02030186 CITY OF CUPERTINO +--' s = :
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION,-
BuBpIgclA5fi5F,%%1MPERIAL AVE TAYLOR WOODROW HOMES I'MmITNT2030186
rhihi WOODROW HOMES 2300 CAMINO RAMON APPLICA'rInl/IT6F 2002
PHONE: (925) 365-3100 SANITARY NO, // LL �� CONTROL NO.
ARCHITIiCr/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB M[CH
0 0 0 0
jQ00LICENSED CONTRACTOR'S DECLARATION
I-. I hereby affirm that 1 am licensed under previsions of Chapmt 9(cnmmenciag Job Description
�Uz. wim Section 700(nof Division Sof thc Businassand Professions Codumd myliccnso is NEW TOWNHOME
t_ow infall bmcand effect. 1589 SQ. FT. LIVING SPACE
zo�z Licenkclam Lic.ii
ozgFo Date Contractor 492 SQ. FT. GARAGE : �r ��Io �®
NFION
I tmdrWand my plan, tI shelf h ti em puF CHITECTS c m,ords p Amo
6owu INCL 3 O ZO03
Licensed Pnticssionu
that OWNER-BUILDER DECLARATION
00 I hereby.titan that 1 ore exempt from the Crnmm�Co License Law for the
w pO Which in gmason prmilt 71DL5,Business and ve,Profession;Code:Any city structure Which myuires a permit m conswch alter,improve,demolish.nr repair any atrunure
1°� onto to its ismou.atvn requires the applicant far such permit to Ne a signed statement
that he is licensed pursuant into,provisions of the Contrai License Law(Chapter 9 Sq. R. Floor Area 167&'IPIBI[ion
€Q (commencing with Section Man of Divisionl of the Business and Professions Cone)or
y —
that he is exempt therefrom and dte basis for Ne alleged exemption.Any violation of
Section 7071.5 by any applicant for a permit subjects the applicant to a civil penalty of
not mom man five hundred dollars(s50n. 49; e U Occupancy Type
❑ I.as owner of the property.or my employees wim wages as their sole compensation,
will do the work,and the structure is not intended or opposed for sale(Sec.9M4,Business
and Professions Code:The Coommun's License law does not apply to an owner of10 2 - PIERS qui
ered Inspections
property who builds or improrchere
s ton,and who does such work himselfor through his
Own employees,provided that such improvements arc not intended or offered for=)a.If. 103 — UFER
however,the building or improvement is sold within one year of completion,the owner.
builder will have the burden of pm ving that he did not Wild or improve for purpose of 104 - REBAR
sale.). 105 - ANCHOR BOLTS
T'n owner of the property,am exclusively contracting with licensed contractors to 106 - SEWER & WATER
construct the project(Sec.7004,Business and Professions Codc:)The Contractors Li-
censeLawdnesnotapplytoanownerofpropertywhoWildsorimproveshemnn,and, 202 — UNDERFLOOR PLUMBING
Lcenu Law for such projects with e enmrannr(s)licensed pursuant lathe Contractor's 203 - UNDERFLOOR MECHANICAL
lamexcmpt under See. B do P C for this noon 204 - UNDERFLOOR FRAME
Dow 205 205 - UNDERFLOOR INSULATION
WORKER'S Coh DECLARATION 301 - ROUGH PLUMBING
(hcrchy efiinn under penalty Bury one of the following declarations: 3O2 — TUB �c 0R SHOWER
❑ Inaysand wieforbmaintain eCion370eofthe" eCodinsuromrerformaceorthe 303 - ROUGH MECHANICAL
satinn,a provided for by Section JAM(of the Lahr Code,for me Performance of the
work for which hisremainisissued. 304 - ROUGH ELECTRICAL
D T haw and will maintain Worker's Compensation Insurance,as requited by Section 3 05 - FRAME
37N)of the Labor Code,for the performance of the work for which this permit is issued.
My Workers Compensatina Insurance carrier and Policy number aro: 306 - HOLDOWNS
Cartier: Policy Nn: 307 - INSULATION
CERTIFICAI E 01;EX EM P'NON MOM WORSE IRS'
COMPENSATION INSURANCE 308 — SHEETROCK
(This union need ata M completed if one permit is for one hundred dollars(SIM) 309 - EXTERIOR LATH
iirlCm.) 310 - INTERIOR LATH
I certify mat in the performance of the work fm which mi permit is issued.I shall not 311 - SCRATCH COAT
employ any person in any manne s rob
Aicant ome b*%Lt eWorkers'Compensation
Laws r — 313 - ROOF NAIL
ppl
NfrrleE To APPLICANT:ILaur making this Cert'; c of Eumptiuq you should 501 - FINAL ELECTRICAL ENERGY
become lancet to the workers camp n tmn pat MI the Labor Code,you must 5 0 2 - FINAL PLUMBING ENERGY
O O forthwith comply with such provisions or this permit shall W deemed revoked.
Z CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
n. nrerenyanirn,Nmtherei.saconswctionlandingagency0athepedorminstol 504 - FINAL BUILDING ENERGY
cG � me work for which this Pmmltisissaed(Sec,7B97.Ci..C.) 505 - FINAL ELECTRICAL
Lkt A Lender's Name
az LcndersAOdmss 506 - GAS TEST
0
U O I certify not 1 have ithJ this application and statestatethat theshove information is 507 - FINAL PLUMBING
U correct.correct.l agree m comply with all city and county ordinances and
state laws relation to
building construction,and hereby amhonrz reprencntatives of this City to enter uptmth 5 FINAL MECHANICAL
r G move mentioned property for inspection purposes. O 9 FIN E
(We)agree h,save,indemnify and keep harmless the City of Cupertino against
F' IA liabilitict.judgracnia,costs and expenses which may in any way avers,against mid City 5 N G
U Z in consequence ofthc graining of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINr Issued by 51 WORKS Date
j tCULATIONS.
Re-roofs 603 - OF BATTENS
SNoawm of ApplicanvC.'a"Wmr Date
HAZARDOUS MATERI [EOSURE Typeof401s; - ROOF IN-PROGRESS
Will d¢.,pli,anin,future Wilding upon store or handle hvsrdous malarial
as defined by the Cupeninn Municipal Codc,Chapter 9.13,and the Health and Safety
de.Section 25532ppl / All roofs shall be inspected prior to any roofing material being installed.
(3Yes Com+
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, 1 agree to remove
emit hazardous air cnntaminamsusd tried by the Bay Arca Air Quality Management all new materials for inspection.
Disuct7
0 Yes a
Ihave&Safel NcharSNoons 25505,2553 and 25534.1 under u Chatand tht afore Calsudden, /0 .,� �'-
niuHcalth&Safely Calc.$cations 255115,35577 and 25$34.1 untkrsmnd Nat if Nc building
does not currently have a mnam,mat it is my respoosihility m notify the occupant of the
airem,riLi<nmmsl M�^tp ce ora c,rificate or Occupancy. Signature of Applicant Date
10 actinium; ia<dagent Date All r verings to be Class "B" or better