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03070052 CITY OF CUPERTINO 's; °� _�• a BUILDING DIVISION PERMIT B CONTRACTOR�INFORMATION BUILDING ADDRESS: SYL-MAR CONSTRUCTION PERMIT NO 03070052 OWNER' -N TANTAU AV NAME: 1310 TULLY RD. # 114 . PERMI77L59UEDA'IE E: (408) 293-7969 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LOO LICENSED CONTRACTOR'SDECI1,,,,AARATION Job Description O _ 1 hereby affirm that 1 em licensed under prmvyt(3hs of Chapter 9(commencing I Secion7 Bef Division Sof the lluaims.lUa s ms Call my license s '0 � in full fnrc deffen. 6�' 6✓ OCT j z License CI Lie. 7 TENANT IMPROVEMENT 2003 net- Dam Cuntthe <—MISQ ARCHITECTS D ATION p., I undennnd mu aorda F[� At,n.m.hall he used public re W11 �',v�1G u LL/ 30t; Licensed Pmfessinnal 5 OWNER-BUILDER DECLARATION i y 1 hereby aRum that I em exempt from the Control License Law for the —00 following mason.(Section 7031.5.Business and Profcssiom Cock:Any city or county m which mutual a Permit to convect,Mur,improve,demolish.or mpair any structum Fiy primmi4 iuuence.alsu mquimstM appliamfm such permiuo fileealgned nemmem F licensed puction7 )orivado of the cmm�ns:nd ProflswfChapmr9 Sq. Ft. Floor Area Va allOn ERR (commencingathe wit thectior.And df Diissis far she alleghe ed Business iom CMe)or .. Net Ae is uemp Nemfrom And de buH for the alleged cnmptlon.Any vinhtion of Section 7031.5byAny applicant for a permit subjects Um applicant to a civil penalty Of APN Number Occupancy Type oat more Nen Ove handled dollars(55007. ❑I,umvner of Ne propcnY•Or mY cmployua with wegu uNelnOle mmpeue0nn, pT will do due work.and the swoon is not intended oroReretl for sale(Sec.7044,Bulinus - - 101 — FOUNDAq@Nd Inspections and Professions Cal The Clinical License law decs not apply m an owner of property who builds or improves benon.end who doessuch work himselfor through his 102 — PIERS own employees,provided thin Such improvemcnel not intended or offered for sale.If, lO3 — UFER however,the building or improvement is auld within one year Areal the Owner builder will have the burden of proving Nat M did not build or improve for purpose of 104 — REBAR Aide.). I,as Owner of Ne initis .em exclusively convecting with licensed eonwcron to 105 — ANCHOR BOLTS nnntronthe projaet(Sec.70i4,Business end ora nnsCol Title Coattail Li. 106 - SEWER & WATER come law does not apply to an Owner of property,who Wilds or Improves demon,and, ZO2 — UNDERFLOOR PLUMBING who comunI mis!or such projects with a contrail licensed pursuant the COc roe License LIsco. 203 - UNDERFLOOR MECHANICAL ❑1 am aempt under Sec. .B&P C for this mason 204 - UNDERFLOOR FRAME Owner ata 137WWORKER'S COMPENSATIONDECLARATION205 - UNDERFLOOR INSULATION I hereby&Man under penalty of pal oro of lie following dailar.dnm: 301 — ROUGH PLUMBING have and will maintun A cmincneofCement ro salr.inaum ter Walker'.Compen 302 — TUB & OR SHOWER n,u provided for by Section 37M of Ne Labor Code,for the Performance of the 303 - ROUGH MECHANICAL for which this permit is issued. have and will maintain Worker's Compensation Insurance,u retailed by Section 304 - ROUGH ELECTRICAL of"e Labor Code,for Ne performance of the work for which this perming issued. 305 — FRAME C9rnkcr'g4 namsin�lnaml camicnnyP]icy number am 306 — HOEDOWNS eY/yO MI PryRyNO.: WOLo79,0yt/// CERTIFICATE OP EXEM ON FROM WORKERS' 307 — INSULATION COMPENSATION INSURANCE 308 - SHEETROCK (This Ail need not he completed lithe Permit is foram hundred dollars(SIM) 309 - EXTERIOR LATH it,lCs4.) 1 certify that in the performance of the work fm which Nis Permit is issued,I men not 310 INTERIOR LATH employ any parson in any manner an u to become subject to the Workeri Compensation 311 — SCRATCH COAT Lew,of Cl Data Applicant 313 - ROOF NAIL NOTICE TO APPLICANT:If.after making Uds Cenificne of Demotion.you mould - 5O1 — FINAL ELECTRICAL ENERGY become mbjut to the Wal a Compensation provitions of she Ishm Cede,you must ZO forthwith comply with such provisions ordusPermit shall Wdeemed mvnkad. 502 — FINAL PLUMBING ENERGY CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY Ihemhy aRvmNet"ereits coastal lending agency for the performance of 504 - FINAL BUILDING ENERGY C'Y the work for whichthie permit is issued(Sale3097.Civ.C.) a 0 Lenders theme 505 - FINAL ELECTRICAL O Z cmaer'aAeem:: 506 - GAS TEST 'l J0 I unify Net 1 ban read this application and suite that the above information is 507 - FINAL PLUMBING fL coned 1 wane to comply with all city and county ordinances and state laws mlatimg m O V building convection,and hereby amhurim representatives of this city to emer upon the FIN aMEICAL W ahmvc (We). .pmpcny fotlnpacti keepha. (We)came ro 4eve,ar!.A ify tl keep harmless the City Of Cupcninn against O 9 F I p3 Iiabllitieb Judgmen cost,mdeape whichmay in any way accrue against aria City mcnnsequcn of c r 1 guf thi noir 5 NG "^ APPLICAN U D T NO WILL COMPLYgH AL NO POINT Issued by:5 C WORKS Date URCE :G 1 N .r,is6 Re-roofs AignJuriforApplicaVCO mncmr Dale HAZARDOUS MATERIALS DISCLOSURE Type of Roof ill Ne applicant or future building OOcupam atorc or handle havatdou,material As need by the Cupertino Municipal Code,Chapter 9.1 i,and the Hetlthand safety Cod.Section 35531(a)? ❑YuNo All roofs shall be inspected prior to any roofing material being installed. Will the Rol Or future building occupant use cquipmem Or devices which If a roof is installed without first obtaining an inspection, I agree to remove 1 hanrdnus air aromainanu As defined by the Bay Arca Air Quality Management - all new materials for Inspection. ixtrict? ❑Yag Nu Ihove maJ"e msNous mamri myuiremens under Chapter 6.95 of be Cl nie liculb S ety n ,Sec' ,25511 5533.,115534.1undersmnJNmif Na ilding dlxerico nmly roe et a "m' my responsibility ul' them p ofthc uimmen wh' b net Iprin issuance nnCanircl a a Signature of Applicant Date � Dole All roof coverings to be Class "B" or better cone am orived afenl