02060071 CITY OF CUPERTINO -
•
BUILDING D[vfSfON. PERMIT ;CONTRACTOR.INFORMATION;
BUILDING ADDRESS: PERMIT NO.
,b358 ' LOZANO LN R & Z DEVELOPMENT 02060071
OWNER'S NAME: PPLICATION SUB DATE
AMPO DE LOZANO L. P. 21771 STEVENS CRK BL 410 02/28/2002
iPHONE: SANIMARY NO. CONTROL NO.
(408) 252-1101
..ARCHITECT/ENGINEER: BUB.D04G PERMIT INFO
00''
BLDG ELECT PLUMB MEC11
L"-1 LJ
ay
Z rJ h Z LICI hereby vRrm�m I aSEDmOcensed CONTRACTOR'S DECLARATION Job Description
o�-o pmviam fChep¢r 9lc.mmcncin TOWNHOUSE-LOT 6 #A
Fm{=w with Section 7").17M.1 Jof Ne Business en .e ,afi�h n
zo6'u , Lien Poll f. a de t. /-"] LIVING SPACE 2 , 023 GARAGE 441
z re a Liccn C ss a' " Lic.N I I
k w Dat Com r
F�DYn ' ARChallE use DEC ° SEE ORIG PERMIT 02020]���RE S®
g , uWars nil my glens shall be usedesp li . ea�.rsC�
oaf
at p O Licensed Professional •t q q
Oat I am exempt
from
DECLARATION MAY 1 2 2003
-w 1 hereby affnn slim 1 am exempt from the Contractor's License Law for the
F Z a I following r,peat.,]011.5.Bminesv and Professions Cale:Any city or county D ri
whim requiresimsi a gamut re enres the alcor,improve,demolish,or repair any structure,
.pnortudlicemle 'tows issurtiou. requires the applicant at cap nu',o rile License
gaw(Chament on
>•3
that bdis «,yell Secl )t the prf Divi of theC E cors, Law(Chapter9 I
po ,S t,Foor•Acea. ff Y ! $208 on
(e tmc epgwih Se tloni7W0).f0iv Jfth qusinest nil Pmfcssionx Cod<) ; '�4L�a�f�•�,4'lQ ./AL .[JR I'L'Y{{t'�;O.t Ju ,l;
ofS t h xlmp(ih rcfr mimJ the baits for the object,
the
eae 'pilon Any violin on
or axon,a Iba 5 by any hundred
d mr°ry permit anjccu the applicant m a civil penalty
�i.rnatmnrt.�nanRven.narcae.u.rslsStxn. ,,gqpprr�NN rub . � Occupancy Type
3693200r . fi
will
do he or:.rd the
t,ny entplo t es intended or offered thefor a c.mpensmion, f'
it ll'do the Professi ns smicwrc C nut mrcnded La for sale -
tBunneas amd erofas Professions Cale.The Contractor's License Law docs not apply m an 101 - FOUNDAT I� I(red Inspections "• ' ^ -
owner of progeny em builds or improves such and who does such work hded
or through M1 employees.pm u d that h' p menta.rc not tmpndpa or _---. .PIERS. ------ ._.-. .._-. __..._ _.
,offered'f su 'If,'However,the building - ___102 " ""' -- —"
8 P improvement sold he did one Y�of1.7,vf.P r tug
aomFletion the nwnenbulderwill have thehuNcn.fproving thmhed'drot buldor 103 - UFER I `
,
,,completion,
purpose.( •
-1-0-4-------REBAR _ _ _
an
L
bf the progeny:am scion ely vacs ngwthlicensed unci to 105 - ANCHOR BOLTSo.
' ° t t the pinta,(Sec.7 Basin n d Prof ons GMc)Th C.mm t s I.
' u nsb Law does
not agplyi an.woe rpr.pery eo b.lean rep sin 106 —_ SEWER & WATER
and w contra (.r.$.c podecul ffi co t el u(Ircensed ursuam.to.the .-__ _....
