07120268 CITY OF CUPERTINO
BUILDING DIVISION 19TTORINFORM,
PERMIT ' C'0N`TRX ,W.
BUILTT,,TrS; PERMITNO
CALVERT DRIVE TBD - TO BE DETERMINED 07120268
P kNER'S NAME: PERMITSSMDATE
BILL SULLIVAN 02/20/2008
HONE: SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BILDO ELECT PLUME MWH
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es LICENSED CONTRACTORS DECLARATION
with S I homey from deal I tat licensed under previsions of Chapter 9(commencing Job Description
acticer 7000) fDivii..3 of th.Business and Preload..cmac.md try lice—is DEMO EXSTNG 814SQ HSE & 300SQ GARG & SHED. OTOVO
in full fame and offimt. � - 0 7 99m 4 BUILDERS PD FOR BUS LIC 2/20/8 $110 . 00
License Iss. Lic.
�r Contractor Z)ZMC 0
A ITECTS DECLARATION
I ummossood my plans small he mad at public meards
Licensed Proressi...I
MNER-BUIMER DECLARATION
I hereby afflam that I am mumpt frousto the Contraclar's License Low for the
l:0 following (Section 7W 1.5,Business and Professor.Cuts:Any city tor moray
which requires a Permit to construct,shor.improve.demolish.or upon MY MUCLUM
prior In its issuance,also requires tho apeplmaffi for such pemit to rile a signed statement Valuation
(commencing with Section 7000)of Division 3 at the Business and Professions Cade)or
that he Is nompt thearefroura and the basis far tho alleged assumption.Any violation of
that he is licensed pursuant in the Provision of the Contractor's Limam Law(Chmocr 9
Sees.703 1.5 by My applicants for.permit subjects the plicanot in a civil penalty of 18 0 OYN Number Occupancy Type
not mom dem fin hundred d.1has($30y. 375
0 l,nowmr6ft�pmp�yormyemploycuwi�w�uftirmic��mdon,
adll do the workmel themacture is act intended oraffared fornm(Sm.7044.Buturnow
and Prolemadona Cadc:Thed Contractors Licemse Law thass an,apply to an owner of Required Inspections
property who buildsorimparms Lhomera,mul who doessatchworklaimselforthoaugh his
own employ=,Provided thatUmb hapsonfleammul Ana net intended unmanned forsesm.11,
however.the building or Improvement is mid within am year ofcompletion.the owner.
builder will ban the Worked of proving Beat be did net build or improve for purpose of
sale.).
1.as owner of de,property,am exclusively contracting with limmand=Me=W
conarruel Use totaled(Scoc.7W,Business ind I'micasions Coaha)red Contomme.U.
..Law d. at apply he a cramer of property who build.or firpermse,mename.and
.he contracts far such proymeat with a...bacteria)licensed pursuant in tho CarmmW3
License Law.
0 1 man exempt under Sec. R&P C far this a
One, Dam
WORKERS COMPENSTTION WDECLARATION
I money sabre under penalty of pedury and of ft milmaing declansfians:
some,as provided for by Smash 37M of the Labor Code,for thas performance:of dend
work for which this pternalt is isamad.
[]I ban and will maintain Worker's Compensation Insursonce.as requindi by Scacma
37M of the Labor Could,far me performance of me work for which this Permit Is Issued.
My Warlm�e'�C;Faamlfirm In c..arior and Palo,number anc:
Carric'. Palmy No.:
CERTIFICATE OF IDIMMITION FROM WONRIS'�"
COMPENSATION INSURANCE
Ttlas sozion necal nothc completed time,Permit Is fartme bundradeallars,4101)
ar,ten)
I midly me,in thm perpremens..of me waA fee which this peradit Is issued.I shall ma
employ say .a I.my andener an as W became sobject to tho WoommCceripmeation
Laws of California.Data
Applicant
NOTICE TO APPLICANT.If.after making ths;Cori of Exemption.you should
Income subject an the Worker's Compensation provisions of tho Labor Cade,you most
z forthwith comply with such provisions w this permit Mad)W mearved!arrested.
z a
CONSTRUCTION LENDING AGENCY
1 hereby air,.that mars is a mantractimn landingligancy far me ,i.e.or
the whole for which this permit is issued(Soo.3D97.Civ.C.)
Larder Name
Lonelm's Add.
U I modify that I haw true this application and seem that the abon information is
L� comea I as=to comply with all city and county ordfinamm and smic laws misting in
0 building construction,and hereby ammorme representatives;ofthis city to color upon Jace
Move-mentioned property for inspection purposes.
(Wed agree to saw,indemnify ad kcacp haturnaless ft City of Cupertino against
Qrl liabilities.judgments,corts and expenses which may in my way same against said City
md" this i"
is i"
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top 11C&UNDUMSTt LL COMPLY WM ALL NON-POINT Issued
A by: Date
SlIpealdre culAIrpliessm/CmullIFI., D.am Re-roofs
HAZARD=SYMATERIALS DISCLOSURE Type of Roof
Will the applicant or foam building(Maperstatme ar handle hassudeas material
as,dolined by to Cupertino Municipal Cods.Chapter 9.12.and the Health and Safety
Section 25532(a)?
0 Y. lffl�a` All roofs shall be inspected prior to any roofing material being installed.
Will me applictom or future building occupant usto equipment or devicani which If a roof is installed without first obtaining an inspection,,I agree to remove
mail hamakors it conerrefinarda as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
[D Y.
I ban mad the hannimus;materials requirements ander Chapter 6.95 ofthe Califor.
ni.Health Ja Safety Code,Smucre,25505.25533 and 25534.Immentuard thatiff he building
dcaut not (1,have a Worm, millityrie,roof,she cammum Of the
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Cc
ma
morm
Me
notubearm hich most is to of0c
Dg Signature of Applicant Date
Owner gerlaullutrilad agent Dam All roof coverings to be Class"B"or better