01070014 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR•INFORMATION:
BUILDING ADDRESS: PERMIT NO.
19929/79 STEVENS CRK BLV PINN BROTHERS CONSTRUCTION 01070014
OWNER'S NAME: APPLICATION SUB DATE
PINN BROS . CONST. 1475 SARATOGA AVE 07/06/2001
(-In HONE: SANITARY NO. CONTROL NO.
(408) 252-9131
O O ARCHITECf/ENGINEER: j BUILDING PERMIT INFO
py❑ BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
ZO 4 E 0 I hemby affirm thin 1 am licensed under provisionsof Chapter 9(commencing Job Description
PKI to with Sect 7")ofDivobon3arrive Businitsand ProfeesionxCde,andmylicense 7 RETAIL STORES
I,in�fu��CJr��cited aFfena� �(, - 5�( - (401050180 FOUNDATfq AWT
®
K 6 Liccai£Claa r✓' L'.M 'Y
D°r Y Con or
x� ARCHITECT'S
C O 1 understand my plans shall be use as public xcnrd.
JUL 21 2003 6 0 Licensed Professional
OWNER-BUILDER DECLARATION
1 hereby.Rhin Nat 11. exmpt redraft,C,,i...Ca License Law for she
?< following reason.(Section]031.5,Business and Professions Code:Any city or county
P A which requirtx a permit to construct,aline improve,demolish,or repair any xtrunurcjNr
ouc. -poor to m'ssuence.also req theappliant for such permit m fileaxrgnad statement - - - - --- - - ---------- -
that hesforemost roahmadstncrivonwassamcc..,.eaLicenseLawChirac,9 S FE,FIoorvArea nn+,• YY Valuation
(comm ng with5 tion 7000)of Divson 3 of the Business and Professions Code) { )�4 „ '^� K9'Ft.iA Fltr-AratiZ�iS.t -.11 y'i 4:
.,,bar he is exempt theref om and the had,for she alleged exemption.Any violation l
-of Section 7031.5 by any applicant for a pemut subjects she applicant to a civil penalty
,of a.,...than I,.hundred ddlare Will, APN Number Occupancy Type
01,asr of the propeny,u my employees with wages as their sole compensation, 101 - FOUNDATION
-will do thesolk:and the nmcdre 19 no,iatended or oBered for sack, tv ,7094;" ],O 2 - PIERS Required Inspections,
" "'••'
Businesi and Professions Code:The Contractor's License law does not apply to an q p
owner of property Who builds or improves thexun,and who does such work himself 10 3 - UFER _
or through his own employees.provided that men improvements am not intended or _.._______.........._..._—_.._.......-
.oBeredror sale.lr,however,the building of imm
proveent is sold within'one year of 104 ' .-. .REBAR-- .,,;r r,
completion,the owner-budder will have the burden or praying that he did not build or
imp..com,dri.,casale.). 105 - ANCHOR BOLTS
_.
co1;asowner ofthe propmy,oat exclusivelycontractingPrating withckda)Th contractors - -- '-�" PC:'it I:f
I:
construct the project(Sec.]094.Business and Profusions Code:)The commemr'x
202 - UNDERFLOOR PLUMBING ' "- "' k,
License Law does not apply to an owner of progeny who builds or improves thereon,
li -andwho commcts.for.such.projects.with.a.contracmrta).licenud.rursaant to.the. _. _.. __...._20-3•-__ .UNDERFLOOR--MECHANICAL..
Contracmrs License law.
❑lam exempt under Sed"' - ,'B&PCfor this main 204 - UNDERFLOOR-''FRAME-;'n
'Date205 - UNDERFLOOR INSULATION
s ;% WORKER'S COMPENSATIONDECLARATION 301 - ROUGH PLUMBING
I hereby alum under,penahy of perjury one of Re following declarations: 302 - TUB & OR SHOWER
4- I] I have and'will'maintain S Certificate of Consent in lelbinsure for Worker's 3 03 - ROUGH MECHANICAL
Compensation, as provided for by Section 3700 of the Labor Cade, for the
_ performanaoftheworkforwhichthisPermitai.sued. 304 - ROUGH ELECTRICAL
❑1 have and will maintain Worker's Compensation Insurance:as required by Section 3 05 - FRAME
3700 or Labor Co l theperformance of the work f which this permit is 3 06 - HOLDOWNS
is d.M ker's Compensatin Insurance camer agfl Policy number arc.
a �✓ 307 -' INSULATION. :_. ._ . .
