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04100056 CITY OF CUPERTINO -- -- rw»<d.�=r,:a•; c:; ;.w'. . BUILDING DIVISION PERMIT -.CONTRACTQRINEORMATION:`= BUILDING ADDRESS: PERMIT NO MATHARU BHOPINDER 04100056 121828 AT, ARAR AVF - --_ — — - ---OWNER'S NAME.NAME. PERMIT ISSUE DATE MATHARU BHOPINDER 21900 ALCAZAR A17P � n-/nA /')004 E: SANITARY NO. ' CONTROL NO, ARCHITEMENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Y F 1 hmeby afrw Und l am licensed umler pmvldom or Chapter 9(commencing I lob Description <Zu, with Section 7")of Division 3 of NC Business and Professions Code,and my license is - _ - - - - r,a. mmRforceandeffect. REVISION--BAY WINDOW/STRAIGHT WALLS j ttg z License Class Lk.a K;:o D,m Contractor NO NEW PERMIT ISSUED/ ORIG. #04060017 ARCHITECI.S DECLARATION �y I understand my plans shall he used as public=Or& JyU o Licensed Professional S OWNER-BUILDER m DECLARATION 1 WreM1y.(Sect that 1 I.S.exempt from the Cmimms Co License Law for the O O which reason. paint I ](13 1. Business and Pmfesstons h.m Any city or county $� which requites a pennis to construeL alkr,nnpmve,demolish.m repair any swmure -ai prior o is issuance,also requtra the applicant for such patent to file a signed statement z< that he is licensed pursuant ft provisions of the Continuous Luenm Law(Chapter9 Sq.Ft. Floor Area ValuatiG�115 set-$ (commencing with Section 7000)of Division 3 of the Bnsiness and Prefessimns Code)a .. that W is exempt therefrom and tW bon for the alleged exemption.Any violation of I - Section 7031.5 by a"applicator for a permit subjects the applicant to a civil penalty o. : - APN Number Occupancy Type not mum than five hundred dollars(SSW} ❑I,as no,or de pmpcny,mmyemployca with wages as NUr sole compausai ; 35714050 . 00 will do thework.and the owmure is mtmteMW m toffined forsale(See.7W,Btavness and Impact..Code:The Contractors Licem,Law does.1 apply to,n owner or Required Inspections - propeny,who bulldsminsprows thereon,andwho deesaucb work himself orthmugh his own employes.provided that such improvements K mumteMW oraBesed for We.If. , however,the building or improvement is sold within one year of eempkuon.the owner- builder will have the burden of proving that he did not Wild or improve for purpose of sale.) � 1,as owner of the property,am exclusively contracting with licensed contractors to O construct red pmlees(Sec.7044.an Business of and property whdons Cade:)TW Cs Wheat'. n come law dots not apply je an wish a of pmpertY wce Wilda or improves thereon,and whanbc contracts a for such pmjecta with a eonuactor(s)licensed pursuant to the COnmemis license law. 0l am exem Sec .B&PC(rUs mazon own WORKER'S COMPEASATION DELL AN Xmby affirm under penalty of perpry one of the following dedanuons: have and will maintain a Ccnirute of Consent to self-insure for Workcr's Compen- ution,as provided for by Section 3700 of the labor Code.for the peformance Of the work for which this permit t]issued. ❑1 have and will maintain Wurkcr's Compensation Insurance,m reymmd by Section 37W of the Labor Code,for Use performance of the work for which this permit is caamrL My Worker's Compamauon Insurance amm and Poitry number are: Came,: PoLry No- CERTIFICATE OF FXEMMON FROM WORKERS COMPENSATIONiNSURANCE j t (This section reed not W complemil dthe permit rs fmane hundred dollars(SI W) or less) I ceiufY tb' the perfnrmance of the work for which this permit is issued.I shall not cmployany t many mannersoasto me subject m the Warkess'C9mpcwtian Law of Calif i n App ream I a'�— N C 4PLICANr:IL after making this Ccmftcam or Exemption,you should cco object to the Worker's Compensation provisions of the labor Code,you must ., z N comply wM SUCK pttvtatons m this permn shall be dcemcd revuWd. Z Q CONSTRUCTION LENDING AGENCY 'e+� I hereby arm that that them is aconstractiton lending agency for the Performance of lla be work for which this pectin Is issued(See 3097,CO.C.) f+d Q Lancer's Nam- = z lancer's Addm­ V C) I comfy that 1 have mad this application and state that the above information is I,, f' correct.I agree to comply with all city and county ordinances and sole laws relating to 0 building conswction,and hereby suthonm rtpresentativs of this City in enter upon iW i y. above-nummocd p.,,Iy for mapection purposes. CL (WC)agree to,ones indemnify and keep hay I.an w y of CYpenrta against y I /�( h inconsequencments.grassing exyemeowht. may in any way acrncagalnstsud City � I// V z to consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-PPINT i Issued b Date SOURCE Tr.1L,A710NS. kZ4�(U4- ` i/oi p'I! �,� �J ` I Re-roofs Sign lor6af ApplisnUCOnRDO ✓ pale HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant future building occupant,Chpt store or handle hazardous material as dcOned Section 25 Cupertino Municipal Code.Chapter 9.13.and tW Health and Safety li Crsk, 7 Yes 25532(a)a All roofs shall be inspected prior to any roofing material being installed. Yes Nu If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or fu um building occupant use cyuipmem or center which I g P g t humrdous air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection. strict? ❑Yes I have read the harardo akrialsrequiremcnts untkr Chaporh.95oftheC,lifor- maHealth&Safety Code.Sictons 25505,25533 and 355341 undcumnd that if tW Wilding does not currently hoc a tenant.thaut is esponsihti hit k notify inc occupant of the tern mch mum W me,pnaran a` o ,cemrcamofgeDupa,my'© Signature QfApplicant Date J r or aUlhmacd sgcm �,m All roof coverings to be Class"B" or better