08090047 CITY OF CUPERTINO
BUILDING DIVISION PERMIT rkC�NTRAC��TaRINFRNIATI01 ;.-
BUIL91§cMDI�LKNAP DR
PERMIT NO.
QUALITY WINDOW & DOOR 08090047 ,
'NER'S NAME: PERMIT ISSUE DATE
BARON STEVEN W AND KATI 3597 HOMESTEAD RD 09/10/2008
PHONE: SANITARY NO, CONTROL NO.
ARCHRER/ENGINEER: BUILDING PERMITINFO
INSTL 2 PATIO DOOR& 7 WNDOWS BLDG ELECT PLUMB MECH
D O O O
�Oo LICENSED CONTRACTOR'S DECLARATION Job Description
u 1 bercby amm that 1 am licensed under provisions of Chapter 9(commencing """"'- "^' '^ '^
with Section]a1u)and.Rnes.
o(DiHaion 3 of W Bud•...amd Pro(esduv Cade.rM my liccnsc'r
lo roce G I 9 3 7
-min for.
I-, Dain Contractor
ARCHr1ELTS DECI.ARA
1 undersand my plans"I be,hand as public rd,
irdV
SG Licensed Professional
5 OWNER-BUILDER DECLARATION
ZO f I thereby alum oro 1 rte exempt from W ComranCo L My c Law for W
O O following rears..(&.tion]In I.S.Business Apr improve.
din ons Code:My city m,ounty
ZOO
$v` which his issu n permit to c im,i1m eller.impmvu,stn emit fie a sir any etaesuro
_i y prionto s licensed
cans d pram mqo the W aiions of fursuch Contrarmiuo cic a LAW(atammat
ss<
that WlicensedpurmanttoWofDivision
iviomofWCousinesSUccrsclaw(Chapmur9 Sq.F[.Floor Area Valuation
iFg that(commencingheounp, Suction 70011)ndth basis n3 the
aeBed coo pi Pn.My
Cock)or
Q��
that W u exempt Wmfram Ntl the beau fm W alleged esempuan.My Halation of
Section 7031.5 by any applicant for a permit subjcce,W applicant an a civil penalty of APN Number Occupancy e
but mom firm five hundred dollars(SM _ P y 11 p
I,v ownu of the prvpmq.amY uoplayeea wiN wgassthe'm cote compenssuan,
will do fe wont and W swesum u notinLicensor Law
do tarsale(Sec 7016.Bud r of
and erty who ns builds
The Conduction Lice..Law doe out apply ir ao owner hr Required Inspections
pmputY who W ilda orimpest at at It improvements
ve who doeon,intwart croffe orNmuN his
owneer.ft Wilding ded
poloch ire issoldevhinnot our efst phumm.ned for solo B.
however.Ne building hr uepmmsmt amid within arc year or comPledfo,the owner-
builder will have W Wrtico of proving that W did not build or improve for purpose of
am.).
1,as awrcr of the property w exclusively ca.aaesing wia licensed vmbresors to
construct the project(Sec.TON,Business and Profeadhns Cotler)The Com barons U. .
¢rue Taw dons not apply to an..of progeny who Wilda or impm ms damon,and,
.he conhacLL for such pmj.eta witha emnraeshr(e)licensed pursWnl in W L'hnhYNre
License laws
0 lam.aemptunderse, .Ba Perorthismaro.
mer Dam
WORKER'S COMPENSATION DECLARATION
1 hemby alrmra order p orshy of perjury arc of W following drdaati..
1Imm and will maintain a Cenifiamof Cortinnt b self-insum for Worker'sCompen-
titian,u provident for by Section 3700 of the,Mbar Cot.,for W p ularmnwe of the
wart for which this permit is issued.
0 1 have and will maintain Worker's Compensation Insurance,as mgdmd by Section
370Baf N,latter Code,for the Performance ofd work for which thus permit is issued. '
My Worker's Com Saudi Iv�rar�ay artier and Poliry num Ware: -
fSrtier. USA Poliry No.: Z�^rZ.o o2
CE Fl 1E OF EXEMPTION FROM WORK
COMPENSATION INSURANCE
(Thu xniou reed rot W chmpkmd If tie permit is faun,hubtlmd do0ara(6100)
orleu)
I certify that in the performance of W wart for which this permit is issued.I Shall not
employ any person in any mmner eo as in Wemc subject to the Wmkus'Compensation '
Lam of California.Dam
Applicant
NOTICE TO APPLICANT:If,a0er making this Cenineatc of Exemption,you Should
become Subject to the Worker's Compensation pmvivans of W Labor Cade.you most
.J O forthwith comply wits reach pmvuihns u this permit"I W deemed mvokrd.
vy CONST ucnoN LENDING AGENCY
[-+ IWmby.ffirm that Wm is.emusucunn lending u,ne,for W pnrfunnance of
Ri.�. W work for which Nu permit u issued(Sec.3(19),Civ.C.)
W Q Larders Name
z Lender's Address
U O I certify Nat 1 have rend mus application and state NY W AWvc W.Mution is
n, cortaL I Agra m comply MN all city last county mdhun.*a and nam laws muting m
C)>, Wilding consimemn,and hereby authorize mpmxnutives of this city N now upon de
{1) above-menudgm nt.cents
for inspection purymet V
(We),gra to ave,indemnify and kap harmless N.City of Cupertino against
h to
judgment. bonigof this,which may in any way Alae gainst hist City
U Z in consequence of W granting or A DWIpermob,
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU:V,EGULATIO S.
" 1{t' X Re-roofs
smgmmuam ImunHA DDOUSMATERIALS DISCLOSURE Type of Roof
Will IW applies it or future Wilding occupant SIM or handle havdons material
sa dinned by the Cupertino Municipal Code,Chapter 9.11,and IS,Halde and Said,
.Section 15531(a)T
❑rex ON. All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future Wilding occupant tie equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
Mit haraNra air contamivnu as defired by Ne Bay Area Air Quality Management all new materials for inspection.
DiWictT
0y. ON.
I have mal the hvardwe materiaumquirenems underChapter6.95 of the Califer-
bothl] a SaA3yCode.Such..U_%5,25533arxl 5534.1umd:nwd uutiftle building
dour net currency hate A Stuart that it u my maponslbilily th notify the,occupnot of de
mquimmcnu um hes tW met Prior to issuance of.Certificate or Occupancy. Signature of Applicant Date
D o
Owner Su orF dagent Dam All roof coverings to be Class'W'or better