvnlof Dore Re-roofs
ITA"dARDOUS MATERIALS DISCLOSURE
Will Ihs:rpprnaret or faults haddios ov,u......Tom Or nano,haaarlou,mamrial Type of Roof
a,defenw by the Capenino Municipal Ie.Chapmr,1.12,amt d,c Deaeh end Sorely
CoxIt.Scmion 255?2ptl9
[I yes .No All roofs shall be inspected prior to any roofing material being installed.
will m,e applicant or comm barking I ntl,am,rve c,Inipmem or devices which If a roof is installed without first obtaining an inspection, I agree to remove
em itha,arlou.aircnnmminanI a.deli ,t he Bay Area Air Quality M....Into
[)arelr all new materials for inspection. Applicant understands and will comply with
aye, ONO all non-point source regulations.
1 have read the h....do.,material,irwid cmem,under Clupmr 695 of role
California Resole M Safety sae,Sections 25505,25577 and 25534.I understand that
If the building does sol currently have a lennal,thou h is.nr r•,ponsinibly to salify Thu
rwcupdnt of the nynir menu which mus,le,mer prior w isunace of u Cenilicute of
D"ritia�wYe Signature of Applicant Date
re,Oramnoaorls! cut Data All roof coverings to be Class "B'• or better
OFFICE