02060153 (3) CI mvwoNO
BUILDING tNPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
862 E ESTATES DR EARTHQUAKE READINESS 02060153
OWNER'S NAME: APPLICATION SUB DATE
MICHAEL TAERLEY 236 STANFORD SHOPPING CENTIR 06/24/2002
HONE: SANITARY NO. CONTROL NO.
(650) 324-3322
O O zO ARCHITECTENGINEER: BUIL-DING PERMIT INTO
w E BLDG ELECT PLUMB MECH
5z.
zv I_7 C-1 --- I--
LICENSED CONTRACTOR'S DECLARATION Job 1 ' tion
I hereby affirm that I am licensed under provisions of Chapter 9(commencing
w wires do ]turdeine..��aProfession,ewe.,nemyr<en� SEISMIC UPGRADE . p
m y is In fret Kv and C 'aw
Oes,yu License las Lic.n
UD e Com ror q G
3 w ARCHITECT'S LA
RATION (�
F.LL O ni4.Qi 1 understand my plans shall be ave public records , J ai
w }p e(�
`5 Licensed Professional '�
OWNER BUILDER DECLARATION O1•tl/�
^_ 1 hereby off,.than I am exempt from the Cratior f's License Law for the
t z< following reason.(Section]ons.aamne:=and Professions etde:Any air of county
,91 ce=e which requires a permit to construct,alter,improve,demolish,or repair any strvcuu e. 5400
`-etProm.to tin isswastce.also requires the applicant forsuehpermsmmm
it wfileasignedem. _ __ _ _
a.3 m Brat ha is hmnxe pursuum tq the po s'ssions of the Conuacmrs License Taw(Chapter 9 Valuation
fcnmmeti<ing whh,Simian]O)o+ f Division 3 of the Busmcs and professions Code) C{I_'1•.1 '6 24F�O I�Or ea,. . .t'p--.f�
or that he ii diem t 1hciefrom and the basis for the aIle eA diem tion.An 3� t. 0 0-1'S\-i irk l
P 8 P Y violation 1
of Smtiw 7031.5 by any applicant for a permit mi the applicant to a civil Penalty
Occupancy Type
of no mothan five hundred dollars re APN ��rr ff���n�e��
101 - FOUNDATION
CIo
1.as wner ofthe prop ry,,or my employees with wages a,their sole compensation. "`
-will dobe work:and-be'Swnure'is-not intended or offered for sale(See.7Wa; - - - - -- - -- -__
'Business and Professions Code:The Contractor's License law docs not apply to ea 10 3 - UFER Required Inspections 1" �•
owner of pmpeny Who Wilds or improver thcoam.and who does such work himself
nrthrough blOwn howeveres. builded inthrtrfip iebentcmenmare nmonintended of ._.-1.04_.._._REBAR_ _._ .__—.
"-:oRcieJ firs rule:IChowcvcr-the Wildin "" I_ ---------- ---- -- -- - --
g of improvement ngsold within tint ycm-of 10 5 - ANCHOR BOLTS `
completion.for the ower-o deer will have the burden of proving that he did not Wild or
V.
improve liar purpose nr sated.
106 SEWER & WATER
as Owner propenyam euinivelycomrvct contracting Jconva<em'o 202 - UNDERFLOOR PLUMBING
coniwd the project(See ]6W.Business and Professions Cede.)The Contractor's
c
_
Licari Law d«.not apply to an owner ofpmpeny who builds or impmvr.tharcon, 203 - UNDERFLOOR MECHANICAL_'
-and whosu
.contracts for" ch ptojects.with a.conrommrfs)licensed pumui Ne_
eomm<tnrs License avis 2 04-- _UNDERFLOOR":FRAME" _-
❑IamexemptunderSre.,""' '';B&PCfonbisreaxon 205 - UNDERFLOOR" INSbartION
Owner Data
WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING
ZT " Ihereby alfinnand<rPenaltyofperjuryone of the following declarations: 302 - TUB & OR SHOWER
303 - ROUGH MECHANICAL
❑ 1 hadc and will raminoin'a CeniGrie of Consent to self-insure for Worker's
r7 Compensation. as provided-for by Section nor of the Labor Cote, for the 304 - ROUGH ELECTRICAL
- ' - rofm
perance of the wefk for wMeh his pepnit is issued, . 305 - FRAME
111 naveand will maintain Worker's Compensation Insurance.as required by Section 306 - HOEDOWNS
- 3]00 of-the Labor w
Code,for Ne performance of the ork for whicM1 thisSection
ea ,3 m.af < c efama cit y x 307 INSULATION
.xs y
I rNoc a. ^o27.Qfuf'�Pcsji 308..Y SHEETROCK,,i�.,;d,,..;
�/ [1 CERTIFICATION O EMPTION FROM WORKPRS a Q 4 J G 3 019 q 'EXTERI ORs,LA,I,H
i/ _ COMPENSATION INSURANCE.a^
I . . .._- .._
': ---" I- _ ................. ...._ .._ _......
