01010044CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
I11111.DING Al)DRISS('
PENh11'1' NO
22361 SANTA PAULA AV
BOBBY BUILDER
01010044
OWNER'S NAME:
APPLICATION SUB PAIR
JAUHER
21946 HYANNISPORT DR
01/1.0/2001
IUNID
SANITARY NO. COMhROL NO.
(408)873-7129
ARCH] r ECPF.NGINEER:
BUILDING PCRMI'IINTO
RLPG ELECT' PLUMB MECH
CI 1=1 IJ IJ
I.ICI:NSEU CONTRACI OR'S DIiC1.ARATION
lob Description
I hereby aft n mm I am Iicanel under prni,tnn, of Chapter 4 mentro Acing
with Scmina 701X)) al�y ion 3 of the Hot.... and Prefl.sion+ able.; Imy
i, to t1ln Atmel wtn cy(cT.1�
Clan Lic. Y_/��
2. BATH REMODEL/NEW DOOR
;SamIIe _
Pam - egp— � cMLA
��
ARCHfI'[CI"s UECIARA'IION
dolo ishn us d, hhc Its
lundmmnd lm'
—
Licclvred P nrL: iauu
A-CLARNION
=NER-RUILOIik
I Lerch, air mn tllea 1 am exengn tintn the Contrectnr's License Law bucolic
f"Ihwing m"n. (Section 703 t.5, Reale, aml Pedes a Cliche: Any city .,county
which mquima permit a+construct. alter, improve demolish, or repair any nmcwm
,it... to it, I ... ance, also reptiles the appllcent fnr inch permit m file a signed aatemem
Sq. Ft.
,Floor Area
Valuation
that he is licensed PwaaammmePm,I,nrIII Commaor'euoanseLaw OChrium")
(Con,cna' will Secunn 7000)ofDivixlon 3 or he lholtas and Pndcs.ion.. Ccdr)
�3�0�
n that ten in earmpt merclnan and the had%ter lie alleged exempt"". Any violation
of Seninn 7031 S by any applicant rte a pvanit snhja,.v the applicant m, a dell penalty
APN Number
Oup• Type
of act marc thou five hundred nouat%(s50o).
cy
35704058.00
01. as owner of the prnpary.ry my cmN"ycc% wed+ wage, as their.cle compersetnm•
Required Inspections
will the h I the t t t intandell or ollemd (Sec. 7044,
d
Huxln d P fc. n CooIl C I s L t ppl, n+.+n
ow . Pe",turpowes at d ith.lice, such workhimself
o through h-wnca plyc provided that n n t arc not lifeblood oraffere1fo,sI
101
— FOUNDATION OUNDATION
Uhowee, he building ,,itpr t Id within year
122
— FIERS
unfe o.v+limo:ng that hedd or,
/
imtPu"a o It .eof%ales)
103
— LIFER 7
0�
O L mownerofthe property, aincsdaucly contracting with ficcn%edc...amom"'
104
— REBAR
the pmjeet (Ss. 70,L4. Hu%dws% and Protections QNc:) The Contractor's
Liconstruct
cense Law doe, not apply toantcaner of pro who build. or Improve. merco"'
105
— ANCHOR BOLTS
amtwho comilcts rte such pmjeus with a vommcmrb%) licensed pursuant m the
C"mmot'a,[,c cLaw.
106
— SEWER & WATER -
O I ani exempt ander see. . B k P C tin 1111, mason
202
— UNDERFLOOR PLUMBING
Owner nam
WORKER'S COMPENSATION DECLARATION
203
— UNDERFLOOR MECHANICAL
n+lrcby 111111 lm 11111111 ry"mIyat osdjary late of tte following dadma(u+m=
00
204
— UNDERFLOOR FRAME
1 nave and w;u maimain a Certificate of conscal to't-in."rc In, worker%
205
— UNDERFLOOR INSULATION
Compcnvtnn. a provided for by Seaton 374 of the Lahr Godo. mor the
PLUMB I NG
perournice, of the w ... k for which this permit is i ... al.
