00110085 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING AN)RF1 S�100 TANTAU AV rI:RMI'INO,00110085
OWNER'S NAME APPLICATION SIIB DA'Z'E
COMPAQ 11/15/2000
PHONE: SANITARY NO. CONTROL NO.
BUILDING PERMIT INFO
00 ARCffITFCI'/IiNGWIi11R. III.Dfa ELECT PLUMB M1:01
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LICENSED CONTRACTOR'S DECLARATION Job Description
OZ—e I nerchy ufirn]hot 1 am llem"ed under alo i>inn<ol Chapter 9(commencing
t=NCw whh Section 700)of Diviaiun 3oitile BurinccxanA l'rofcsiions
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lion 1.11 forcenaC�ldeund nny licn�_s
T. I.6u iieeneGl.. saoAW
Contra\RCHITId7CS DECLARATION
Cg 1 T p1 I ll F 1 p 11' ll
w6p^
eased l � ,
se OWNER BUIL DLR DI CLARATION
6¢1^_''
I warby affiroubanl .I loan❑ C t t L' I fn the
L: hollowing (Section 7031.5 !1{ 1 I InWon,Care:Any 61y m ey
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which requires a peralit to construct, 11 1 demiorp' ) were
i 3 ce prix I t 1: requires theapplicant I h permit fl , .signed se mon
mal the is liceiredrat ,I he pA,,sure,ortlee . I,r 1 c : 1 Chapter Sq. Ft. Floor Area Valuation
tau nmenc ng with Secton 7000)of])'vision 3 of the Bas news and Pmfese Inv Code) $100000
of flat he is cncmnt I lI......and las hoeia Int me-all,ed cncn,plinn.Any viola)n,
of section,7031.5 by any it fliema lin a 1%moil wbjecta the applilmd m u elvil penally
o1 no.more moa use hundred dollars n500). A PN Number Occupancy Type
Cl I,as ouncrot the prol,cry,or my croployce%with wages its thearsidt,conds,now ir 31519061. 00
will ill he dl and the t ture s aid mendi or tillenctl (see 711,11,
Bae d l r Code Ie c t I 'r en d f lman Required Inspections
more, ff pertyWn bold a th dh L h aihinself 101 — FOUNDATION
or through has ..ply pamidedml such airproemem,.n...intended or
ide dfor ok,ll.Nw ar.lheb ld',e I'. old it yearn 102 — PIERS
im„..pleurae me ownc i^aIle,.',will hnvc he h1 d,,or Poe, ,g III,,he 11.11 nm na Id or
prove ompowso 103 — UFER
❑I,as owner of the yapcny,am exclusively contracting with licensed contractors to 104 — REBA R
instruct the project(Sre.7044.Ihoinew and frolic vions Code.)The Conabiwwr'v
construct
Law doe,.,it apply Ban ow..n air rouseny who build,or mini therw"'• 105 — ANCHOR BOLTS
and who contracts tor such pmjwts with a conhal licensed pursu:mt to the
Comractors Liccmc Law. 106 -- SEWER R WATER
01 con cwnp under Seo. ,B&P C far this teawm
202 — UNDERFLOOR PLUMBING
Gw"" lime —
WOHKIiR'Sin COMPENSATION DIrCLARAl10N 203 UNDERFLOOR MECHANICAL
lie reby corm,a.der peniI IyaI„erjnry iliac of the to I lowing nice In 204 — UNDERFLOOR FRAME
• 0 I hi and will inaimm a Cerdil.1 Content m.ell-intna III'walker. 205 — UNDERFLOOR INSULATION
Cnnpenwfon, at provided fm by Section 3700) of the Ivbor Cale. for the 301 — ROUGH PLUMBING
perfmm etre.of the work liar which his remits is island.
