02070056 CITY OF CUPERTINO ' - -
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDINGADDRESS:
PERMIT NO
525 HEATHERWOOD DR RTISTIC KITCHEN & BATH DES GN02070056
OWNER'S NAME:
APPLI
C. COMAL 31 E EL CAMINO REAL F�T�Os � 002
PHONE:
650) 390-9615 SANITARY N0, CONTROL NO.
-
O
in be ZO IL
ARCHITF.L`r/ENGINEER: BUILDING PERMIT INFO
G1-F4-
S BLDG ELECT PLUMB MECH
EE I-.J ILI LJ I_7
LICENSED CONTRACTOR'S DECLARATION
O z=G 1 hereby alfttm that I am licensed add provisions of Chapter (commencing Job Description
P'^t with Sa'on]0001of Dtvision3ofthc Bu,32'and Profemions Code.and mylicenu KITCHEN REMODEL
zxx Lici I fnceos,and 11
T �l+ -•f op tj-00 `V:/��s�®
rc a Licen sLic.
a�3 u Date—�jas�-���0�� Can,, 1
ARCHITECT'S Can,,
yt�o s 1 understand my plans shall be used as Public rtcoNs OCT S 1 2002
Hol
R c O Lreemed Protessional
u =8� OWNER-BUILDER DECLARATION
1 hereby al8rm that 1 am exnnpt firm the Councl m's License Low for the q w
t z a lidlowing reason.(Section]031.9,Business no,PBUILD[
mressions Code:Any city or county" 42 o 0 0
F❑ which requires a permit In constmn,alter.improve.Jemonsh,or repair any IlmOme yrh
n 3� purse
don
t is s e 1 the aper tf chpa in rle asmreme
' at ht u I enssd n,Yoro flairpmomm, fine Cormanno.,License lLaww(Chapte9r 9
g with sea r D) fD J nn Bmin a Pro a tnna Cede) ! f ;3'5 965 °0.9®r a f Valuation
o thvt he t exempt therefrom and the basis(or the alleged semptionlgny smite on - '" �' `'g U-VS"-d i To
,
of
not a 9 than
e u dred dollars
a ll far a pctmit subjects the applicam ro n civil penahy 1
' of not than five hundred tlouars(S900L 101 APrMM#NATION ;rl"B•! ' . Occupancy Type
1)1•as owner of the pmpeny.ar my employees with wages as mei,cola nmpedaund,
will do)he'work,and the strucmrc snot intended or offered flit side Sec.7(W.
Basilicas and Professions Code:The Cammnor i Liwnu Law does notInspections,-- - _-'"- "-'--
mnly;^.at 103 UFER Required +
owner of property Who builds or improves thereon•and who docs such work himself
or through his own employees.provided that such improvements are not intended or 104 - REBAR
iffinnid for sale.1f however,the bidding or ifininnsamou issold w;thiliane year of
ANCHOR-
105 .
m pl e the ow bu Ider will have the burden of praying m - BOLTS
at he did not build or +
improvee rnr patinae lir sale.)' 106 - SEWER & WATER
. OI n n ''of the p w-nv:m ex,,l iely ennirntywth licensed oontroomm m 202 UNDERFLOOR -PLUMBTNG __._..... _.. -...-_"
construct the project sec ]Baa Business hss
ss and Pro ;ona Code:)The C°mracmr's
License Law does not apply to an owner of property who build,lir tort tharean, 2 03 - UNDERFLOOR MECHANICAL
ane who,contmcts.for such.project,.with a contmnor(a)licensed pursuant to the
Contractors License Law.,. - - 204- - UNDERFLOOR- FRAME.2-'-
❑late esempt onJat Sec." 8 A P C for this reason 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION ow°"; ENS .ATION DECLARATION 301 - ROUGH PLUMBING
.. - _
Inertby.frim ander penalt ar 302 TUB & OR SHOWER
r Ixriaryaneannermmwingattlmori°"s 303 ROUGH MECHANICAL
❑ I have and will ma Iain a crnihcate lir canttnt m:eleimme fn,Wmkara 3 04 - ROUGH ELECTRICAL
Compensation, as provided for by Senion J]W of the Labor Code, for the
pe,rannancenrmewnrgrnrwnienmlapermit,aiaaaea. 305 r FRAME
O 1 have and will muinm;n Work,",Cnrnpansm;od In....ria.as required by Section 3 06 - HOLDOWNS
3/00 of the Labor Cade.for the perfnrmonce of d¢work for which his permit is 307 - INSULATION
issued.My Workers Compensation Insurance rimer and Policy number are '
lite s 1'E X5`.`19 �0-� ...._, ...30,8_.. SHEETROCK-"' _
(u„y
�{ CERTIrICA ONoaFvTnMPf(okFROMwort-KEIT t i'^t30'9-- -k IEX•TBRIOR.iLATHI''*'' _- .Y
COnIPENSATION INSURAN!E,
310 - rINTERIOR LATH '.._ ._....-o......
