01060101BUILDING DIVISION PERMIT I CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10146 ALPINE DR EXTERIOR SOLUTIONS 01060101
OWNER'S NAME: APPLICATION 5138 DATE
PARK NEON CHIU 1771 SMITH AVE 06/18/2001
(408)358 -1233
CONTROL NO.
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BLDG ELEC[ PLUMB MECH
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z z v LICENSED CONTRACFOR'S DECLARATION
I hereby atErm mar I am licensed under provisions of Chapter 9 (commencing
Job Description
z- M, with Section 7000)-( Dinum3of NeBisinessandProfessionsCade,andmyEccme
x f is in hill fora and erzect
RE —ROOF, 40 SQUARESERSO
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Lic. M
Dale I Contractor L x7T1 PI
0¢ ARCHfIECF'S DECLARATION (-� /Q,US
_COL
5 Otis- 1 undersund my plan shall be used as public records 1nNKC..
„u
w a p O Lensed Rofessronai
.. per-' LL
ce
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I hereby affirm Oat I -in cmp,Efrom the Cmdom rs License Law for Ne
i
z following reason. (Section 70313, Business and Prefiessions code :"city in county
f C which mOims a pmdt m ronsww, alter, improve, demolish or repair any swwurc
2 O 9 O O
- er "m us
p 5 ace al ^l tthe apprcan,fw xurhyr lufl Igoedstarenlerll
=3 m -
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h the Vi nw pun (N yrovswneof the Commas : L des
( ease g O'K IW 7000) f Division viCode)
Noe BUSrc odaL
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'� �'3,Lb�37lUj r,�V a'��'' y? %::'
Valuation
of Sec he Is comp therefrom and the pars fw the acts the mrcmpo to Any vroWroa
isfor Any
ofnn�um,Oth °�i.,wq�'""appramroar;vopenal,r
five hundreddol llarrsis5w
305 APN f )
.'. ., Occupancy Type
°Ld Owner my Cis.1iawiN wag contamination,
_ T
WO ,and me structure
"- wRi'dq Ne'work,-am the swcmre -is sI intended w oRcrcd for sale (sec. 70ii,
offmij for s
"Business
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601 - ROOF TEA&40F1l`Inspections; '
it Prbfessionti Codc: The Comraclor's License Law does not apply m an
Who
owner of property builds or improves theism, and who does such work himself
. or through his own employees. provided that such improves nu are not intended or
'If.
602 — ROOF PLYWOOD NAIL
-off d for sal how the building or dnplovemend is cold wnhm'*o a year of
completion, the owner builder will have the limited of proving Oat he did nut Wild or
... ._ . _. .. -__ _ _. _ .. ._...... - . _ - _ _ _. _. _
6 0 3 - ROOF BATTENS I .,'. ^ r -, •r
impownfwpwposeofsale.).
604 - ROOF IN- PROGRESS
_
—'- - - -- °- - --- - -- - -- --
am exclusively cumngmg withoeemcd snnucm is
❑ I: as owner of the pSec.
- - —. - -
_ _
omww 7C
(Sac. ]05i, cosiness and Code:) The i
- -
_ - -
Law ties no m, whops
License law dose no, apply m an owner of property who) tie, commit
or improve, dire
1
-
-_
0'
. and who cenvacts (w such projcwz with a covvac,w(s)_licensai p,m, - "• m ,he
ter
Conrimwx lxenu La
_
❑lam e..mp uMe Ss' ' .Bff PCfw Nis maven
rl
Owner -
- WORKER S COMPENSATION
I hereby afE de R arty of palit, of one following dee
Ipm EOcfoli mi,
j
edrc
1 have tit self-bmu for Wm:
Nfork
mvided] a Cby
C ion, an provided]
Compensat,ofthe:povidcd for -bY Sccdom3700 of the Labor Code, for the
Sirmom 37 o de the
pvfortmna of the work for which this prnnid is is mad, ;1 �
hnveand will eminerm Worker's Compemmion huuianq az mryirtd by Section
W of the izbor Cade, but ,he pMOmurcc
_
- -
of the work' for which this period is
issued.'M Ww e c numion Imo carrier and Policy number me. -' '
OO Z3 ���
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Gnier.'OQOTLC % /!lU : - '.Pdiry Na: •rQ,Q
'[,,CERTIFlCATION -OF EXEMPTION FROM WORKERS'
___; n- r +PF >- -. _COMPENSATION INSURANCE'" :'•::•' i
aioh need nod be romplem! if,he permits for one hundred dollars
-' ' < `..9 �'.il Y•' .
