02030187 y CITY OF CUPERTINO '
BUILDING DIVISION PERMIT • CONTRACTOR'INFORMATION:
�'BUILDINGADDRESS: PERMIT NO.
10106 IMPERIAL AVE TAYLOR WOODROW HOMES 02030187
OWNER'S NAME: APPLICATION SUB DATE
TAYLOR WOODROW HOMES 2300 CAMINO RAMON 03/26/2002
( PHONE:
(925) 365-3100 SANITARY NO. CONTROL NO.
9 zO AS CHITECTo'ENGINEER: BUILDING PERMIT INFO
kC mF BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
ow 1 hereby ellirm that 1 em licensed under ,pravisione of Chapter 9 hei m uchring Job Description
wit Section]0W7ofDivisionJof to Rosiness toes Prol'csxions Cale,end my license TOWNHOME LIVING SP. 1771 172707 .
s ce s is I.top farce
an etfeet. GARAGE S P. 498 GARAGE : glge s� 0
z. License Class Lic.ro
a'
01'.6' DateContractor a
3 a rat " ARCHITECT'S D[CLARATION
F 0 g 1 undersmnd my plans shall he used as public records
oo LidensedProfessional APR 2 3 2003
o OWNER-BUILDER DECLARATION
—m 1 hereby affirm that 1 am exempt tram to Contractor's License Use for the
f- a following rex n.(Section 7071.5.Business and Professions Code:Any city or county o 1 1'1L. 'p'�w
which mquires a permit to o ndracL roar,improve,demolish,or repair any stmwBUcre. NG
u`xj 3 :aprlor to its issuance.rlso req ims the replicant for such permit to file a si,ned haamem. -
thatbyislicencedpursuanttC(heprovisiom of the Conadedoes License Law(Chapter 9 S FL Floor Area Valuation
(c`ommrncing wish 5ectiont70'IB)of Division 3 of the Business and Pmmo,ions Code) Cfly''F II.t 7,k Sq
;JL': t. Iliit^A
or that he Is eumpi telefrnm and the hates for the alleged eiemptiah.Any vialminn )IR 1
df Section 7031.5 by any.1dicrnl Into Permit subitod,the applicant to r civilpenor, _ „t Occupancy Type
,of am m..tfloc an flhundred doums(s5o0). APN Number n ..
°1,as owner of the property,nr my employees wth wages ns their woe eompemad...
-'will da the work,.,to the staiode:The
rd intended d License
feredLaw doe sole(Sec,]045;' -- - --- —
' ..In
and Professions Code:The Ctaror's License law does not apply to en 102 - PIERS Required Inspections,, ••
I; rater.rpmpcny Who Wilds or importer provided
tNcuch improvements
d wno docs m h work himself 10 3 - UFER 1
a
or through his own employees,provided thus such vementemenls arc nm intended or
'-coffered for sble:If,however the building - "- — ' -
g or improvement n sold within nate build of 1-04 - REBAR "
iounplemprove to, urpeashe r-builder will have the huN<n of proving that he did not build or 105 - ANCHOR BOLTS
'
improve f t putpou mfado,.). '
i, aso ate project
tBusinesand trfessi wmlice:)The om otsio '-" "'1Q6 SEWER-'& ''WATER
consumer th p )ccs(Sec 70.11,Basins and Professions Code')The Commetor'x
04
License Law does not apply to an owner of ro,co,es loo,builds or impowes thereon 202 - UNDERFLOOR PLUMBING
...end who contracts for such.pmjeas with a camactot(s)licensed Pursuant to the. ........ _ _'2'03- - ..UNDERFLOORMECHANICAL'---" -------- -------- - ....._ __ -
Comment's License Law. .'