Drink section
oeed not be completed if the permit is for one hundred dollars F'..'••• t t ....
(SI00)orlms)_ 311 - SCRATCH COAT ”- - -
- —313 -- ROOF--NAIL--
I c n toy at person
pc in tiny do dd the work(or which th s - - -- - - - - - -
pc nisi ueJ.l -- - ....:.:_: _ _ ...:._._
Call t employanym .Dit'ncra°asmbecame subject r theWork„,, 501 - FINAL ELECTRICAL ''ENERGY
C pe sat n Iowa f C I'f m a.Daie
Applicant
502_= PLUMBING .ENERGY .,_
NOI[CC t TOAPPLICANT If afit,ino ,mr,'ntfcom ,E. lupi n You should
-
Z tec e-p)e tt dt Workers e mpen inns idmisoft Lab Code,you 503 - FINAL MECHANICAL ,ENERGY
rtnnwmc,imply with ¢cliprovisions non Permit%holl hdecurad ocialked 504 FINAL BUILDING ENERGY
1 CONSTRUCTION LENDING AGENCY ” '' -
E nercn Irmmmm 505 - FINAL ELECTRICAL -
a:� : y 'ntmr nlena' gagenrymrmeperfhrman,,e 506 - GAS TEST
.., oath work for which thro pc t uuued(Stt UM)]'Civ.C) " .
Lentlert Name + _. _.-
DZ Larne,I'Aqa . ..... -507 - FINAL -PLUMBING. . _ .. .. -
U 01 rfy th i;ln ad-his application and state that the above informal 508 - FINAL MECHANICAL'
E. cone r I agree,r ro ply:with ell city.and county ordinances and ,are laws telat ng
m
building connmction.and hcrebgauthonae representatives of thi,siry to enter upon 509 - FINAL GRADE
y.w . beaho.e.memianedpmpenyfrin.peninnpalinates. 510 - FINAL PLANNING
.F; 0. 1 C)area to save,indemnify and keep harmless the City c(Cupenino against
.Z ' liabilities,judgm costs and expenses which may'in any way acerae against said 514 - FINAL UBL C WORKS
:C,1'.Z. ; C mcunsegtin ae fthc Fr.mngof Chitp,.h. �/V
PI' CANT ON)E'STANDS'AND WILL COMPLY\VITH ALL NON-POINT '
Off tEREGU A IONS., Issued by: !Date
., „ _ -m
St t r \pp' a r ,Date: Re-roofs
HAA L MATERIALS DISCLOSURE' -
Will the appl an or lute b ilding occupant store or handle huWous material Typo Of.ROOF
as Jahn J by the Cupcn M t 14 role Chapter 9.12.and the Health J Safety - " ' - ^-•" +
Code g a o 2993O
0 Yby Otho. I I s i v
All roofs shall be inspected prior to any roofing material being.installed
Mum applicant u dhng byatothe lit useequ p mat Management meet If a roof is installed without first obtaining an mspection,'I agree to remove
em t h ab a mmam nncd by the Bey AT:a3.ir Quality Maneg'them
Dist m
1 as.
_.. _ all new materials for inspection. Applicant understands and will comply with
all non'point-source regulations::` - -
1
have read dh uCode. maens2alk rtgw 25133a ander 4.1 699 understand she '
I fo He hh& to Code Sect ons29309239JJnnd2993a.lilytomthan
I tilling does tcu cony havcate um.thus it is my nsponsibilirymnmify the
ici p I ,thequ I hieh must a mEl pr°r la tunnc of o Cert ftcatn of
ncy,
GE1ti�� Signature of Applicant Date
""^°ra`d"g tDate All roof coverings to be Class,"B"or better
- - .... OFFICE