07080173 CITY OF CUPER :INQ WNk'Q ilk AjTXt)
BUILDING,etY151ON PERMIT ;C'11?) `RACTOR X
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�. PBAMrf NO,.euu.oVIIMAI AV BRYAN & SUSAN LANSER 070801730
•. PWOW iS6Ua DAss
OWNER'S NAME(
BRYAN & SUSAN LANSER ,
- ... SANITARY NO, CON77WQL N3.
9HONI
ARCICITECrfSNC)INBBR: BUrLDIM3 PERMIT INFO �.
o at-am "VAMP
t icaNsn coi�naActon srlArwN Job Description
t bamby afArm that t are Ikeued MrAw NovWom or Clupat 9(comam 11"1
1F .•twSowo 7MnofiKaaw+39(40su W K94111111oft COO,adinyBcenMI'm KTTCHEN REMODEL NONSTRUCTURAL
in full fovea and offaa
t.taan"C Cies
Dina w �'onrtnc+a
ARcmrmm DRL7 AR.MN
I W)dcruawj my phaas 11411 be(pod u pabhe rows*
u
Lkett"d Ptoreggonal
0WNaIt•9UILDP,R OBr:LARATN✓N
I hereby dors that 1 am curnpi[tutu rho Convenor's W.lcaeso I.Aw for do
4 fotnrwin`rasion.(Sonia+7031.S,Sugom ark Pmfaasiotk C9do:Any city a trmy
$1 which moms a permit to covww.raker.hnluttv0,domolim,or rapoir my uAgAtmoe
x Mian W inuancu.also mquku,be spp0ant rat tach parmhm Ru.si{nod rWamom gt Cor A ea Valuation
< thru hC u iKcnsad pursuant to hrK provlsiosa M ata Conusa Wt Wane Law(Chapter 4 v�(1>
(commandno with SaWon 7000)of DMSWat 3 9(uk B Winws and Prafwaluns Cede)Of $20000
dot b9 I.attempt lhemfmm oral oat iieaia for tik W§spd umpdan.AD vlokO&A of - -�-�--
Se"i 70 LS by My app8tyrn ea a $VtOW We 4+p4ant to a f�i3r tK Occupancy 7*
not mac tho five Yundtnd dolibn E� �6 2 0 0012 . I�tuml3ct` UcCU arts
0 I,u rrWW at sir pnpeny,or my amps W"Wapu k thak ooh empeni aso10> �-•-.•-.--+•-. •.•
will dothe Watt.adtwstruaweis oma botenmdofo9wad(Of wa(s«.7`W-NRequired Inspections
UW Pto UW*,.0 Codi The ConrMao j Lkesue Lav does art apply W 29 Owner of
UWV 4"y who OuiMa aim upro'mit swb hMp"n," ora as Watt" o fatil fa ado H.
9waem9kyob Maui
ltt».9vru,the brdkisp)or Irnpmvsnat 4 aoW whLie new Year at wnptatioa.dk evertor•
lri umin WW ttea9 tm haom"of Mvi"Aa M de ea Murk or imwft rot pwpoaa of
i•u owmr of hbe proputy,aro aacir "ly conumd4l;wdb kruM Wo noon to
cm%lnn ttx prooct(Sa,7044,Aril m mod pwav"u Coda:)7'x cowwmes Li.
coma Law done ant I;h*to sal roma of pontWy wke WWI of Ugffm ea nharedn,VA.
who aantnetS for Ash proJom wish a OWWWlOM Basmed"""a to on cokmow'
Liaeeae Law. B 3 P C for IMa faauart
t;� "atzt.'d
ttmler Se .�.... ,,�� ZC
IJ
owtkr �g�tcm utU^C1.ARA7WN
A kaebyof perjury Ona M dna bikwlnS 0oetat9dat `
Cl I bsve WA will rtndnuln a eenibak of Conana vat revfawre for Rows Compea•
nflor.,a pmvidad for by moon 3706 of the Libor Cok for the iwfamfuru of dk
wok for Which this parmh t"WKW&
Soctilomi
. 33701 rc�ih o�l.t will
f tain�m fw*of ark amu(h POMN WrW g
my warmer Cartpegatitio inwrarea cattkr+wd Polley number rhe;
Polity Na:---
CLiCnFICATE of SXkMP110N F—M WQRKEKS'
COMMSAT WX UWJRAMM
(hIm.ahUM noted Tal he canPkred tr d0*11101ab Is rprmkAWdnd doBaf($1001
nr bp.)
I eeniry that in the performance of am wort to wbkb this Pennh M imkd.I abrtl a,a
1.mpl9Y any(artmn in any Matto t�pQ,e ubj
aoct to"Workm,cometawatNat
Lin"o(Cua ifornik 0
AAl
ppllau
NLYME TO APP�JCANT.-If,Mks antrrryy this C9rufksto of FA Mptfan,you iltotlW
tkcttma W bJocl ar dk Wat1Y"Cempotwti9n plorl>i0nt or the Labor Codk yet mus
a 0 fort(twsth comply with strh provWoo"of this pahtwt 4W to. l revolrat
T_ coNSTRUCnoN LaN(ym M3ENcY
N
"W I hamby alrism that Nan b a corwtuat3tr k**q a PWy ror dk f ar"onva a of
x?„r tha wpk IN Whith nMo pamtk is;saved(Sec.3W,Gk.C)
Q O Lender's Nsrtw30 w._
LandWsAddMU .,. .»
JO 1 mofy Or"r I have orad rids W.Allowtoe mrd sato Nu Wer 4buve(srcanatlua is
comet,I%Area W crimpy with alk city and cataWY ard(r,ana"s vnd sure laws td*UAI le
buddinS con"0141, hemhyamhoriao rcp(mnaWtwa of Uta City to anher upem Lk
�+ abo".tnanurmvd property for hnsprctiwh 111API tt
(m)mora to saw.Inkin ily aid he"P ttasrrWM that City or Cupertino aoaest
4 habil$ks,+odornwnu,CO-"9410101101 W►Li sa IN BOY Way wawa sWut"K Qq Date
,. �•���
in CQAAa icna9 of drat onntinrof"Porm14
Ap CANT UNDERSTANDS AND Wnl COMPLY WM ALL NON-POINT Issurd by:
SO RP.C)ULAITQ
Re-roofs
sh 910 t was KAAlsielALs rmSMOSUKK Type of hoof '
VA 40 feOata bulkkir aK'Cup"otmaC or b"udie harartlow fRalatl"I
u dc&W by shat Ck'I111631 o MtrdvW Cats, 9,11,old at HOA Cad W41
Cone,:mr3.+s320)r All roofs shall be inspected prior to any roofing material being installe(i.
Yur9.pWi�aa+a Dome brave,rte wmfpur,m oqulpmeN a „., If a roof is installed without first obtaining an inspection,I agree to remove
emh twxdGwt aU conowIRsntt u dvAr"+y*0 B,ry AM Au QWin Mea psba« all now materials for inspection.
Aurin?
Qw, s,.
I harm rad doe harardtrus maartato wq*4rt*rcna w,&fUPW 6,95 orf Gra Gonion•
ramiitaldh i sarctyCodo.SwboftUSM^.x'19.1,aw115334 IW4CW-Wtbaifthe bWWnS
doom not tw.emly have 4 seMartt,that It It toy rvmonsibiihy 10 aadf?rM 0""J"r*11 •- e ^"^"'
resaimmry WtuCh mum be nomll F(-so 0mv of a cortkale Signature of Applicant Date
All roof coverings to be Class"B"or better