00060007 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BHI LDING ADDRESS, 1117RNII'INO.
OWNERSIN08:35 WUNDERLICH DRIVE APPucm'IONSUB DAT H
0
HGNE PRICHARD, CLARE MALONE wITnH n a i'ROl.rvo.
COC ARCHI'JECIENGINEER: BUILDING PERMIT'INFO
BLDG ELECT PLUMB MECH
17_1
pyo I,ICENSIiDCONTRAC'IOH'SDI!CI.ARAIION Job Description
oZ-e 1 hcmby idur"mm 1 ant licensed under provisions of Chapter 9(commencing
F_1-J with Section 700)'of Division 3of.he Baainessand Profnsiom Cale,angry license
m< is in full force tnd eRcn.
z K 6 License Claes Lic,p
�3LLN vale comrae+m REMODEL, DEMO OF EXIST. CARPORT, ADDIITO
= °<, antanJmyplam haI16 Na.publ nrecmas TWO CRR GARAGE, INTERIOR RENOVATION KTCH
�;F
d o o Licensed vroressi„nal
J e e,IOWNER..BUILDER Ian the INTIIIN
u7 I masa.(Tian Ihm 1 am exempt ham the Casten Cu License Law for he
!-Z following reason.(Section consumer.
Business and vet de io demolish.
Cala Any citystructure county
4 C xhich reyuirce a panni.re ameweL aper,improve,h permsh, fie pair any amaure F1
prionnhacemne pursuant
Wh..hea...... Ifnrsuch Pcnniun Bleasign.Aaalanmm
mea horm,in,scdpnmmmlonmp I D.1lsofine me,Business
loodpose l�sion, ,xJc, Sy. Ft Floor AreaN At a cation
(annnn he is roving,beref91X1anofebasin3 itme, corruption,
Pon,Axions Cede)
,or thin he is excmpn any applicant
and or,basis fnr one subjects
the c plicas to Any t Pennon APRY
ofSection e than anydredollfnra permit suhj,.c,a.he applicant mxcivil penalty
oomt marc Actofive nwnwed mBmn(ssw), APN Number cSo' ,00y"ype
r of the properly,or my cirrhotic,will,wallet n,tbell vote enmpc vapmn, I[[II
�i nn the work.ami the,Imetom is not inn„ded or m'r and for stile(Sec.nus. "'ii,,,I
Business and Professions Codc:The contactor.License Law does not apply to an Required htspe s`
owns,of pmpeny Who builds Lir improve, bercnn.and is ho does such work himself 37929022. 00
n nhrnugh his own employees,prnvlJed thill...h improvement are nm intanded nr
libeled for sale.II;hn the btild'reg o ;aI)n1VvrlrrI Is sold within Qlar ycu of
cnn,pletiuq,ge owner-builder will have the M1urJen of proving that he JIA not nuIIJ or
improve b,rpapmenl sale.). 101 — FOUNDATION
❑1,as owner of the progeny,star e.eln.ivcly contracting with licensed contactor,m 102 — PIERS
Lm,,mO the Pmjeel Sec.7N4.Blinn,wall Probe........Codecs)TIm Cnnuaam'x
icense Law dos,not apply to,m owncrof progeny who huddle o,i ovcs mercom 103 — UFER
and xmo contracts ter such projects with a contwctog.)licensed pursuant,a the
ContractorsLicenwl.am 104 — REBAR
❑lam n.uaJ /_/Barch,nnisma.o 105 — ANCHOR BOLTS
uwne ” Doe �d�,z
(/ KCR'Scanu'LrvSAl.ION c., (AT,oN 1.06 — SEWER 8• WATER
I hereby affirm under Penalty of perjury one of the following declamation.: 202 — UNDERFLOOR PLUMBING
I have and will maintain a Cergrcete of Consent to self-in.me Ibr Workers 203 — UNDERFLOOR MECHANICAL
Y . Jon, a, provided for by Section 3700 01 tlm l.mear C,xle,'fnr the
" ran permit is issued. 204 — UNDERFLOOR FRAME
performance„r me work for wmen ms
01 have and will nutinminWorker',Coml, nionlasuance.axrepaintbySartain 2205 — UNDERFLOOR INSULATION
