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HomeMy WebLinkAbout01080083 CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 22350 HOMESTEAD RD 01080083 OWNER'S NAME: APPLICATION SUB DATE BPPR LLC 08/16/2001 PHONE: SANITARY NO. CONTROL NO. ( 0 O OARCHITECT/ENGINEER: BUILDING PERMIT INFO F BLDG ELECT PLUMB MECH y Z LICENSED CONTRACTOR'S DECLARATION Job Description 1 herchy affirm that 1 am licensed under provisions of Chopler 9(commencing 'j=�.E with Section 7")uf Dwisrm3aflhe Businessand Pmfessior,Cod,un© ar iese REPLACE SUBPANEL. is in full have and effect z rc 6 License Class 0 Dail ?set /-Al B. C Cnmraclor C0�25� 'ARLIRTECTS DE A g 1 undermantl my pions shall be used as public rtcuNs :not— Li t a p O Licensed Professional °• OWNER-BUILDER rnDECLARATION w o 1 hereby.(Sero that 1 1. exempt from are(.comes Co e:Any r Ind for Ne t:Z n fallowing uiaeon.(Section t 1031.5,Business andimprove. Professions Code:Any ray or county $2000 2 0 0 0 eF❑ which requires e pnmu to construct,uhea improve,demob h or repair any structure Y to3ve prior to itsce,,al srequires the applicant for such Permit to rile astgned smmmem - - - - - - Nm10 isliceimacdpar nnathepro iOmeri theCommcmr License Use(Chapau-9 ,yCp �PCj� r,n9[� '1 Valuation (commencing with Sem-.n 1000)of Division 3 of the Busmn d Pmfgss.ns Cone) \ 1.1�. f i3'L C7 �V j j.1:V U a�'�'L l [,}..<�: or that he is excmp,thercfmm and the hosts for the alleead uempda;Any violation of Section 7031.5 by any applicant fora permit subjects;the applicam ur a cruil penalty: APN Occupancy Type r an am mare than five hundred dollars(tem). I"'-'• p y yp 304 ELECTRI AL ❑Los owner of the property,or my employees with doges resa edtheir sole compensation. - 'will do miaNimwork;and the ode:The not intended or a Law doe sale(Sec.'to an r owner if pro erty Whons Cade:The Contmaor's License Law docs mi apply m an 505 - FINAL E J Slir'I'R�lI1 CtlOnS"'°�r" °n' owner of h his..Who biers m improves thereon,m, who does such wank intended or , err erfo his awn employers.Provided amt sock Imnscon roots oro not oneNcd or' offeredle ion.sthe.11.however,the lhave Wilding ..- tis sold within one of, - It theowncrhuilJerwill have te buNev of cis that he did not boildm completion.isfor 1 sale.). proving improve puryou o' _ . , ❑hasowner ofjhe pmpeny..roe Business and mrfeingwiNlicensed:)The Cwnorsm 'answer the R.Jat ISec 'Ito a,Busts s d Profession,code)The Contractor's 7 ��• t •d ,.. Li cis Lu does nm apply man owner (p pcny who Wilds orrimprovestinscroon, j and who contract.(m such Pmm lec .w tit c t 'tons)Ice nro m J,p othe ,.. .. ,.._ .. .._.. .. -.-. _ ...... _- er L EI Immnx lyw n ❑1 exempt undm mile,S . B&PCfm ten rcmat Orct '•.'{- 'Date'.. .•• ' . a WORKER'S COMPENSATION DECLARATION " Ihereby eM.under.penahy of perjuryone of the following decloratimee O 1 have'm1d will armat n'n Ceriliwe'or Consist,to xlf-Inwre for Whist ompmmion;-as provided for by Section 37W of the Labor Cade, for the pedannanre of the work to which itis permit is issuN.