00050171 CITY OF CUPERTINO
xun.DING DIVISION • PERMIT CONTRACTOR INFORMATION:
BUILDING ADDR&SS: - n ,�- PERMIT NO. <
OWNER'S NAME:10526 A R 3J - APPIICA'I'ION Sr
PuOISE:. THE OBRIEN GROUP s^NrrnaYNo. cC dr]
OARCHITECT/ENGINEER: , - BUILDING PERMIT INFO
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LDG ELECT'"' PLUM❑ Ni 't
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1 Ir 1 NSED CONTRAC9GR S DI CI ARArION
z _ nrrcny n ;tht r ,ce da pro fi C pt ,y9 rte . a Job Description ..
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Dm -� IReci:ti n�c�A� llµ�ry � �TFAl7 3772 'LIVING SPACE, , 53�r• GARAGE.
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plan:.hall ba used as pubhe record, Y -
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OWNIiR-BUILDERDECLARATION
or I hereby alfm,that I em exempt fmm the Contmcmr's License Law battle
ollosI reason.(Section 9031.5.Bundnesv and Prolda,ioe,Code:Any city nr county
F❑ which ooprine,a penut m cnnxtruct,ala,improve,d"molish,or trial,uny amcmn
3m pnonoit,r,aamce,alsore,nme,the applicant for such annot In lllevsigned statement
that he is licensed pursuant to the pmvidow.of the cnmmetnrs License Law(Chapter 9 Sq.-Ft. Floor Area Valuation
' (a,mmencl ng with Section 7000)of Division 3 of the Business sad Profession.,Cade)
or that he in exempt therefrani and the lair for the alleged exemption.Any violation - -71�
if Section 70315 by lmy rapplicam fora perishOccu h subjects the appl team to a civil penalty '� (`1�
- of nm more than rse hundred dollars H50n. APN Number'
01,ii,oI theproperty,ornry employees with wage,as thcir.vole i,ah,nsmioh, 7 -it]it,,the work,unit the Sruelure Is nm intended nr offered for air,(Sea 7044 _
Business and Pmre,,wa.,code: ne,Coillonmr's Liecmlaw,w,docs not npplT m an - - Required Inspections`,
..be,of pb,,ay Who Wild,m improve,thereon,and who dva,such work himself - -
nr through his own employee,,pmvieed that such impowemrnta me not intended or .
nrcered for sale.It,however, no building or imprnvemcnt is sold within one year of '
ompleion,tnenr.builderwilihavethehurdemorproving thlnhedid not baildnr 101 - FOUNDATION
iwne
mpmve fn,,pary®enr sale.)'
102 — F'IERS ' ..
01,Its(wrier nnha property,ain exmtlslvcly contracting with braised pnntmmm,to. 1.0.3. - UFER
Lnna nnO the ins d(See 7044,Business and Profession,c de:)The CDnuacmrx'
ice se Law due,not apply man owner d peep ray who build,in improve,thereon. 104 - REBA R
and who contracts for.such projects with a contrustons)licensed pursuant to the ,
Cnnt,mdnra licunve'-uw' X1.05 — ANCHOR POLIS
01 am exempt under Sec B k P C for this reason - - - -
Caner Fine 1.06 —' SEWER R WATER
WORKER'S COMPENSATION DECIARrcrION _ - .202 — UNDERFLOOR. PLUMBING
Iharenynffnnunder!serially offairly one" the following deaa,minns: ' 203 — I-INDE14FLOOR MECHANICAL
❑ I name ad will mainuin a Certlreane (r Consent to wif-i sme for workers 20A — UNDERFLOOR FRAME-
Co
mpn"miun. as provided for by section null of the Lid, code, fit, this, f ,
parmantnce if the work I.,whill thispematisissued, 205 — 'UNDERFLOOR INSULATION
