01100024 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10101 N. DE ANZA BLVD. 4TH TAISEI CONSTRUCTION CORP 01100024
OWNER'S NAME: APPLICATION SUB DATE
SANDHILL PROPERTY CO. 6261 KATELLA AVE 10/04/2001
PHONE:
(714) 8 8 6-15 3 0 SANITARY N0. CONTROL NO.
❑z Z ARCHITECT/FNGINEER:
P❑O BUILDING PERMIT INFO
m BLDG ELECT PLUMB MECH
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y a n. CJ I-'-- CJ L..I
H= LICENSED CONTRACTOR'S DECLARATION IOU De$CCIpIIOn
5 Z-❑ I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing
w t_m with Section 7")of Division 3 ad he Business and P ofessions Cock, dray license INTERIOR IMRPOVEMENTS .
c m 4 j
is full force and ellbct. n '7
z e a LiicenuSlass�/J Lioc.a .J
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Date p_'3___ S manor
a u y �� AR ITECI"5 DEC ATI
1 undemand my plans shall he used asp hlic records
3 d O O Licensed Prol'esional /
rc OWNER-BUILDER DECLARATION O
a I hereby a1Bnn thin 1 am exempt fund the Contractor's License Law for the
?< following reason.(Section 7031.5,Business and Professims Code:Any city or county �l 2 O O O 0
s ❑ which requires a permit'o consumer,aper,improve,demolish,or repair any snucurc
a 3°�O 'Poo tot Iso q rhe pprcont far Cmdracrmlu is Law(
that he 1 ce d p rs t'o tit'p .Ions of the Contractor.L' La (Chapter 9 -
(commencg 'thSat7")of Division 3 of the Busincra and Profep ns Code) Valuation
or Nat he rs excmPi therefrom and the bass for the alleged ekempuon.Any violation i
of Satin 70313 by any applicant for a permit subjects the applicant to a civil penalty
of net mem than five hundred dollars S!410). l 01APN QDATI ON I• Occupancy Type
01.as..,of the propenY,ormYemployees with.'eras than sole compensation, 102 - PTPT
will do the work mall tie structure is nos immtrdcd ar offered for sale Soc.-70x4:
Busincu'and Professions Code:The Contmcmr-a License Law does not apply to an 103 — UFER Required Inspections
owner of property Who builds or improves thereon,and who does such work himself
or through his own employees.provided Nat such improvements are not intended or 104 — REBAR S
.offend for sale.If,however,the building or improvement is old within one year of - - -
theowner-builderwill have the burden of proving that he did no, 105 - ANCHOR BOLTS-
completion. �f ,
mprov rnrpagm ors°"')' 106 - SEWER & WATER
_I.. .. ._ . - _. .. . . UNDERFLOOR PLUMBING
Cl 1,as owneno(the n,am endusivd convanin 2 02 --- - -
PmPe Y Y 6 with licensed contractors t° - t l ,
Lconsumer the project(See.7/314,Business and Professions Coda)The Contractor's
icense Law does not apply to an owner of property who builds or improver themes, 2 O 3 - UNDERFLOOR MECHANICAL
and who corim,,ts.for such projects with a contractor($)licensed pursuant to the
C°mraem'sLicenselaw. 204 - UNDERFLOOR FRAME-
Olmm<semptunder San
. B&PC for rhisreaun 205 - UNDERFLOORINSULATION
owar " rude 301 - ROUGH PLUMBING
- WORKER•SCOMPENSATION DECLARATION 302 — TUB & OR SHOWER '
1 hemb,affirm under penalty of perjury one of he following declarations:
303 - ROUGH MECHANICAL
01 lone and'will maiatim a Certifcme or Cement to self-insure far worker's 304 - ROUGH ELECTRICAL
Compensation, as provided for by Section 37W of the labor Code, far the 305 — FRAME
performance elite work for which'his pnmit is issued.,
3 se d My CERTIFICATI OF E%EMPr10N FROM c q d by Se u 3 0 6 HOEDOWNS
I h add ll m°m W k Coo e I 1 mer
C 00 f the Labor Cod f the psR mn c< f theork f h ch ed perms is
k<rse pen I I nip«5p dPol r number 307 - INSULATION
Card "Pl ynoO ! 3 308 SHEETROCK, •r .'
