01040039--'Z. -..•- -'-- --- -.` - OFFICE. .... ... ...
CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
PERMIT NO.
20330 STEVENS CREEK BLVD
WEBCOR BUILDERS
01040039
OWNER'S NAME,
APPLICATION SUB DATE
CUPERTINO CITY CENTER ASSOCIAr
2755 CAMPUS DR
04/11/2001
PHONE:
(415)349-2727
SANITARY NO. CONTROL NO.
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ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
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1 -DG ELECT PLUMB MECH
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LICENSED CONTRACTOR' S DECLARATION
Job Descrl Ion
I hereby affirm mat 1 am licensed under pro,isi m, of Chapter 9 (commencing
Isco�on]IX10)ofDivision3of,hmBusinnsanJPm(nxi Code..amybanse
A/C UNITS, & UPC
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s in full roregand erre
ace mems ue.x 700$$ 7
ADD 3 A/C UNITS.
i
ate Contractor
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CHITECI'S DECLARATION
1 understand my plans snail he used as public records
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Licensed Professional
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DECLARATION
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I am exempt fir Low for the
I hereby alum that 11. exempt from the Contractor's
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Code: Any city o
following reason (Section ]onstr Business and e: Any my
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e, alter, irapmvq demolish. or repair any swoon
which requires a permit improve, rec
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re uirest lb crunitt
.'hwho ikv issuunco, also requiresmeapplicant for mchpecmluoicense
S F.[. Floor Area ,
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a nation
a,e(Ch¢ment-
thath s m' dh mto Ne pro si m: r License La (chapter9
Profenn Cade)
ole 1U,ho ons
n 3 the Basins nJ
Ire mbeemg rn Section om anor a ha
or inn he is eiempt therefrom iml the Wasis for the alleged eaimpuon. Any violation
i . � ; !� s s , r,
.
- M Section 7031.5 by any applicant for a permit subjects rhe opi lit -a , mit civil pemslty
.of not more than lore hundred dmnars($5an,
umber
,.., Occupancy Type
❑ L as owner of the property. or my employees with wages as their sale compensation.
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102 - PIERS Required Inspections''
will do'the 'work. and the swmure'is not intended or offered par suit (Secf]o4J:
Buimess and Profession Code: The Conn..,', License law does not apply to an
come, of p peny W'n Wild p x d J n does such work himself
103 - UFER
or through n ply provided th t nimprovementst intended or
"bffc df -:'I If'h ih b Id' a P t s Id ith year of
•complt
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104 - REBAR ':.
theowner-Wildernn dsebame ry gthtkddnotWldor
rapt- r i myem ofiaile).
105 ANCHOR BOLTS
91 owner of thePropemv m idevocly contracting willl' licensed contractors to
106 — SEWER & WATEFC
construct the proter, (sec. 7014 Becomes, d P fc,imw Cade I Thm Contractor s
License Law does nor applyt. anwomr ifproperty h Wald p thereon
_
202 — UNDERFLOOR PLUMBING
'
and n contracts. r such.p Ie rs wirecommutators) man 1 sed purramnI-m the
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„ 2 03` --UNDERFLOOR-MECHANICAL j
Contractors Laramie Law.j
01 am exemptunder S'c B&P.Cr tui emo.o
204 UNDERFLOOR' TRAME `
Ow oat
205 — UNDERFLOOR INSULATION
,. WORKER'S COMPENSATION DECLARAT] ON
1 I hereby affirm under penalty of perjury one of the following declarations:
301 - ROUGH PLUMBING
302 — TUB & OR SHOWER
O I have'da1 will rtuin,ram . Cenifireve of Cement no self roma for swokem's
303 — ROUGH MECHANICAL
Compensation, as provided -for by Section 37W of the labor Code. for the
performance of the work for which this pymit isNstual..
304 — ROUGH ELECTRICAL
❑ 1 h nd will maintain Worker's Compehiation Indearm, as required by Section
305 — FRAME
37 of the Lowr Cnde, for the performaem. of the, work for which thin p<mou is
'e
306 — HOLDOWNS
I . ed. My Worker, C pe t n l our c and 11.'obey randW, are
C F4 PoliyN �(00�$Z)
_ _ _.. ..,_ .:_... ..
.30.7 ':_ ;INSULATION
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CERT OF EXEMPTION FROKWORKERS
-
308 SHEETROCK -
COMPENSATION INSURANCE
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309 ;— EXTERIOR`liPTH' .,-
Th.0 nIFICAF
n�eJoatbeumplucdifinspermtls far me nnmrm dollar,
310 - INTERIOR LATH'
151001 I. 1
' 'fth' � 'p'esoeJl
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3 Tl— SCRATCH.COAT
'
I rinfy th trh pef kth e which nt'
shin pl y any a y man - , to beton nublect t n Worker,
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313 ROOF NAIL"!
Compensation Laws of C I f Date, '• .
.-50-1 -- FINAL ELECTRICAL- ENERGY--. ,, -- -- - -
NOTICE TO APPLICANT: IL urmr making this Cemificae of Exemption. you should
'become
502 - FINAL PLUMBING ENERGY
subject to the Worker's Compemmion provisions of the Labor Cade, you must
mmbwim emmply w ,in stwh pnwi cm,or this permit shall dremearevoked.
503.F.INAL .MECHANICAL .ENERGY.. ---
rq
r CONSTRUCTION LENDING AGENCY
504 — FINAL BUILDING ENERGY;',
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