08060247 CITY OF CUPERTINO -�- -,�..-:};.:j, .- ,. . , f•"x'�
BUILDING DIVISION PERMIT -aCQNTRA.CTQR INFORMAIpN:
PERMIT NO.
IawLIQ,Agl�a ALCAZAR AVE TBD – TO BE DETERMINED _ 08060247
2S
NEWS NAME. PERMIT ISSUE DATE
WILLIAM ROWAN _ _ 07/01/2008 _
PHONE:
SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED COWMAMWS DECLARATION
m 1 bmcby of red that I am licensed under provisions of Chapter 9(commencing Job Description
with Section 7")ofoiAtflon 3 ofthe Business and Profession code,and my license is ADD 157 TO FRONT BEDROOM, 500 SQ FT TO BACK
5°q 3 uanm Chinaad`n`tt Lc.g BEDROOM AND BATH ADD 625 SQ FT TO DETACHED
=�° Date ARCHITECTS DECCLARAMON WORKSHOP REMODEL MAIN HOUSE
e I undereand my plans shall be used as public tecorda
U
leo Licensed Professional
OWNER-BUILDER DECLARATION
i 1 1 Wrehy alrnm that i am exempt from the Contractor's License Law for tW
O O following mason.(Secuan?011.5.Business and Rafesilons Dude:Any my or county
U 3 K which requires a permit in arms rest alter,impmva,demolish.nr repair Ny atmaurt
qei prior in its issuance,also requires the applicant for such permit to Ole assgned mtemcnt
< methenlac enscdpursuentt ateprovishositicC omrocwr'sLeon.Law(Chapter9 Sq.Ft.F1oorArea Valuation
r $ (commencing with Section?000)of Dhvmon 3 o the Business and Professions Code)or I 50(]0Q
Nu he is e¢mp temfrom and the basis for do,alleged eumpdon.My violation of
Section?851.5 by any applicant for a Permit sub)ccle the applicant to it civil penalty or Number Occupancy Type
not mart than live hundred dellvs($500). 35715 0 6 8 . p y yp
❑1,se ownm of to Pr.Pcny,or my moploycat with urges as Ness role compemdon,
will do the work and the structure,is not intended or offend for sale(Sec.7144.BuRnm
and Profeadons Cade:The Conmcuses Lemue Law does not apply to an awmr of Required Inspections
properly who builds or improves Lemon,and who does such work him W f or through his
own employes,pmvided this such Improvcmcnu art not intended or offered for We.If.
however.Use Wilding or impmvwent is sold within ons year of completion.the owres,
budder will have the burden of proving that he did not build in improve for purpose of
sale.).
1,as owner of the pmpc thy,am exelusrvely contracting no licensed..=to.m v
construct the projcm(Scc 7W,Business send Professions Cade:)The Crui is L-
come Law does not apply to an owner of property who Wilds or impm es tcrcon,and,
who contracts for such projects with a conuacmr(s)licensed pursuant to uW Contracmes
License Law.
❑lameum I ,B&Pcror Is
d? v Dae
ERS PENSATION DECLARATION
IWrcby under t o Perjury,card of the following declan ns:
❑Iha.e and wit for by eCwrioe of COnsesnr self-0nsurtrarWfunmeCompn-
saVOn,for for by Section 5700 of to Labor Code.fm to peAonnan¢of to
work for which this prmit is issued
❑I have and will maintain Worker Compensation Ihsmrance,as required by Section
3700.f the Tabor Code,for the performance or the wort for widen to permit is issued
My Werkera Compemamm insunot.artier and Policy numbcr are
Gorr- _ Policy No
CERTIFICATE OF E%EMPnON FROM WORKERS'
COMPENSATION INSURANCE
or to..) secuon need not W completed If the Permit Is far one hundred dollars is LOO)
ss)
1 cendfy that in the zonce nor of o far whleh this permit u issued.I Nail nor
emplcyanyprson, man m rectrote Wmkesi Comrcwtion
Laws of GJl��r(9^��L��L�C$t{�.y� a�i w _ �y)
NOTICE 10 APPl1GPTr:-IZr making this Cc%arc of cm- Fs plan,you shwW _
listens subject in to Woher's Compensation provisions of de Labor Cade,you must
.,O forthwith comply wait such previsions or tss permit shall W deemed revoked. I
'Z...'" CONMUCf10N LENDING AGENCY
[r.�., 1 Wmby affirm des there 4 a consuucunn lending agency far de pMUrmanm of I
ce the work for which this p u issued(SO,.3091,Civ.C)
ow "nifir.Addre,-
U.
V Q 1 wree that 1 have red this application and sue des and sedan information u
tg, carton.l agree te comply with ill coy and county matim of and sue laws relating e
� building conighm,a.cmdhamby mtonm rtprcsenuuvus of this atymenter upon NC S aWve-mcnured property fm inspcnion Purposes.
(We)agree to sase,indemnif and keep harmless the City of Cupemno against
liabilitia.judgmenss.cosu an wh¢hmayinmywayac agmmtnrdcity
z APPLICANT`UNDER a hN WILL COMPLY WITH ALL ON-Pot Issued by Date
SOURCEREG TI _
/9 Re-roofs Q
Sit^uurt of Applic�nV n to Derc
Doses ATERIAIS DISCLOSURE Type of Roof
WiBtheapplicamor ilding oavpantmort orluMle hamdow matuiil
as dented by the Cupertino Mensn 1 Code,Chapter 9.11,and the Health and Safety
ode,SOYes o uon 15532(a)7 All roofs shall be inspected prior to any roofing material being installed.
Will to aMlmam or furore Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
call hvaNnus mr conuminanu u rhmd by to Bay Ama Air QW,ty Managcmem all new materials for inspection.
DuuhcO
❑Ys. Nu
i ha-o"d maenalsrcgmtemcnss under Cupter695ofde[ilhfar
ma HCalthm`o" 73"ft,533 and!15534.1 undcraund des if the Wilding
dos not cum tat Itt a my responsibility to duly to me���aaannnt n the
rtym ma tmount. uvecor,cerurw.merOcapapty. Signature of Applicant Date
owne oath ascot All roof coverings to be Class'A."or better