02020006 (2) CITY OF CUPERTINO
i.'"ILDING DIVISION;. - PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS:', PERMIT NO.
-1068, WALLIN CT (LOTS) 02020006
.OWNER'S NAME: ,. APPLICATION SUB DATE
K'. DEVELOPMENT CORP. 02/01/2002
PHONE:,. - SANITARY NO. CONTROL NO,
s Z ARCHITECr/ENGINEER: BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION Job Description
O Z 5 G _. 1 hereby aRrm Nat 1 am licensed ur ler provisions of @apter 9(commencing
with Section 7")of Division 3of me Business and Professions Code,and my license NEW SINGLE FAMILY DWELLINGFI ALED
F-tt`is in full tome and effect. y
�x � (LIVING SPACE 3196 S FT.
z w<�,License Claes Lic.N SQ. TT. ,
3 ',�Dvm:a, ARCHITECT'S DECLARATION GARAGE
t.� 413 . FT. ) APR 2 12003
uuuh u.O S I uadersmnd my plans shall be used as public records
y
p K •Licensed Processional ." BUILDING
'I I t OWNER-BUILDER DECLARATION
I.tierctiy arcirm-.that I am exempt from the Contractor's License Law for the
C?< 'following anc or.(Sec.ion.70313.Business and Professions Code:Any city or county
•'
HO o h ch regmrts.,.it ro conswct,alter,improve,demolish.or repair my structure -
3$ :poor wits issuance also requires theapphcan,for such permit to file v signed smmment
ththellenhed pursuantmfm provisons of the Contractors License luw(Chapmr9
g„ : ' S9_• F_tFloA
nSecpv ?IO�ofDvts Division of the BwmasanJ Pmlcmons Code) ,. . .
. ' 35000N&
luation
Route
ormaJi6o
I therefrom and the basis for the alleged d empdun.Any violation
of Section 70313 by any applicmn for a permit subjects the applicant in e civil penalty
pf tont more map five hundred dnE�a($5od). 3621��1�}'.�'6r, ;r''..,: ;'..; Occupancy Type
l O 1,as owner of the progeny,or my employes with wages as their sole compensation.
:will dome work;ssions ads:n C nor tion mad or License
Law for doses 1.not(See: to an ns;
i Bdsiircv and Professions Cade:The Comracmr's License law docs not apply.o m 101 - FOUNDAT I BBdquired Inspec[ions>� !,r
ownerf property Who b Id.or improve,thereon,and who docs such work himself 10 2 - PIERS
,I r Nr gh his own pl yea. provided that such improvements am not intended r
q ......_..-- .__.. ...__ -1._. ...
'tofferedt -Ie:lf fi- the Wilting 'tes of proving
wuhm one year 6f 103 - UFER ' 1 Nt •
completion,the ow cr-W Ider will have the Writes of proving that he did not Wild or
'improver puryosenraal=). 104 - REBAR I
rof -" ”- -- 05 - ANCHORBOliTSthemlycontractngwithlicensedcontract t - r — --
If'"f
wet the project(see lou,Business and Professions Cede)The Contractor's 106 - SEWER & WATER ' r :1.j la-u;
'i- License Law does not apply to an owner of properly who Wilds lir improves fo reon, I - _
`'0 such' nwith..coauaemr(A licensed.pursuant ..the ^ G
and whorl Lic an _
- ❑lamexem 2c. ,B&PCfar Nure=son 203 - UNDERFLOOROMECHAN'I•CAL
204 - UNDERFLOOR FRAME
y,n ton and
penaltyn1ENSry DE^ offlitRATIONdealamuonr: 205 - UNDERFLOOR INSULATION
301 - ROUGH PLUMBING
:❑ I "n and"MW,' ,intein'a'Certiricme of Consent sel6inwrc for Worker's 302 - TUB & OR SHOWER
Compcnstoon; as provided-for-by Section 37N) of•mrfabor-Code, for the
w
