02060121 OF
CI BUILDING DI,VC'ISSIIONNDPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20004 NORTHWIND SQ SHOWCASE KITCHENS INC 02060121
WNEWS NAME: APPLICATION SUB DATE
1CREE CECIL W JR 12333 SARATOGA-SUNNYVALE RD06/19/2002
PHONE: SANITARY NO. CONTROL NO.
(408) 253-0412
naeO ARCHITECr/ENGINEER: BUILDING PERMIT INFO
be w C BLDG ELECT PLUMB MECH
<tau CI r—I L:J I__J
OO Z�" LICENSED CONTRACTOR DECLARATION
_C 1 hereby arum that I am licensed under provisions or Chapter v(commencing Job Description
fir rnFw is in s<clinn]said D ion3of the Basin` dna fir, rot,teo my license KITCHEN REMODEL
m is in full and<Re 7-' �0 J
3 a e 6 Rate u Lic.p
ii D m Com cn r
F te to0 Q ARCHITECT'S DE RATION
I snag , y„ ali-I,ntsysed as bre record.
\11 I_y J • vw :+tri.
woed},vfCs
`I'i OWNER-exemptBUILDER DECLARATION OCT 2 9 2002
I rano,flim,that 1 1. exempt s an to Coamnnrs License law for the
F'?a which ngrtuoa(Secaon consruBusiness ands,.demolish,
Cock:Any city or county $17222
F Y O which requires a permit to construct,aIle,impma<,demolish,m repair any structure.
i°3� -Mat once cprlsortto a the pili i1 - hp rein fl L (Chaps em ����
(colo s licensed pars M( Thep inion f h t trustor.L V Professions
9 pe_
or t a exempt' th( om an !Divi; 3 f h l sine. d Prof d,vi Codd ( .'('31 3 0,��F.Q a^'V7 f_J ',� y . Valuation
or natio 731.5 bany a oto and he basin for ubject the a tempuoo AnY violation S' '��, Y i J$4.'
-of Section]W LS by any applicant for o pem,it subjects the applicant w a civil penally
°foo,more ban five hundred Coma(Sint). 101ApN V"FDATION "" r Occupancy Type
❑1.as owner of the propery,or my employees with wages as their sole compensation,
will do the work.and the structure is nor intended or offered for ale-(Sec:7041. --
Ru,ine,s and Profession,Cote:The Contractor,License Law does nm apply to an 103 - UFER Required Inspections ia' fl:
orr of prupery who build,m improve.,traded,and who doe,such work himself
through his own employes.provided that such improvement,are not intended or 104 - REBAR
offered fur,ale.If,however.-the building or improvement is sold within one year of ”' "'—"-"—""' - "--'"' — _. __ ...-__.—. ___.... .___
oinplefim,he owner-builder,will have he hadmaf rinsing modhedid out wildor 105 - ANCHOR BOLTS ) "
improve I.,puryme°f al,l' 106 - SEWER & WATER
11i:asowner (thepr,;prty,gime.las'W;contractmswithaosedconGeiomSi 202 - UNDERFLOOR"PLUMBING-_._._
<on,wct he project(Sec.71X0,Busing,and Profc,:ion,Coae:>rhe connector, 2 0 3 - UNDERFLOOR MECHANICAL'
License law does not apply m,n owner of property who builds or improves hereon.
and who eommels,a),,smeh pmieR,with a contractors)liaenud pursuer,as he. . _ 204 UNDERFLOOR -FRAME
Contractors License Law.
❑lam exempt ar,Jer sec. .BePcfor lin reawn 205 - UNDERFLOOR' INSULATION
owner Data 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER
I hereny:lfdrm antler peamty,of perjury one of he fo0owhg declaration,: 303 - ROUGH MECHANICAL
❑ I have,ad will ra mitia a Certificate of Consent to If.....a h,Worker, 304 - ROUGH ELECTRICAL
.t Cariammaion, as pmvidcd for by Station 3700 of the Labor Gide, for the
performance onha work hr which.his pem,gis issued... 3 05 - FRAME
❑1 have and will maintain Workers Coinpensatwn mann,,as regaired by Section 306 - HOLDOWNS
37M of he Labor Code,for he performance of he work for which his permit is 3 07 - INSULATION
issued My Worke'sC pc r' Insaranm c. ',rand P°I'cy umber.,.
