02030146 ICITY OF CUPERTINO CONTRACTOR INFORMATION: I
BUILDING DIVISION PERMIT
PERMIT NO
BUILDING ADDRESS
02030146
10349 AINSWORTH DR
s ^ NER'$NAME APPLICATION SUB DATE
D BRENNAN 03/26/2002
W
`�' - SANITARY NO CONTROL NO
1l PHONE
a:Z ARCHITECT/ENGINEER: BUILDING PERMIT INFO
O
O O BLDG ELECT PLUMB MECH
r IJ I I IL.7
z LICENSED CON. RACPOR'S DECLARATION
I hereby affirm rhm lam hrznscd"Doer pprro isms"f Chapter 9(commencing Job Description
?yr° wnhSecuon) )ofDinaon ,wc,,,Bmmass'vndPmlcssmns Code,and mylicense
BATHRM REMODEL.
iota furl[ a.A ett t l
uceamc .
Lc * 23 ������®
•O a V a C.nvac r
1 u �tj ARCHITECT'5 DEC I
O< 1 understand my plans shall be used as p. cords
oo i.i,enssd P eteaaronal I I: 1 0 2002
OWNER-BUILDER DECLARATION
ca 1 hereby affirm that I am exempt from the Comwmr's License Law for the
C? following reason Sorion 7031.5.Business and Profe,mr,Cole Any city or coumy BUILDING
$3 0 0 0 0
wh¢h rcgmms a permit w ,camoun aluer,improve,demolumh.1 repay any a-- _
p'ai3 c _Poo,so its muance.also raptures rue applicant for such pemm to file a signed smmmem _ .. ._._. Valuation_ ...- . ..-- ----
that beis licensed pum.9nam mg provisions ofthe Conuacmfs License Law(Chapter 9 = p. pr{�
(commercmgwoh Section 7")ofDivisma 3 of the Business and Professions Cale) I 'ii`•aj �3,�,�'�I���•-C1 U;G�,S:i,���.:I,!''• '
or that he is exempt metefiom and the ba.is for the allaged esemMmn.m a Anani
y vrolaunalL on I
-of Station 9031 5 by any vpphs,m for a permit sobjmm me apphc.m l pe 101ApN- � S „ , a Occupancy T YP e
of not m mor five hundred do][. s50b)
❑1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,.and the somcmm is nor intended or offered for sale(Sec-'10,41,- -
'Busineis and Professions Code The Contractor's Licence law does not apply to an 103 - UFER Required Inspections '
owner of property Who builds or improves thereon,and who does such work himself
or through h,a own employees provided that such improvements are not intended m - , . 104 - REBAR _ __ _ - _-_------_ _.--_
oRcred for sale If however m<building or mprosemcm is solJ wnhm one yc5r of - -
. fn the owner builder will nave the nurecn of Womng ih.t rte d a not buds or
10- - -- ANCHOR BOLTS
improve
'
for pmpose.t.a.le.). 106 - SEWER & WATER '
- -,. _ - '
Ol,vat mvner of me prmuny.am exclusively tontmcvng w.h licensed contiactas 1. 202- - UNDERFLOOR- PLUM N .. ....".
--
construct me project(See 70.4.Busiows and Professions Code.)The Contractor's 2 03 - UNDERFLOOR MECHANICAL ' ' '
n - c License Law doe not t apply to an owner of property who builds or improves thereon,
and who contracts for such project with a c.mmaor(s)licensed pursuant-m.me. . ._._._ ...-204-=- UNDERFLOOR—FRAME
Convxror,Lamle law.
❑lam &
exempt und,r$ec' " B PCfnr this reason 205 - UNDERFLOOR' INSULATION
ow er Dam "' 301 - ROUGH PLUMBING
<
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
�� Ihcreby etfsm under pcnahy of perjury one of strc following declazations 303 - ROUGH MECHANICAL
❑ I have and e'dl'mmntam a Certificate of Consent to self-Insure for Worker's 3 04 - ROUGH ELECTRICAL
Compensation, as provided for by Section 37W of the Labor Code, for the -
_ permrmance o(dm work s"r wmch mis perent is issued 3 0 5 FRAME
❑I have ant wJlmeinmin Worker's Compcnsau.n Irtsumnce,as requited by Se,:uon 3 06 - HOLDOWNS
307 - INSULATION
i3w�d Mn w kaea�m for Loon 1 sumnce c'ren enwork L<r umbernwe:Permit
a p=
p� �,���q{,,)L�n• o_�j,p Z.. Q __ ., p ._ .,$, EETROCA .. , .,. ,.,_.....
