02060074 CITY OF CUPERTINO -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10378 LOZANO LN R & Z DEVELOPMENT 02060074
OWNER'S NAME: APPLICATION SUB DATE
•CAMPO DE LOZANO L. P. 21771 STEVENS CRK BL #10((02/28/2002
/ PHONE: - SANITARY NO. CONTROL N0.
1 - (408) 252-1101
ZQ ARCHITF.CT/ENGINCER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
A i.� I'_7 CJ LJ LJ
z vmi 3 LICENSED CONTRACTOR'S DECLARATION Job Description
Q i- I hereby affirm that 1 am licensed under provivio a of Chu mr9(commencing
py-n, echo seen��oryrynee]t3o0) ian3onne Baameaa ,a ry'en TOWNHOUSE-LOT 8 #A
3 Yu Dio¢^ Iffi� nee Ceg I LIVING SPACE 2 , 0231 GARAGE 4411
.K�Ki RCHITCCT'S r SEE ORIG PERMIT 02020115 FOR FEES
I�h a 1 u noted
my plums small be used as tib¢rt
ia pO Licensed Professional
iFINALE'
>o. OWNER-BUILDER DECLARATION r
S = 1 hereby affirm that 1 am exempt firm the Contractor's License Law for the
+ C? following reason.(Section 7031.5.Business and Professions Cade:Any city or county 1 2 20 03
I F Q whicti res requia permit In construct,alter,improve,demolish,or repair my surramre. MAY
@r C
prior to in issuance.also mutair<s the applicant lursuch permit to fdeasignWsmadmin -
tbmlf5i�lisenredpvfs rNtosme)mpv onsof Ne Cont wesLicence Law(Chapter9 _ '' S F,t Floor,ArP T+\ V luation
(commermingsyith Sebion7600)of Division 3 of the BYajssagd thpfpssions Code) •+i)Iti 6f�=l 9,Ft, j:ry}';/14L,PSS• A11�'
- or that Ac is eiempl InercRom hnJ the basis for the ellEBad C%impl n Any A onion
..of Section]031;5 by any applicant lin a permit subjects the applicant to acivil Penalty-
of not mom than five hundred dollars(S5M). ppppN ��fI mbbe •:'.n: Occupancy Type
❑1,as owner of the ° n.arm laces with woes as sheirsole cam 369320004
m th Y YemP Y B pcnsmlon,
-well do'Ih ark".and the swcturc isnot intended or o%erect for into(See:]OJ4;'
'
Busheasi'nod I'mfms ons Cade The Contractor's License raw does not apply to an 101 - FOUNDAT I 6f$uired Inspections -•-
owner of propeny Who hailds or ini,ed.MroMa,and who does such work himself
or brought his Own employees.provided that such improvements am not intended or
.102....- . PIERS
iVReedfosdeIfho r'the building Wim
mpvemcm sold it Toneyearof --'-- - "-" -
---_ .-..___. ,..._
'completion,the owner-bulder wi 11 have the maden of proving that he did not build M 103 - UFER
improve for purpose of sale).
- _._ ...
r ...1.04._.-__..dusivelyconracting with licensed contiacmnto 105 - ANCHOR BOLTS
n fce,o.Fbtec.]o - - .... s-.. --,•�-_-,,—„,.—+-' ,-
-
Ll „c . ..
censel wdoesnotap,ily to an owner ofpropcn .y< ,
y who builds or improves thereon. 106 - SEWER & WATER '
_ c
and wh .con .for su -protects M Ira mr(s)Imensed pursuant to the. .-_
C 1 na Law _ , 202 - UNDERFLOOR .PLUMBING
n � Se '' B&PCT r n I
203 - UNDERFLOOR'”'MECHANICAL
O ENSATIONDEC RAT 204 - UNDERFLOOR FRAME
n n a under Pe ityofperjorY;oneofther°nowingded„ratons: 205 - UNDERFLOOR INSULATION
301 - ROUGH PLUMBING
❑ 1 have and will maintain a Citnificsic of Consent 10 self-insure for Worker's
Compensation, es-provided-for by Scclion 3700 of the Labor Code, for the 302 - TUB & OR SHOWER
perform6nce of thework for which ihisprunk is issucd... 303 - ROUGH MECHANICAL
❑l have sand will melnium Wmkcrs Compensation lnearunce.as tailored by irOwn 304 - ROUGH ELECTRICAL
- r 3700 of the Labor Code,for the rfo f the-work for which this permit s
sa,.«..•.y...a...,.. Pen'sa Policy number - 305 - FRAME_ _ -._ _ ..,,.__...._...
