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BLD-2020-1603BUILDING PERMIT CITY HALL I0300 Farm Avc'ue• CUp IIW,, CA 95MM'+cS PHONFgVIZ]f18 RYNOIMO MUM 10367 HENEY CREEK PL Cupemnb ARM: Sill PERMIT NO BIAWNIN] OWMIKI MAM1: OWXER'S PXONI: Nor PmvN COMRAOOR: C 6 E REMODELING WCOMORA1fD. Po1 HA965 AVENUE SAN IOSE CavinnC50R PNOM: DAM MID IWI/'NMO 31 PM IMID 11Y: NONLINEAR VALUATION: g605R dC&M omm . INt'f1'PANEL ROCP MOVHIO PV Sli 16MS ad CMMR C E E REMODEMa NMRPMAlm IICMOIDCLAIu YCMYD w: CONTRACTOR I" DATE 01/3V]ORI I Weby all that l am ltem under Me pevl a of Chand 2 fsgmm2acin, with acIgn Zi or poorer 3 or the aunner L Fairmont Code and that my Xcenm N he Moe and NNct. I nmebyo under morally of ped ore AN the MwMnR tree detlararens © I rave and vPo maFlaln O tern&ate of consent to sen:ruure la Workers Compematbn. m pmvidea fa by Snr'n+n ALM nl ion . Ea the paEamance OF wakfww ch Msp lhhswd. ❑1 nave and wR m rnlaln wanerS CampentaMn Imurance. OR pranced Mbv Section SILO OF the Labor code tar the pa'Iamance of to wak far wnlcn INS wnNNs blued. ❑ l off thorn IM performance Of the work for wmcn Mb pe It Is all I EfwE Iwt am" any person In am inner No as to become ugecl to nre wMM3 continental Mws of California. If aflm ma9ND INS cenlAcale of Normal I Mcane supect to the Workers Corrpemanbn paWbnS of the Ltlwr Cape I must f afoul h anph, Ain Such gavinam Or HIS pMwl Shol be d"e dmnsoW. 121 no" read the haxatlauf mmetlatl requirements mdm Cobbler 6.95 of the 1 All manroln campNmce wlM live f'merenn Mom... I rg and the Healm S SWIy Cape, Seclkn 25552101 sbwltl Istore or handle namrtlam MONOL Mulroney al l use equesmenl a aevlcm which Emil Mxmdam or cmlaMnaftca defined by the lay Area AN Wary Monapement WMI I wN mdnloln complal MIT the CuwMno MUNCIptl COW. Chuplm 9.I2 and the Malin R. Solely Cade. SeOlons EMS. 35533 and 25536. ©An EPA Lead Soles CerllMd Rmovala AN be rmpm9de for INS palest. CMIIted Film Name'. 1-1 CenllkOnan No EPA Lege.mfe cemnea Firm b regaMtl for me poled, firmNe: r•^rMnrvL le.mM -AeS I reeby of under di OF pi that lMre h a consMClbn MMnD pill for the wdormonce of the work wNM 0b pi Is issued ISecnnn SW), CHI Cedeb ❑Ye3©Nor Lender W1M: Le gAdMM: PN AWN fMIXYAMN I cm111ym l have read NO appllcollan and slate Nat Ind above Ffbmalbn IS caredl agree to comply wllh all chy and cants atllrm[m and state Iaw3 reMWV to bvlNkO wsmsPon,and hvebv oulborlierepaentollvesal mb tlry to enter upon the ocher menllonetl of fa Inspection pUtpotm. IWet ODree to save Me and "NO Mr ss the ON of Cupri ampi Mabllnm, lutlpemenb,cmS. and erpmm which may, accrue agarat sad Clly, in cameauence Of Me ganXnD Of INS wmil. AMlllandly. the applbanl ndental and"It comers, Ash d ranpgnl source rep4albnS err the n.natm, u..n',r roil 51Drgfum'. All hm'PmmYweeaervvnlneNvrwuMmkakewwreMwmPrnmYvmmxsMami MlMarrlxr.eMe. vXuewkaaNrwee,MwNveAPemlYwpweawiwv6Yre Rrwe MPsnerrr wrwree.nY.w...mars.