02030014 OF CUPERTINO
. CITY ILDI c DIVISION PERMIT INFORMATION:
BUILDING ADDRESS: PERMIT NO.
NIJ-DESTGN MANI JFACTI JR ED 02030014
^WNER'S NAME: APPLICATION SUB DATE
NIGHT GEORGE T AND JOAN L T U 1566 LA PRADERA DR #3 03/04/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 374-4362
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
Iz BLDG ELECT PLUMB MECH
is If
LICENSED CONTRACTOR'S DECLARATION
L h Job Description
z- hereby )m,Division
In3licensedunder provisions,iva Cracr.r(commencing P
m 1-,�i with Scnion7 )of DivisionJof me Business dProrasions Calc.end myli<enu
rrE of .I PATIO ROOM (192/rG9�,k'TT.. )
a. Lee seG Li .p (192P
"�� a,
i3 rc u - S �vacp R �H+a�►
a C In l RCHITECTS�Ar I
£,�;:.� 1 understand my plum hall be used as Public records MAI?
1 Fq r,
1 v' r /YI/"1(� 2002
K p O Licensed Prof<saional
6 R OWNER-BUILDER DECLARATION
tw I hereby ff that 1 pt f theContractors L' La r the
F'Z Q
lodowing mason.Sector.71315
3O priorits - 8 - d Professions CW Any city o
which a pet ict t alter. h repair anystructure U� `w -. 13 IL
I_IV-.C_.S. .1 10
0-0
. PPprgneatmem
d»In< I< aian„na .
D ;' n nn Contractors c La Icnap, 9 S Ft.FloorAreaw„
(commencing 'tnsen 'rano fD' 3 nn B m and Pror�«o:Cod a v' gg ,y �`, ; Valuation
or that he s cxempu immi7mnt and the basis for me alleged siempuon.Any violation f�S r't '3 6'9 3 6'019'.,0 OFT'I``1'd t
-of Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penalty
of more than five hundred dollars(Sso01. y APN Number .. Occupancy Type
❑Lasown<,of the norm employees with wa 1,a,theirade cam nsmlom 101 - FOUNDATION
-'will do the k ad NeYumt y '.poi intended or offered for sale(Sec.-701;' '--- -- ---
�Bu .n< and Professions Cod :The c ntactor s uecose Lan anew mn apply to an Required Inspections--,. t
owner of property Who to lea or i raided t thereon.and vem doer such work himself 103 - OF ER ,
nr m d h his own employees.provided that such improvements ere no,intended or L04--- REBAR----
;orreRa�l=alerlLnowevec me nuilam _ ._..-- . tis said witn�-nne��ea;i,r . . .-.-. --.._. _.._-._....._.. ..__....... ......g or improvemen n y
r adci on,the uwric,la ider will hove be burden of pra.to,that he did not build of 105 - ANCHOR BOLTS
improve for pu,pme riffle).
'
.
106_.-_-.--SEWER-&-SEWER & WATER
p l:as owner ohne inclosed,a exclusively contracting with r dcontractorsed
rOnatrvn the project(Sec.100.1 Business and Professions Cars)The C t scams 202 - UNDERFLOOR PLUMBING , -
LicenseLowEoe,ant apply to an owner of property who buildaorimproves thereon _ 203 - UNDERFLOOR MECHANICAL
:. -and who.convacts.ror such Projects with.a.comrectots,licenssd.pursuam m.the
cnIdreirsueenh,Scc. 204 - UNDERFLOOR FRAME., _....._..._.. _- _.._ ..__...._--- --. .
❑lam cncmpt under Scc.' �,B'&PCfonhis reason
owner ' '•rive " - 205 - UNDERFLOORS INSULATION
WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING
Ihe,ebyarrrmunaerpenaltyorperjaryonenthe,following deelaadnna: 302 - TUB & OR SHOWER
❑ l have nye wur'mamtom'a Cenifcam'of Consent io self-insure for Worker's 303 - ROUGH MECHANICAL
Compensation, as-provided-for by Section 37W or the lanor Cade, for me 304 - ROUGH ELECTRICAL
performance or theconch,work for which this pm, is issued. 305 - FRAME -
D i have and will mamtnin worke'ra Cmrfman3atiom hisamrwc.a:tegfirea by section 306 - HOEDOWNS
J100' fine Labor Cad f the performance of me work for which din permi
issued.MyWorker's co 3.0.7,,.,_ , INSULATION. ,
_..Compensation Inswance cam- nd folicy number am.. _ y.
r /1 ...-:. :-
nrs .S%'a� L0.%{`NN/�PoICY T/l�" , t+z' ;308�:`:iSHEETROCK,a
FEX "IONF O WORKERSsr !
rv.