301
— ROUGH
❑Ilease larid w,If dindoinWIA,',Crnlpenelim+llnmmorc.ill rcgaimdnySoaton
302
— TUB & OR SHOWER
370() Lir th1 later Cod", fnr the palbnnnnce of the work for which Ili, Iclan' I,
303
— ROUGH MECHANICAL
fssad.MyA'Lee ICorel+cn.alion Insurance eerier a lm Policy runner am:
304
— ROUGH ELECTRICAL
Corer: Policy No.:
CERTIFICATION OF ENEMRfION FROM WORKIiRS'
305
— FRAME
COMPENSNilON INSURANCE
306
— HOLDOWNS
rmi,,cefa. itself act h..... leled if the romdt is for roe ltmtdrcd doll..
(Slap or less.)
307
— INSULATION
' I certify that in the performance of the work Lo which this Perini[ is issued. 1
308
— SHEET ROCK
,hall nut em Noy any person in :my Runner, ,I a, a, hese.. sahjea m the Workers'
Crinpca,at"n Law% oW-At It. P�
309
— EXTERIOR LATH
Applicant � R��
'Plr.ngen.CertlhcmrorExetttpm,nynlr%hard
NOTICE to .1 INgi
310
— INTERIOR LATH
Note nne suhjoao m the Worker's Cnmpen.xtrn provl,ime, d the Lahr Code, you must
forthwimeomplywimtouch providon,or his Knothat lIN, created mvokcd.
311
— SCRATCH COAT
CONSTRUCI ION LENDING AGENCY
313
- ROOF NAIL.
lnercar which thatdri, vionii%a c"neseco 097. Ce. C,) li+r me perronnaoee
of tire wrnk for which this i i, icwm (Sec. Lro7. Civ. enc
501
— FINAL ELECTRICAL ENERGY
Lnlcr's AVIA.
502
— FINAL PLUMBING ENERGY
toe"AylltutIlial.erea Ill i. ..... lanoa1..ldsun"1halmeah"vainbannmul'Is
503
— FINAL MECHANICAL ENERGY
Cor ran. I agree,, anlgdy with all city and "Dunt, nr1'm:ume, and stem laws miming
504
— FINRL BUILDING ENERGY
toribusegCoatiwed pro,and umnmizempresenwtivc,rani.city urenterupm
myhereby inspection
me ahw-megtoned pmPendeali in,pnd
505
— FINAL ELECTRICAL
keep heatless
(We) agree n mvc, indemnify and keep h may in the City of cru a ages Again. l
Iia
ra s. iodgmnms, l I and expell.es wren may m any way acerae Itsam,t .aid
-ng
506
— GAS TEST
C'vy in cun,aryenm ul me pr of Mie L Lon t.
y
ONCE SS I YWITH DLI, NON.Pp1NT
Issued
Issued by9017
-e-y�
— FTNFaI RI IIMATNr '�l Z Date
SAPPLICANT OURCE EGUI
Re -roofs 508
— FINAL MECHANICAL
Signature of nppneanf/Conractar Dam
HAZARDOUS MAI F'R1ALS DISCLOSURE—
FINAL GRADE '
Win the applicant stable building +scupam stem nr handle nauodo". mmcrial
Type Of li�8M
as defined by the Cupertino) Municipal Code Chaplet 9.12, and flue Health gad safety
51 0
— FINAL PLANNING
Calc. Stier 255320)!
0 Ye, 0N++
All roofs-,>4i}be—in6pf44AWriptUeWry¢o(tt]CgMgerial being installed.
Will th applicant n future nnuding"ec"pam lose equipment nr device, which
If a roof is installed
without first obtaining an inspection, I agree to remove
All h:v:ndous ail cr"'It nfm:,at, as 1111111,1 by the Bay Are" Air Cloudily Managemmot
titch
..
all neve materials
for inspection. Applicant understands and will comply with
O yes 0 N
all non -point source
regulations.
I have read the hazardous materiaH requirements under Chapter 695 of the
California Health a Safety Cal Section, 25505, 25533 and 25534, 1 understand that
It the building doe,. nut CLumarly lone a tenant lhnt it it if, m,,a s bil'ny a. nifty the
cupmn or he reclaim mm�n a 'ch nmol he met prior it iavun � � Lir u Cuinfmwe o1'
"""p""`y'
Signature of Applicant
Date
All roof coverings to be Class "B" or better
Owaaor Hatt
aut�l agent
OFFICE
CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
I11111.DING Al)DRISS('
PENh11'1' NO
22361 SANTA PAULA AV
BOBBY BUILDER
01010044
OWNER'S NAME:
APPLICATION SUB PAIR
JAUHER
21946 HYANNISPORT DR
01/1.0/2001
IUNID
SANITARY NO. COMhROL NO.
