02070130 CITY OF CUPERTINO - ' -
BUILDING DIVISION PERMIT .,CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO
20803 ALVES DR 02070130
U "�/
MEN S CHRISTIAN ASSOC F APPLICAn R�%p22002
"ONE: SANITARY NO. CONTROL NO.
a z ARCHITECT/ENGINEER:
O O BUILDING PER-MIT wF0
"i BLDG ELECT PLUMB MECH
N z c U r L.-I LJ
E,i LICENSED CONTRACTOR'S DECLARATION t�P
,z_o I hereby affirm that l am licensed under provisions of Chapter 9(commencing INSTALIa.$O�UnND �Llis�RF1OItOOT
L•• with Scction7")of Division 3 of the Business and Pmfessions Code.and my license u'ON�
is in full fore and effect.
:z x a Liccnu Class Lic.tr (�®
I u.U Data SDECLA �e
ON
�� ARCH ll h,used as ub rcT.m
I anamrsiane my plan:anal bo arca as sabre rtcoms OCT 2 4 2002
i
E:p O Lmensed Professional
OWNER-BUILDERtI.. rp,fr DECLARATION R J
Sus 3 1 h.... M.on 1 1. .Beane from the Contm Co License law for theUpL®QIyCi $2 0 0
t < followinguiresa(Sealot ]onstru Businessand Professionsh.Code Any city meounry
Y F O which requires a permit re vires%e alter,improve,demolish ore a sig any strvemrt
ts.rli 3m --pdonoslissuuntt,alwrcqui res thevisions tit for such Compactors LiceseLaw(Chaptem• _ Valuation
— that hem itpSectiinto Ns Provisions Ne the Biomass
License Lew(Chapter)
''yy��,,6& do�Afk ......
(commencing that bs eiim §eniom7r-and the
J of the Business and Any Vi Code) r,.,��s'y k.'a•, Valuation
or that be is 31.5 bt Nd applicant
and the basis for the alleged exemption.fiut Any violation '
of our no]OJ n five
hu dred doll for aycrmii mbjests the vpplicam t...ivil penNty
torn"t meR then roe nanaace eeBara(ssw). API`IN - Occupancy Type—
ype❑ICI 1,
,as whet" the vrepeny.nrmy employees wimwages a.their solemmpcn=ntinn. 102 - PIERS
,will do the,work:and the suubmrc is
not imcnded o,offered'rb,ulc(Sec.-]044;' _
'Business and Pmfcsvions Cade:The Conrractor's Limum Law does not apply to an Required Inspectiolis'"' "-
owner of propeny who wilds or improves thereon,amid who does such wom himself 104 - REBAR -
'&or Nrou ,ha own employees. WildingNat ppm im art is sol am not ontendede year or 10 6 - SEWER & WATER
1rde rale:1(,htiwevcr:the wavinge;urdenf„wvisrolahedida.,yearof- ` ._ .. .-... 105- ANCHOR'-BOLTS---
completion,the ocm mfs.le.).will have the burden of thvr he did not build or
improve for purpose of sale J. proving
_._._.o_.._—..ePst .. exclusively_..—__. _...._ ting wit `
---- 02-------UNDERRLOOR--PLUMBING----
f3i:asowner ohne p(Sm.7i.am Buinesand PrecssionstCmensehe,Cod con to to ro ,:'.D�'.'iL'n
comwcr the Project Isec.lora.Business and Protesalons CoeeD The Contractor's 2 03 - UNDERFLOOR MECHANICAli;'f n,�_;,, ..
License law docs not apply to an owner of propcny who builds or improves thereon,
_and.who contracts fm.a«h.projecu.with a.contranorts).licensm p irsuant.ro.thn.. ._....__-.__2 04 . --._UNDERFLOOR.._FRAME._._.__._.:
- - -
convano L nseLaw 205 - UNDERFLOOR (-INSULATION
y7leme pt ndSm 1 tom' '' B'&PCT this•mason .
