01050048 CITY OF CUPECONTRACTOR INFORMATION:
BUILDING DIVISION
sto" PERMIT �!ypp1
BUILDINGADItI421 OAKVILL_E AV I_ARRADEE CONSTRUCT Nie No. 01050048
OWNER'S NAM:. APPI.CAl'ION S N LATE c ,�
FIC KENZIE THOMAS M Ati IICKENZ.1 -3275 STEVENS CREEK BL�I, # 0c05/03/200].
SAN]FARY NO. CONTROI.NO.
PHONE:
(408)985-4121
HUII.UING r
YCRMINI tl
Z.]_ nHClll'I'110rlIiNOINIJ3H:
�O O 131.K ELGC'1' PLUMYB Mr:Cll
'z u to C CI CI LUl
G=yLICENSED colvrxncroH'suucl.ARnnae Job Description
z m t I nemby dfum Ihm um IicemeJ ower pow Minn,of chafer,9(commencing
win,Sew'tion70gn,,jDickionlorxmunxm !,,III n
nxCode. mlmyreco FOUNDATION RENOVATION.
in loll lane nm Ilvcl,I�. �
z tt 6 hiccnw Clan. C...i
WS o w u �pI S DECLARATION
,3 W H ARC111TECI'S UECLAHATION
SC "core,
undcnwad n,y Plmu ensu tw nwA us puhlic
aal O�O LiecnxN Professional
xs IIWNER-HUILDER DECLARATION
I li 1 hcrehy alhnn Ihot Ian,eaanpl brindle Carte is License L for the
t t following lemon.fstttinn 41111 5,Nu<inexs and Pndeneion>Cwe:Any c'
civil
FO wh 1 I p nn tl It p 1 Lh p' y.wuutc
F pi I,il,roare,alkieLIoc,11elf f - 1r ' t tI ; "nedealle,inn
jo tnahl I cnwd pa„ n me pn,n ko I dic L unio—l-c wI.rrroCh,po,,9 Sy. FL Floor Area Valu:lloo❑
(cm„Inenc,ng with Seaton lag))ofl)ial.enn a o1 the Bn.ine.x J profession,Code) $1 tl00
aided he is exempt Ihemhom and the Iasif for the alleged c mphin I.Any violation
of sectio,70115 by;any applicant for a pertnit subject the plwordto a vied penally APN Number Occupancy Type
of not more than live hundred dollars O500L
3691 033. 00
❑ll d the
work.and PenY.mmy. el is a,,'harnn ogee atetaco holec (Sec.7tion.
will Jo the work,and Inc ode 1h i.not vele e ne c eardLars roe sale(see.nu4' Required inspections
Ba>mesa and Pny Whin,ewe:rhe comma+ ,.and w law de.•,nm apply to ao 515 — FINAL BUILDING
r of pmpcnY Who M1uilds m in,pnacs t neon,and who dews such work himself
rn ered for
nix own employees. bolded ,I aja eco o t i, oii are not i roc y e r nr
nl'I'emd ler rale.It,however.arilde the hnliJil e r i rdenid cont r sold within one year of
m,ovic I ,the ownerbuild),will h: the burden of pn,ving Ihul he did nor bull ul
In,peove n,r vnmow nr,me,l.
Of.usowneroflhepro r , nc clu.ivdycnmrwtingwithRecallcony torso PINALED
,nmol the pmjea I.cc. 94,Rasinmx and P..I...was cwe:,'rne Contmaor'.v
Licence Law dual nal a Y R,no owner nr property who build,nr inq,rnvr,Ihenvm,
dmf who contracts f such fall will,a panlla,row hcenmd pnrsulat to he MAY 1 5 2001
Contractors Licca w 4
01ameveirl Jcr tie.. .B&1'C far,his reason
Owncr [)air
WORKER'S COM VENSN'[ON UIELARAI]ON BUILDING
I hereby olYnn older p..rally of perjury one of lire following dcclamtinne:
. 0 1 have and will main lin a Certificate of Consent to wGinl for Worker'. .
Cnmrynsaiop as provides for by Section 1700 of the WMrt Code. Iia the
perli,rnlancc or the work for which this pernat is issued.
11171 he and will ansa in W..ker'n Can,pcnalhon Inwmnce,uc required by Scotian
1700 of the Labor Code,for the I+erionnrace of IM1e work for which this permit is
,,sued.My WorLet,Cnmpensmion Insumme currier and Policy nuenber are:
cartic,STArtIT Tull" policy No,.I Z03�1.—"Q-4
Clill nRCA1[ON OF I:%EMP110N Ill WORK17RS
COMPIiNSA'I'[ON INSURANCE
mus waion need not he completed if the permit in for one hundred dollars
IS I lgllnr I.,,I
I certify that line perjora,loolec;itII ark or which this Il is esseed,I
'hall ,reoplo,' YP Y : o obj I I the Workers
Cort,rourtionL : ICIf ' ,Ula
Applicant
N(YIILITOAIPIIf ANTI aA gth'Cnfcm fL mph Yu%buld
Me nnv.a bjeu uuhvWake C n1x.n t p nn of theIhMa Code.You neat
Q Q lunhwilb comply wh1,mvh'elision,nr hili,'.mind,hall he decnmd revoked
F = CONSSI-RUCIFON LENDING -.
