02060078 CITY OF CUPERTINO "
BUILDING DIVISION' PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
R & Z DEVELOPMENT 02060078
OWNER'S NAME: PPLICATION SUB DATE
PODE LOZANO L. P. 21771 STEVENS CRK BL #10 02/28/2002
.PHONE: SANITARY NO. CONTROL NO.
(408) 252-1101 '
z z :ARCHITECT/ENGINEER:" - -- BUILDING PERMIT INFO
w BLDG ELECT PLUMB MECH
Z 5 H= LICENSED CONTRACTOR'S DECLARATION Job Description
'�m 1 hereby offire,Mat I am licensed under provisiom or Chaprcr 9�y (commencingwish Surian7 'vision 3of,ha Basin rssio li eree
gxf3 'iarmm�rree , TOWNHOUSE-LOT 4 #C
KpwU 'LDiatrnse a - �o^a ' LIVING SPACE 2 , 012 ' GARAGE 444 '
F�LLo ensoEc RA' SEE ORIG PERMIT 02020114 FOR FEES
},g .I nderstand Y plans shall be used as public c
tor
M 2 Licensed Professional or
OWNER-BUILDERDECLARATION '
r�r I 1 hereby of rr r that 1 am exempt from the Contractor's License Law for the
F z a following mason.(Section 7031.5.Business and Professions Cole:Any city or county
Y x O which«quires a permit to construct,alter,improve,demolish,or repair any souctum•
u"aj3� _ptror tots issuance,ekw rtqui«sthe apple t(rs ch permit toll aignW statement. -"" -_
ththgtl R<needfuis-@t tgthepmvislonsofth Cm ter LicenselnwlCMpom9 S F6.Floor-Area V luation
(c mmencng with Section 70001 of Divio 3of,h Bsmois and Profusion,Code) ('f�4°;';'l;�tlq :vlr,. !.'k r, +,r:::IT�Sb T.r)''": $20759
or Math s exempt th f nnand the bass for the al legN exempt mo.Any violation
of Senior 0031.5 by any aPPiicant far a p it subjects he opplicam m is civil pen thy
,.four am In .&ehandled do[lars($50to, ffl,qpNN robbe .• �� : Occupancy Type
36932001
O I,u owner or the property,ru my employees with wages fe Meir sole compensation,
do*t
will .-
Business
ca work:of and ns Code:ureThe C..Iintendeda Li or se Law foes alenot apply o an "- - - -
owner ss and Professions ild,o The Conuactot's,ad Law does not apply m an ae uired Inspections" "
owner of progeny Who builds or improves t such improvements
who encs tech work himself 101 - FOUNDATI V JUN 0 9 2003
0
or offer
aafa his own employees. Wilding
Out mgr int ant is sol are not intendedcyear
or .10 2 - . P I ERS-.._. ___. _____
;ocin,1Tor sale:'IL hbwevcq the buildingelimprovementismid hiidid one year of 103 - UFER I--
. -cdmpletion,the owner-builder will have the buNcn of proving that he did not build or `
fnkcl
eTorPu au"of sale.). 104 REBARBO - - - UILDINGownerofthe progeny am cxclus'dyrnmmningwiMliccmcdcommciursm 105 - ANCHOR BOLTS
-'' the project(See 7UW,But, and Professions Cmic:)The Camrecmr's
enaeLawdoesnotapplytoanow of Property whobuimaorimproveshcmon, 106 - SEWER & WATER .
."
,and,w connote, rar,suc .project ith a.communist licensed pursuant to the ._ .._ . . _ ....
.. a rS ' &PCfo 's reason .. _ .._... ... .._..