C etrsu oat mow. rtaaon - 202 = UNDERFli00R,t,PliUMBING
6 0m 203 - UNDERFLOOR' MECHANICAL
c _=. Ovine 1 Q 1PElare DELLA ON
204 - UNDERFLOOR FRAME
aRrm under penahy,of perju .a6.nne rml.wing acpieme.�.: 205 - UNDERFLOOR INSULATION
301 - ROUGH PLUMBING
t� ❑ 1 have'and will Maintain a Certificate or Consent to self-insure for Worker's
Compensation, m
per ,pmvtdcd for by Section 1700 0( the LaborC.de, for the 302 - TUB & OR SHOWER
formance s he work for wh-i.h this permit i,i,s«d.. 303 - ROUGH MECHANICAL
❑I have and will maintain Worker's Compensation Insurance,as rcquined by Section 304 - ROUGH ELECTRICAL
i= ,
3700'of the Labor Code,forthe performance ofthe work for which this permit is
.. - iss.ed:My Workers Comppq.adon ms.,an=e egrier..d P.1ie_numberrua :. 3 0 5 - FRAME
r: f4 'Ll tQ.a<r Nn - ,�,-.,.,;306.,, I1HOLDOWNS--'
Ca aril,j CLRnIICATION OF EXEMF71ON FROM WORKERS] '1/ • ' '307 "- INSULATION' '1-p,. {
COMPENSATION INSURANCE ' . . ._.,..-.- -.__.__ - .._
"s"?n s section need nm be completed it the an t is for one hundred dollars 3 O 8 -' SHEETROCK- -J"I.• ( ' Vit.+!!. " r:r. ,..
�E100;°r'csa) 309 - EXTERIOR LATH
r n w` ai ,3.10,._._"INTERIOR,LATH
el ail wn
al B, ' ' 'h`W°'�`" 311 - SCRATCH COAT '
p n
...NOTIC tD I - '_ _ '. . " .._..- - 3-13.__..'"ROOF 'NAIL.._.-,
gmn en me fExnmpto 'y u h Id
O Z lfnnh tryuhj«i th' er.Cmpensmm p s ns ofih l b Cod youmst 501 - FINAL ELECTRICAL ENERGY
ply n.1 .. .v. :Dili p rm.. deemed-d .revoked._- 502—'- 'FINAL' PLUMBING -ENERGY
+CONSTRUM]ON LENDING AGENCY4
Ihertby affirm that there ma construction lendng agency forthc performance 503 - FINAL MECHANICAL,IENERGY:'
} of tae work for which this cnail is issued(Sec.309],Civ.C.)' " .. '
y.;p .'Under,Name'— ::_._..::_,..� •_. .-_'.. _... ._. 504_.,-.. FINAL.-BUILDING. ENERGY-----
As
.... .. .
Lender's Addrcs�"-'+
z 505 - FINAL ELECTRICAL...,
-1'cenify that I have read this application and state thin the above information is 506 - GAS TEST
1 cc--..1"pom to comply with ali city aed county ordinances and state law,relating 507 - FINAL PLUMBING
rebuildingcansuunina.andherebyoutndriv rcprcxenmtivesoftailcitymemerup.n
the vbove-meminnedptse-, i .penin pntourril. _ ,- _ 508 - FINAL MECHANICAL
.0. e)agr emd bifyanJ - pharmlesstheQty f perag.tainm 509 - F NAL
W lip n s luJ• em c n d expenu h h may in any y asst t sail
U,.Z ry u ¢e (ilia arcing of rmn / '
- SOPPI -CU' D'RS ` I S A t CO\IPL\',ivlyr�tl�ib'l;;r� Issued 0 N I G Date
S' - .r f cat - . t. - `77//nIDace '
F RDOUS ATERIALS DISCL URe-roofs
RE '
h pplcxmo future building otc panto arh MI hazallous material ._'type of-Roof-..—,. - .. ..
as defined by Contention Municipal CM Chapter 9.12.and thHealth andSafety ,, t .,F q y.~ .r t - t^ '� -., - - -.'`.a.t ...L '•'R••••.--"__�'•.
Cade OYs 25532( ) . . :.•h.
All roofs shall ke mspected.prwr to.any roofing matenalbeing installed
Will th applicant for bu i g pant use equipment odevices whips If a roof is installed wit out first obtaininganins ection I'a tee toremove
•inn b z rd. s comamina s as de in d by the Bay.Alra r Quality Management P g
Distnu? all new mate for i pectio Applicant understands and will comply with
°Ye t - . . . of so rce r gulatfo s', -
1 Navel eud'the rely v mat ria 505th retreats oder Chapin h.95 of the
Calif ria Hm SfetyC Se 5505th) d 5534Iunacrstond arm ("J�
ift in t es mem have t be cr t a ny resp n ofaCa tfy Ne
c a o ItF eqt rcmet bch.n be ma pr.no soon .feCo woe f "'•' '
'•,w -_°'' _ ` �� Signa,, r o pl icon[ _ Dat
r mint t Date All roof coverings to be Class,"E or,better
FFIC '