,IS 1001 Or less) ..
.'. it mfY thatmN pdormanec fthe' kformh hth permit ed.I
-n
_ _ -_• .•. (,`a� _ -, _. - -_ "_ ._� ., .
sh II employ any pe any man as ro become when to the Workers'
`
c pe set on Laws of Cal fo .Dal -- -
ii
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NOTICETOAPPLICAYT ILaBer.rtmk WsC nifieme E mpd ou You Nsld
Z
Q
become subject lb,M1<WOrke(s Compnsazron provrmons of. l-mcocode:ynummr
foMwith tly,viN
0
er m meh pmvitions w dus pmnir shall ha dxmd rewkM.
;
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._ �.. COYSTRLCnON L6.YDING AGEYCY
I "by atimn thin die ecutumifion lending i8 pq for the performance
_ - _ _.___ .
.,
the work for which thh permit is luved 3097, C. C.) '
•(Sce.
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Ldnde'r's Address. •. ... ' � ... -
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1 certify Out I have read this application and suu,hat rlrc abme information is
cwrettl d
1
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-re compY ball city dcounty ordinances d hit fits relating
to Wildi., motioned on and by ill s
au,h p didiv IN' ty , ceder upon
the bove -mend tined pr perry fo
cm time p r e ses
f~ d
_
(We) -rec to de n fy and krep hamdmsNe Cry Of Cupenmo.,,unw
V]
V
h
li b u red u es iml,m d n
pees which an
y n y ) ,insl said
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APPLICpN T equNenDce E Rof S TNAe NgDmnS,A in\e D of WILL COXIP L"Y'W RH-' LNON- - ' P OIVT
- _
SOURC EREGULATIONSt. < _`-C;-.
Issued by: Dale
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Siglumeof ApphcanNConlrecmt1..:. 1' .,, Dare
. x RDOUS MATERIALS DISCLOSURE
Re -roofs
'Will dlc hpplicarli or fiiwre building attvpant some ri bmdie hazv dons venal
Type of Roof
as dailwed by the Cupertino Mmucipal Cole. Chapter 9. a. ana the xealN and! Safety
Cod S t n255 bo -
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}
All roofs shall be inspected prior to-any- roofing. installed._.
.. , Will the applicenut or future Wilding occupant use equipment or devices which
emit 1rumiums air
material,being
If a roof is installed without first obtaining an inspection; I'�aaree'to remove
co i m nmc as defined by the Bay Area Air Quality Management
District?. -. • :. ... ... .r:.
OYes ❑
a
all new aterials for„' pectio 'cant.un_derstands_agd will comply with
_
..' "o,
.Ap
all n n- int source regulati r
I ha e'read Ne heard al req Ircmehu der Chillier 6.95 of Ne
California Sa(ry C4 sections 3505 533 a 2mS 1 ondersuM ther
- iflhebud ngd tint currently ho In yrcsponsrbili, notify Ne
- - - -' - - - - -- - - - - - ---
rcroale
dace an of,he equ m "o Issuance ofa Cenifa¢of
0.s
'ar ature_of Applicant _ Date
All roof coverings to be Class "B" or better '
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Owner w0.11; d e d : Dare
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. OFFICE - ...._.. - - --- --- - --
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