_ �exempt under See " ,B&PCfmolism.so. 204 - UNDERFLOOR''`FRAMEt '
� cY , Dao" z 3 t _• 205 = UNDERFLOOR INSULATION
WOR R'. MFENSATIONDRC DECLARATION 301 - ROUGH PLUMBING
Iheteby am penalty of perjury one ofthefallowing declarammod, 302 TUB & OR SHOWER
❑ 1 ni:e and will mainim.'a anine. m
le of Consent I.'self-tae for workers 3 03 - ROUGH MECHANICAL
ILI
Compensation, as provided for by Section 3]00 of the LaborCode, for Ne
perormanscoftheworkforwhl<nthispiisissaed.1 have and will malnmi0oYorker's Compensation Insurance,as required by Section 3 05 - FRAME
37M of the Labor Cade;for the performance of the work for which this permit is 3 0 6 - HOEDOWNS
issued MyW rkers comPens ro aryumher ort
Insurance caand Policy n
Crtall >t "' ; It o ¢:eaury Na. _ _ . 3 0 7_- 'INSULAT I ON "' a
{, t" CERTIFICATION OF EXEMPTION FROM WORKERS'! s i 1 3 Q g. _- '$HD'D'TRQCKL- -s.i i.
COMPENSATION INSURANCE
_. 309 -EXTERIOR--LATH
(This sedan need nm be completed ifthe Perrot is for one initiated dollars
n ulo)m IessJ 310 - INTERIOR LATH
_. 311 - .. SCRATCH COAT-
I ce t fy Wa t t Person
pert any manner tr th rk for wh h Ih's p i t s Is o A 1 o!
Cam not mplay anY pets ny e�o o b cyLL
Inew kers 313 - ROOF NAIL`
.Apel ca - fm��q,�t L��— -_ 50.1..-.. FINAL.ELECTRICAL. ENERGY....
NOTICE TO LICAN'T If.aOcr makm,t nc<rttr titan you seat nil 502 - FINAL PLUMBING ENERGY '
beer subject m the Wo keys Compensation pr its or the labor Code,you must
0 zforth ith comply with. -h previsions at this permit shall he deemed revoked.
O _ 503 FINAL, MECHANICALENERGY._ --
''-
CONSTRUCTION'LENDING AGENCY 504 - FINAL BUILDING ENERGY '
�.'•'' work h by which that th nm coat t 07.Civ.
agency for the performantt ..91-.:Z
B kde re - this'--- z tanarea(se< J0] crv.c.) 505 - FINAL ELECTRICAL '
Lend sAmrc - 506 = GAS TEST. ..,.. -' -
Up rteetocom dm'city
t estate that
boinformation6 507 - FINAL PLUMBING /��
m E. co I l , t comply t nctYand countyordinancesanastt I , 508 - FINAL MECHANICAL U
O r,� mbuilding ot t nahereby' tri p ti fill,ctyt trupon
p w me b e rap t, •a property rrp«n purposes. 509 - FINAL GRADE
[� 6:
(We)agree to sae .dem rfy and keep harmles.the C ry t Cupertino rgemll
.In liabilities 7 dgtnems Cost, d pence hchma> .any y re.,ain'tsaid 510 - FINAL ING
U.7�. city q <e of th g t ,rate sP t $14 f' F A WORKS ��
APPLICANT UNDERSTANDS-N WILL COMPLY WITH ALL NON-POINT ISSUed 1 Date
Si ruWlltlh I Ile
HAZARDOUS
Daa = ROOF BATTENS
^STIO •3—.V.
s vP Re-roAO33' R
r HAPAROOUS MATE LOSURE - .Type 0�1C(70f- - .-
pp ha tem.12. ad he l
OOF IN PROGRESS _
aS d fined by theCupertino Municipal] de Chapter 9.12. nJ t Health and Safe,,
G tle'S cti .2551?Irl �..%, yf's'•y"s "t it as {�{"t 4 vx'b l�
-All roofs shall.be inspected pnor,r_to.any roofing material being,Installed
- worn applicant rr I eb ildingoccupantu- equipmentitidevice,which if a roof is installed without first obtaining an inspection;I agree:to reinove
emlh 1 tsars. I:mnamsas AeIII pvd by the Buy.Az,1gi Quality Management
Dimmer 7�.'/ all new materials for inspection,_Applicant understands and will comply with
°Ye _ all non-point'source regulations. .
1 h,m read the haduket maunals requirements under Chapter 695 of the -
Califomia Health&Safety Code.Sections 25505,25577 and 25534.1 undersmnd that
if she building does not cumm0y have anam,dou it is my responsibility to notify the'
.crop..,Mie requirements which must be met prior to issuance of a C<rtificme of / 'a'\)
V. • _ Signature of Applicant Date
Ow I .tnnatmotag<nt -��� All roof coy�Args [o be Class "B" or better
OFFICE