(408)873-7129
ARCH] r ECPF.NGINEER:
BUILDING PCRMI'IINTO
RLPG ELECT' PLUMB MECH
CI 1=1 IJ IJ
I.ICI:NSEU CONTRACI OR'S DIiC1.ARATION
lob Description
I hereby aft n mm I am Iicanel under prni,tnn, of Chapter 4 mentro Acing
with Scmina 701X)) al�y ion 3 of the Hot.... and Prefl.sion+ able.; Imy
i, to t1ln Atmel wtn cy(cT.1�
Clan Lic. Y_/��
2. BATH REMODEL/NEW DOOR
;SamIIe _
Pam - egp— � cMLA
��
ARCHfI'[CI"s UECIARA'IION
dolo ishn us d, hhc Its
lundmmnd lm'
—
Licclvred P nrL: iauu
A-CLARNION
=NER-RUILOIik
I Lerch, air mn tllea 1 am exengn tintn the Contrectnr's License Law bucolic
f"Ihwing m"n. (Section 703 t.5, Reale, aml Pedes a Cliche: Any city .,county
which mquima permit a+construct. alter, improve demolish, or repair any nmcwm
,it... to it, I ... ance, also reptiles the appllcent fnr inch permit m file a signed aatemem
Sq. Ft.
,Floor Area
Valuation
that he is licensed PwaaammmePm,I,nrIII Commaor'euoanseLaw OChrium")
(Con,cna' will Secunn 7000)ofDivixlon 3 or he lholtas and Pndcs.ion.. Ccdr)
�3�0�
n that ten in earmpt merclnan and the had%ter lie alleged exempt"". Any violation
of Seninn 7031 S by any applicant rte a pvanit snhja,.v the applicant m, a dell penalty
APN Number
Oup• Type
of act marc thou five hundred nouat%(s50o).
cy
35704058.00
01. as owner of the prnpary.ry my cmN"ycc% wed+ wage, as their.cle compersetnm•
Required Inspections
will the h I the t t t intandell or ollemd (Sec. 7044,
d
Huxln d P fc. n CooIl C I s L t ppl, n+.+n
ow . Pe",turpowes at d ith.lice, such workhimself
o through h-wnca plyc provided that n n t arc not lifeblood oraffere1fo,sI
101
— FOUNDATION OUNDATION
Uhowee, he building ,,itpr t Id within year
122
— FIERS
unfe o.v+limo:ng that hedd or,
/
imtPu"a o It .eof%ales)
103
— LIFER 7
0�
O L mownerofthe property, aincsdaucly contracting with ficcn%edc...amom"'
104
— REBAR
the pmjeet (Ss. 70,L4. Hu%dws% and Protections QNc:) The Contractor's
Liconstruct
cense Law doe, not apply toantcaner of pro who build. or Improve. merco"'
105
— ANCHOR BOLTS
amtwho comilcts rte such pmjeus with a vommcmrb%) licensed pursuant m the
C"mmot'a,[,c cLaw.
106
— SEWER & WATER -
O I ani exempt ander see. . B k P C tin 1111, mason
202
— UNDERFLOOR PLUMBING
Owner nam
WORKER'S COMPENSATION DECLARATION
203
— UNDERFLOOR MECHANICAL
n+lrcby 111111 lm 11111111 ry"mIyat osdjary late of tte following dadma(u+m=
00
204
— UNDERFLOOR FRAME
1 nave and w;u maimain a Certificate of conscal to't-in."rc In, worker%
205
— UNDERFLOOR INSULATION
Compcnvtnn. a provided for by Seaton 374 of the Lahr Godo. mor the
PLUMB I NG
perournice, of the w ... k for which this permit is i ... al.