1 real o ien that three ie a coal oa . la
hag agcncY for the perfonnarcc
Q of the work for which this permi,is i. cc yfN7.Co.C.l
0. A Lcndcr's Not
Q Z LunJer'n AAdros
V C) Iceirif,ham Ihave read Ili,application an I sore,harlie Wove in arandion is
Is. E,,, corrin.1 agree u,calory with all city and county ordinances and slate laws relating
Q C.1 o huilding construction,and artery Initialreprewnmevc.ofthis city to enter upon
ry, , construction,h M econed pooreirryl .pet pm+_
y Q
(We)shJ .ty Ik 11 I ,,th Cily tC p him 'y'ina
V] r 1 lin j db I I: 1 1 h l y ,a Y Y uga 'h olid
VZ City APPLICANT
ND.RTAN SA of thisWILL
COconal. /a7
APPLICANT UNDIiRSI'ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE RrCi IONS.
Sigm,aacnr A,oimemtCnmoao Date Re-roofs r
IA9.ARDOUS MATERIALS DISCLOSURE
Will theapphcna,mmmrehaildn,gaccupal,lsave arnamnehaaardoe,maherial Type of Roof
ns delined by IM Cupertino Mthakipal Curie.Chup,er 9.12.and he Health and Safe,y
Code,Section 25532pol. T/t'/
O Yes All roofs shall be inspected prior to any roofing material being installed.
Will lhcappucaolor rmarc mtudiag n.chgaa+I n,e egaipencm nr Jevlu:,wild+ If a roof is installed without first obtaining an inspection, I agree to remove
nnilbwaIdeas at r m...a, rhe xa Alined by the lluy Ana Air Oualhy Manugeencnt
I);,,tia,., all new materials for inspection. Applicant understands and will comply with
ore, r.< all non-point source regulations.
I have read the tvnNous Inwcrials tegh:Iremmn,s under Chapter 695 of,he
C.alilienio ljohl,&Safety Coale.Sarll ro,25505.2,1533 and 25534.1 undersl:md l hue
it bilabial, hcuncnlly baveuow,ract if i ismyruance o li rymnoifythe
aup'ila is the nquirr ichhas ar an rola prior to issuance nr lr Co raoio,e of
Occupancy Jr�a/ai Signature of Applicant Date
owll�rtnaellhe+ri'.c,Insenl lotto Signature
roof coverings to be Class "B" or better
OFFICE
CITY OF CUPECONTRACTOR INFORMATION:
BUILDING DIVISION
sto" PERMIT �!ypp1
BUILDINGADItI421 OAKVILL_E AV I_ARRADEE CONSTRUCT Nie No. 01050048
OWNER'S NAM:. APPI.CAl'ION S N LATE c ,�
FIC KENZIE THOMAS M Ati IICKENZ.1 -3275 STEVENS CREEK BL�I, # 0c05/03/200].
SAN]FARY NO. CONTROI.NO.
PHONE:
(408)985-4121
HUII.UING r
YCRMINI tl
Z.]_ nHClll'I'110rlIiNOINIJ3H:
�O O 131.K ELGC'1' PLUMYB Mr:Cll
'z u to C CI CI LUl
G=yLICENSED colvrxncroH'suucl.ARnnae Job Description
z m t I nemby dfum Ihm um IicemeJ ower pow Minn,of chafer,9(commencing
win,Sew'tion70gn,,jDickionlorxmunxm !,,III n
nxCode. mlmyreco FOUNDATION RENOVATION.
in loll lane nm Ilvcl,I�. �
z tt 6 hiccnw Clan. C...i
WS o w u �pI S DECLARATION
,3 W H ARC111TECI'S UECLAHATION
SC "core,
undcnwad n,y Plmu ensu tw nwA us puhlic
aal O�O LiecnxN Professional
xs IIWNER-HUILDER DECLARATION
I li 1 hcrehy alhnn Ihot Ian,eaanpl brindle Carte is License L for the
t t following lemon.fstttinn 41111 5,Nu<inexs and Pndeneion>Cwe:Any c'
civil
FO wh 1 I p nn tl It p 1 Lh p' y.wuutc
F pi I,il,roare,alkieLIoc,11elf f - 1r ' t tI ; "nedealle,inn
jo tnahl I cnwd pa„ n me pn,n ko I dic L unio—l-c wI.rrroCh,po,,9 Sy. FL Floor Area Valu:lloo❑
(cm„Inenc,ng with Seaton lag))ofl)ial.enn a o1 the Bn.ine.x J profession,Code) $1 tl00
aided he is exempt Ihemhom and the Iasif for the alleged c mphin I.Any violation
of sectio,70115 by;any applicant for a pertnit subject the plwordto a vied penally APN Number Occupancy Type
of not more than live hundred dollars O500L
3691 033. 00
❑ll d the
work.and PenY.mmy. el is a,,'harnn ogee atetaco holec (Sec.7tion.
will Jo the work,and Inc ode 1h i.not vele e ne c eardLars roe sale(see.nu4' Required inspections
Ba>mesa and Pny Whin,ewe:rhe comma+ ,.and w law de.•,nm apply to ao 515 — FINAL BUILDING
r of pmpcnY Who M1uilds m in,pnacs t neon,and who dews such work himself
rn ered for
nix own employees. bolded ,I aja eco o t i, oii are not i roc y e r nr
nl'I'emd ler rale.It,however.arilde the hnliJil e r i rdenid cont r sold within one year of
m,ovic I ,the ownerbuild),will h: the burden of pn,ving Ihul he did nor bull ul
In,peove n,r vnmow nr,me,l.
