02060073 CITY OF CUPERTINO
BUILDING DIVISION PERMIT 'CONTRACTORS INFORMATION:
t .
BUILDING ADDRESS: PERMIT N0,
10368 LOZANO LN R & Z DEVELO MENT 02060073
OWNER'S NAME: APPLICATION SUB DATE
CAMPO DE LOZANO L. P. 21771 STEVENS CRK BL #10 2/28/2002
PHONE: SANITARY NO. CONTROL NO.
-- (408) 252-1101
O O ARCHITEC(ENGINEER: BUILDING PERMIT INFO
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LICENSED CONTRACTOR'S DECLARATION
o Z r3- 1 hereby affirm that 1 am licensed under provisions of Chapter 9(comm emg Job Description
F_F wimse<tion]oml iortbeanaimp r erase TOWNHOUSE-LOT 7 #A
sin full'rce un e
on Za LIVING SP 2 , 0231 GARAGE 4411
moa
ARCHITECT'SDEpubsreco SEE ORIG PERMIT 02020115 FOR FEES
.a lundcrstond my plans shall rte used as �a����®
T
OK
ip p Licensed Professional
OWNER-BUILDER DECLARATION
I hereby of rat that 1 am exempt from the Cmunro is License Law for the
following mm...seetion 703 1.5,Business and Professions Cade:Any city or county _ MAY 1 2 2003
F O which requires o pemtit m conswc6 her,improve,demolish,or mpair any stratum"
3 m--prior m its issuance.Was requires Neapplicam for such person to file a signed statement ..
than hq l9,limn¢d pursuant tome Mansions ofdte Contractors License Law(Chapter 9 S Ft Floor-Area � , • uation
aoimn<m;pepsim smgnn,]000f or omiamn3onnp aaFjness Pyd fmr ssioes Code) C N' 1F;=i'q:t?>:. e.wi'e,�¢214A'1'jj};s, I � m���NG
or thaf fie Is exempt therefrom and the basis for the alllged efrtmpmA.Any violation Y
- of Smion]OJLS by any applicam for a pemait vubjetts t!K applicant m e civil penalty
of not more than five hundred dollars(5500). APN 'pNer`/❑mbe[ ; •.P'•r :• Occupancy Type
°I,asownerofthe n,urm emloess with woes as their sole compensation. 36.91PA . Ob
Prole Y Y p Y g penv
will do mei,a Footork:and the someoneore:The
not intendem"A d orLicense
a Lave draw sale apply toll; --
owner of end Processions CWe:The Cves ther's Ltceme Taw s such
not apply to an 101 - FOUNDAT wired Inspections!, "• ''
owner ofh his ow Who builds or improves thereon,and who does such work himself
or eyed h rats own pmpioyces.provided Hort such improvements arc not intendedoffor .10 2_- -P.I ERS
cart or sae. obuildete covetlding orimprovementof proving
sold within doe year or
an omvtion,nueowner-builderwillhovetheburdenofprovingthatheJidnutbuildor 103 - UFER '
m r erorp mos r 1 I. 1,04 - REBAR..
a her'If m p'ee 7nt Hausly cot n'gwith li )redo temrsm 105 — ANCHOR BOLTS . . t.
nnsimci the prn3mn(Sec ,Bas,a in ss and Professmas C ie)The CContractor's1. -
+' "kens Low does not apply u an own of property who builds or improves thereon,
:.. r .; ... tW au comr to r.su projecus inh.a conirmmr(s licensed p....wal lra.the. 106 SEWER & WATER
°Owa a arse - ;B&P yr. 3s.fea.�rah _ ..205...-_-203 UNDERFLOOR''MECMHAN ......__. . _...-_....._ .... __...._
Cut n Law ING
ICAL
h,P She ATIONDE EARA 204 UNDERFLOOR FRAME
I re atrmondprpeaabynrperlaryenenrtnernlmwmgdpolaratia: UNDERFLOOR INSULATION
1- - 0 1 h < d will mamtWa a Cerificam of Coaynt'm selr.imme far worker's 301 - ROUGH PLUMBING
m = Compensation. as provided for by Section 37W of the Labor Codit, for me 302 - TUB & OR SHOWER
performance ranhawnrkrorwmmmnpmiiaarra., ., 303 - ROUGH MECHANICAL
°1 have and will maintain Worker's Compensation Insurance.as nequired by Section 304 - ROUGH ELECTRICAL
a 37W of the Labor Cade,for the kdReimance of the work for which this permit is
issued.My Workefs Comppnsmion Insurance carrier and Policy numhrare: 305 - FRAME
t':"F.,,'t '.policy
No.: ;_i .1,.306,• ? HOEDOWNS n" Si�'.;. ..,..,a.,. .
