01030090 CITY OF CUPFRTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRISS'. PERMITNO,
114q STAFFORD DR 01030090
ONVNI!R'S NAME. APPLICATION SUB DKIE
JD KAREN x3/16/2001
PHONE. SANITARY NO, CONTROL NO,
C ce O ZO ANCHITECIYCNGINEER: - BUILIA PERMIT INTO
t-w❑ lC 'LCCI' 1'LUb1N M1tEC11
FEW L.
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LICENSED CON'nRACrOR'suskom,RAT"fN Job Descripti n
z_ 11ion70.fhrrn i.. 1emalicensed lotander pmvisiuns of CM1afmr9(romn,ecense
b.mtal with Scwiun]I1lNp ill llivsin M1ol the Nnsinass unA l' Qda.nnJ myiccnvc
m lull force and off �It��a�y�ut.
�� :ilWU 't, n'rCbas Lm,a_ W7S�' KITCHEN REMODELING.
sLL� Jon
01C \RCHITFCI':SDECLARAION NEW CABINETS & AF'F'L'1ANCE
C=° I undcrannJ my plan.v sh;Jl be uccd as pehllc rounds
� pO
Lioenwa Profeeaonal
it..
UWKGR-BUILLER ni ffic ARAfION
W o m I hereby affirm Nm I am c13 n fmm the Comracm Core:Licence law for the
C < follwhnwinitrano.,(Swsennitu,]onst5, t..1,vxsandrve.de fih. , Anycinn,ummy
�a
which 9 ' Ire n construct. p f J opt P r Y.t mere
d5= prion 'I. q the kio If enpen,illic. signed:[emcnt
mall 1 dl nt d p . Id L t t I 1 (LI mer,) Sy. FL Floor Area Value o
or that
teethe exempt m Sect ajd t e that.. 3 01 the Bus Bess and Pn lc:1 ry Cele) /
of,be Mas31.5 banyuptherefrom and the per r.. he alleged,, hexemption.Any 1 scoulm
of Seamon e(tha S by any dred doll fnr a Permit vubjeett he applinam m x civil Ixnalty
or not more man five hundred sonar.(sca), APN Number - Occ:u]4I1k85TOW
0 h as leer of me pmpcny.or it,,employees wish wages as their vole compcnwro..
will do the work,and the armemm it not intended or offered hw sale(Sec.1014.
I n,mcs dna Pmrc.,iont Code he Contramno',Utters,Law does en npnly to no 36206019.1 t34[Pired Inspections
r of proper Who bolds or impnwo thereon.and!who does such work himself -
or ll
owner
bis own c;.nloyeos.provided-that such imnmvements are mil intended or
ofrertd for sale.IL haxever• In:melding a,Improvement is sold within enc year of
nmplea ,the ow ne.baihie,will have he baric.of o,) ing mat he did no,build or 1.01 — FOUNDATION
ia.
mprove for furprr,e oaala.).
❑I,as owner of the pmpan,amexclnxlsdnycontractingwithlicensedcontractorst1.02 — PIERS
.ns ods,the p.rject(see.1(w,nusmets:inn Promaiont Coded mme
e Cmmort 103 — UFER
License Law do s not apply to an owner of property who builds or improves memos
ani h 104 — REBA R
ntrawo rnlrams far soah Pnj cis with n um.ractons) Ilccnwd Por Iver to the
Coctors license L w.
O 1 eae.tm rude,Sem. .B x P C for this reawm 105 — ANCHOR BOLTS
Owner Late 1.06 — SEWER & WATER
WORKER'S CTIMI'ENSA'1'ION DECLARAI[ON
I
hereby rollout under fealty of erjory one of the following declarations: 202 — UNDERFLOORPLUMBING
'
203 — UNDERFLOOR MECHANICAL
0 1 have and will maintain it Certificate of Convert[ to .self-insure for Worker's
Compenmaon, ;Is provided for by Section 3700 of the I"ar Code, for the 204 — UNDERFLOOR FRAME
perft
,om,anceoheworkofwhichthispcoutiti,sued. bo205 — UNDERFLOOR INSULATION
01 have titwillnc lain Worker,Cou,e:ei Iletmane,usrerouedbySeen... 301 — ROUGH PLUMBING
31(X1 of the Labor Cole.for the fcrlimmance of the work far which this fermi[is
ute'n.My ...kers nnttpens;tnon mslrzancn cam"`a E berate: 302 — TIIB R OR SHOWER
caniI _ P.EaNn.: — 303 — ROUGH MECHRNICAL
CH 'hIFICA" OP I'.XEMIN ION FROM WORKL .
