02030081 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:,
BUILDING ADDRESS: PERMIT NO.
10141 DENISON AV SWAN POOLS 02030081
VNER'S NAME: APPLICATION SUB DATE
itICHARD GUARDINO 1495 S WINCHESTER BLV 03/15/2002
PHONE:
SANITARY NO. CONTROL NO.
(4 08) 866-68 93
Q-7 ARCHITF.CIENGINEER:
BUILDING PERMIT INFO
'Fs,03
rc"' BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'SDECLARATION Job Description
O 1 hereby affirm mm 1 um liccrvsdd under provisions of Chapter 9 cc"' an
P
m with Section 7W0)ofDivision3oftheBusincssandProfessions Cost it my license NEW INGROUN &MMING POOL & SPA.
f�z-' in full fomes Sj1m � )
u came ria_. u<.a ( 429 SQ. FT.
O a O Data Contractor
ARCHITECT'S DECLARATIOZb
O 1 understand my plane shall he used as public race DE
Y c1 82
I 6 o O License)Professional
OWNER-BUILDER DECLARATION OO
t5-'m 1 hereby affirm that I am scamp,from the Commmnr's License Law for the sO. -,
?Cfollowing reason.(Section 703I.5,Business and Professions Code:Any city or county /V/ ®,�
xhich requires a permit to consumer,alter,improve.demolish,ore
r pair wnrc
any su
i 3$
prior to itsa 1so require,the PDI' rt for such parmhzo file.,inced surrat _
_ .. - _ - -.
that he Iingwitp le mthe oProvisionsoftheCommcmrsLce W (Chapter 9 S Ft:Floor-Area
mom n ag with a J000)ofD i, 00f the1agedBusiness rib dP f sans Codd 7�� t.s'e? _'l9 S t iv-fie;,•<[t.}sts� Valuation
or thatSec W u 31.5 b tang apple anJ the bass for the a s the exemption.Any vrolst rid
-of Section than v any applicant fm a pamtit mbjttm the Applicant
m a civil penalty- s `
:or mot mere than Ina hundred a°nam Isslro>. umber gip' .', Occupancy Type
I.aswneroftha property,ormremployees x ith wags as ihairsme<omr<nsatlnn, _
-will'do the work."and the stln<ture is not intended or offered for sale(Sec.7t . - - - - -- .
IBusinessand Professions Code:The Contractor's License Law does not apply to an 104 - REBAR Required Inspections`?^n c>i T.
ox.ner or property Wit.builds or improves rancor, ad who does such work himself
or through his own nnployces.provided that such improvements are not intended or 107 - POOL BONDING
-otfemd for,ale:If.hdwcver;the Wilding m improvements sold within ora ycSr'o!' - -" " "-"""'----'" - --- - "--"" —'----____ -------- ---...
-dal,;Dla6nn,meewnar-badderx.innavemdwmonerprnvmgmatneaane,bnddnr 301 - ROUGH PLUMBING '= ..' '.'
improve for Panama,drams.>. 304 - ROUGH _ELECTRICAL
_ --
OLa. fmpSearty,aI.Busiessan rintlicensed Ths,contractorsrn 5p2—="FINAli PLUMBING"ENERGY�I _ };t- �.• ------ -
_ oniwci he pro3cct(Sec 76W,Business rid profession,Cade)The Commaor's
- _ aaaWwa«anntapplywanownardrpropn>•xmnFuodanr;mprovmmerenn, 503 - FINAL MECHANICAL'lENERGy
..!. -and whomanowu.forsuch projems wiN.a contusions)licensed porsmm to me.