..a.m....,....w..� .__..----. .__
�tJr +Porn "}} 308'"'S 'SHEETROCK'"-'-"`""'`"'�"' -
J"
ERT Af1ONO'EXEh ONFROMWORKERS'• .laY:ali X309 t_tyEXTERIOR "LAPH'•
COMPENSATION INSURANCE s` r - _ LATH—
(This union need nm be completed if the peen is far doe hundred Julian
uloo)orl... 311 - SCRATCH COAT
313 .._: ROOF NAI,L.:...
I certify+hat in the pe f f thek f which Ibis pv 's ,sued I - �.
shall not employ any perwo in any mannerso as h becomesubject to he.workers
Laws of California.Date 501 - FINAL ELECTRICAL '- ENERGY
Cnmpcnsaion
Applicant 502 FINAL PLUMBING ENERGY...... -..
mi„wun<eeemedrodeca. 503 FINAL MECHANICAL
O 0 toahw acO ply%sihAa alt after
atnthihi,cenhcmeolEaem h.......n°md 504 _. FINAL BUILDING E ENERGY
e v
+rcome subject m the Workers Campcn,atian provisions of he faMsr Code yon must ENERGY .,_
Z comply ni provisionspc
; CONSTRUCfION'LENDING AGENCY ' 505 - FINAL ELECTRICAL
1 httchy affirm that,hem'is a construction lending agency for ire pertnnnance
ty of Me work for which this panni(is issued(Sec.3097,Cis.C.) 506 _ - GAS TEST
o ise :Cs nae 501 - FINAL PLUMBING.
.V.0 rrlythat Ihave ream peter albove information is 508 - FINAL MECHANICAL
m E.. correct.I agree to coomly withill city and county ardirrinces andvf relator, 509 - FINAL GRADE � e
O U nobdd gf fin dl by authorize representatives fthi city to nae upon
he hoe eat node pert ( inspectionprpo- 510 - FINAL PLANNING
G (W)aolm,tis d 'fY dk ph 1. heft} rC perm,against
liabrt prisoners. J expenses h n any y read,against id 514 - FINAL PUB IC WORKS
U Z City' consegaen<effinttl.,,g Ili pe 1 fi /aPYLICAr T 1 NOBND ti'IIJ.CO\IPLY N'ITH L O]POINTIssued b Dates cr 1=.c DEI� Ytgvt ¢, A pliu _ Dais- Re-roofs
HAZARDOUS MXrERIALS DISCLOSURE
Will the
a pplica( r future wilding p m;store or handle narrrdm,s m t I Type of Roof _. .. ._ .. _....�...._..-. .... .... .. . ...._ ._. . _...
cs d i V by nh Capsri n M e pal CW Ch p( 9 12.radius Health and s f t ,
,vle scf 7,5537,0 - i. , 't: VY'. (,.;;'d sT?„ 7,5;.4. it
oY r �`�N° t `1 _ All roofs shall be_mspected.prior to any roofing material being,installed.,,, _
Will( pplic n future buildingrca pant use equipment ordevices which If a roof is installed without first obtaining an,inspection, I agree to remove
mit hazardous rconn t s defined by the R3 Are`dA 0 al t. Management
Dimmer, all new materials for inspection. Applicant_understands and will comply with.
....ore, _ �.va-.. . - .... .. .. .. .-
- � -all��non=point source regulahons.:
I have readhhc hazardous materials requirements under Chapter 695 of he
Califomia Health h Sardy Code,Sections 25505.25533 and 25534.1 understand that _
iflhe buildingof
he e, Icuar,which
met me,my soI...aresibiliry ioificnefy of
he
«cupant of the r air mems which must bent,(prior m i.¢uantt of a C<nir<a¢of
saps"` Signature of Applicant_ Date
F ad age t n All roof coverings to be Class "B" or bettei
OFFICE