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CITY OF CUPERTINO
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CONTRACTOR INFORMATION:` ;
BUILDINf. DIVISION PERMIT
1..'.:....x.4
BDILT061A3°2ESSIMPERIAL AVE
TAYLOR WOODROW HOMES
PERMITN'02030189
YWR WOODROW HOMES
2300 CAMINO RAMON
APPLICATI®NS`M6TV2002
/ L
PHONE:
(925)365-3100
SANITARY NO. CONTROL NO.
ARCI IITECDENGINFER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
Lm thatIUCONTRACnUR'SDECons Of CON
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing
NEO,
Job Description
TOWNHOME P
with Section added of Division 3 of the Business and Professions Ctde, and my license is
mrulfarm add tfte06
1589
SQ. FT. LIVING SPACE
License class Contract,,,
nam coemeCL
492
SQ. FT. GARAGE
ARCIIITE
.�
®
m,rd.siCl.ARATION
1 undecstanA my plana shall be used us public records
JAN 2 2004
Licensed Prdcssimnal
OWNER DECLARATION
BUILDexempt
1 hereby affirm that 11. exempt from the
m fir Limmc law for the
-
snsCContractor's
(Scainn ] Professions Gavle: Any city nr county
followwhich
Business andimprove.
which requires a
re rens a concordat, .pee improve, demolish structure
also w Lure
mea sig any
iconth
ddonnits issuance.assnrequires theapplicantOf Isar such pandit Llilaa Law(xetcmcm
e. pandit t statement
mencingwidnma„aminthe the
Sq. Ft.
Floor Area $1 [ion
comdral
epstnamadProalaweenapmry
(commencing with Section ]land of Division 3 of the and Prnlcs
X))ofDiran.nofthf
vi Code) or
aged exs
that he k exempt therefrom and Ne hmis for the alleged exemption. Any violation of
y
a
Occupancy Type
Section 7031.5 by any applicant fora permit subjects the applicant to a civil penally of
not man than fire hundred do]].. (s500),
0 I, as owner of the properly, or my employes with wages as their sale compensation,
will do the work. and the structure is not intended or offered for sale (See 7044, Business
and Professions Code: The Contractor'. License Law does not apply to an owner of
1. 0 T.
102
—FOUN
- PIER S equired Inspections
pmpcny who builds or improves thereon. and who does such work funded f or through his
own employees, provided that such improvements am not intended or offered for ole. If,
103
— UFER
however, Ne building or improvement is sold within one year of completion, the owner.
builder will have the burden of Proving Nat he did not build or improve for purpow of
10 4
- REBAR
�`a)e/').
105
- ANCHOR BOLTS
l, ror of the prolixity. am exclusively contracting with licensed contractors to
106
- SEWER & WATER
consultant the project (Sec. ]044, Businem and Professions Code) The Contractors Li-
censelawdoesnu, apply 0,anowner ofproperty who builds orimprove. the reon,and
202
- UNDERFLOOR PLUMBING
who contracts for such projects with a coemanf(s) licensed pursuant o the Contractors
License Law.
.203
- UNDERFLOOR MECHANICAL
I am eacmp, under Sec. .B&PC fortis rcazon
204
- UNDERFLOOR FRAME
wet • Date
205
301
- UNDERFLOOR INSULATION
— ROUGH PLUMBING
WORKER'S COMPENSATI ECLARATIO
enaRy oe ryentottbe trades for declarations:
thereby aNtm vain
302
- TUB & OR SHOWER
a of
0Inave and will Fee byneCion 3700 of Consenar Codeself . sum for Worker's Codified or
satinet, m provided for by Section 3]Ip of the labor Code. tar the pcTfoTmanro of the
3 03
- ROUGH MECHANICAL
work for which this permit is issued.
304
- ROUGH ELECTRICAL
0 1 have and will maintain Worker's Compensation Insurance, as required by Section
3 0 5
- FRAME
3700 of on Lahr Code, for Or perfotmancc of the work for which ,his permit is issued.
My Workers Compensation Insurance carrim and Policy number are:
306
— HOLDOWNS
Carrier: Pat icyNo.:
307
- INSULATION
CERTIFICATE OF EX EM "ION FROM WORKERS'
COMPENSATION INSURANCE
308
- SHEETROCK
(Tnisseminn median M1ccnmpleted it permitisfowne lmodreddullars($100)
309
- EXTERIOR LATH
mrlem.)
310
- INTERIOR LATH
1 certify Nat in The performance of Ne work for which this permit is issued, I shall no,
311
- SCRATCH COAT
employ any person in any maanc so .
ls 1betrtm uothe Workers' Compensation
Lawsot Cali c CJ /
Applicant -
313
501
- ROOF NAIL
- FINAL ELECTRICAL ENERGY
NOTICETOAPPLICANT:If, after making this Ccdificamof n, you should
become subject to the Worker's Compensdion provisions oflSe"hor Code, you must
forthwith comply with such provisions or this permit shall be deemed revoked.
502
- FINAL PLUMBING ENERGY
503
- FINAL MECHANICAL ENERGY
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for performance of
504
- FINAL BUILDING ENERGY
The work for which this permit is issued (See. 3007, Civ. C.)
Lender's Name
505
506
- FINAL ELECTRICAL
- GAS TEST
Lender's Address
I molly that I have read Nis application and stale Nat the above inlimmatien is
507
- FINAL PLUMBING
rect. I agree to comply with all city and county ordinances and state laws relating to
building construction, and hereby authorize representatives of this city to enter upon Or
5
FINAL MECHAN CAL
shove -mentioned pmperty for inspection purposes.
O 9
F I N
(We) agree to save, indemnify and keep harm les The City of Cupertino against
liebilities,judgmenq toxo and expenses which may in any way accrue against mid City
55
F G
in consequence of The granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON POINT
Issued by51
- WORKS Date /
E RPC. LATI 5.
C
e� �—
Re -roofs 603
Type of P940'4
J
- OOF BATTENS
Signature of ApplicandCnmranor Dela
IIALARDOUS MATO DISCLOSURE
.
- ROOF IN -PROGRESS
Will Ncapplicamorfutdm1mibit Occupant store or handle hmardous malarial
as defined by the Canadian Municipal Code, Chapter 9.12, and the Dustin and Safety
ode. Scainn 25532(x)]All
roofs shall be
inspected to any roofing material being installed.
0y,
prior
if a roof is installed
without first obtaining an inspection, I agree to remove
Will the applicant or future building Occupant use equipment or devices which
emit hatan ous air contaminants defined by the Buy Area Air Quality Management
all new materials
for inspection.
nixTday /m
❑ res leN
I have mad the harmonics mamna6 mquimments under Chapter 6.95 of Ne Califon-
Q
nia l Italia A Safely Cook, smiuns 25515, 25533 and 25534.1 understand Our if the budding
•/•O�
does not curmntly have a tenant, Nat it is my respm onstelity notify IM accident of the
(r ��
m.d,whichmustbem mtenractrmcateofQTupancy.
Signature of Applicant
Date
"B"
All roof verings to be Class or better
owmm nr ansa trait ugeat
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