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base and will maintain worn,,Cnmpe"arml Insurance.[I,'tell by Stttior 302 — TUB 8• OR SHOWER
1 1.)or me Lala,Code.fm the sit...came of the walk tot which mit permit it 303 — ROUGH MECHANICAL
issued.My Walkers Compensation Imumnce sonic,and Policy number um: -
Catner;_ �/, ( nlicyula � ��yn/�/ 3s4 — ROUGH ELECTRICAL
II'IG'IION OFIiXEMP'l 101 FROM OItKLR.' t 305 — FRAME
COMPENSATION INSURANCE
(pni,were.need let hee...ddodifd,epermitisforonehanJdd
,ennars 306 — HOLDOWNS
tsBgBotle") 307— INSULATION
I certify mat in the penom,ance of the work for which this Knout is issal 1 306 — SHEETROCI
shall not employ any person in any manner so as e,become subject m me Worker:
cam malion[.a.,orCrideria.[)ane 309 — EXTERIOR LATH
Apnlimml
N(yflCl?'I'O APPLICAN"1'.It.after making coir Ceniticole.I Eicmption,you should ,310 — INTERIOR ]_ATH
woe subject m Ibe Worker's Compensation prnv,vinns of the hbar Code,you must
O0mkmmiM1conplywith achp.,isionsorthis lae,,air4milIs,deemadrtvukcd. 311 — SCRATCH COAT
CO NS'IRUC'I'ION I.FNDNfiAGE.NCY 31.3 — ROOF NAIL
' I hereby call laat mere o n cnmuuclion lending agency for the perfnrntunce
oo• —
nncwmee
work 501 FINAL ELECTRICAL ENERGY
I,cader't Name r,
z Leader,Mines, 502 — FINAL PLUMBING ENERGY
U O Isalad,ther Ione maJmisupplicmiA6and tlate thathe uMacinlbnnmlon1, 503 '— FINAL MECHANICAL ENERGY
I,, F center.I agree m comply with all city and coup(ach unces and state law,alining y1 504 — F T NAL BUILDING ENERGY
[) mh IJ y , do dh by mu p -nPlvcs fm.city lo lar pan _/
F m ° n Ir Irl cti r ' 505 — FINAL ELECTRICAL
0, (We) b Iir I Iv ndk I I I..fla,C y lCo 'ab' nM
rn liah1t jdk tn. t d pa wt n 1 r'nilty ) smatiro 5506 — GAS TEST
U Z City in tt,nseyuc nI the gmmin mit pemait.
.. SOURCE N1. nLATI NGND. WILL COMPLY WIT..AL"NON-POINT Issued by: 507 — FINAL, PI_LIMRING Date
sign, a pfieany ,tractor- Re-roofs 5VB — — y — HL HA,AR ,, MATF.RIAISDISCLOSUKE509 — FINAL GRADE
Will lhcupladcvmnrfumfc buildingcacnpnll cum or numlle hnanWn
us mtonul Type of Roof
defined by me capnrthm Mmiei,al chis,Chalfant 9.12.nml he Houle,and Sorely 510 — FINAL PLANNING
Code.Section 255321a)I -
OYet .>Ln - All roofs shall%d.(nspectRlIblilQ%fRboTGIg bilitG6i>$being installed.
Will the appliatml or future building occupam use nlulpmcat or dcs'ioei which If a roof is installed without first obtaining an inspection, 1 agree to remove
Gala h,mndon it cunl:nnWm,li at 11clined by me Bay Arco Air Quality Manage..,cal
o all new materials for inspection. Applicant understands and will comply with
ore. all non-point source regulations.
Ihaw read tire haat.. a
..,..adedala I, mens under Chirpier 0,95 of the
Calf "in Lemih&SWety Cndc,swain.,255115,25533 a all 25534.1 understand Ian
if the building Jo,no ave a hal 1,tail it May retpnsibila,in unify the
)ecu recurrent ich nal he and poor to issuance of"Certificate of
`apo Signature of Applicant Date
rormiledage� / . Z Do All roof coverings to be Class"B" or better
OFFICE