02060018CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
PERMITNO.
10080 N. WOLFE RD
APPLIED CONSTRUCTION TEC 02060018
WNER'S NAME:
APPLICATION SUB DATE
IENLO EQUITIES
10050 N WOLFE RD, SW2-28 06/04/2002
PHONE:
SANITARY NO. CONTROL NO.
(408)252-9990
ARCHITECDENGINEER: -
- BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
Job Description
I hereby affirm that I am licensed under provision of Chapmr 9lcommencing
with Section 90001 of Division 3 of the Business and Pmfasions Code. and my license
* NO CONDITIONS
s in fall Immoral effect.
Liccns Chis Lin..
Dae Contactor
ARCHITECT DECLARA I N
I i ndersmnd my plans mall be usN os public records
Licensed Pmfossiowl
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following mason. (Section 7031.5. Business and Professions Cade: Any city or county'
6 O O 0
which requires a pem,it m construct, alter, improve, demolish, or repair any sweture
. Prior to its issuance, also requires the ri"Iicunl fur such pamot to file a signed suremern.
-
duthglslicenseUparmangm the provisions of the Contrect«'s Licentt Law (chapter 9
SectioniOWJof Division 3ofthc Businessand ProfSssions Cale)
Sp .,yq�I Qpi'{n�[�a..,
���)'1,tA2F(f.V�64 �i:(1.i
Valuation
(cobbmwcing.iN
or Rai he Is eaempi Nc&frbm'and the basis for the alleged atern iod. Any violation
.,V'U; (S p13.1'
-of Section 90)1.5 by any applicia l fora permit subjou s the applicem m a evil penalty
of am moreman five hundred dollars ($500)
Occupancy Type
304AP_NftELECTRICAL
CIT. as owner or Rhe pmperty, or my employees with wages as their sole compensation,FINALSLEC-TRIGAL
ENERGY
50i_
-will' do' the work'. and the sducmre isr not- intended '.1 nliertd-for sale-(SeCTM4,-
Bdainaa aced Proresaiom Cade: The Cummlom's License Law d«s not apply m on
- - - _- - -
505 - FINAL EL15GTiR4 LyAEclions l''' • ; -
or r or property Who builds or improves themon, and who does such work himself
or through his own employees. provided that such improvements not intended or
di
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within
improve Yao
-"dffcad'roTsblc lf: hfiwcvcCthc building-orimprovement is sold within one c- f
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1-•-''`Pl ', , •.
the owner -builder will have the burden or proving that he did not build or
oprove
improve for purpose oLsolc),
for
' vel I t th l' sW .. contractors
C71.m ow of tbepropcnY I - y gw,
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comhdct the prej t (S ]641 B J Pref n Cod ) ThC I t
o - ,
Lo does oat a l t f n who buil)improves Ri
property
prolcc prs Loth
_ andewho.convac¢ fors h is with. caohvaor(s). licensed dam
contracts
-
Contmcm LawY r
❑IalScaem funder see:'' B&rCrortms reaaan
Ownh •' r..,•. , r:: Dale„''`'f'I''
”' "WORKER'S COMPENSATION DECLARATION
one following declarations;
S
1 hereby alfimr under pcnaltypf perjury of the
❑ 1 have and 'will'maiu'min'u' Cenificote of Consent to self -insure for Worker's
Compensation, unprovided for by Scniom 39W of the Labor Cade, for the
Perfectionism of the work for which this tenth is issued. ,
U
I h o d ll'meina n Workers Cornpe moa 1- m cc readmit by Sect o
39W of thelobo Code fd the perform race df U k f which thispermit Is
i'slue s p t nn sumo a me
Cari
It
i n''s J n a s} r i '+ s :'s 1.2 A� Z i I I�'1
rl� 1 CERTIFlC ORKERS I
1
1 i
COM ENSATEONSIIRANCE
IThis uictioKnfednot be complumd if the permit is for one hundred dollars
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(51 W) or Ins.)
. t
_ ,
1 certify d pc f c f tl o hYh tIssueJ
_
it
tok.
ub ct
toy any manner m s id becomesubject m the Workers''
shs all not employ in any
w, of Cson
Dat
Comtion laws of Colifomia: Dau"
NOTICETO'APo after this or Exemption, ould
i'i,icmom
Compork-anong
Labor you st
the Wormi's previsionsof the Lobar Code, you moa
brthwit
or
forthwith comply with such provisions or this permit .hull be JttmeA revoked.
comploint such is
'
CONSTRUCTION LENDING AGENCY
' u ' I hereby aff r n that then is a conswci on lendmg agency fortheperrorinaett
s • '
sid he wiik for which this permit -s issued (Sec 3090 Civ. C)
-_... .
Lcnders Name-- ,..__._ us. ._:._ ....._... ..
__.. ... ._ ._ .._.._ ._. .._... _-�._... _._._._—... __ ..._
LeuJs'sAddress -
ly.
,.il Icenfy tom lha pPfpto nd.rd thho
rfonu
often 1 H t comply withIIclyari county d.tt I lawsrefining
enter
t bald ecce t n m authorizep tt .orlh. City to ¢r upon
/
nyfor
l the bu a I n J pmpcnY r pet Purpose,.
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harmless the pen against
IWcl agt vs d d keep h
hi wayity
may i acc
] city t judgments, and _expenses which y', any Y ccm< again said
—O Z�
Ijcosts
City c y rte at lheg i gar this per nn
LIC isN ONUERShh S A WILL COMPLY WI'1 tI ILL NON PoINT
_ LD1. c e s't$I
r
;,
Issued by: Date
Re -roofs
ignammof ApplicantlC tract« , :- -.oat
HAZARDOUS MATERIALS DISCLOSURE
" Will theapplicant rt building occupantstorer hadle hazardous material
...
... Type Of. Roof ._ .,..... _ _ _.......,,......,.. ._....___...,„
as defined by the C pc e M pal Cods, Chapter 9 12 and Ill. Health and Safe,,
Code S non `553''fal
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n
c:1. y1. , sn ..�. ,, , l -l.
.,�
❑Ye Na +
All roofs shall be prior to, any roofing,ma[erial being mstalled..
w,u lne ppl' t r t bade ng «cupam equipment a vices whim
_ -inspected
If a roof is installed without first obtaining an inspection, I agree to, remove
chair fiNous air contaminants as defined by the Bay Area Air Quality Management
Dist set
all new materials. for inspection. Applicant understands, and will comply with
r
❑r. rvn .. „
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all non-pointson ' Ice 'regulations. ,.
" tc l have read Ihmlb,,i doas materials mquimmcros'umEr Claptcr.6.95 of the
Celifpmla Health & Safey Calc Sections 25505:25533 and 25534 1 urchrsu d Ihm
if 0fc building class not curtrntly have Im...... has it is my msponsibilay to minify the
occ i' t f mrequirementship"'ust M t prior to is f a Cenificatc of
t
of Applicant Dae _
pi-,1,..,.._Signature
IJIISLI_� 1�n11(1( NJ U l/
All roof coverings [o be Class "B" or better
ow eroradtno aageal Date.
._..— OFFICE_It
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