01110092UFFICE' - -
CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
7565 ERIN WAY
BATHROOMS BY HANS
01110092
OWNER'S NAME:
APPLICATION SUB DATE
JIM KEENAN
4986 TIFTON WAY
11/20/2001
PHONE:
SANITARY NO. CONTROL NO.
(408)978-3053
00❑
ARCHITECT/ENGINEER:
BUILDING PERMIT INTO
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.DG E Cr PLUMB MECH
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LICENSED CONTRACCOR'S DECLARATION
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1 thereby afror that 1 am licensed under provismn, of Chapter 9 (commencing
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with5mion]UW)o'ff 'nJoftcBusinessandPro+ siomC n3YI
is in full forte .:nd f�rcl ��
KITCHEN REMODEL.
ad,
Liccnu C as> t%-. l t Lic. M
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On
Dae S DECLA
ARCHITECT'S DECLA IOh
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I mmers,and my plan shill be used as pahlic It cora, fin`�'S
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JAN 1 1 2002
Licensed Professional
RATION
OWNER-exempt
1 hereby alum that 1 from
exempt from the Contractor License Law for the
the
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aama (ermut t TO316, t. allcs imps ve. de o demolish, or Any city oeracti y
whim requires
whoflich pemsl re wrest ell alter, i demolish, m repairn ny t
$18000
3 .
n
. poor i , issuance. requires ,�n,Siapplicant f hue
for statement
Law
- - - - - - -- -
-
rsit
Lice se
thatne i«ngd aaaannaNe 'thee tare ucen�l.wlcna
(Chapter 9
(r ',h Sato vwe) fhe J f the Bus ss and Profess ons Cade)
S
r ;-+kl, •3'Se126'OUBr 1��1'-L,.LI€ia;,: Valuation
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'
that bmntg
or that s em npnn and the basis fns the alleged on Any
l pennon
im y applicant pplopt
-of Srtion'/031:5 by any applicant for a permit subjma the applicant to a civil penalty
of but mmethan five ntodaddollars (S50%
101I`N P'VUNDATION '' Occupancy Type
DI, as owner of the property, or my employees with wages as their sole compensation.
will do the work. and the lame um is not intended or offered for sale (Sec. 701kI.
102 PTRRR
Business and Prefersions Code: The Contractor x License Law docs not apply In an
103 - UFER Required Inspections 1'
owner of pm"ny Who builds or improves thereon, and who does such work himself
or Ilmaugh his own employprovided Nat such mprovemems are not intended or
4 REBAR
offered f I If h- a to titan m fI, sold w to n one
g e provemen year of Completion, meawne,b�la<rw,nnaveNenu,aenerrprosngmatneemnaIbuildor
" - - - _,"10 „- -- .... ... --. ...._...... -..._, ... ...
105 - ANCHOR BOLTS-
imp,nverorpurfwvofmle.).
106 - SEWER & WATER
-
r . rnfins, prnpenr I fvelrtermmerngwthlicensed ontaIctu to
sbnswr the project (Sec. ]0.W. Business and Professions Code:) The Comracmr x
202 - UNDERFLOOR PLUMBING '• r:'; :�
-
'<
uanseLawdoesDotn 1 to an owner or property who builds or
vP Y pr Y w Improves meteors,
203 - UNDERFLOOR MECHANICAL'"
a
m
and wit °roan for such pmjecs.with a conwemrts) licensed Puauam to the
C°mmn n'
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204 "- UNDERFLOOR FRAME " ---
us,'C
111 me mut c Sc. ,B&PCfor Niaauon
205 - UNDERFLOOR'' INSUliATION
one
W E DECLARATION
301 - ROUGH PLUMBING
1.
302 - TUB & OR SHOWER
the a manaerpnaererr Perjury errs<afm tmlerwmgdalaadons:
303 - ROUGH MECHANICAL
01 have am will maintain a Cenmcae of Conant to elf.momm for Wonder's
Comparation, as provided for by Section 37W of the fetter, Code, for the
3 04 - ROUGH ELECTRICAL
peRonrmnce or the work for .Dian this permit is is un d.