C. aLi ne aw. 202 - UNDERFLOOR-PLUMBING
203 - UNDERFLOOR MECHANICAL
are01PENSATIOND[C R ION, 204 - UNDERFLOOR FRAME
Ihr yafrtmunder seepy'otprju oneanhemtmwingdulvndonx: 205 - UNDERFLOOR INSULATION
'e. . for Worker's
301 - ROUGH PLUMBING
❑ 1 bav and will maintain a CcrtiGcam of Conant m self=nsur
a Compensation, as,provided for by Section 3700 air the Labor Cone, for the 302 - TUB & OR SHOWER
- arf9rtaeearhewaararwh<nthis p itiaisatreo. 303 - ROUGH MECHANICAL
❑r have ar4will maimain,Work<r'es-Compehsation Insurance,as required by Section 304 - ROUGH ELECTRICAL
37W of the Labor Codpermit
Corte,for the performance of the for which this is
issued.My Workers Compensation Insurance carrier and Policy number am: 305 - FRAME
cram c;t';" 1,;:ar,-r:pmmyNo: ,- s.; "3r06,.aa)HOLDOWNS; +,,,pj-lrt
`a.CF.RTIFlCATION,OF EXEh1Pf10N FAOM'WURKERS'1,' L4
COMPENSATION INSURANCE ' 3'0 7" _` INSUliATI ON
......___ _. ... __ .._..__. .P -� -. ._ . .. _...
'(This ecium neve not be w Iemd H rhe rmit is far one hundred dnllan 308 - '�SHEETROCK
(5100)arless' 309 - EXTERIOR LATH
. ,.1 nd]a rt eperto an« the ar io,:vm�nt "--r�i�a�:e;� 310 - INTERIOR•.LATH'::, :;.jt:;h; .... .,:,r
rn in em to Cali
i nr ma ner�" � � arkers 311 - SCRATCH COAT
m as
o caB nes
_.APpli a - ... ......_.. ....__...- -- -
'N Priacenh3entearExemption,you.naam _ - 313, = ROOF 'NAIli . .
Q'Z her ab it a pentanpro it hannhdLahnCalesardlr et 501 - FINAL ELECTRICAL ENERGY
Q :(onhwiM c ith z c provisions this pcnnit shall be deemed invoked.
"^ ="" ''� ""ctiNSTeucriDNLENDING ncENcr FINAL-PLUMBING-ENERGY -- - -
a:>" I hereby affirm that thereis a construction[ending agency for the performance 503 - FINAL MECHANICAL ENERGY
W ; of Me walk for which his permit is issued(Site.3097.Civ,C.)
y,q -L<neerxName .. ,.•.' . •. --� .. _ _ _ 504. -.....FINAL-BUILDING.. ENERGY...._ _... . .. ._ . ._. .
-O finder's Arklre:a;-' 505 - FINAL ELECTRICAL, ,
U Q , l chrtify that l have read this application and iMm that the above information is 506 - GAS TEST
comet.1 agree in comply with all city and county atdinances and stain laws Palating 507 - FINAL PLUMBING
r' �SU ro building conardciion,and hereby authorize representatives of this city to enter upon
rhea ve-mmriob<d prnpaf hirinspec'onpurpases 508 - FINAL MECHANICAL
L.Qs; (We)egr etas nify'nn key Mel, Cry fCpcnino ages nst 509 - F NAL � 1
Lir Vi li n to its t and xp<ns 5 which y in any Y me against said
U AP U� colt gI of L<orni s'.[ V Iq r'
� Issued p F I G Date vV
A a tUSMA
are Re-ro41D _ ROOF PLYWOOD NAIL
HAZARDOUS MATERIALS DISCL URF
Int capplicantorltuturc building o:cupant stere or handle huallous matanid , ,Type fQ',6,,�Of-.._ROOF--BATTENS
'ae d n 6 th Cupert M mint JI'C(W Chapter 9 I=,had the Health tine Safety
case oY zs53zn '604"',= ROOF.+,IN'=,PROGRESS
..All roofs shall be inspected prior,to.any.roofing.material.being installed.
W'lI the ppI a I r t naildi g c Pum useey , err d ee.whish If a roof is installed'without first obtainingan ins ection; I a i'ee.tdremove
emthe rd us at,cunmmn I as 'rel by theBay,A�:r�SrQ dry Management p g
Distnm, all new materials for ins ecti A beam understands and will comply with
"-.�Y ,�...,, -.-.. . ..
allni
, Z-2,
golati s. PP - .. P.,y .. . _ . _.
1 he e ad 5h hazar us material'reyu eine is ruder Chapterfi 95 or the '• t
ah oia He Safety c S vi s 5505 25513 and 25534r trhd that if.
f Ildt ae not rr ntlyh e t u that tis r «.p t ihd'tyt notify toe. . .or h .st be met pr ar r ries, ce of a C ntfcam of '
0 a g
- I n u D e
ht t uircm ¢w h
>. .
Date All r of coverings to be Class "B" or better' "'