xtrnrmanrdormewnArnrhich hisPemitisiaayon.,.,_ 303 - ROUGH MECHANICAL
f C I W1,and will'm t I Walker'.C mpensation lnsumnce,'as required by$eceivn 3 04 - ROUGH ELECTRICAL,
' 3700 of Ne'Lnbor Code,for thelperfgrmance of the work,fer which this permit i,
305 - FRAME
sued loy Workers Compc set on insurance earlier and Policy'number are
^ :cwn<° nr.F,(!`(POIcyNo
1 -I CERTIPICATION QF EXFMPTIGN FR WORKERS # 3 O7L A 'TS
111 11 _ COMPENSATION INSURANCE T^t WI;,._ ' -10'8„1 SgEFTROC,.'K ,,--
(fhYcctibon"dnot becampismdfNe fiction.is for one hundred dollars _
s100)or leae.l 309 EXTERIOR LATH
3.1.0:.:_,.:.INTERIOR:':LATH -
f certify that fis c' f the fni wh h"Is ptrmn is us 'A;1
" hall not employ 'o in
annex ,..m tiecm enlcn to me workers” 311 — S�.'RAT(..'H COAT
Compensation so C e '
pram... . _... _ .._._ 313_ .=.-ROOF_..NAIL.. -
- —
_ ICE TOA 1 Ahis Ccni ol. of EsemPon..you Aboutto
I' Z eeomexublecno rer',Com' sduon'provisinnsonheLoMrcade,ynumust' SO1 — FINAL ELECTRICAL` BNERGY
O rah .n triply m tip N' permitanauxaamedrevnked - _ 502 FINAL
'� : S'• CONSTRUCTION LENDING AGENCY ' ' 503 - FINAL MECHANICAL ENERGY, " '
Ih by affirm flat" etr
eonscton leading g cyf "for.We the b
-� nn kforvihlIhthspemllis nta(s<3x97c c) "' _ _504 -_ FINAL_ BUILDING ENERGY _
Lenders Neme :. a�.+ ,. ..tea t... __. .. _._. ._..
505' FINAL ELECTRICAL ., .
U Q G Ia"I at Iha rt ad apphcaton and ism,l ton bo emfmmwton la' 506 - GAS TEST
g*s-ry :c rrecr 1.9 a.o c mply with II lily'and c my mllimascas and w rc law,mining, 507 - FINAL PLUMBING
.OAU ,jmbu ldnge rn ctl n q'1he by antW xe',pre' afiv Iity toe ie .,an
508 — FINAL MECHANICAL
W ;thee W mem on d pro pcny fi r inspection p rpwes_
ylWe1eg a inti if an keepha mlessM Cryof Cupeninsi agwnst
Vi lublfesldg, txcsec ,wh y,my ycceagamaswd 509 -- FINAL RAD
s .A gnawWl the pppl sant orl�rrebaDlW1 COMPLY Y'WITH ALL NOI-P(IM1YI" ISSuety4 { F A G Date
V Cty in se < o h g t
soul G v
P Re-rC692 ROOF PLYWOOD NAIL
A7. SMATERIALSDISCLOS yp ��oof ROOF,- BATTENS .
Idi gcec p t m dl hazardous invmnal .T 0 ._... ....... ..... ... ... ..
e ram ytM1 C Penn lin P. coo Chapter 912 and the Health ads Safety .604,1. .ROOFy. IN. PROGRESS
',Code Sellsor f�Ye, 2553330 ! 7 I r /'t,I i r.'r{ ,'3 } 5., 1 IN . `1'a i s }e , I ..
I. t
All roofs,shall beinspected.prior-to any roofing material being installed_
W111 tl, appl nt f t b i d og capon,use g p nt device,which If a roof is installed without first obtaining an mspecnon,''d agreeto'remove
eve.M1azardo ev c nmminahs1fired by the Bay Area Air Qualify Management'
Ot,n e. all new,materials ori sp ,t n Applicant understands_ and will comply with
` \oral} o yrs `all non=point sod e gu ns re., n,
1 ` 1 he d neon the he lido r I. q ircmenn under Chaprcr'6.95 of Ne
Calff n NHeahh S f C d' ons 505 25533 d 25534 1 oder m J th t
^ fine hu ldmgd t rte to al,that it is my responsibility to notify the
oetupam f emu 7a Be met prior to issuance of a Cenifcat of
6 Signature of .p . .ant. _...i .. ate
fhcupa
wner'1 amh aced r m All of coverings to be Class B or ,better"
,>....'. . ` .. _ . .. .. _OFFICE