Owner Date 301 - ROUGH PLUMBING
RIS COMPE�',SA'tdON DECLARATION 302 - TUB & OR SHOWER
Y qs I hereby affirm v ser Penalty f pcpury ane of Ne follow ng declarations: 303 - ROUGH MECHANICAL
❑ 1 have and will"maimuin a 6rulione'af Cmeeoi to self-Timm for Worker's 304 - ROUGH ELECTRICAL
Compensation, as-provided-for by Section 3]00of the Labor ewe, for 305 - FRAME
performance of the work for which this permn is issued;
O l h ve and II maintain Work 's Compemat I ipraiee,u rq Tied Dy s«tion 306 - HOLDOWNS
3700 of the labor code for the psixformance of the work for n ch this permit is 307 — INSULATION
', e4 My W ke s Compc uon Ins tic aMe end Pohcy mbo '
_ - .SHEETROCK::...
C aiieri „ qa si,r.: ,.:Cs .PoIrYNo ”' L . _.:.._
,. CER�TIFICATION of exEMPnoNFROM.WORKERS- - i. `, i. `309 ;,—r.E$TERIOR LATH,
comeervspnod INSURANCE-� .�. 310_. ..INTERIOR..
LATH...._ ..---_____-_-,-.
9.5,:11tL un on ncadnot ba mmplmed if the permit neun
s fm ohundred claim 311f"'—`'SCRATCH COAT
moojal >
n«nrNrnn 502 FIONALNPLUMBING ENERGY _-
y pert m � �f�i< k f r which this smut t d'1 ....s__._
h=li a employ any m5 YnMyd v t c e.ibinmNeW krs 501 FINAL ELECTRI'CAII',ENERGY:."
A t w rc I 1 D - `1142T -
N ro—pPn.Se�p rat , ngNacenrgteorE stn ...:anole 503 - FINAL MECHANICAL.'-1ENERGY ---
ti rdi ub3eeno theWorker's Compensationprovisions f d Labo Code you must
O 0O tonhwNco ply vvilh inch provisions this perms shallbed ee nwked. 504 - FINAL BUILDING ENERGY
y " ! � LENDINGAGENCY 505 'FINAL ELECTRICAL-
CONSTRUCTION -- -
"" Ihcrtby firmM. —
III,
a se�onswct led gagcncy fm the per(o ahem' 506 - GAS TESTorum s ss ed(S<c'J09] C CJ ''"'`:._. µ .. . 507-.._.,-FINAL_'PLUMBING---=-- -Z - jDate
O 508 FINAL MECHANICAL:'Ic mfy Na lhdNis appl uon ends uth Rhe ebo informationg509 - FINAL GRADEWF abreed i gee to comN II city ane co iy a nences a a i m le rtlering O.T� mbuilNng mnximnioereby authorize rtpr«nmuvs o(Nis sty to Inmost'. 510 - FINAL PLANNING
the above menuoned pfo spat ov p rpousp�. 4i N' emnfy and keep hamdcuiw Ciiy of CLperuno against 514 — FINAL PUBLIC WORKd scums wh ch maY anY way mecum egaurt acidC.) z t ng of N i perm rS ApD R'1 ONPLY N'p'H'pLL NO PoINi vOI„/,] Issued by:// � .//SBL
3ylarvrc of Apph`H oRDOUSMATERIAL5 DI5CLOSURE'4i�;'aiDate:;moi`;, Re-roofs
.e-Willt ..Type of.Roof_
the ipplicant m f Tart wildin%ompant arae a handle haaaddic a material
C d f ed io N C pemvo Municipal Cod Chapter 9.12.and the Health and Safety yP -
Code.$ t 255JNe) .
_ oY I V frr(III�N :��llj yur Y 1 � 2 kfr'- :
_All.roofs shall.be inspected prior to any roofing material being mstalled..�.
:` bon n ppicanio Tum wldgg« a na reeaAir caro devices which
If a roof is installed without first obtaining an inspec[iairi,=1 agrfieao remove
Laurie?t heard s 4,
c ntaminant az deft ee by N Bey Arta Air Qual ty Management g ...
all new materials for inspection Applicant understands and will comply with
�t u'y ” gNo f all'non point source regulations --'
'I
have read tho'.tis d u annals rtqu remenrs'under Chaps r 695:of Ne l l rt"i 1 '
Caliromu Health&Safely Code,Swtibns 25505.25533 and 25534ha e,6.95understand Net
accupbuildingereqccur ,i. are lyhvve a tenant.Nat itis my respovvibi iymnmdythe -
Ocbpma of Ne rcquiremc-a which nun be'met poor ro,issuevice of•Cenifio¢of n
Signature of Applicant Date
. . . -. _ ..
._ _. .5 ......
All roofcoverings to be Class."B" or:better
.:xi .i.. ..:.