06060034C ITY OF CUPERTINOae�+��
J
OIYTRA OR'TNFO.RMATION:-
BUILDING DIVISION PERMIT
v.a.,1Yd"e:n^.
BUILDING ADDRESS:
KI ENS BY MEYER
PERMITND. 06060034
10387 AVENIDA LA
"A'S NAME:
PERMIT L445E DATE
YVONNE MURRAY
278 CASTRO ST
13 2006
ONE
SANTEARY NO. CONTROL NO.
(415)968-8318
ARCHIIEC IENGINEPJR:
BNLDWG PERMrr INFO
ELECT PLUMB MECH
LICENSED CON IkACIORS DECLARATION
lob Descrlptro
I hmeby YTum W t I w inloN urder prwiu«u of Cluywe 9 (mmmmdnt
with S.IIm ttt1J)of Divialm 3ofthe Butir„.• and Ndci .Code,.nd my it
infdlrar.uddfm. 2
REMODEL KITCHEN AND:,I ST? AIj6 NEW WINDOWS
cCT
/-Ci'(O
Ditto/ Comm
Ditto ( SCIS DECLARATION
I uP c(. my phi -hall be usd u pabtic mcmm
LiccnaJ Pmfcstlao.l
DECORATION
Oil
I. ..Pt fmm the Cmtrame Ltms U. Lar t
1 h.cby mrrum Nat 11.,
OI d mwuy
ma,aa. (Sevum TUl I5, Bailmv and Praf®tau Cale: Any
Bwi Y
$30000
which moo b. flce m
which
Sq. Ft. Floor Area
Valuation
ju i&iu.pmmtt
ftoiM Wictt rar hP itiiirandm,cmcm
uiou applicaat Lor ouchp
p.,t U.dswenimt
P. ttotur dme G*euz .',Li O. (Ciaper9
hoi
Uw he l.Il.nwit purauot m00).r
io,ii Ndldw
Dim PrafadMlwu Coek) Of
tim T00 i"m J of the B
(canmeii
d c,cud
, pt them old the Eula f« the ted eawpm Any vial.«& Of
it the
1 that b V aempt Ihoy
r
Occupancy Type
. to
any .ppllant f« . pewE abjcros the appB�t m . 6vB perwty of
Swim 1 ppli
thin m
not mate dun five Evndrea dallus (I500A
❑ I, u owmr of &tie pmpaty.. my empbycu cdnpeewlm.
foto uudle
Required Inspections
q P
«art�d (Sec. e�nO,a
. too wok4 d th TIO ..
Cbmoatm . I `a
Pmfoo3. Cd,
i, oat WAY li,.
uta Cadc Th Canaamorm Idr a*m oat appy n u awn-
M who a
propertywhobuadm rtiraPrved ,and who does
Orty who W
off'r«Wmtb hu
imwortt
wn cmplvycc, provided Beep d for sale. U.
mac! imp... are trot tour9c
inpica
v Jmbum « np am lar ofimop
fmmeovoa-
of immtVtufawithin
wuaa wm n..<the eaam or Amity wt ee ala aw Wald «toptave r« pmpo¢ of
Wij ijiO
ale.}
❑ 1, u wm a the proiietty. w ..•i„avely conte ' with Um mrd to
caaarmt We V*m (5 7014, Buz. -Id Pmf=—Code)The Cmv '.li
Liv d*ea oot appy n. awns of pmpmty wbo builds «improv° Ihctmr. >od,
who c*n ^^• r« nrth pajern wish-omaaenrrm) Il.as l pmmwm m de COruracm '
Lvccns Ido.
❑ Iwacmpttmdn Bee .B&PCforihuteuo,
D.r
WORKERS COMPENSATION DECLARATION
I beroloy tiffirizi umler pointy of peryry me of Nc follovitq dmarel"
Il..ap wiBf "•OaCcN3700aComeatnfrJf.f. f«W. Co.fm
r>om. u provided f« EY Scctimi 3T00 of the Idbor Cane. rm thv perfdmmoe of Je
wart for which Ibis pmoit Ls imsl
Q 1 ba a inti will ouinuin Worte . Compom-1 . Ioau-rla, u rcgimd by Salo
,
3'7W olIhO Idbar Cade. Lar me pmf«aurrs Of the wort f«.hici Nim pCmb I-I-
MyW.VCom Itawnrt¢ a rt{v aril POLLYI-m-ly�.bnqque.
Carrier. U'd 11 .r Pniky Na:lLY^"•-6o-
CERTIECA OPE7fEMPTION I'ROM WORKERS
COMPENSATION INSURANCE
rfh6 acctlm ocd nd a wnpkactl Ras puma V r«sae h«ISva a00sa (SIM)
«kaa)
I artily Jut io the paf«ma«o d wrvk fd which Jda p.mb la ivuel l mt
=u
employ airy person m any murcnn u u n b.ame wb)ect m the Worbma' Comp®tba
,
Laws of Caliform>. Das
NOTICE TOb) APPLICANT. If, �, Esmopfnn, yo,, mbmot
NOTICEBcr
r* msiom, of Code, yw vtoR
W.term Cmppeoutim pm it Tom Of Ne
bans mbjw m CommwtJt
it mei i
ranhwim comply with mach proviuon�«mu permit 001 bo ticcacd n+atcd.
CONSTRUCTION LENDWGAOENCY
1brrew Ihumem u-eaanrtai3nkMint-tmcY f«Aamutrs Js peof
> the waf« which thLs permit b Tama (Sec. 3097, CH. CI
rt
LetdcYs Nvoc
� leohrs Addcu
1 a fy thu I live rrdd this applkuim and swe that the above i Warm W m u
` mm1-true to comply with Al city and cmmty oldlnarau W awe lawn rtl-ant to
W iMint convructim, and hereby onhafi. mpleuntaJvcs of mi, City to cnsr upm me
4 ]trove mentio d property fm it vtim ptry &
(Wc) atm[ to ave. Indemnify .ad t¢p humla, the City Of Cupmom .taiam
1)) IIablBtim jod5meou, coil nd upvuu which may In any way.caio-&-imit aid City
in cmacqumce of me {nolo& of this pm,nit
APPLICANT U ERSTANDS AND W COMPLY WITH ALL NON -POINT
Issued by:Date X177 iV
L
OURCER TI S.
__A
Re -roofs
T of Roof
Type
si&auurt O&AppiovUCaur.n« D"e
HA]ARDOUB MA DISCLOiURE
WWNe hatmc haaaowm-uvl
afuroreipti
Co*..Chanta«c«
' delloed by the CupMim Mttnklgl Com.per 9.12 and the Hath >m BaMI
Cip
. S«Jm u53u.n/
fW
All roofs shall be inspected prior to any roofing material being installed.
ElYa ,ICJ
If a roof is installed without first obtaining an inspection, I agree to remove
Will me.ppmnt or futus bullWn& mvpam us cqulpmcd a &c v h
omit hudrdow air cmumiiwu o JcMcd by the Bay Art. Air QWity M.utv«_ot
all new materials for inspection.
Dv tT
❑Ya Pilo
1 bava wd Je haaNrus wl.,L.4 imincmemi m rc",495 allkfdl+ror.
nil Halth&Safnyc*de,SwOotts 75705.25577 and 27534.1 imolco rd thitifthe hoTmnt
Jou not c w .IrmnL it u my ral,oh ibi ity to edify me o.Wam of me
-ns .naRho ar.C.JBO.barSignature
of Applicant Date
All roof coverings to be Class "B" or better
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