01100132 (2) CITY OF CUPERTINO '
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION-"
BUILDING ADDRESS: PERMIT NO.
1072 WALLIN CT 01100132
OWNER'S NAME: APPLICATION SUB DATE
B.K. DEVELOPMENT CORP. 10/24/2001
I! PHONE: SANITARY NO. CONTROL NO.
O O ARCHITECr/ENGINEER: BUILDING PERMIT INFO
m BLDG ELECT PLUMB ME-CH
is
.ria L� �J U
LICENSED CONTRACTOR'S DECLARATION
y I hereby affirm that I am treated under provinces or Chapter 9 recommencing Job Description
u�t xch Section 7")of Division 3 of the Business and Professions Code,and my licenu NEW SINGLE FAMILY DWELLING.
j it in full rupee and arrmt
:442 Lrenucs LIVING SPACE 3086 SQ. FT
•O a U Date Conmermr ' � ,, Q p�
1 3 o H ARCHITECT'S DECLARA o GARAGE 462 SQ. FT. •— .i!�Y
w g 1 i ndcnan my plans shall M ascd ie public¢cords
goo LicensedProfesamal JUN 12 2003
OWNER-BUILDER DECLARATION
in, 1 hcmby affirm tet 1.m cmmpt from the(Contractor's License law for the c.
C Z Q toll g maium.Ie , n 7031.5.B hat, and improve,
dem ns Code:A y ly nrmeone BUILDING O
which requ a permit to construct,aper tmfar in demolish. p any someone ®�/'L®'.IYG_
3$ priort unadporaoregmthe teapplovof for such pemuttoic Lxdsmmmr9 -- --- -- — --
talhKi3ltenwithSeuanno00)of s 'sof the Ce mittees Business n Is ices(ChCor) .-,.y Sq._Ft. F100C l�rea�n f� k e
or
n
withSectiononia ofhebasin3oftheleedesand Prf sons Cade) s 4 i' ' 3130 'atlon
or tot he is exempt thcmfmm and the bass for the alleged eaemp(nn.Any violation "� '1 ? 1 t 's S�Lt S,t. J(:�g:.l Id).-t
of Section 9031.5 by any applicant for a permit subjects to applicant to a civil penalty
of not more than Five hundred dollars($500). 3 6 2`i1W I'lr " Occupancy Type
°I,as owner of the progeny,or my employees with wages as their sale compensation,
will do the work,-and the cuucture is not intended or offered for mg,(Sec.7044,
'Business,and Professions Code:The Contractor's License law docs not apply m an 101 - FOUNDAT104bired Inspections' `
owner arprapeny wnabaile�°r improver teean,.m was drct tarn wapk himself 102 - PIERS '
or through his own employeesprovided that such improvements are not intoned or
off ._. ._ ._. .- . __ ____ .._..-_.._._.
carc e.u e. however,the i oath or tmpr.cif,mt is told wnhin Dim yearof 10 3 - UFER '•t -- -
orbpledon,,he owner-0uilder will have the burden of proving that he did nes solicitor ' " ' - ' -
improve for parpauofsale.). 104 - REBAR _ I
1,ns owne of the n am.mimcvel tmctin i,h IicensN conwemrs to
- e stmet to project 704a.Badness and rrufett opt Cuieo The Contractor's I 0 5 - -ANCHOR-
License Law doeesrnot apply to an owner of property who builds or improves thereon, 106 — SEWER & WATER 1
_and who<.I.%.for.suah projects with a.immactorb)licemed pars....to the .._.. . ..202 "- -UNDERFLOOR--PLUMBING--
C .._.__—._. ._..._.- . .._._ .._. ..
