02030203 CITY OF�CUPEWHNO _.' .�
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION %i
B l I - pss L AVE TAYLOR WOODROW HOMES PERMIT N(02030203
e1AY/1YOR WOODROW HOMES 2300 CAMINO RAMON APPI.IcnT10f4it/024�2002
PHONE: (925) 365-3100 SANITARY NO. CONTROL NO.
— ARCHITECT/ENGINEER: -' _ BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
00,
�a 00 LICENSED CONTRACTOR'S DECLARA'1 ION Job Description
F ,' :1 harchy affirm that I am licensed under provisions M Chapter 9(commencing NEW TOWNHOME P
�mS With Section 700(hof Division 3.1'the Business."d Professimis Core.end myliceracis
u infull Rfice-pndefect:' LIVING AREA '1819 SQ. FT
ZOaZ License Class"` " _I.ic.M
0Zpo Date .. Contractor GARAGE AREj—.HV�Q� $12568 . 50
ARCI I ITECTS DECLARATION
a v I opeFrx and my plans shall M used as public records
LLo LicensedPmRsiional Nov 1 2003
' 'OWNER-RUILDER DECLARATION
s, E d I hereby-5flirm that 1 am exempt from the Contractor's License Law for the
toc. 00 following mesim.'section 7031 t,Business and Professions Code:Any city or county
$� which requires al permit v)consumer,alter,improve,demolish,or repair any sweum
prior in its issuance,also requires the applicant for such permit m file a signed statement
Thar he is licensedlamoduttothepnwisionsoftheContractor'sLicensefaw(Chapter9 Sq. Ft. Floor Area 189'%Bfition
y�a (commcnci ng wi th Section 7000)of Division 3 of the Busi ness and Professions Code)or
yNal he is exempt perform and Ne basis for Ne alleged exemption.Any violation of
section 7031.5 by mry applicant for a penni,subjecu Be upplicam to it civil penally of
not more Nan rive hundred dollars(SNIO). a Occupancy Type
❑ 1,as owner of Ne property,or my employees with wages as their sole compensation,
will do the work,and the cWdum is not intended or offered for sale(Sec.7044,Business
and Professions Cod,:The Camocmrs License Law dose an,apply In an owner of102 - PIERS equtred Inspections
piopeny who builds or improves thereon,and who doessuch work himulfor through his
own employees.provided that uch improvements are not intended or offered for aide.If. 103 — UFER
however,Ne building or improvement is sold within one year of completion,Ne owner- lO4 — REBAR
builder will have the burden of proving that he did not build or improve for purpose of
'ssle')' 105 - ANCHOR BOLTS. '
,is own;eiof the property,am exclusively contracting with licensed contractors to 106 - SEWER & WATER .
conslmel the project(Sec.7044,Business and Professions Code:)Thus Conlracmr's Li-
center Law does no(apply toanowner ofProperty who Wilds orimproves(hcaon,and, 202 - UNDERFLOOR PLUMBING
Lwho cense Lawtsfor roan projects with acontracmr(s)Ilttnsed pursuant to the Comncmr's 203 - UNDERFLOOR MECHANICAL
Tem exempt under Sec. ,B&P C for this reason 204 - UNDERFLOOR FRAME
Dntn
205 - UNDERFLOOR INSULATION
WORKER'S CO R AT DECLARATIOrT' 301 - ROUGH PLUMBING
I hereby alBml under p:na I ejar3'one of lee faunwing drelare inns: 3 02 - TUB & OR SHOWER
�ED i how and will maintain a Certificate of Cement o ad f-mourn for Worker's Condom-
.hot, 3O3 — ROUGH MECHANICAL
as Provided for by Section inn 37of the labor Code,for the performance of the
work for which this permh is lssaed. 304 - ROUGH ELECTRICAL
❑ I have and will maintain Worker's Compensation Insurance,as required by Section 305 - FRAME
3700of Ne of
Code,for Ne performance of the work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy Muni art: 306 — HOLDOWNS
Carrie,: Policy el 307 - INSULATION
CERTIFICATE
COMPENSATIONION FROM INSURAANCEGRICT:Rs 308 - SHEETROCK
rphlr scatinn necdnm beutmpleted ifthe permit isfnrone hundreddollars(5111() 309 - EXTERIOR LATH
orleSs') 310 - INTERIOR LATH
1 cattily that in the pefformince of the work for which this pesmb is issued,I shag had 311 - SCRATCH COAT
employ any perm"in any manna` oMco esub t cWnrkcrs'Compensation
Lawao 0 313 - ROOF NAIL
AnNieam
NOTICE TOAP rmakmg INS Ccnt eau of Lie ,y.+a sm+md 501 - FINAL ELECTRICAL ENERGY
become sit"ectto the workers Compensation pre+ilio Mfr Cssfc.you mast 502 - FINAL PLUMBING 'ENERGY
0zfmlhwithroadn"wou such prnvisinm ar this perm deemed revoked,
z.o 503 - FINAL MECHANICAL ENERGY
CONSTRUCTION LENDING AGENCY
F,'N 1hereby affindMat Marc isaconstruction lending agency lot[he perlormanc,of 504 - FINAL BUILDING ENERGY
C4 > the work for which this permit isissued(See.3W7.Cie.C.)
Lenders Name 505 - FINAL ELECTRICAL
]ul C' 506 - GAS TEST
Z Lenders Addmss .
U O .^'1 croily chat,I have read this application and sme that the shove information is 507 - FINAL PLUMBING
correct.l ague to comply with all city and county ordinances and scone laws relating m 5 FINAL MECHANICAL
O building construction,and hereby aulborimrcprescnmlivcs of his city to cnmrupnn the
Wamivomentioned propcnyfor inspection purposes. O9 FIN
(We)agmen to save,indemnify and keep harmless the City of Cupertino against N G
h in
isequene of ts,the costs and expenses which may in any way Weems.gains said City ,S N b/�
U z A APPLICANT
of UNDERSTANDS
of this permit.
�+ APPLICANT UNDENSTANDS ANU WILL COMPLY WITH ALL NON-POINT Issued by51 WORKS Da
SOURCE REGULATIONS.
r
. 192 1 Re-roofs 603 - OF BATTENS
st nature of Applica'IUA;Zzt DOUS MATE .CLOSURE nate Typeof Ro®t4 - ROOF IN-PROGRESS
Will Ne applicant or future buil - occupant store or handle haiardous maredal
as defined by the Culaort Munici Cade,Chapter 9.12,and the Health and Safety
-aMr.Section 25532(s)7 All roofs shall be inspected prior to any roofing material being installed.
Q Ven
Will the applicant orfwueeWilding occulumusecquipmemordevices which If a roof is installed without first obtaining an inspection, I agree to remove
emit haeardous air contaminants as dclined by the Bay Area Air Quality Management all new materials for inspection.
O'stricT/, KI-
0Vcs (�rv11
I have read the hasandous materials mquimments under Chapter 6.95 office Caliber �_ ^
Iia Health&Safety Ctale,Secuam 25NI5.25517 uW255W.I understand Out if the building
docs not eurnally bare normal,that to my resp,nsihility In nobly the occupant of the
cvim Iwhichmusthacost ' nnissuanccafaCettiEcamofoccupancy. Signature of Applicant Dac
Owner orawhorixcdagcm •Uma All rgo verings to be Class "B"or better