00080098 CITY OF CUPERTINO
RUILDINctnv'sION PERMIT CONTRACTOKJNF )R FI0N-:P OGRESS
BUILDING ADDRESS: 1•ERMI'P NO
OWNI?It'S NAME: J= AI'1'LICATION SIOOYJ. Id 9l�
22211 QUINTERNO CT
PtIONE: SANITARY NO. CONTROL.NO.
HILLIARD REED L AND JAN E TRU 08/14/2000
OM seO ARCH1'I'E IENC�IN'MR: IIUILDING PERMIT INTO
_ \\ IILDG EI.EiCI' PLUMB MECH
l� r CI
G y c LICENSED CONfRACPOR'S DECLARATION
Job Description
0 =,� 1 hereby offer that I ern licensed under provisions of Chapter 9(commencing
LL with Section 7fd0)of Division 3 of the Bmusi and Prol'es,ions Cod,:nm,ny license
<Y�'� ie in lull li�rcecflit',.
0 6 m Glas,_ a_66_7.8.6.6
y Date q. 0.0 comrnemr
5 LLO ARCIIITI'(T'DECLARATION
yy„g l understand at, ,oil n
y plans shall le, o .Public records ADD. WINDOW, DOORS
y a n p sacro,d Irrofcw it n ll
a o a OWNER-RUILDEN DECLARATION -
='m 1 hereby a1Br that I um excrnpt from the Coin...ons.I Iecnsc Law L. the
C ti following reason.(Section 7031.5.Busincas and Professinm Cole:Any city or county
O wh sh requirin v pe ,it to constral alter, pr a demolish.or rePy structure
i3= Poon I c Inn rey ' th po
. 11 tt hpe. II lite ,g dl soncionern .
a.,1) 1 dp u. II III 1)I c t -s1 la (Chapter 9 Sq. Ft. Floor Area Valuation
(cntial g with Section 7000)(if Di%„nn J of the Business and Pmressons CrMel
or that he is exempt theren and the breis for the alleged ucmplion.Any violation
of Section 7031.5 by any applicant far u po old subjects the applicum In a civil penalty
moot,roammfile hurdled dollars S5aR, - APN Number Occupancy Type
C 1.as .net fir file properly.fir my employee,with wngns as naeir,nlu eo,lapen%adon. $14000
will do the work,unit the ztmnnre is not intended or offeredfor wle ISa.JPLt.
Bmimi cad Prifesslons Code:The Contractor's License law dues not apply In an Required Inspections
of properly Who builds or improves motion.and wait does shah work himself 55709072. 00
ool xlh 61 h'. pl ) .providedth t. M1 p tintended or
offered f I If.h thebuilding p s Id Ih' Sur of
coupled...II h IJ II1t ,1 1 I II ' ,tell Jl tbldrr U
nlprp p . r 1 . 27/ 101 — FOUNDATION
01 flhepnpety IIY l y 111 1 ' t Ir.m, 7 102 — PIERS
,fit- t theIt ,tell S JOJJ B I Ih f.. lis Coal IT C clot%
Live.Law doe,aot apply m an owner fir pmpenY who builds or napnmes thsacon. / 103 — LIFE R
and who commes for such fojles with a cnmmalorcnl Eccnvcd pururm,l me 1 04 — REBAR
Contractor's License Law.
01atncncmptunder Sec. umPCfor this reason 105 — ANCHOR BOLTS
OwnffDaae
WORKER'S COMPENSATION DECLARATION
10E — SEWER 8 WATER
Ilmrehy anion utter pcoahY 1)l periary one of the following decmndions: 202 -- UNDERFLOOR PLUMBING
C I naso and will maintain a Ceninedle of Consent m neu:m.ure hit Werke;a 203 — UNDERFLOOR MECHANICAL
'mapemallm,. a, provided fm by Seen 1 3700 of he [.,,hot Code, for he 204 — UNDERFLOOR FRAME
pertlmni nce ohne work for which this permit is issued.