„ ❑I hove and will meinmiu Worker's Ca n,shomlon.lmiroaree,as'te,m J by Section 3100 of the Lam CNet fer the pimicrmence of the work for which'tMs permit is iiw d My Warier',Co,��`,wa Insniw¢i overate oat Pol cY number '. C r30 f'A T'1'/'1. tlti''PoI YNo.. - �/- s t 4� aft , M11 f'sC.- y 'J9 1 'UI I 'CERT (CATION OFr iMPDO FROM W RKER , ;', t„t'.N7. OMPENSATIONI ANCE a f r IThs- tinnmNnm cI ars 151Bid orlessJ I; L. ... ,... - ... -..... . ... _. ............. ,_ .-.... n4 t I cert fy that in titer ped o cel f the winds for which this Permit is issued:III sit II.,It employ any ,00mr an any mann .,as t Wmme bJ n m he War -� CmuNroaden(awe of California:Date ..APPhcet ...•. "NOTICE TO APPLICANT If ofmr rook ng tit a C nifcate of Excmpti n you should Z bee me;Object t,theta rkefsCompensation provisions of the Labor Cade:You must Q O fmihw th contipli p perms s o ked it h v a FFncY for the .emvme ... ... . .- FtRd ' J CONSTRUCTION LENDING AGENCY I hertbYSRrm Nat Nere t a cnnswaiun IeNN a pert,.,- ti " 'w ��, of the wwk forwitich ten perms is issn41Sd.3007.Co.CJ,-iul-•u.n n. -. _ .. -. . _ .. .. � _. . ._ . -. ,dQ 1<nder'sName"- F7 z Lcntl Ad41 d -s'. . - _. .- .,. e•,.i;, 'I ;'.,t ,l cert fy tit tlha tread Wsoppl' t nwd tote their Ne oboe in(mmwam is .�u 0 cmreft.I agree m camply,with all city and county oNinances and same laws relining 0.� to building consadction,end hereby auNoiiu repnesenmtiva ofthii city,.en¢rupon rheaMvememionedpmNayfuTinspectionpurposcs,,-, .,-,-, -(Wc)age reto save:indemnify and keep harmless'the City of Caperton against ars Ln liabilities,judgments,costs and expenses which,may in any way nerve against said ' V.Z City in consequence of the Startingof thin.permit,, J " APPLICANTUNDERSTANDS AND WILL!COMPLY'WITH ALL NON-POINT ' Issued by: Date SOURCEREGULATIONS,',l ' - 'i`>';-`.. �. Signature fAlpllcem/Co t ono DO m- Re roofs CI '-HAZARDOUS'MAT-RIALS DISCLOSURE Will the'applrc mor future Wilding occupant st re Nl hasmaxn "l 1- — --J �k,pa OfROOF _.- ,_...-.... . tlefinetl by.Ne Cupemno M n real Code Chapur 972 oM N H aha and Safety 1 ! ( Y v ode Sat.n Z5532hd ,' , l ❑Y i' °No;d '`r '` ' ..-.All.roofs,shall be ins ected nor.to.an .iDofin matenalbein ,installed._ ?. p y S g -_ .... y W ll the pplic nt rhyme bdid goccupant use cgmpment rdevtees hi'h, If a roof is Ihstallcd'wlthout first obtaining an in'spectio'rjt1 grea't0'remove ems haimmin s t wren was at as dcfn d by the Bay Arta A,Quolity Management D amri „ all new materials for inspection. Applicant understands and will comply with _ oY� oro., t all non-point source regulations.. 1 a c lth'&eed Se hamNous Smui nils kqu¢mems under Cha4.-1 un a 95°(the if font a Health'&Safety Cole have al 25505 H533 and t onou 1 understand tent tem ifthe building doevnu aye eetn mthat tn 1my.i"Woo Nr,.0 notify the 'occ Pont of N,raqut m rs it ti u t be mm porno is uade of Cendiaem of p, L � .Oce pe cy I ' Signature o_o Apt - Date .. g Data All roof coverings to be Class"B"dr better t OFFICE �' A, — t. coon. '