00050201CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
BUILDING,ll8:7 NORTHRIDGE SO
KITCHENWORKS
PHRMITNO. —
000 0201
OWNERS"PMMAMOTO, ROBERT
DPA HOMEWORKS INC
APPLICATION SUB DATE
051,
PHONE:
SANITARY NO. MOPPO
Z ARCHI'I'HC'IdiNCINEER:
(415)456-4696
BUILDING PERMI'1'INFO
0
BI.DG BLGcr PLUMB MECH
LJ
j LICENSED CON 'rRACOR'SDECLARATION
Job Description
1 hcrchyaffirm teat Ism licensed under,owi ort nl' Chapter 9 gm
omm�cing
0 with Secuum 7(XX)) of Division 3 of the Business and Pm@ssions Code. undri licence
is in full fore and effect.
S Lic... v Clew Lw N
O
)am Cumen,or
G
ARcBmicr'S DECLARATION
aj 1 undersmnd my plans shall he food it., public records
* NO CONDITIONS It
o ueetteee rroreeinnal
OWNER-BUILDER DECLARATION
Oar
1 hemb, ,(Sera Thal 1 am cxa Siam the Cnsints r'e frr the
I an
following—non,(Section 7031.5. un f, Any c ty o
aftesunJ Pmftheir can nrcdium
oIt.
loth, or
❑ which requires a peal... m peter, improve, their o any sruemm
mm, die(, (repair
the v,
for such Permit m lien a signet Ualnnmm
prior to its ievuuncu.:Jso myt)
Sq. F(. Floor Area
Valuation
the o Ce
— 'hatheeNicemsed lmntion
Business and PrlawonsCor9
Division 3 of the Business and Professions Code)
(commencing with Section 70hcprovisions Dn 3 o
$ 1
or thatheis om and emmant n.to Any violation
for the allsubjects
therefrom ant Ior
31.5 b rep the l
of no, .m'AIb n by any hundred doll fon: permit subjecu the applicant to a civil Penalty
o .me ban Svc hundred Jallum (ESIXI).
AP�(jJ� mega- 00
1.5�bt(I
Occupancy Type
l.r senile fvelecompensation.
❑1, avowns'ucIhuproperty,mmy et
Required Inspections
,, offered
is ,of mended er eLaw fur sale (Sec. 911ii.
will do he work, and the ome I e is nal Contractor', m alt
Bulinus and is License Law dmn not
The Cove,
orrly
owine, of prnpeny W'hn builds or imPmves Nemo,, and wen does .wee work himself
ert, Who Wild, o the
or though his . I n employees. provided tea such impms trams are not intended or
for eine. If, however, the building s sold within one year of
igen
cofferedompli e of proving
oproveautneowner-baiterwillhovetheM1urdenofprovingdtaheJiJnothuilJnr
204 — UNDERFLOOR FRAME
improve lin Purptnsc of wlc.l.
❑I.a,—o"mlheProPer(y,vats.dasiselyenntraclingwiotlicensedcnmra.lm.ln
301 ROUGH PLUMBING
Lin truct the pmjcct (See. 9ui. Bnnlmss and rmmssiuns Codc:) The Cnmmr Ire
303 — ROUGW MECHANICAL 40
303
cense Law does not apply to an owner of pmreny who Wilds or impmves Merron,
and who contracts for such pmjears with a contractures) licensed pursmnl at the
304 — ROUGH ELECTRICALCone/[o�
01maor,LicendeLaw.
C I am csempl ender sec. . B & P C for this reason
^-
505 — FINAL ELECTRICAL o
Owner Dam
507 — FINAL PLUMBING
WORKER'$ COMITNSATION DECI.ARA'fION
5— FINAL MECHANICAL
theroowingdeclarafnns:
Ihereby aninnunder Penalty ofpejor,(me ofw
51144 — FINAL PI-IBL I C WORKS
.elf-in,e for Wmker'e
0 1 have amt will maintain . certiacac of Cnnaem In m
Compensation, us provided for by Section 370o of the Lahr Code, for the
performance of the work for which this permit is issued ,
have and will iffor Woke", Cmnnmtiun rcImnrunca a required by Section
nmup
AI nl'the LaM1ur Code, for the Parrnntmnee A the work or which do, permit Is
r :
suN. My Workers Cumpensainn bouanue carrier and policy autnlwa
Card'. 'i�eCG PnBcyNo, %. ,%T�k1?%
CERTIFICATION OF IiK1iMYT10N FROM N'DRKERS'
COMPENSATION INSURANCE
(1 fit, c,fiu. need nal be cntnplced film m'rmit is ILP Inc hundred dolens
($100)m' le".)
I certify that in the pedismtame of life work Inr which his permit is footed. I
shall not ctnrloy any Person in any nmmmr so as hs become subject to the Workers'�-
Compensation laws of California. Dae
Applicant
NOTICF. ro APPLICANT, lf; aBcr making this Cenifcac of Exemption. you should
s
subjes to the oCoiou,oaion provisions dia of the Lubar Code. you ntua
ha dmnmJ
MAY 2 as
'k''M
Iql
...h revoked.
.� IbnM1wlh comply with such Pnrvi,iuns or this permit ,hull
It,r
I y 2000
C(INSTRUCI'ION LENDING AGIiNCY
.
1 Inert affirm that there is a construction lending agency for the perfnmtance
of the work for which this Permit iv issued (Sce. 307, Civ. C.)
] Under Nanm
� Lendeh AJJreas
` �f
1 cenily Ila 1 have rad (his application and stat (hit the alWvc inlbrttnlrnn is
coffee, I pice u. aontply with Ill city i I county on int re, mal state Inws relating
to building eangaednn. and herchy an(hnri c m,m,,nunivcx nl'this city to enter upon
s7 he above-mentioued prnpeny for inspection purposes.
L (We) agree to our. indemnify and keep harmless the City of Cupertino against
n liabilities, judgincov, costs and enpen.ws which may in any way accom against said
7_ City in consequence of the gm I of dd, ppmdul.
APPLICANT UNDERSTAND.' .1 WILLC LY W TH ALI, NON W14T
a � ,e
IssUedb Date S �O—r/�/
y'
SOURCE REGULATIONS. S
.�C
Signature of Applicun unl cls Dew
Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future (wilding meapam arm or Itatnfle humdrms material
Type of Roof
as defned by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safely
Cale, Section 255321.)? ,,//
Dye, e+n
All roofs shall be inspected prior to any roofing material being installed.
Will haapprtcamnrmore heB<ungoecupant:nceynepmemadevice, which
If a roof is installed without first obtaining an inspection, 1 agree to remove
til hvurlou- cumantinars m dufacd by tee any Acv Au, Quuld, Manage fit
u,isrictl
all new materials for inspection. Applicant understands and will comply with
OYen
all non-point source regulations.
1 have mail the hor.ohm, materials rcyuimmcnn under Chapter 6,95 0l the
California Health h Safety Crude, Sections 25505.25533 and 255:41. 1 understand that
if the building does not emorri ly have a court. that it is my, «.egm,dulay, to notify the
ccurant 'film myuinmmnls which t ya he met prior m isnunnce oft Cenilicum of
DCSOpn '� t� l
Signature of Applicant Date
✓
All roof coverings to be Class "B" or better
m thnrva t D. e
OFFICE