" ' an t on'need not W<omplema one pnfmn�a f ,nr nomarea eou,fa 310.':'= ' I'NT&R OR� LATH-- „ , .; �; • ;
fsmo)orl"x) 311 - SCRATCH COAT
tam oo Laan nt vii
a Dme",fen a k f th h 1h _ -...: „'. ....._ .
I nB tit n :amts 1 - _313`....."ROOF' NAIL,;, t I, I., „ .... ..._. ....
ico t of v r T< r at in neutme a M1)cc m the Workers - 1
cep 501 FINAL ELECTRICAL ENERGY
"locamZ .
r nee bdf 1 PLI1 1L fl t k p mtiahal-orl be Est al yeas d "502 -- FINAL PLUMBING ENERGY---
CAN -
meWorker,C p sale p 1 503 - FINAL MECHANICAL ENERGY
an npmv. o n
T NONCE 1 O AP
gin cel t to pi y n
s
O Q forth the ply
504 FINAL BUILDING ENERGY --
CONSTRUCTION I ENDING AGENCI
a=> Ihrelry ff meth eat t nhaen, ,ca,torthe rron.brom 505 - FINAL ELECTRICAL. .
of m work for which thPc t a smell(Sec 109],C'v,C) '
_Led N _ ... ,_ _. .. _.. .50.6 ..--_GAS
p z Le° Acidic,, - 507 - FINAL PLUMBING
U O Ir urrth ill a n appli r n nd.1 remmm n < f tin 508 - FINAL MECHANICAL
'coir 1 gree mco
g mi with Il, iiyiJ ui ordinancesod.tt srclaing
O.V tnb IJ .nuaii d herebyautho' ep - tmlvex ofins city to enter upon 509 - FINAL GRADE
m
he b roProperty de p ro 510 - FINAL PLANNING
A; r9me to udeoram and keep h rmlessme C'p fCuP n'nougainst
W liabilities,judgments,cot d expenses och may n any yaccrue
c gainsi.and 514 - FINAL WORKS
U z Loy n o q &of thejointing tth pe t r
APPLICANTUNDERSTINDS AND WILL COMPLY WITH ALL NnN'OL 1 v
OURCF r 'LM'i s 6 Issued by: ;✓ Date
CHq.(pc N knav ( _
§ignpmre of Applican broacmr : Date Re-roofs
t HAZARDOUS MATERIALS DISCLOSURE'''"
Will the applicant orfuture Wilding oc apart store or comic hat.Nous mmelial .of Roof..
•as
de f cd b 0 C sane the Health one Safety ..--.Type
Y Cupertino o Municipal I Gd Ch pee 9 1
Code 5 dv'..i1 la)\. r ❑N 1 4" 1 '["I ^ 1 t, s lf'.0 3
OY`- ` I _ All roofs shall be inspected poor ro any roofing-ma[enal being.installed. _
w II he or furore Wilding Occp nt use iaptipearm Or a ice,which If a roof Is installed without first obtaining an inspection; Pagree to remove
emir factitious rnm nam¢as defined by he Bay A4ako Quality M agement
.•Dix' ' - - _ all new materials for inspection. Applicant understands and will comply with
❑Yrs Otho P. PP. P Y . "
. . all non-point `source regulations; -
I have read be hty Code twmns 2 requirements 25533u under 4,1 an erar of the -
Celifo of Health&out
coli Cote.Sections 25505,l it
dna 2553a. undersmnd that
' if the Wilding does not comedy have cannot.that it is mY msponsibiliry to notify me - ------
Signa
----- - --- -__
xapam mf the requircmems which must be ren poor m iamancc of a Cenificme of '
Signature of Applicant Dae
f eau J lir c— e -.. F
Q au nue agent,. — Dam All roof coverings to be Class "B" or better'
a. ._ .. ,. . . . "_. .. OFFICE -. "". . .