:''CERTIFICATION.OF EXEMPTION FROM WORKERS'T'
COMPENSATION INSURANCE 307 - INSULATION
"•`(This seciiudn'ced not M comple d if the pen it is loro308 •.. ' SHEETROCK ne hundred dollars 309 - EXTERIOR LATH `
(E Iql)rn less 7
. � .. nod. rtmo,r orf ' o f'"li' i s �.y..reiveu�d'1 "310- "--`INTERIOR:, LA:
1"I c tr ih ._ ._... ..
sh et er fi . an rte v IQ/4e Workers Lr .:i.
pehsm 311 - SCRATCH •COAT
313 - ROOF NAIL_ . __..
�NOTIC 1 f n hi enif¢ate mf Exemption,you should !s��" ., . .
Zbeconn subjec t orkell ompenamiran rovizionsofiheLbhorCode,youmnst 501 - FINAL ELECTRICAL ENERGY
z 0 forthwith camp h such pmvi.sions or this permit shall he deemed revoked.
CONSTRUC- LENDING AGENCY - -"502' -'FI'NAL PLUMBING-ENERGY -.--
F-'� Ihereby shim that them a construction lending agency for one perfomtencc 503 - FINAL MECHANICAL 1.ENERGY
Cd ;a. 'of newnrkrnwwmnmtapmiiaiaaaed(s .3o9]:ci,.c.l 504__-- FINAL-BUILDING-.ENERGY-..--.-.--
..
Leader's Name..- .-___. . .. ."-..-_.._. _�...-d.. ....
`"°"aA`wr`a`' 505 - FINAL ELECTRICAL ..I
V - ;I certify that 1 have read this application and stain that the above information is 506 - GAS TEST
:Ta'F. cort<et.1 agree to comply with all city and county ordinances and state laws retailing
= O.V to buildgeonnmmiran,andhpedh 'ath"Fire pmsenmiivesoRhiecity menmrupon 507 - FINAL PLUMBING
me ab , ...o n pLnyfor 'Ps 'a. wposn, 508 - FINAL MECHANICAL
F 0. Iia I t , g e to s e mde i1Y and k P h less me City 1 c penino against
meg qa. t o Pensee n n y to any tart said 5 0 9 - F NAL
V Z Ly < ce th g god di t '
APPi 6- DE \
COMPLY I H L NOQQQ///-���P���%%%���jjjJJJ��/...���T��/ Q ! ` N I G
sot L+ Issued Date
S 9we as DateRe-rooi - ROOF PLYWOOD NAIL
s'd=en Cuen" icpa Cha ter9,lzandttl,<H 1m "db AlJro 60 ll- ROOF.-BATTENS
He ARDOUS MATERIALS DIS OSURE
Ii ppl¢ato fn bld'nguc< pnttom Qrha dlch¢' dou'tnatenul T eO f,
Code sect ,s°a p r x 1=*t R00F?'IN-,PROGR'ESS ' t '
°Y s 4I '` a bte Inspected pnor_to.any-roofing,matenal.being installed.
Will We applicant or' arc building occupam use equipment or devices which If a roof is installed wit out fir t obtaining an inspection; I agree'to remove
emit hw. mms aircontnmi is as d ed by he Bay Arca lir Quality Management
Disi xi,? vp, n. %, - all mate for i pectio Applicant understands and will comply with,
- -
a n n- Oi o ce r gulatio s,
have read the"'C t matelots 05,25533 a under Chapter 6.95 of the
Calif toi Safnyend haveSectionstea 505ot it
y 255. .lityI understandthatthe
iR tali d v cons, ich mus
).mato is to siOf. ificavthe
• u m n e r quip�mcne hi<h mu a men prior to,(5spa cc of e C ilea¢of - r�
gnat . . f pP-icant_ __. . ... _. _. -- D-e
o m r - Dam All roof coverings to be Class "B•' or better
OFFICE-. . . .. .. ..