08090034 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTONINFORMA.TION
yae� x.
Y��3
BUI` I S: PERMITNO.
8�FSN BLANEY AVE PARADISO MECHANICAL INC 08090034
va S NAME: PERMn'ISSUE DATE
- PACIFIC GAS & ELECTRIC 2600 WILLIAMS ST 09/19/2008
PHONE SANITARY NO. CONTROL NO.
AllcxITECUENCINEER: B
REPLACE EXT CONCRETE SLAB BLDG ELEINrG PE0.P PLUM CMECH
�Op LICENSEDCOansed oT00.5DAsions AnON
fChap
uC 1 hcleby alum duh 1 m lumnscd under nd Pwaso of Chapter 9(commencing Job Description
4�W with Section] )af DivWanlof de Butineas and Professions Codeaantl myl...or
Ifeence
e�q DamCe��an erc
9e C W Cc
ARCHrfECrS DEC ON
U I andedoaM my pWu shall k cud As m
Public cmtls
Dw6
ga In Licensed Profcs6anil
w v,3 OWNER-BUILDER DECLARATION
1 Wmby.IBm Nal ham exempt from the Canmactes License Law far the
y
00 following meson.(Section 713 1.5,Business and Profeoions Cadc:Any city or County
�$ which racruim a permit to coMm:L alma improv,dcmolim.car xpoir any structure
Mar An its ismanee.arm dequiles the applleam for such permit to file a signed statement
�O that he is licensed pursuant to the Pmvi.m.of du Commerces license law(Charm,9 Sq.Ft.Floor Area Valuation
a (commencing with Section 71)(0)of Division 3 of the Business aM Profeoions Code)or
03 dot he a exempt therefrom and the basis fm de alleged comptiou Any violation of
Semen 7031.5 by my applicant for a permit subjects the Applicant o a Civil Penally of APNNumber O
ret mom Na five handled Miami(53001. ccas pancy Type
I,uowner of Ne property,mmy ervplayca aids wgaas dsev role compensadan,
will W Newark.and the structure is notimmnded or offered tarsale(Sec.7044,Business
and Profcsumns Cade:TW Caatractoes License law does,ant apply in an owwr of _ Required Inspections
property who builds m improm demon,and wed does such work himself or through his
own employees.provided last such imprmemenu au not intended moRered fordle IL
however.the Wilding or Improwmmnt is sold within arc)ear o(compktian.the awm-
Indicate will law dee burden of proving Nat las did ret WiW or improv for purpose or
sale.).
0 1.as saner of Ne property w raclumely canucung with I earmi mnaacte s as
considet the project(Sec.7014.Businm AM Professions Coda)The Contactah V. ,
cense raw dna not apply m an owner of property who Wilds or improm themon.and
who compacta for such Projects aids a controurds)licensed pursuant m the Condacto's
License law.
emacmptunder See ,B&PC for Nu won
Date
WORKER'S COMPENSATION DECLARATION
I hereby anion Motor penalty of perjury ane of the fallowing dcclvations:
❑Itswunvii forbyS Oon370eofCansenuaself,for fm rfamsCompeer
.orlon,r provided for mi$sItion 3700 of ted laWr Cott,for dm perfarmmce of de
work far which Nu permit is issrel
❑I have and will maintain Worker's Compevadan Wadman,as required by Section
3700 of the latmr Code,far the per(omanec of Ne work for which lata permit is Issued.
My Warke/s Compensation handsome carder and%licy mark,art:
Cartier. S rcarvD Policy No.ap. ?-24Crich
CERnFICATE OF EXFMPOON FROM WORK
COMPENSATION INSURANCE
(This crew heed wt W complemd if the Permit is format huMmd dollars($100)
or lea)
1 aNfy Nat in the perfomancc of Ne work for which this Permit is issued.I shall not
employ any person in any motherm as in become subject to the Worimn'Compensation
Laws of California-Dao
Applicant
NOTICE TO APPLICANT:If.after making this CCnUkate of Escmptior,you shwld
become subject As the,WoheYs Compensation phorisioru of the Iator Code you meta
.J O forthwith amply with such Providons w this permit shall W called mwked.
Z y CONSTRUCTION LENDING AGENCY
[—r IWrohy air=that there u utcnn k
a conatindintagency for Nrm
e parfarnme.r
E
7 dm mit walk far which this peru island(Sec.3097,Civ.C)
1 0 Lender's Name '
z fen&es Addw
V Q 1 cW fy Nat 1 hate rand dos application and nam con the show iNormadun is
IL ^ Cortes I agree to comply wah all city and county mdinar¢s Nd sae laws mooting an
0 Wilding construction.and hereby audsonee mpm_mnodm alibis city to amal upon the
H[2] aWw-menu rty for WpeNon Puryoaes
g>, ( agrLin. mnify and kecp humkss the City of Caperton adainst
Vh liabili' MetapwmwhichmayinMywyammcagainnsudCityin coniequcnmf this Permit.APPLICA S AND WILL COMPLY WITH ALL NON IMT Issued by: DateSOUR GU
sit of ApplioARe-roofs
HAZDam
HAZARDOUOU S MATERIALS DISCLOSURE Type of Roof �-
WIII ted a Applicantcar funi Wilding e.0 atswm or handle h aNaua material
road by de Calamine
Municipal YmlClpll Cade.Chapter
@ W N
ter 9. . e Health and Safety
.o es 25532l.)7 [9dqa� All roofs shall be inspected prior to any roofing material being installed.
Will the applinsat or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit ha a i-as it coreac amu As defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Ya
I head the Noel mamriab lequimmems under Chapter 6.95ofdmCalifw-
nu &SafetyC Sectiau 25505,75533 amt 25534.1 understand the if the Wilding
does t tomo w twain dot it u my mspmuihiloy m entry Ne Occupant of Ne
mquirtman, ch slkmetPriorteismanccofaCenillegue w,ney. Signature of Applicant
Q Date
owner car thomed.gent Dote All roof coverings to be Class'A"or better