Of.usowneroflhepro r , nc clu.ivdycnmrwtingwithRecallcony torso PINALED
,nmol the pmjea I.cc. 94,Rasinmx and P..I...was cwe:,'rne Contmaor'.v
Licence Law dual nal a Y R,no owner nr property who build,nr inq,rnvr,Ihenvm,
dmf who contracts f such fall will,a panlla,row hcenmd pnrsulat to he MAY 1 5 2001
Contractors Licca w 4
01ameveirl Jcr tie.. .B&1'C far,his reason
Owncr [)air
WORKER'S COM VENSN'[ON UIELARAI]ON BUILDING
I hereby olYnn older p..rally of perjury one of lire following dcclamtinne:
. 0 1 have and will main lin a Certificate of Consent to wGinl for Worker'. .
Cnmrynsaiop as provides for by Section 1700 of the WMrt Code. Iia the
perli,rnlancc or the work for which this pernat is issued.
11171 he and will ansa in W..ker'n Can,pcnalhon Inwmnce,uc required by Scotian
1700 of the Labor Code,for the I+erionnrace of IM1e work for which this permit is
,,sued.My WorLet,Cnmpensmion Insumme currier and Policy nuenber are:
cartic,STArtIT Tull" policy No,.I Z03�1.—"Q-4
Clill nRCA1[ON OF I:%EMP110N Ill WORK17RS
COMPIiNSA'I'[ON INSURANCE
mus waion need not he completed if the permit in for one hundred dollars
IS I lgllnr I.,,I
I certify that line perjora,loolec;itII ark or which this Il is esseed,I
'hall ,reoplo,' YP Y : o obj I I the Workers
Cort,rourtionL : ICIf ' ,Ula
Applicant
N(YIILITOAIPIIf ANTI aA gth'Cnfcm fL mph Yu%buld
Me nnv.a bjeu uuhvWake C n1x.n t p nn of theIhMa Code.You neat
Q Q lunhwilb comply wh1,mvh'elision,nr hili,'.mind,hall he decnmd revoked
F = CONSSI-RUCIFON LENDING -.
1 real o ien that three ie a coal oa . la
hag agcncY for the perfonnarcc
Q of the work for which this permi,is i. cc yfN7.Co.C.l
0. A Lcndcr's Not
Q Z LunJer'n AAdros
V C) Iceirif,ham Ihave read Ili,application an I sore,harlie Wove in arandion is
Is. E,,, corrin.1 agree u,calory with all city and county ordinances and slate laws relating
Q C.1 o huilding construction,and artery Initialreprewnmevc.ofthis city to enter upon
ry, , construction,h M econed pooreirryl .pet pm+_
y Q
(We)shJ .ty Ik 11 I ,,th Cily tC p him 'y'ina
V] r 1 lin j db I I: 1 1 h l y ,a Y Y uga 'h olid
VZ City APPLICANT
ND.RTAN SA of thisWILL
COconal. /a7
APPLICANT UNDIiRSI'ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE RrCi IONS.
Sigm,aacnr A,oimemtCnmoao Date Re-roofs r
IA9.ARDOUS MATERIALS DISCLOSURE
Will theapphcna,mmmrehaildn,gaccupal,lsave arnamnehaaardoe,maherial Type of Roof
ns delined by IM Cupertino Mthakipal Curie.Chup,er 9.12.and he Health and Safe,y
Code,Section 25532pol. T/t'/
O Yes All roofs shall be inspected prior to any roofing material being installed.
Will lhcappucaolor rmarc mtudiag n.chgaa+I n,e egaipencm nr Jevlu:,wild+ If a roof is installed without first obtaining an inspection, I agree to remove
nnilbwaIdeas at r m...a, rhe xa Alined by the lluy Ana Air Oualhy Manugeencnt
I);,,tia,., all new materials for inspection. Applicant understands and will comply with
ore, r.< all non-point source regulations.
I have read the tvnNous Inwcrials tegh:Iremmn,s under Chapter 695 of,he
C.alilienio ljohl,&Safety Coale.Sarll ro,25505.2,1533 and 25534.1 undersl:md l hue
it bilabial, hcuncnlly baveuow,ract if i ismyruance o li rymnoifythe
aup'ila is the nquirr ichhas ar an rola prior to issuance nr lr Co raoio,e of
Occupancy Jr�a/ai Signature of Applicant Date
owll�rtnaellhe+ri'.c,Insenl lotto Signature
roof coverings to be Class "B" or better
OFFICE