301
— ROUGH
❑Ilease larid w,If dindoinWIA,',Crnlpenelim+llnmmorc.ill rcgaimdnySoaton
302
— TUB & OR SHOWER
370() Lir th1 later Cod", fnr the palbnnnnce of the work for which Ili, Iclan' I,
303
— ROUGH MECHANICAL
fssad.MyA'Lee ICorel+cn.alion Insurance eerier a lm Policy runner am:
304
— ROUGH ELECTRICAL
Corer: Policy No.:
CERTIFICATION OF ENEMRfION FROM WORKIiRS'
305
— FRAME
COMPENSNilON INSURANCE
306
— HOLDOWNS
rmi,,cefa. itself act h..... leled if the romdt is for roe ltmtdrcd doll..
(Slap or less.)
307
— INSULATION
' I certify that in the performance of the work Lo which this Perini[ is issued. 1
308
— SHEET ROCK
,hall nut em Noy any person in :my Runner, ,I a, a, hese.. sahjea m the Workers'
Crinpca,at"n Law% oW-At a.P�
309
— EXTERIOR LATH
Applicant � R��
'Plr.ngen.CertlhcmrorExetttpm,nynlr%hard
NOTICE to .1 INgi
310
— INTERIOR LATH
Note nne suhjoao m the Worker's Cnmpen.xtrn provl,ime, d the Lahr Code, you must
forthwimeomplywimtouch providon,or his Knothat lIN, created mvokcd.
311
— SCRATCH COAT
CONSTRUCI ION LENDING AGENCY
313
- ROOF NAIL.
lnercar which thatdri, vionii%a c"neseco 097. Ce. C,) li+r me perronnaoee
of tire wrnk for which this i i, icwm (Sec. Lro7. Civ. enc
501
— FINAL ELECTRICAL ENERGY
Lnlcr's AVIA.
502
— FINAL PLUMBING ENERGY
toe"AylltutIlial.erea Ill i. ..... lanoa1..ldsun"1halmeah"vainbannmul'Is
503
— FINAL MECHANICAL ENERGY
Cor ran. I agree,, anlgdy with all city and "Dunt, nr1'm:ume, and stem laws miming
504
— FINRL BUILDING ENERGY
toribusegCoatiwed pro,and umnmizempresenwtivc,rani.city urenterupm
myhereby inspection
me ahw-megtoned pmPendeali in,pnd
505
— FINAL ELECTRICAL
keep heatless
(We) agree n mvc, indemnify and keep h may in the City of cru a ages Again. l
Iia
ra s. iodgmnms, l I and expell.es wren may m any way acerae Itsam,t .aid
-ng
506
— GAS TEST
C'vy in cun,aryenm ul me pr of Mie L Lon t.
y
ONCE SS I YWITH DLI, NON.Pp1NT
Issued
Issued by9017
-e-y�
— FTNFaI RI IIMATNr '�l Z Date
SAPPLICANT OURCE EGUI
Re -roofs 508
— FINAL MECHANICAL
Signature of nppneanf/Conractar Dam
HAZARDOUS MAI F'R1ALS DISCLOSURE—
FINAL GRADE '
Win the applicant stable building +scupam stem nr handle nauodo". mmcrial
Type Of li�8M
as defined by the Cupertino) Municipal Code Chaplet 9.12, and flue Health gad safety
51 0
— FINAL PLANNING
Calc. Stier 255320)!
0 Ye, 0N++
All roofs-,>4i}be—in6pf44AWriptUeWry¢o(tt]CgMgerial being installed.
Will th applicant n future nnuding"ec"pam lose equipment nr device, which
If a roof is installed
without first obtaining an inspection, I agree to remove
All h:v:ndous ail cr"'It nfm:,at, as 1111111,1 by the Bay Are" Air Cloudily Managemmot
titch
..
all neve materials
for inspection. Applicant understands and will comply with
O yes 0 N
all non -point source
regulations.
I have read the hazardous materiaH requirements under Chapter 695 of the
California Health a Safety Cal Section, 25505, 25533 and 25534, 1 understand that
It the building doe,. nut CLumarly lone a tenant lhnt it it if, m,,a s bil'ny a. nifty the
cupmn or he reclaim mm�n a 'ch nmol he met prior it iavun � � Lir u Cuinfmwe o1'
"""p""`y'
Signature of Applicant
Date
All roof coverings to be Class "B" or better
Owaaor Hatt
aut�l agent
OFFICE