01060039 CITY OF CUPERTINO
BUILDING DIVISION p IT CONTRACTOR INFO CATION:
BUILDING ADDRESS: - PERMIT NO.
21685 GRANADA AV 01060039
OWNER'S NAME: APPLICATION SUB DATE
• BAUER SHEPHERD & ROSS 06/07/2001
PHONE: SANITARY NO. CONTROL NO.
\. D OO
w w0 0 ARCHITECT/ENCIN[GR://�� B ILDING PERMIT INFO
a a s / ! BLDG Lu - PLLI MECH
ia
LICENSED CONTRACTOR'S DECLARATION
c S y— I hereby affirm that 1 am licensed under Job Description
D i_ Y a tidos P oe xi ,Cad nad(commencing
FH t-m with Section]000)of Division lofthe Business and Profusions Cale,and my license
Rx.-c 1,i. uIlf tralofre 4$STGO REPAIR.
O i License Clazs Lic,p
Date - - Contractor
ARCHITECT'
5DECLARATION EMERGENCY REPAIR OF WATER DAMAGE .
Sup
cxntol 1 underxmnd my plans shall be axed as public recoNs
Y
i o:po O Licensed Professiowl �j�, `1-
n OWNER-BUILDER DECLARATION
— 1 hereby sham that 1 an exempt Rambo Contractor's License Law far the
?< following reason,(Section 703 1.3,Business and Professions Code:Any city or county �\ ✓�C � �C tT
,
I x❑ which requires a permit mnstruct,coalter,improve,demolish,or repair any structure V v /� li /•� J Y f
n 3—F prior to ixuLance,also requinckh ppl t for such Permit to rile a signed statement
that he N lectordlonl6al to the provurmi,tIfthe Contractor,Licra,c Law(Chaptee9 S Ft Floor Area Valuation
(c rnmemm�g wuh Sect m70011)a[Divis nJsfthe Bus'n pd,Pr fcssions Code) , a' y ,«+ :9 . '15, -. .. t '•�.
ar that he i5 ekmpt thercfnim and the basis for the alleged exemption Any violation '"
- S
Iection 7031.5 by any applicant for a permit stmiects the applicant to a civil penalty
2I Occupancy Type
rntnmrmniR
nvehundred ealmtstssw). APNNumber "r.+:,� . „
❑Las owner of the prnpeny,or my employees with wages as their sole compensation, i
will do'the work.and the structure is not intended or-offered for.ale(see.70". Required Inspgst ^
I'' '
'Business and Professions Code:The Contractor's License Lew docs not apply to an jI$
owner of prnpeny Who builds lir improves thereon,and who does such work himself . Y A e C
or through his own employees.provided that such improvements are not.intended.or __ ._.._ .-_1.O 1._.-.. FOUNDATION.__ __ _ ._,_ __.. ..- a
-bfferzd for isle:IL'however,the building or improveecm is sold within one year of - ------- __.__.._.
completion,the owner builder will have the burden of proving that he did not build or 102 - PIERS
improve ; 'FEB- 1 2 2002
for purpose oriole.).
- - - -- - -' - - 103__-...UFER.-.
—no
exclus
maing with
contrac
ors
,Li lens Law ofIN,
an owerofycontsmtho builds or
d rsaam,erson, _105._ r _ANCHOR_BOLTS___._._ ./ p. . .• f
v construct the project(Sec.71ki Business and limitations Cade:)The Contractor's 104 REBAR ,,
License Law dos not apply to an owner of prnpeny who builds of improves thereon, BUILDING
Commerce,License
for p w a.con tilt __.�
'c. CantmexempItcnalaw. 106 - SEWER & WATER:-. ._. .__.__-_ .._...._..._
- - _ ❑lamescmpt under Sec.' � � ,B&PCfonhis reason �`:J"'�)0
202 - UNDERFLOOR PLUMBING
" s
WORKER'S COMPENSATION DECLARATION 203 — UNDERFLOOR MECHANICAL
:';• - Thereby affirm under.penalty of perjuryane of the following declarations: 204 - UNDERFLOOR FRAME
❑ 1 have and will inimmin a CmiError of Conant to self-m ure for Worker's 2 05 - UNDERFLOOR INSULATION
p
Compensation, as previded for b Section 37W of she Labor Code for the
/trrarm,ve or me work for which Itis p omit it is...d.. 301 - ROUGH PLUMBING
'- - '1 have'mil maintain Worker's Compensation Insurance,as required by Section 302 — TL` B & OR SHOWER
PW at the Labor Coxi for the performance of the work for which this perms is
.: issued,MyWrker'sCompesit InsurncecandPoltc,ynumlocare. MECHANICAL._,-
- ca (Qt:ti4�EtlNti'('bhrtyNa,:N7�51�15+�B' 30:4-t ', ROUGH':'rELECTRICAL
FROM,WORKERS' - - -
.r. COMPL'NSATION,(INSURANCE _------ __305--=.._FRAME
"CFRTIFI AT O
(lin.xatmn ed nm M:rn npineJ if tM1e permit is far one hundred dollars 306 = HOliDOWNS '
(g1(MII I sd
._.307 -. _INSULATION... .