COMPENSATION INSURANCE 304 — ROUGH ELECTRICAL
(This section meed rte Memn.leted 11 the action is lbr e handed dollms 305 — FRAME
ISllp)ser las.)
I verily mal m be fcifnnnance ill the work rte which this Permit is Issued.I 306 — HOLDOWNS
.hall a,,,employ any fe,,.a in any neemor ao as ,,become.abject ,, he Wmkcrs 307 — INSULATION
Caotpra,alio i I.uws.l'Califon.ia.Iro,
Applicant 308 — SHEETROCK
NOTICE TO AVI'LICAN'T:If,uncr necking this CcNGcma of Exemption,you should
become subject in the Worker'sCotelvesation provisions of thel,alno Code.you at t 309 — EXTERIOR- LATH
O e,nhwah enmply w;m such tornia,ns a, his pe.air than rte amemed revoked. 310 — INTERIOR LATH
F' h C(INSTRUCIION LENDING AGENCY
x Iherebyaftlmnh.athen•isaconstme,ion lending agency for the nm —
efom
�tt 311 SCRATCH COAT
I[be work for which This fermi,is Issued(Set.3097,ON.C.)
y p Lcndcr'tName 31 —
3 ROOF NATI_
.7 Z Lein,,',Address
Umercer thmlbase,.no this a healam oil side m
emmeabovemarternnls 501 — FINAL ELECTRICAL ENERGY
b.. emma. ,igeeYmeantflywidtau<vpand emtmyma:Nanee,and,elelaw.totaling 5x2 IN I_ PLUMBING ENERGY .
O U to building construction.and hereby authoriie representatives of this city it)enter ufon — F AL ME . NICAL ENERGY
>a ry the(move-mc.ronca p,,,,,by Inv intneaien furpr,sys. ..
F, p, (We)agree,osuvc,indemnity and kccphanal... he City ifCupcninouyuina �aa — NRI_ Bl. II INE ENERGY
Vi handilms,judgments,ants and Icspentet which may in any wary accrue against said
U Z City in.an,egne,we of Inc ge trop til this Permit.
APPLICANT A 'AND W111COMPLY WITH ALL NON-POINT Issued by: 5x5 L E CTRICA�.tlte
S URC REO —
ignimn' , --."Bra. Date Re-roofs — NAL PLUMBING
IIA%AItDOUS MAI RRIA LS DISCLOSURE
Will applicant or mere mimingreveer,sate or handle naando.,naaenal . Type of Roof — FINAL MECHANICAL_
ax Jetined by he Cupenino Municipal Code.Chapter 9,I2,unit the Ihealth and Safety
cmle.Seems,25531(')' 09 — FIN
f-L GRAf�.E
0 Vox 0N" All roofs b I etre {I 9 I X r erial being installed.
Win me anpncammwere nauamg,Kcufant use evwpmenlmecvitetwbmb Ifarool' mstal21'LW.ithf>ufp�HTylr'fkstxl1'/r-6�ry�bhan�llr11arr n .4'S{ cl n Igree to remove
emit hazardous ousair nmraninanl.mdefined hy the N.YAreaNrQualityhlanagcmrn, ��r9 P """ "1'P� "� PY
Liede[ all new materials ns ec I I rs will comply with
°Pas °"° all non-point source regulations.
I have read the hamrdam ntmeri:dt requirements under Chapter 6.95 of the
Calif is Health&Safety Gale.Scaions25511.5,25513 and 35534.1 tode,send that
ill -hui laingdrwsnm coram hlwcaemon.thin It mnmy ey.....ibilin m oatoy the
ufan[of'he m, rich must be met prior to issuance of a Cmiifcme.f
1`cunaa`y' 6 'Signature of Applicant Date
Owner orual ed agertt Donn All roof coverings to be Class "R"or better
OFFICE