.:.CERTIFICATI N OFtEXF-MFUUN FRO ORKERS'•" 'tt-IIIb Y �3 O S•+�f Y .S HE ETROC'Kw I
.w ..v.. COMPENSATION INSURANCP'. EXTERIOR--LATH _.—_.,. . r, ..._ ..___
•t section ne<J na be completed d the permu n f r rte h ndrtd dollars 310\`_ INTERIOR LATH `• '
($100)., '
less.)I
_31.1..._...SC-RATCH- COAT
1rearly that in the Performance of the k for which this p roti i is issue) l4-
Compensation
i,l o
sh 11 note ploy'ws person t any man m become subject to the Worker
313 - ROOF NAItElf
Cmpent, nLawx fCalifornia'Orae
Applicant _ 501,_- FINAL ELECTRICAL ENERGY___
'NOTICE TO APPLICANT If after making thCnlicarn of Ea ,l ed,you should 502 - FINAL PLUMBING ENERGY "
'bee rte subject m the Woke Compensation-p ' is ache Lahnr Coude you must
CZ forth th comply with h p isims ur this permit shall W deemed revoked,
Z O. _...----- --.. _..-----_-. - ____—_.. ... ... . _-- .__ -. --.-- 503 FINAL__MECHANICAL_ENERGY-------.------------ - ---
_E.,1~ " - -."'`CONSTRUCTION LENDING AGENCY- 504 - FINAL BUILDING ENERGY - "'•""
-a,' I hereby. mn dad th rc is iconstruction lendingagency(o the per(omwnce n
.W:.. ane iforwhichin,peet sued(Sc NA7Cr c)
a 505 - FINAL ELECTRICAL -
a. IznderxAame - 506
Z - GAS TEST
o Z a Address 50 FINAL PLUMBING' r
V G - ...
1 comfy th t l h re d th appl cat o d st t th s th b e informamn g
�r' :an act 1 g to comply with all city J county ora nances and 1 state laws rclattng 5 8 - INA. MECHANICAL
O" rabuilding constructorsand hereby nurture representatives of this arty to enter upon 5 9 - INAL E
the above-mentionN rt for inspection a xs.
P. .save. y., penkeep p ma _ .. • 51 - INA.
-Ii
(We)6gme tosave.an expennJ which
in an City of Cupertino against
y liabilities,judgments,chests and expenses which may in any way same against said
V-Z Cly i s q ea a ft t gof thispermit. - 514 RK
AP CI NT NDER TA SAND WI LCOMPLY WITH ALL 'OPoINT
. ro s ✓may Issued _ Date
c. Dam Re-ro4sO3 - 00 BATTENS
Sig r f pplI HAZARDOUS
„ Dae
: HAZARDOUS MATERIALS DISCLOSURE I (Jd R IN-PROGRESS-
W
Will the applicant or future building eccupant Wore or or hatulle hazadom matenal Type OT��RQOf - - -- - + •+ .-,.
c as defined by the Cri,pentim,Municipal Cod Chapter 9.12. d the Health and Safety
0 ys
-cod on zss3z(a) a.. -r '1 >t -' t 7' rZ!�,•i:9 :, -
I All roofs shall be Inspected prior-to.any roofing material.being Installed
) N '
W Il th appli ant or future build ng a cupant use equipment- devices which 'h
r .
.
oat h N- 'chatmardasdefinedbythBay A.Air QltyMamsgnneat Ifaroofismstaped'ivitfiou[firstobtaininganinspect5on'Iagree-toremove
o t ct all new materials for inspection.,,Applicant.understands,and will,.comply with
ElY 511 non-point spurce regulations,;
1 hood read the hazardous materials requirements undo'Chapter 6.95 of di '
California Health&Safety Code,Sections 25505,25533 and 25534.1 understand that
'-if the b tiding doexn c rI have as ttbarI', respond bility to amity the -
ocapan ru f th q rt core wh h
in sr he met p' r ro is _ is
a Certificate of
°c Signature of Applicant Date
Sl�aD�Oe _ _ ... .
ownerora onaeaagent Date. All roof coverings to be Class"B"or better
OFFICE
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