woRKERs] I-t . ;309 s-'EXTERIOR=,LATH°;
., T COMPENSATION INSURANCE"" ' .--........-_----
_
1. 310,--z-.:INTERIOR'-LATH:__.'
mda acaddn<ed h-tri x enmpineE inns pemrh i$for one namared malars .. .,.I ..... .._.._ _. ...
(SIM)or lest> „ I 311 SCRATCH COAT
, I cemfY,dom a the pefformsi°r me work rte whim Ims penmil i:1.��ea.i . . 313' — ROOF NAIL .+..._. .. . . . .
snail nor employ any pexn in any manner so as to become subject m the Workcri 501 - FINAL ELECTRI CAL ENERGY
Com
laws of California.Date
App'Lt .5.02 - FINAL PLUMBING -ENERGY
AI
NOTICE TO APPLICTFU armmaking this Crtfcale of E.emptim.,you should
O z forth m the wnrsC p"sate provisions onn LaioCed you mus, 503 - FINAL MECHANICAL ENERGY
with such forth Pettit t hall be. d revoked.
504 - FINAL BUILDING ENERGY
oden
5
ro%ithcomplysubject
' 't r CONSTRUCTION LENDING AGENCY 505 - FINAL ELECTRICAL
a 1 herebywhich that there,is construction lending agency nor the perfortnance 506 - GAS TEST
W,QLeNc wink for which this permit is issucd'(Sec.3097.Civ.C.)
l<ndcr'a Name' '-` -
j z Undn'$ndd ps 507 - FINAL PLUMBING
U O I ify that I have read this applicator mal stunt mat he above information is 508 - FINAL ME CHANI CAL'
Ot& E" correct 1 agree,o comply with all city and county ordinances and state laws mlating 509 - FINAL GRADE
.V to Wildingconswction.and hereby authoiiie representatives ofda city to enter upon
jw.:W theab°ve-mennonedprepenyfor inspection purposes. 510 - FINAL PLANNING
ti6. (We)agree to save;indemnify and kap harmless the City of Cupertino against
V1 liabili'ic"jadgmems,coats and expenses whichmay in any way accrue against said 514 - FINAL PUB C' WORKS
V-^ City in consequence of the granting of this permit. I
�. 'APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT'
SOURCE'REGULATIONS " " -I r Issued by: Date
,IB.n. I
OpF HAZARDOUS MATERIALS DISCLOSURE
Date
iRe-roofs
Wll he PP tf'ortbu ldngpant stem eur handle It",matcnd Type of R
oofas tlef W yth Cupertino MunicipalCSafety
Chapter 2 and Ib Health and Code S a 255tyy f^ rr + / .. . . ONo t [' ' r " "'yes
n v.. t .at: ' ]fJ t t..• .• .. .'
Ali
roofs shall be Inspected prior to.any roofing material being installed.,
I, Willthe airc0nnto fumrtbuildingbytheB Bay use
pm r devicesragerach If a roof is installed without first obtain an inspection; I agree'to remove
ami,hnwdovaair collum tan's as defincelbuilding
by the Bay Area Air Quality Management g
Diumc T� 1 . all new materials for inspection. Applicant understands and will comply with
Oyes ' ,O No
4= all non-point source regulations..
I have read 'broadous mamriili requirements under Chapter 695 of the '
California Health Se Code,Sections 25505,25533 and 25534.1 understand that
ifthe bit in g0 n y avec tenant,(bar it is my respinsibilit,'.notify the -
nccupant of no, ch must be me'prior to amance of a Cenificam of
Occupancy
Signature of ApplicantDate
`^' Date All roof coverings to be Class"B" or better
OFFICE ,