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00090178 CITY OF.CUPERTINO " - - - ButLDtNCDIVISIIN' , PERMIT CONTRACTORINFORMATION: •- BUILDING ADDRESS: P12RMI'INO. .��.r/I ' nPPUCATION SUR DkFE OW,ER's NAM[: ., 1 v-M�-Y , ' 4"i3i Air 'non- 1 v II Iii 'I_aNDscaraE 00090 78 'HON& _- - , r SANITARY NO. Co T, Rol.NO. 19977, BENEDICT LN' 09/28/2000. '-O Z ARCHITECUIiNGINEER: , BUILDING PERMIT'INFO' - , BLDG - ELECT PLUMB _ MECH LICENSED CON TRACTOR'S DECLARATION z mm'1a 1 an Iiron.e,t ammo Tcha t 9 rammene;I' Job Description I hereby . Z_Q Y n Pmvixinnx h p cr .. F_F'a ..ams«dan nNgk,rniasien3anne Ba,ioessandpm&ssiens Cade.and lar Bancea . ,i f pf Ad cff[a � - d z z a i,in a Lie se 3 a F Dm - • ca - ARCIIII'N. r' ECLARAIION • t t=°5 n:m ma. an UNDRGRND RECEPTACLE ' 55w caused Probes, OW NF1 ILUFR DECLARATION thereby u7 1 thereby aro an that I e PI In th C i t 1 L t for me t-z� foll y r (5 ).7158 ' JI f:. cd Any ry aunty f r2 O h h q pe m u c .IN p pn J I'.I P y t Imre i3pr, t t e d. re I. Ib role nr chpermu 1, y d.n mmemfail he tP II d p h C I Laov(Ch.plar S({. Ft. Floor Area - •' Valuation tea nnearing inSection)Wld of Di,- J i Businessdl [ oda) - e, mle .ux.„1uh I o db tribe alleged . Ir Any udon nun ofW Sect nn)dl l s ny a y ol+Plican'f m a pit mniem.the uppl Coco n,,<i\il penalty coon mare n'an can nmmrM dhnar.16500t, .APN Number � Occupancy Type . P Y YP 'M 1,as owner(if the r ern, eminees with woe,as their.sole corn .inion, - 7 pap y or n'Y P Y e pen s ¢+ s will na Iha work,and In,ode: Du C ntr Contractor's ul nr bl'ILwv I'm alfa(Seeappy 1.an ,. Ba, IertyWhonncMn meconn n -1 - 'l.awdocsnetapply' n Requlred7nspechims ' •< _ ' of property Who hl'Id,n- npmn. x,tu and hn thou a.h ti te h1a)WIF or l through his own em Ih '.fi Wid[d II,,inch,a maen'wi bre not intended year or --ss B P L V p .'r�t4:]F1ft'I� 2. ���' ofl'afnd Ian hale.,,..w de the l have the burden env Ix sold within one geld of om lotion the mvner huilder will hme the nurden of+rano•aha he did not build or I 6 + J innnpne for pa'pose er xam.t • . - - ❑Lasowneronhe ru•rt,andexclaskel tunneactm with 304 - ROUGH, ELECTRICRL property, y e .. _ a., mu the prolal c. ,.)I 4.Bn,Imxx and I rmesx'hns,cedn.I Tea cammmnr•s 50 1, . F I MAI_ ELECTRICAL ENERGY License Law Jocs nm apply m an owner of property who Wildfire inipnncs thereon. _ - and tl'o a mraoti lot ,a pn Il a,emmetorcxl ensed'pr,,tu I fo R,e _ - 505 - FINAL IELECTRICAL . Cnmmcior I.i ease Law +/JI - ❑lnme np Inder S . ! •tt YCti,r lhisreu - Owne aI l`/ WORKER ATION 1 he. y aftuan under penally of perjury one of the Iullowiny d,elnur"Irs: , J I have net will maintain a Cmifcale A Conwat n,Shlf-insure for Wnrktu x - _ - Compcosation, as provided fai by Section t)W of the Lahor CMC, for the - performunaurlh—...k forwhich lhixpcnnh,,issnal. s : •Olh nd i111uiminW All'In by Set)Wto bCM k. tl p r 1 s �sa d � IrsC t ond of y mbcrore. �t ATI( O 'IiGM WORKCR4IRANCIi ' h' . n ncd tl anlplenJ'fd' P 'I Ix I'nn„c hundred Aollnc. _ u - . , �' , I c[n fy tt pe mance oft rk f 'h ch thispermit-.WI hml 'nt enp 'vion if y e s hl II vh , W,,,kk . ' Co R Sall I N C I' Appl t n _ NOTICE IAP 1. 'A 1 a 11 mak' ''C Can, Pf > shield � Oh aomesuh,M1mnd, sans of the Labor Code ynamuel limhailh avnpl sm.orlh prmil nhal(Mdee Wed revhkeJ - ti E-• � CUNS'I ItUC'1'ION LENDING AGENCY 5 - a I herchy winch Ink Where is n eon..i cern lending agemy for the performance W of the wad for which Ihix permit h issu[d fScc.}IM1),Civ.C.I - a - Q Lender's Nmne Lender's AJArnn V_0 I certify that 1 Leve read this applicatim'and state that the above infonnmioo is N y •• come(.I agree to comply with di'cily and cmmty ordinances and slate laws relating - O U -tib ld 6c t dh by authorizep m n Inh' cryo n pun -Ihc libIwe-nuhnintedproperty I,,,in,lectrollpurp • . . L., d Ohe)agree to save,indeannify andkeep l '.deCny ofC peN banst Lfn Imb t: W nxl yIn' Iny y,. i ny 1'n,aid - U Z City di sn enceof' rani "pem �.+ �/ O�- �•t APPLI 'NT DER. AND WILL 1 WITHAL -POINT Issued bOe, /"�' Date SOU CI R 'L S. ' Y' Si namreol Applien mto Jwe Re-roofs HA7. ., SCLOSURE Willi nlhrinwremlilln�rxrol4aat.mmerhandh,bma'doe.InalcnalType of Roof . . a'-derma the Cupcnino Municipal CMe:Chapter 9,12,and the Health and Safety - - y Code,Senien25532002 , i /' - g �Yf4 41/1 - All roofs shall be inspected prior to any roofing material being installed. Will aper[amh.'future naueiagapatd use egmpmaon or device,which ` If a roof is installed without first obtaining an inspection, I agree to remove• 'i,h,,odnuxnrconuuninantsasdetl M hy,the Bay Area Air Qunlit Mnnagemem 'h,riett - all w ction. Applicant understands and will comply with . °Yc" al Aiv ti S. , I h' 1 th d d' . nom al. req nt v under Chapter fi 95 of the s C'ah it hh dos IyC 1 5 t s 25505.25533 d2551d d .tanII if theholdingd inch mlyh m thou . yrcgn.bltyt notify the sup, t of the cyuire env.wh I net pr'or , 111race of a Ccniftaac of occu icy. Sig ature of - `- D aile ' AI root'coverin s to be Class "B" or better rl�i neo r mnnd.e asem — Data g . t