- ,`yn`rJlfII:� FICATIO_XEMPT OMWORK \. 30eVv C..,i. :/dilYr:• •J.
CERTIFICATION'COMPENSATION EXEMPTION MOM WORKERS' �• y '3O9^-'^EXT-ER I'iOR�LATH`
r OMP[omlereddme tisr.r.nentnercea.hatx 3T0-;-, INTERIOR-'liATH '
,.-• )o:r_ _ 'C LNSATION INSURANCE;; ___-
Thisseauonneed � � -
not be p pcoo, V i ,' ;'
(slop class) i 311 - SCRATCH COAT
an in zit man I.In _
- - -313°---ROOF -NAIL '"trimly lhm In me pert a w.fx for whmh this perms is,slued,l v 4,) ,-
sn;hhmemPloy ypers.n y sossmbecomesubjttnotheWOrkers' 501 - FINAL ELECTRICAL ENERGY
Compensation Laws of Cal we Dam "
Applicat " •-- - -- 502- - FINAL PLUMBING- ENERGY - ..-
INO'f10ETOAPPLICANTI(,after
m.kmgthisCcmficamofExempuon,youshould 503 - FINAL MECHANICAL ENERGY
beeome sub ee,m the W'miser',C.mpensmion Orovisions of the L.b.r Code,you taro
O mnnwimcomplywn bs uchprovisormwmixpermitahanxaeemedrcv.kee. _ ..504_ FINAL BUILDING ENERGY.
of the work CONSTRUCTON LENDING AGENCY '"' 505 - FINAL ELECTRICAL
t•. I hereby affirm mat mere Is a cdnevucuon lending agency ter'ba P"miance
a-> fm which thisTerinn,aissuedIS".YNI._CisC.> 506 - GAS TEST
Lender's Nam.'.. '., ...,.._.",- .�. _ ,. ,. .� ., .. ..._ ... _._ __ .___._ .__.
p..� Lenders Adireal - - -- ---507 - FINAL PLUMBING
CU O 1 onufy that 1 have read tart application acrd state mat the above inform.....is 508 - FINAL MECHANICAL
W.=p•, cmrcct I age,to comply with ill city and county ordinances and state laws mlmmg 509 - FINAL GRADE
"V m on
building csti au
ucb.n,and hwa6y mm reanpresemaoves of this city to enter upon
�y me above.mcmto7ed progeny fee inspection Purposes. 510 - FINAL PLANNING
i-y (WC)fgree fo shve,mdemmfy and keep hamless me City of CUpcnmo'egamn Ci
Z) Im bildie:,jnd menu end ex
,cos scs which may in any way a -ccrue aganst sate 514 FINAL PU i I C WORKS
V-Z Osy in c rent of sh min It Is pennnf _
APPLIC U O R D COMPLYIWITHALLNON:POINr Issued b602 0 L ^NAIL Date
E 1 T Y4
gnome fAppLcanJ .n Itr h�imewarmtxmm� Re-roof6 4 - ROOF IN-PROGRESS
„ TDOUSil Code,Chapati9LOS URE � at
- c r d Wild,.,oeeo 5�a' aim . Type of Roof._
HAv o
e vat^ -. .. ... - ., ., _, ..._.n_.- ..;... -
,. , .12,and the Health. and stray i ' ...
' as deli b me C1 n Munur
otic.Section 25592(q. rirum 1 11`1 1" I " s, l _ i.I'iv1'd'!'
❑Yes'! ,B«.vi,,; i• ru 1 a i
All roofs shall be inspect prior to any.roofiog material being installed. _
Will Je apphevm or
me burldm cu .__. ...—
-`- • 'Pant use egmprent ar devices which If a roof is installed without first obtaining an inspection, I"agree tolremove
0,.rm jiimirus am mm. Is de fined by me B,Arc.Air Quality Management
I Dismen I n all new materials for inspection. Applicant understands and will coin 1 with
P„Y,._
❑Yes i oNo ,r all non-poiritsoorce'regulations. . l
Phase road,m h us,materials requirements Order Chapter 6,95 of the
Cabfd 'He h&Safety e.So lions 255D5,23533 and 25534 1 understand that
B
d)nebmld .axons cu ly hay amore, m,v Drs my issuance_ ocayam t rcgmre is be t pnono vsuavcc of a Cmifrcne of
° y Signature of A_ pplicant Date
a„ed a, �� �� All roof coverings to be Class"B” or better
OFFICE .. .. . .-