.. CEoTIFle_CO�ENSATIONINSURA_NC_E -, ' -_„1_v `309--_, EXTERIOR„LATH. _ -----------
(nil' _
COMP
cam Idea if 310' t' INTERIOR LATH
IS I00) less) P pe 1' (o oneh hundred - ,
311 - SCRATCH COAT _, _
shall,i It mI that in'be a -,f me” •kr which Permit; ko a i _ .. . 313 - ROOF NAIL
v v nyper o y a m home subject to me.warkers 5 01 - FINAL ELECTRICAL ENERGY
Compo t o Low,of Calf u.rletenn r so as
APPI cam.
NO'lICt 10API LICANT If n, -k gm,c mfi<aie arE pt ygsho is 502 'FINAL PLUMBING- ENERGY
Z bee me subject, the W rke Compensation provision,of the Lothar Code you anuit
cc foMwith comply with such Provisions or this peri t shall be deemed moited. 503 - FINAL MECHANICAL ENERGY
QCONSTRUCTION LENDING AGENCY --5'04 ' =----FINAL 'BUILDING .ENERGY; 7-,�- -- - --
y h 'by ffmthtm conies t nlendingagc cyfo th p n tt 505 - FINAL ELECTRICAL • :
y'qfth work for which this Permit's tssuad(Sec 3097,Civ C) -, _ '
Leader',N' .. _. . , ................ .506 ...--..GAS -TEST -.-. _.. .. _
U z Lender's Ada . 507 - FINAL PLUMBING
O mrr m t I n a in apphe r e t;m mat m<abovrnfernation is
508 - FINAL MECHANICAL
lir cor ct.i agree to comply with all city and county dinances and state laws relating
O p tobuilding construction;and hereby eutbortcmiamsentativesofthiscitytoenterupon 509 - FINAL GRADE
. the above-mentioned property for inep,nion pmpous.,
tz0. OVO s mare a< fyandk pnarml iM1'ecty ofCpen;o"agamst 510 - FINAL PLANNING
W liabilities,judgments.c st a penses which may n any y accrue against said 514 NA P WORKS
V-Z City n Consequence of dagra t g of thr red, !'
AP LIC NT UNDERSfANDSAND COMPLYWITI,ALLNONp INT'' 1
- - 1 tEGULATION Issued by: Date UZ
n 2 9
sig atumofApplmanVCo, demi Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will the applicaarrtofr future blding m6upant storeo handleffLamons manen1
Type of Roofm carried by m C pertnoidme pal Cad Ch pt 9 2 and the Health d Safety
t - -- -
Coe S t n255RO i i5p a� C Va 1 ?fk+. a 1?t1 a i C,y!
❑Ye ❑No .. p -
All roofs shall be mspec[ed prior to an roofing.ma[enal being Installed_ _____
Will me apply n, brute bu la' g ju ,sae aqu;p`menon,dev,as whim If a roof is installed without first obtaining an,'
:run norma enol is a fnmb th Ba AmtA Management g Inspection,I'agree'to remove
District' Y Y Q al ry
DY ” ❑No-, ,,. all new materials for inspection. Applicant understands and will comply with
all ri oint source iegulattohs; -
4- r 1 h e ad the ha d le'al req 'mme , de Chapt 6.95 of me
C-lifictini H olth&Safru Coe,.Sect ons y550h t it
d s onsi I d tuna that
the
fine bu ld ng d0<snotctems adich" aten ttht't yrespo of
mof
scups,o c requ rtments wnah mu met pct t Lasts tt of 5 C nificam-'f
-.g _ ._ .. -. - - -- _ — - --._
i nature of Applicant Date
Data All roof coverings to be Class "B"or,better '
,
t ..... OFFICE
xl