Commences License Law. _. _ .._.506 -GAS -TEST _ ----.._..... ..._.__---.-------......._---- -...-- _ --
_ ❑lomexdmptonettsi<;' a&PCfortMsmason 510 - FINAL PLANNIN6'11'"D
'car
e fire
PENSATION DECLARATION.. 511 - FINAL POOL
WORKER'S COM
� I herebyRum under aau 1 er - r,the following declarations 516 - FINAL BUILDING
u p4 Yo p 3ury encs g ;
O 1 hada and will moinuin a Canal of Cam.ent to self-insure for Worker's
Compenamion, as,provided for by Section 37W of the Labor Code, for the
perfomurea of rhe work for which this pamrir u issuW.,
have and will maintain Worker's Compensation:Insurance,as required by Section
_ 3700 of the W Wr Code,fir the perfomtance of the work for which this permit is
"d MyW k RCm p i once )Policy W e
d .Pon,N ..'_ .- - -"_---
c m - . yt , L 1 �.rs r
r CBRTIFICATIONOFE%EMPTIONFR FROM! ti.f�,:• �k„ s (�tl, t 4c � 1.�:K�,: s,'k ;: ;;'••
„- COMPENSATION INSURANCE'^ - s
$1mordent t becont' is the permit far one hundred dollar -' t."" ' •'.C t'.0 s s
($1000 or n1 or less) 1)•:
cent that in the an pa . ._.., .
r =r lo pc form c1.f the t forwhich.1 rte t - k,,I
snail t employ any R any er �t t b�dme s �' r to the Workers y!... ♦ D!Its I' f
Comp -vl Laws ofC Lf "e'Doyss "g la;•-Oc
.Apple 't lY A/oCL
NOTICE TO APPIL A Taft -king lhsCn'fcat fE apt you'.houltl -" --
becbin subPattern,W rkel C tsar o f
Z pd ns of rhe WW Cod you
z p fon mA m comply-itti such anowismars or th s perm r shall W learned uAvoked.
':'CONSTRUCTION LENDINGAGENCY "" - - , ,.;.
"> ' I h by affirm that than,is a Wc lend' g agency f rhe perfnnancc' s
C'tti
of rhe work forFallen h ih thists issueded(Sec.3097Cie C) s• `
y,o Lenders Name' ✓c_. v .......... :.....:_::.
a:ZLentler's AJdress'. '..• r ..., , .. .. .... _ --...... _-_....._ .__.__.____.. ._.. ._-. ..
I amity mat I have read mea.DRlication and antis mm me above information is
f 7p ortmet.I agree m comply with all city and county ardmanccs and stone laws retain,
C.0 to Wilding mmwcrion,and hereby anthnrize rtpmsLnutives mi city to enter upon
,?t'W theabole-mrnrioned property for insvpnion purposes.
(We) rb save.indemnify and keep harmless rhe City of Ctipenino against
.rq liabilities,judgments,costs and expenses which may in any way across against said
U City in Consequence of greening of spermitl"" "
APPL•ICAM'UWE dNDS'AN ILL COMPLY WITH ALLNON=POYLT s` 1
SOURCE REcu - _ Issued by: Date
5
Sign.
ta r urn DO D, Re-roofs /
1 - " NAZARDO 5 MATERIALS DISCLOSURE 1 '" ,
W11 ncoappl' _io from W'Id'goula'ducclor a,uial T e.of Roof,-,..,
u dd ed by th C penins M me p I Code.Ctapr 9 12 d me H hh a d Saf ty YP
Codc:5 un255'tlla), f.•. . s t ' si li �' :1 t-q tt,.f - `. .f _
❑Yaa '` ' , ' ` All roofs shall be ms acted nor[o any roofin _
inspected _ g material being Installed. _
W II th Cpl zrnf t W fir ,«unpaid umequipm t de - bent If a roof Is Installed without first obtaining an inspection;I'agree[o remove
lha rd avcontainment udefined byte BayA aArQ ItyM gement
District? all new materials for inspection Applicant understands and will comply with
riY J all-non-point source"regulations
i h elead the hazards mntcr;als rcgmaments ender Ch pmt 695;6f the
CallPomia Heahh&Sa&ry Codr.Sti.ns25505-25533..d25534,1undl,,Ila,dlla,
-fmcbuilding dims nor cu tlyh ,¢nam rh,'t yrtspo.,bility to notify the66c - """ - -- --- -- _ - --
upLr of the . . .. p mot
irements h h mon tic iter r Isom< f a Certificate "-ccin
-zed agent D m.,
_ s d Signature of Applicant Date
° "`r '^ All roof coverings to be Class "B"or better -
ir',t ..-OFFICE