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CITY OF CUPERTINO
-" "" t: - f','
BUILDING DIVISION PERMIT
'CONTRACTOR INFORMATION: '
BUILDING ADDRESS:
PERMIT NO.
850 ALDERBROOK LA
DANIEL & DESTA DUNLAP
01090121
OWNER'S NAME:
APPLICATION SUB DATE
DANIEL & DESTA DUNLAP
09/28/2001
,PHONE:
SANITARY NO. CONTROL NO,
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
'
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
with i I hereby affirm that l am licensed under provisions of Chapter 9(commencing
Section 7000) of Division 3 of the Business and Professions Code. and my license
REROOF.
is in fall force and affect,
Li.ryx Class Lid.#
"
Data Contractor
ARCHITECTS DECLARATION
j1 understand my plum shall be used as public mcords
Licensed Professional
OWNER- BUILDER DECLARATION
1 hereby amrin that I am exempt foramina Conuactnr's License Law for the
' following reaxon. (Section 703 1.5, Business and Professhava Code: Any city or county
i improve, demolish,
$2000
which require a permit to consumer, alter,
which or repair any structure
i., prior oits issuance, al q" the applicant for such pemduo Gk a signed automation -
_ _ ,_.. -
' that ha islicanned pursuant to Uf provisions n 3 o Contractors License Law (Chapter 9
(commencing with Sermon7(X10)of Division3of the Bu6mesf pod P�rofessrons Code)
1 q „- {
t. (s s { 1�3 9 �' r."tJ� rn ( 4 1 { { 1 Valuation
or that be is exempt therefrom and the bass for the alleged exemption Any violation
t
- of Section 7031.5 by any applicant for a permit subjects the applicant in a civil penalty
-nr nits mntn man five hundred dollars (asno).
3 0 51PNlj'g ., ' Occupancy Type
'$1 :as wit cethe property, ormyarad.,ees with wages asibousoleemaisa cation,
- t
do the work, and theimmature is not intended or offered for sale (Sec. 7044,
,will
`Business and Professions Code: The Contractor's License Law does not apply to an
601 - ROOF TEMPQu4DURnsp'ections ' t' `' '' •"
owner of property Who builds or improves thereon, and who does such work himself
or through his own employees. provided that such improvements are not intended or
602 - ROOF PLYWOOD NAIL
emd or sale the ll lain
r g or improvement i Id - within one year of
completion
" `
- 603 - ROOF BATTENS
c wrier
the owner -builder lder will have the burden of proving that he did not build or
improve for PUrp °sa of sale.).
'
604 - ROOF IN- PROGRESS
am with licensed to
El 1 asut
the p(Sea
7, Basin., d Preding
icewn the present (Sec. Ito Business and Profess ohs e Cmdrtnrs
in The tmmors
1
License Law dots not apply man owner of
a property ills-
who builds se improves thereon,
improves
.and who a conou
for such projects with n comruaor(s) licensed pursuant. to the
'
e. Livens.
Contmmor L 4
'
El spaph Under '' -' B &PCfor this reason
o:
EN
WORT ER S C PENSATION DECLARATION
'
F1IVALED
I hereby affirm d p lty of pe 1 ry f the following declarations:
° 1 h d'will -mans a Cenific t of C' sent on self insure far Workers
Compensation, as provided for by Sect 37M of the Labor Code, for the
DEC 1 9 2001
'performance of the work for which this permit is issued.
° 1 have ntl will meinto n Worker's cmapenautionnintiou.seas required by Suimbm
3700 Witte Labor Cede for 'he perfo tt f m ork fo which this permit is
BUILDING
issuer. My Workers, Compensation t er and Poly number _
'Policy No :.
f CERTIFICATION OF1EXEMPTION PROM�WORKEIZIS ; ""
"i
Y t3 -.
- - -• i l , v„ „ i ra< e J '6,� Iy, -b J
COMPENSATIQN INSURANCE ""
r ....
...
(This section n d d be c°mplet d if the permit is f one hundred dollars'
,.:, ......_. __, ._. _
'
fb 100)or]a.)
f
s" Iearthly that in, the perfnha&of the 'ok f" r which tu pe rihrd ra issedd
ur
-,
hall not employ any pao,mi n any men er so as to become subject to the Works.'
I "
•sir
Compensation Laws of California . De -
- Date
AppI ant.. ,..., .. .. ..
'NOTICE TO APPLICANT.
NT:IL after the of Code,
_
s
the Compensate provisions of Labor Code, you must
you must
bechwith
the Workers Compensation this provisionsll
1
forthwith comply with such provisions of permit shell b<tleemed revoked.
Comply be deemed
CONSTRUCTION LENDING AGENCY
1 beauty affirm that fund is a constructioni lending age cy for the performance
of the work For which his permtrsissued (S 3097, Civ.C)
- TiodetsNme' "'
Lenders Address "
„ Isertify that 1 have reed this application and state thenhe above information is
' „treat.
-
I agree to comply With all city and county ordinances and state laws relating
m building conmractlon ;arid hereby cannon representatives of this city to enter upon
the above- memmor, property for inspection purposes.,
-
(We) agree to save, indemnify and keep harmess the City 'of Caperiino against
liabilities, judgments, costs and expenses which may in any way accme against said
`CANT
Airy
U DERST g nt rig WI pe t L ' -
APPLICANT, UNDERSTANDS AND WILL COMPLY WITH'ALL NON - POINT'
k,
SOURCE REGULATIONS.
/VJ
Issued by: Date
Signatureof APPbcanVCmnr9cmr'; .'::
Re-roofs
'? HAZARDOUSMATERIALSDISCLOSURE
,
the applicant or future b Id g occupant store an h the harsNws materiel
p a of Roof, -- - • � -� ....
as defined by the C32ut M t pal Chapter 912 and the Health etM Safety
Cde Suction 25532fa) s➢ + r
- i . y - f
°Y 6 °"
i•'
All.roofs shall be inspected prior to any roofing, matenal.being installed.
< t hWill applicant Wilding occupant equipment t m <n
x d f he
If a roof Is installed without first obtaining an ms
- ecdoli T'a' ree.to remove
g p g
mis combinational, . Management
Sd' y Y A Quality M nagement
Disposal
-
all new materials for inspection. A beans understands
Bay Area
°YeB 6@/
i.
p PP and will comply with
y ..
all non -point source regulations: "
I h read ale re
aten q nder Chapter 95 of the
Safety Cca
Safcur Code; 25533 and 25534. I a that
if the uil ing dos have to ant, that ity to aand
if Nab building does not sly haveamne ttis'myrcp 'rb "Ily mnotifythe.
occu m of the require t which muss b t uni a
prior to of Cendid tc of
Y. '+ "' '" ' .:'
�.
Signature of Applicant Date
All roof coverings to be Class B" or better
n<r qr au,nprixea agent I- .pave, :, .
..
OFFICE...-. ..