37x1 of me Isnot coir,for be podom,mcc A he wo,k for which anis pend.1s
issued.My Workers Colpenxanion Insurance carrier and Policy moulder sec. 301 — ROUGH PLUMBING
Ca,ric,: Policy No: 3022 — TUB & OR SHOWER
r,1:RTIFICATIUNOil EXEMPTION FROM WORKERS' 303 — ROUGH MECHANICAL
COMPENSATION INSURANC17
(This.mcuour owed nn.he coradcled it the permit i..her one hundred dollars 304 — ROUGH ELECTRICAL_
6BaBorte,x.l 305 — FRAME
I carry than in the forthmnanec of the work for which this permit in issued,1 306 — HOLDOWNS
shill not employ any lemon in:ray munnar an as u,holou a anbjcot u,the WodcrJ
cotnpen.ationLawxorCalls irnia.Date 307 — INSULATION
Applicant
NOTICE TO APPLICAN-ry If.after making this Cenificamof Exemption.you should 308 — SHEETROCK
hcomc subject to the Workce%ornamentation provisions of the Labor Code,you most
O z0 IormwiIll nnnrlywill,altp,ovi,ion.erg1i.,I,<nii,sbill bedeemad ,,liked.- 309 — EXTERIOR LATH
F
CONS'IRUCf1ONLIiNDINGAGCNCY 310 — INTERIOR LATH
7I hereby ofirm that.hem is a com uction lending agency for the Performance —
ofineworkfarwhichmispemdt isi...ed(Sec.3o97.Cm.C.) 311 SCRATCH COAT
Q Isndcr's Naim
z Leader,Adldrcs, 313 — ROOF NAIL
O
1 comify that I have mad his application and state that the alowe inforination 1% 501 — FINAL ELECTRICAL ENERGY
tat correct.1 agree to comply with all city and count)ordinances and.nate laws relining
O U tommdingconvwetion.amlherebyaumori.ercprcsentamesonnis it,to entertien 502 — FINAL PLUMBING ENERGY
W ,hr,nbovomcnllnncl urology ba l pecninn pwpnses.
a (Wwagree tosave,indemnify and keepharndessthe 01,olCement iougainst 503 — FINAL MECHANICAL ENERGY
lin Iiabilide..jud,ameN,covs and capcnus whmh may in any way accrue agairwt aid 504 — FINAL BUILDING ENERGY
V 7 City in conwyucntt of.h<•gmming of tM1i,permit.
.. ArP1 urpuc SnNo ILLCOMPLYWfr11�+.LN( POINT Issuedb 90 — FINAL ELECTRICRLDate
sou ce 1Ecu1. 1 9/_i l y —•
Mg mnprpc tc,n.mru,r /WW Dat Re-roofs
BAZAHUOUS MATERIALS DISCIASUHE 507 — FINAL PLUMBING
w,n.neappheamormtLimn.'dmng,acnpan.onmornwnalenuzarJousnnamrial Type of Roof amnwnynnucupeninoM,mi<ill agar,,enwmer9,Izanamene;annw„°surety 50B — FINAL MECHANICAL
(:n,Ie.Scanlon 25531(a)'�
�Y=• r All roofs shall be inspected prior to any roofing material being installed.
W51l.he upplicam or furore buildingoccupenl Litt e,itipmen,to,devices which If a roof is installed without first obtaining an inspection, 1 agree to remove
it hva,dms air comm�.in...t,e Ju Jhy the Bay Arca Air Quality Management
em
rnsmerl all new materials for inspection. Applicant understands and will comply with
❑vas all non-point souW�"`Iul�Itt Rbl_ GRADE
\ s
1 have mad the hmmdous tiarerial,requirements under Chapter 6,95 of.he
Cal ban shots. feryCode,Set 25505,25533wnot z553a.1understand Pat 510 — FINAL PLANNING
it(he Ing Ioe.m,t cu,r, nctmm.nnu,gi.m,,,w,ondbpity g,nm'dy the
a
wupa ,of tit reyuircm�, 'h:h must ha ton prig nn ivxnwnce ofu Ccnilicmc of . ..
Occup icy �`
A� Signature of Applicant Dale
o—u Ihmilsdagent -�'�""1'>�- All roof coverings to be Class "B" or better