Cl 1 have and will maintain worker's Cone,x oration mmmnre.its required by section 301.' — ROUGH. PLUMBING
3700 or the Labor Cade,far thup if m tanned of the wnik❑m what dila permit is - PLUMBING
a campen,rath�p-'j�nreajan�i<(randpmirynut sora: 302 TUB & OR 'SHOWER
cari<,: ,W HJ,6lS6 � 303 ,—. ROUGH MECHANICAL-
-
kGFICATIONOFEXEMITION FItO ORKF,RS"
CON NATION IN It 304. — ROUGH EI_ECTR7CAI_
blas r ,. nm be comp etd- th p,.rmi r nAlurs ;.. 305 — FRAME
306 — HOLDOWNS
1 oarid,mm in the performance of the work lar whsh,hi,permit is p had:1 f O
shall and employ any parson in any manner so as to beenn a subject to the Worker - 30.7 — INSULATION
Comyen,vrnn Law,of California.Dat` 30H — SHEETROCNx
Appllndtn + _
NOTICE TO APPLICANT Ifl aftermaking If.L etlicate ofE chn nn you should
Z becnmexub7ucntithe W k Compensation p ,ofihel.dm,Code,ymmust "//
4309 EXTERIOR LATH' •, -
OC forthwith complywirat rap isinsorthispermit.h:llhedcensedrevoked _]j/31Qf INTERIOR I_ATFI
f/] CONSTRUCTION LENDING NDING AGENCY /�/llry
E Ih byalrrmth,the nest i foar
lending agency for the // 311 — SCRATCH COAT:
of'he k far I hich th pb it is rswc l(S ARU,Co,C.) .VX—i
w q Iwae :N 31.3 — ROOF NAIL
'U C kndar^near<ss I� . 501 — FINAL -ELECTRbCAL 'ENERGY
W - Icenifythat Ihave madthi,applicationandstatethattheabmxinfonumanis \ 502 — FINAL PLUMBING ENERGY
correct.1 a ree m comply with all cit ,rad could ordimahces rand state laws relatin
F s s
O tobuildingcnsmvctlonpear,Ich andmdneu osenativc(,dais cit mamas ( -
L } �
the nMrvcsmeminneapropenyliv uspenionpu�,e, y p ° 503 —, FINAL' MECHANICAL;ENERGY '
d ' (We)aPhetosave,indemnify a adkeaPnamdes,'he City pfCollxnia.against 50A — FINAL BUILDING ENERGY
m Rich]it , udgments .t. an pe. n which troy in y y rag'against said
�a Cityine gaemr'" s r g nhi 505 — FINAL ELECTRICAL
APPLI UNDERSTANDSA! DW COMPLYWITH. I ISS( d riOIF,
sok ULA DN — GAS TEST Date
si ,stat /, L „Re-roofs 507- — FINAL PLUMBING
HAZARI A'fBR1ALS DISCLOSURE
wlB the apphaant o,rotaR naamms�anpams stare or handle haaminas mate 1 'Typef Roof 508 FIM1IRI_ MECHANICAL '
as defined by the Cupcnino Muni t al Code,Chapter 9.12,and the Health and Safes
Code,Section 25532(,)", 509 —•'FINAL GRADE
All roofs shall be-4mVccted gY1rfrlPAanPg9pf't1I9J1? rial being installed.
Willth<applicarto,fam.libuldingosecufunnastraImpmemmikOet,which If a root Is Install w thuut tai -' +ree to remove.
(, 511 I b
emit humrJ u.in anmminants ase toed by the lruy Arca Air Quality Mnnugen,nm ZNFtL f CJ QPL
Ol,ttlair '� all new materials ' sect' I'
st rad will eom I with
f •IP P_ y P py
°v`" . all non-point sourreNgulatib15S. R �" " ' ��-
I have read the hazallou materials.requirements under Chapter 6.95 of the 603 — ROOF -BATTENS
CmilmniaHealth&Sifetycmde`Secd(n,25505,25533and25534..land,,wandmttt 60A —' ROOF IN—PROGRESS
rhe null ngdne,not curzently haven -ant.tFar it is my reirymsibi'ytonadythe - "
the reyuircmen,x whi h t be met prior bl,Ir r o a Cer ificale of t
o`apa AX r <Owl] Signature of Applicant - . Date
o path., agent. All roof coverings to be Class"B"b'r`better, .
- OFFICE ,