rs tied M Worker's C ti n IIsumnce carrier and ' V
17a-il's'�'PI yNb ' .. ... i t .d-.'_Ai{3061,- °HOLDOWNS }Rti-...-1-....._>r<..-.,-.
t CERTIFICATION OF EKEMPIIOY FROM,WORKERS,,'
COMPENSATION INSURANCE _ - - 307 - INSULATION"'
. ,•• (Th's'canon' Jnot be nlplemAif a4+ermit'-. _- .-`-.�~..• -• "' S
I is for one 308-,='' SHEETROCK 11=,d,
stoolorlaa.j„ 309 - EXTERIOR LATH
r' Mi7ij itid' 310 INTBRIORi"LATH _._..
'1 � '" � -the pe eo the' '---
•olid c ny :y n as to ,Yn c. ';t -
Com 311 - SCRATCH COAT
Appr - _.... -. ...--' -31-1— -ROOF--NAI-L'._...
rN f, ¢rata Is Cenifi mofExemption,you should
nm a <t lheWarkeraCnmp<n ionProvi.sionsofheLaborCode,'youmust 501 - FINAL ELECTRICAL ENERGY
'Z cam' with such provisions or this permit shall be deemed revoked.
C --- - - -- - _ ' _ . _502- ---FINAL--PLUMBING'-ENERGY
t C' CONSTRUCTION LENDING AGENCY' _
I In byumnnt ithe sh_oof torilendngngenyfrtheperfo7monce 503 FINAL MECHANICAL .ENERGY
arm nkmmil for isi,anm(sec3oq]civ.cl _. .-.- - _ 504 -_ .FINAL. BUILDING_.-ENERGY
W Q N - - - -
�•0 �Lenders Name
A°°re' 505 - FINAL ELECTRICAL
v Icndyihot Ihave read this spreplt nanostate thin the monastmnis 506 - GAS TEST / \�
me H con d I agree m comply with 11 city and coo%.y rd urruas and state lawsMinn., 507 - FINAL PLUMBING v
to building const on.and hcrchY au dr 9 repre'soutiivesof rhiscilyvienteraNin
.men me; p n rnrtnspmi pmposes.. 508 - FINAL MECHANICAL
[ti'Pa )' eta ti a aifY and ph I ss�ift`vCtYo C prtino:yu nst
r/3a t j g en1 cot and expcnw hien may,n any y carre aran said
50 9 - FAL
U ty q •nc a non f - rmit �O ". r
APr ND at oMIPLY,,(1'r8 _ ,yq It Issue 0 .� F# G Date
i bb AL " I - �''UUUf Y1
gnatuo i b"canbwmm.mr•.., " '.Data Re
Data _ ROOF PLYWOOD NAIL
1 HAZ It DOLS MAT RIALS DISC )SURE' , '
-„
ill applicant appl t future building scup nt tote_ handle Morocco, mncdal
•_'Type(Qtof- ROOF.BATTENS
as-delran y'heC p 1n p M n 1p oil Chapter 9.12 d theHealth d Safety.
c de Section 553 i604 ,= 1 ROOF--1N PROGR. ESS•
.^•^ •,.:. ^-^•_.-•.•^.
°' shall be mspected prior_to any roofing,material being installed,
Will1h rpr<m rat rebutIng occupant use cy p t or devices whm If a roof is installed it out fir t obtaining an'inspection:I'agree to remove
emtha lu.surconmm; a fare by theBay Arca Quality Management
District? .. - cell W.matC.a , TOC 1 eCll
_•Y t? _ p Applicant understands and will comply with
al o poi rce gulatt
- Ir <,rr t harar o Paten Is yutnments umbe ch pmr 6.95 of the,
Colie He S f IyC Sections Y/05,25533 and2553 Limdema dthat
if i n ties current have a ma LNm It airy spot 16!litym i thw
be
" u l l e req in nr. ich a prior In a of�e Ce Incite.of /
P
. Sign Applicant j7 16.ate ...
7 _
rncr,0kjt5dhycda&cm7 f Drm All roof coverings to be Class `B" or betier"
n
OFFICE... ._ _.. ._ .. .... ._. .._ . . ..