305 - FRAME
e and win m.irraih Woike?s Campcnagbn Insurance, as:equiad by Section
3 06 - HOLDOWNS
3of the lobar Cada, for the peifomtance of the work for which this permit is
tamed M Workers C cannon o Insurance imnito and Policy number are:,
3 07 INSULATION
Cards, -'r•+ Policy iuer.22q-Di DDRIIo
- .308 !:_=SHEETROCK.:, - -
t ';'CERTIPICATIONOEE%EMPI'IONrmv wuKK�II ER$ '—
, COMPENSATION INSURANCE' - ' " "' -"'
INSURANCE,,-
,
5 t ,, i j t' 1 .Ire;; Pl
30§ - EXTERIOR LATH
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.. .... �... ..
fro set 'deed not be completed if the Permit is for one hundred dofaa
._ ....._._ ._.__-- .. ___-._.-...
',,INTERIOR liATH .._ }+.
alemyrle'..)
311 SCRATCH COAT '
_,... 'coaly mai nd the - rr dr m2 ark r , Dian m a t paved; i
- '- - 313 " - 'ROOF NAI li '-
Neill not em oy an I e : n y t become bl t t to .Workers'
Cermpenado Las m nmy:
501 - FINAL ELECTRICAL ENERGY
Appruant.
502 - FINAL-PLUMBING ENERGY---
NERGY--_— - --
-
NOTICETO PLIC . 11, aper making thi Indicate of Exemption. you should-
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nswoursubje lithe Workers Compensation provisions of the Labor Code, youmdst
503 FINAL MECHANICAL ENERGY
C
fonawim«mp with such Pmvislonsarthis wormtanall hed«mei«verked.
- -
504 ----FINAL--BUILDING- ENERGY
hereby •^'cONsereisa'IONLENDwGADEN CY'
- 1 he by (firm that tit onsite ,' lending agency for the performance
505 - FINAL ELECTRICAL,,, 1 ' I
,
Goxmewarlaidcnicnthtspcm,tia
issued (s".7o9T.cm.ca
Lend<r's Name' _: .__.... �.... .. .. ..... .. .. :.a, .._...
506 ..-. GAS TEST
_.. .. ."..._.
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LenderaAddass ..' ..
_
507 - FINAL PLUMBING.
1 <cnify Nat 1 have read Nis apP,lication and stare tits, rite above informmion is
508 - FINAL ME CHANI CA L
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comet: I agree m comply with all Icily and county ordinances and stale laws relating
to building constrvc,ion:and licaby imbecile miumsFnmtives of this city to enter upon
509 - F I NAL GRADE
(a
Ps
the above-mentioned for inspcmmnpurposes. „
(we)egmemsave, indemnify and keep hamlcse,he cd, ofcupcoin. again,
510 - FINAL PLANNING
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liabilities, judgments, at and expenses which may in any way acenm against said
514 - F INA PU I C WORKS
the gam of ii pcmdt. -'
APPTANDS ra. WITH ALC NON'POYNY�"s6u
CityMVIlE
Issued by:Date
ucmura r: . DateRe-roofs
''Y
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ZARDOUS MATERIALS DISCLOSURE ;!
t"( t W Idin
R pal code" hapt r 9 . naMle hazvdrs mSafeill
aennM b N �u Dino M g Chapt 9 12. and the Health and Safry
tyT
e of Roofes
yp
Cad<S ton 25S32m) ,
_h.
❑Yes �v ..
All roofs. shall, be ms ected
p pnor.to.any roofing material-being,installed..--
Will tit applicant f building " p , ¢'equip , 1 device, which
t inIt,h d me t' den ed by theBay A q Q al y Management
_
If a roof is installed without first obtaining an ms ectlon; I agree tri remove
D stns
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^ all new materials for inspection. Applicant undersstands and will comply with
-
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...,
iDt'i
all non-point source regulanons 'III. ...
1 ha rc the h order s matertal wrtr"ms aria e Chapter of
q
if'hemaH at OSulMier 25533 and 255341undo Ind that
if 'he bu loth ❑
-"
u , a.d
shot ume a c a.dm my resp tii'ty to notify he
-anti
-' -- - - - - -
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"cause, e r qu w m ivuance of Cenifi<a, of
Occupanc p' ...
mIc!' m
.
Signature of Applicant Date
_
All roof coverings to be Class"B" orbetter
Owner or nae, reg t ;, .,, Data ,
UFFICE' - -