'nx9i Ic Ip,Itllhpl tefth workf " hsh pe` t .issued:I t ull�'/Yrfl -. _..
tau t 'tploy'anylwvoto I, namoc,so as 'noeon b3 tl kha'Workers 308 - SHEETROCK.�°i1 ,
rion
bNOTIgET'OAPPLIANI.it,�itter Worker., pickatethis
nfs'tf theExh°Icaar Ya mold _ _ - 309 -EXTERIOR LATH ... ..-.. .- -__.'._ ..._ ... ... _ _..
310 - INTERIOR LATH nr
Q P.
0 firm tbtply h p h ons I, this front shall he d em d revoked,
ZZss .. wum311-------SCRATCH'-COAT _
CONSIRUC,rIONLENDINGAGENCY 313 — ROOF NAIL ' t -
Ihereby frinn that the o web n le ti ng agency for the performance " -
W Q 'afth afar which his ti it. issued Sec.Joy? c c) _a - 501- —FINAL -ELECTRICAL ENERGY- -- -'— --- ---
6i Q " Lender s Name -
Z 6npera'Aa1 t. 4 502 - FINAL PLUMBING' ENERGY
U'O r
I cerify that I have read this aFlicalion and$rate that the above information is 503 - FINAL MECHANICAL RGY
correct.1 agree to comply,with all city and county oNinance.s and state laws relating
.:0. V .whuildingcommiction.andherchyaathone,reptesemativesofthiscitymenterupon 504 - FINAL BUILDING E
W Ithe all mentioned Fort for inspection partitives._ af
F alW'el.agrsetosave.indemnify and keep handess&CityCupArmagainst 505 .--FINAL ELECTRICAL
-Vi liabilities,judgments,costs and expenses which may;in any way accrue against said
G.z City in rota rote of the gmmA ah nn MP
- 'AP A�' U DERS +NOSA ' 'ILL bIPLY WTfH ALL NON 0 /
_= Ltgr un I. . Issued EST tq,L�C(, Dale
Igo heollIcan6ZAlot M,kTERIAL5015CLOSURE _.nahe Re-roofs08 - FINAL MECHANICAL
wBt leant rt building pant stare ort m ha'rardowmatend -
Typeo58'&bf- .FINAL. GRADE. ..
as difiredby the C.,omm Mande,I A ' Chrter912 ad h Health and Safety
code,Section ass32u r -
A i 510 'FINAL' PLANNIING
_
All roc�sl4alLbeligspAlgd.p MlyMy Vf(Dfpjl;8material being-installed.
'Will ta pplit nt.1 faine building necpantase eq pmemo Ill which' If a root is iilstalledlwithout first obtaining an inspecDoln%f agreeto.remove
emit hazardous air comm Iv ,g Id by the Bay Area A QualityM agement
District?, / _ P PP - d_wlll,comply with , .
Cl yes
oNa t a new materials inspection. A hcanj understands an. -
allnon-point source regulations.,
I hdvc rkd 6Th haiaNtios maierinls rcquiremanm imuerChapter�6.95 of the
California Health&Surety Cale.Sections 25505.25533 and 25534 1'code rsmnd that
„if th b Idll J es nal rtl,w Mtveat m Thi is my p sbbty to notify the
nth }eyui h whi -t 1 prior miffs t ce i f a'Ccniftsac of
°`° ay;� Signature of Applicant Date
oa� l g _s _. ., . ._..
ow'erora aed�lin, Al] roof coverings to be Class B" or better
,. .. _. ..-... OFFICE .. ..... .. . . .. .. __