anvacon,Ls
❑l am ear t he " e'&P C far this reas°a 203 - UNDERFLOOR''MECHANICAL
o npr G�n 02' 204 - UNDERFLOOR FRAME
r. 's nN?lo D cLARAnoN - 205 - UNDERFLOOR INSULATION
' 1herebyarrtmundo �aIt ofar;uryon of the following declarations: 301 - ROUGH PLUMBING
`� ❑ 1 have and will onimoia a Cmificate of Consent to self-imine,for worker', 302 - TUB & OR SHOWER
Compensation, as provided for by Section 37W of to Labor Code, for to
perrmrmancbanheworkfarwmchmisperm,ititissued. 303 - ROUGH MECHANICAL
- — OI hale and will maintain Worker's Comensation losmance,as required by Section 3 04 - ROUGH ELECTRICAL
37M of the Leber Code;fill(he petformunc,of the work for which his permit is 3 0 5 — FRAME
issued My Wok 's Compacts t o 1 surance camel and Palmy umber arc
Amir " R' aPolaNa. - 306;,, HOEDOWNS
. CERTIFICAnONOFRXEM"IONFOMWORURSI- L0" )307 �f)}INSULAt1.014
COMPENSATION INSURANCE- .
.,
fs100)n less 3" °emd not be cimplanted if Permit it for one hundred dollar.
309 - EXTERIOR LATH I t
d 1 310' - INTER-I OR -LATH
trytit,int eperforman -the k rwhichthst' itslm1 311 - SCRATCH COAT 1 "I'
Coin
R note cover on y a y f on ' t b'ay�me.subject th Workeri
Ac"=a 0 A - 313--- -ROOF -NAIL- --
NOTI EenAP 1 NT: term isCenif¢meofE.amptiamyou should 501 - FINAL ELECTRICAL ENERGY
become len to s orkers Comp sa on Provisions of 1h,Labor Code,you inns,
Z C fnnn ¢ply ,hmmproviti tartitpmittnaub created re.akea. 502- Ir _.FINAL_PLUMBING ENERGY .
e _.
CONSTRUCTION LENDING AGENCY
3 n rby mmanhre'ta twaanlending agecyrnh p ,mance 503 - FINAL MECHANICAL ENERGY'
of the m orwhich this perms ssdl,ser.3097.Civ.c) , 504_ - FINAL_BUILDING EN_ ER_ GY-
lrl Q -
Lathat's Name - -. - ' .. - - .. .—_ ..
Fj;z Led tAudmtt 505 - FINAL ELECTRICAL
U O •._ c 1 certify that 1 have mod tis application and nate that to above information is 506 - GAS- TEST '
�SIPEy correct.I agree to comply with all city and county,ordinances and state laws raising 507 - FINAL PLUMBING
OL,U to buildingetmstrucnon,ana hereby authorize mpoescntmivas of this city to enter upon
y� W to anove-mcrown W.propeny formspection purposes.,, - 508 - FINAL MECHANICAL
[. per (W) gree l6 se hd ify and k p haimlesi the city ofCpenino.gain' —
U Z Cit tui s ludgmems,c rs d pe us hich may in any ay accrue against said 509 FINAL G r �f
U, n City i ro a account,
e, e than f perm t. 1 O — N NG I/
s7sAPPLIC E TAN D ILL COMPLY WITH VON 1 T
so
a s o Issued Date
Sisnara gra 'on tom ; me ;, Re-roof0 - ROOF PLYWOOD NAIL
+t AZAR, SMATER,A,3 DISCLOSURE'S
W e liaanior rcbuld goaupan,norcmBandlehvaMommaterial Type.ol61QAf - ROOF.__.BA TTENS _ _ _ _
as d f y to CUPen p I Cod Chapter 9 12 and the Health and Safety -- - - ;- - '
Cba s lip.2553 res) �. . r r . - t :604 iROOF l N-PROGRESS
Al] roofs shall be inspected prior_to-any.roofing material_being installed.
Will the,-ppl not future building mcapt equipment devices whcn If a roof is Installed without first obtainingan ins ecnon;I'a ree:to remove
pmt h d u eontam nes is az def e4 by th B y Area A Qual 7 M age nt P g
District' all new materials for inspection Applicant understands and will comply with -
er"It °Y •all non-point source regulations-.. -
1 have mad-the hazardous mammals requ mumms•under Chi p r,695,d the
CahPomie Health&Sof yCod,S tions 25505;25533 and 25534.1 understand that
if,hebuildingdoe, n urmm rate a tat itis mY responsibility to notify the
odcupem of e i - menu h mu ma prior m ixsuencc of a Cenilcate of -
Isiss )I
Signature of Applicant Date
All roof coverings to be Class "B" or better
a - . .. OFFICE-. . .. .. --- - .. .... . .. ...- _ .. ....