❑I nave rd ww naalnwm Worker'.,co,npcooadnn ltr,m:mce.an required by Section 205 — UNDERFLOOR INSULATION
3701)fit the Labor Code,for the performance of the work for which this permit is 301 — ROUGH PLUMB I NG
n..ed.My Worker's Compenvti n Innm
unce carier and Policy numbac:milliliter a
.nw,:A92,[-h,,,r� PefcyNn.: _/ _6x77—�S1_ 302 — TUB R OR SHOWER
CERJ'IFICATION OIs ESE,MPI'ION FROM WORKERS' 303' — ROUGH MECHANICAL_
COMPENsnr[ONINSURANCE 304 — ROUGH ELECTRICAL
('loinsve,iou neec comp
d not lleteperm
d it it is for one hundred dollar. 305 — FRAME
(SIO(f or les,.)
I ccnif)'that in the performance of the work for which this permit is issued.1 306 — HOLDOWNS
.ran am employ any senor in any manor,,n a,m heem„e snbeet,o the worker, 307 — INSULATION
Coapmasmion I.aws of California.Duro
Applicant 308 — SHEETROCK
NOTICE?TO APPLICANT:It,alio raking this Ccrlhicnc of Exemption,you should
Z heeern,eauhjm',md¢�erkednco,cape,n,a,ioopre.i.inasnnneLannrCoee.Ynal 309 — EXTERIOR LATH
Q Q fonnwilh comply with such provisions or this pernil%ball he dcemml evoked.
FZ CONS rRUC`T'ION LENDING AGENCY 310 _ INTERIOR LATH
C > Ihereby efrthin there isacammuctlonlending agency for the perranni /f^ 311 SCRATCH COAT
of the work for which this peril i.issued(Sec.3017.Civ.C.1 .
t'SU. 0 lender',Ndn,o �1�'vC•(�//// 313 — ROOF NAIL _
.5z Lende.nnnere%,
U O 1eenhymatIbasereadmi.a"lieadonand'tioefanlaaMx=inn, aationin 501 — FINAL ELECTRICAL ENERGY
❑. Fn vmref.Iagree fcomplyximancityand county ordinree,and%tree lax,rembng 502 — FINAL PLUMBING ENERGY
O U u,building comaral;and healthy mireprcncamdve.fir his city m,en tet upua
mea., ,fie,ahomeJpm,r,for mnpmdonpmpose,. / 503 — FINAL MECHANICAL ENERGY
L twin agree to said,indroniry a all keep Karl... City of C.,mnu against
the "/ —
(A liabilities,judgments,cmR and expenses which my
ay in:mway utttuc agxinsl said `n 504 FINRL BUILDING ENERGY Z City in consequence of the granting or his l ,loft. �1' 505 — FINAL ELECTRIC
APPLICANT UNDERSTANDSA WILL COMPLY Wism ALL NON-POINTEby: s r'Vate
SOURCpE/�vr(�/T}/:ATIONS -0GAS TEST
stgoala `L". - ,a,�•o0 Re-roofs _
nnznxuous Mdia".a1S DISCI�IsueE 507 FINAL PLUMBING
winthe yfileCfeednoMafuture wudfCgae.Choler912. adteH.11haddSafety Type of Roof 508 — FINAL MECHANICAL_
m,cline]Section
Ihu Cupertino Municipal Code.Chapter 9.12.and mu Heahh unJ Safety
Cola. 0yvi 25512fn1!
❑Yen 0 N All roofs shall becl9qecTed pfliS�Yi -al9ISA fig material being installed.
Will the apploodlor fmure building occupant a,,cruipmcan or device,avoth If a roof is installed without first obtaining an inspection, 1 agree to remove
craft ha...I air cantamlnant,as allined by be[to,Area Air Ouuhly Ml a,ment
Dido.? all new materials for inspection. Applicant understands and will comply with
CYe.. CNo all non-point source regulations.
1 have read the ba,mon,,nmerdaE re,cimanenl.ander Chm,ne,6.95 of he 510 — FINAL PLANNING
California Ilc:dtb A Set,,,Cmlc,$ttrlions 25505,25533 and 2553.1 undcremnd Ihm
if the building dr,es not curtly h:rveu rant mail is my respn,nihllity mnosily me — PUBLIC
cupant o nt"s whhh not,prior to i,arra mrd ed. or 514 FINAL WOR
°opoPh1 x /f Signature of Applicant Date
w—(it..�. �j All roof coverings to be Class `B" or better
Owner
nnru ngi a Dam