08090089 CITY OF CUPERTINO
BUILDING DIVISION PERMIT t-CONlR:4C'�OR INF,f}$MA TION
Bua��2 CAS PERMIT NO.
LVERT DR CALIFORNIA ROOF MANAGEMENT 08090089
NER'S NAME: PERMIT ISSUE DALE
SEQUOIA EQUITY 5115 E 8TH ST 09/16/2008
PHONE: SANRARY NO. CONTROL NO.
(510) 261-4620
ARCHPIEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
X00 LICENSED CONTRACTOR'S DECLARATION O O O O
1 busby affirm Na 1 sm lixrred revism under pioof Chapter 9(commencing Job Description
ii wine S.6.7000)ofDivision 3m`the Business and Prof..iamCodoundnylicrstmis RPLC DMG SDNG&TRM LIKE4LIKEr RMV RPOUR DMGD CONCRT
^?yin full fact.wide 6
jy,)z Lm. us L Lt.g a' WLKS(PRVD) LIKE4LIKE&RPLC350 ' PROP LINE FENCE LIKE
C;:, Dam ARCHI'IECTSDECLSRATION 4LIKE
W V 1 uncersoand my plane shall be hand as public records .
gd
Licensed Pmfcuumu al
aha OWNER-BUILDER DECLARATION
f 1 hereby ailing that 1 tett exempt from the Contractor's License Law for the
C O o following mason.(Section 703 1.5,Business and Prohxslom Code:Any city car county
S$ff which memirm a permit to cannoneer.alms improve,demolish,or repair my nruuure
_I< prior h,its issuancc.dw requires dtemplicam for such permit m rile a signed statement
G thatheis licensed porsuanttothe provisiamofMeCanoana''sUccam aw(Chapux9 Sq.FL Floor Area Valuation
(commencing with Section 7000)of Division 3 of the Business and preform...Code)., $105000
$ that he Is exempt therefrom and Ne buil for the alleged exemption.Any violation or
Section 7031.5 by any applicant rte a permit subjects the applicant m a civil penalty of
Our mom than five hundred dollars(SM. 35719027Number OCCIIane. P y T yPe
❑1,u ewnu of W papulY•a mY employees with wages u their suld compenution,
will do Newart and Ne he Comunor.Lt oa.coforumpplyt01.1,Budress
and property
whom code:The Cantracmn. red who law aces rot appy lf an owner or Required Inspections
man enywyees.provided
each
who me not intended
himselfor
awn employees.the WipreNdad dist such imprevemmts art not intended maRered for sale.V.
however.the have
Me o improvement m cold within arc yw or improv for the owm-
Wilder MB have Ne buNrn of proving N,I he did ter build m improve for purpose of
sale.).
. ❑1.as on.of the property.am cxcludvely canu,ning with licensed conummn to
cautrucl the project(Sec.7014.Business and Profetiam Code:)The Contractor's Li. .
come law does not apply m in owner of property who Wilds or improves Merton,and,
who contracts Imsuch ptaje.V with acmuanot(s)licensed precast to the Contractors
Lice.LAW.
El I are eacmpl under Sec ,B&P C for this name
Data
40— WORKERS COMPENSATION DECLARATION
1 hereby air=under Porosity of perjury are of Ute following declamtiau:
❑Ihavemd NimainuinaCmifscamarCamenrroself-WumfaWmicefsCompen-
antion,u provided for by Section 3700 of the Labor Code.for Met performance of the
wort for which this permit is issued.
1 have aha will maintain Worker's Campenution Insurance,u requited by Section
3]00 of Ne Labor Cadc.Ior Use performrme of Ute wart fowhich Nu permit is irhad.
MY Warkere Compematim lwMa cartiu eche Polity numbvare:
Center.&Tn-TLS r✓ t1A Policy No.: o'U!3P1W-,iv7
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This do.neednot W eempleted lithe permit is f ..hundreddallasnI00)
or less)
1 urdfy Net in Um pe,form.of Ne work for which this permit is Luted,l shill ter
employ any person in my mmncran as in gmmc subject to the Workcra'Compcmation
Laws of California.Dam
Appli,.,
NOTICE TO APPISCAW.-IL after making this Certificate of Exemption,you should
become subject m Ne WOtkerf Compenutl.n previsions of the labor Code you most
.J O forthwith comply with such ppovidom Or Nu permit dull he deemed con"
r y CONSTRUCTION LENDING AGENCY
(-+^ 1 hereby dfirm Nem us coruuucunn lending agency far the performame of
(Si i Lc work Ire Pe which this permit V iuurAec(S 3097,Civ.C)
0.Wi Q Lenders AName
dd
7 z lander.Add
U O 1 aNry Nat 1 have read this application and sum this Me Wn womeamon u
w ~ comm L 1 agree 0 comply veld di City and CaWly aNinma.and sum IGMe Rlatl.$l0
0 L�..^) building construction,and hereby.mhoire nprummdms ofNucity to nems upon Ne
alwve-mmtidgm judgments.
crtyot for Wpemim Purpowhich ms
F LL (We)as=to ave,indemnily and temp harmless Ue City of Cuperhino against
l,licy Z liabilities-
ie consequence fMetr.uand capenuewhich may in my soyurnc,gsimtsdd City
U z A PPI ANT of thegranting Of this permit.
^ APPLI ANT UNDERSTANDS AND WILL COMPLY TH ALL NON-POINT Issued by: Dale
S REGULA71 NS.
�G Re-roofs
Si1nmgmOfAppImmtA7iaDam
HAZARDO SMATElrALSU4=SUREType of Roof `
will Me applicantofuturt balding room mhanNe Incomoha mamrid
u dcfino l by Me Cupertino Municipal Code,Chapter 9.1;and circ Health and Safety
.Section 25532(a)70rte All roofs shall be inspected prior to any roofing material being installed.
Will Nc applicant or future balding aavpmt haw equipment or Jev�Ifo-
( If a roof is installed without first obtaininginspection,I agree to remove
iaa which an P
emit harardoo air contaminants as defined by Me Bay Area Air Quality Management all new materials for inspection.
District?
C Yo '/Q;l�
I have read the hum mamrialsrequiremew undorChaper6.95 of Ne Califor.
nu Hca1N&Safcly Co .Sccli=255(L5,75533a B534.1unMsund NaifUe balding
does not cumenrly have a moot.that it as my resp gmibilely m runty Me occupant Of the
mquirc mswItichmupkmnp16 a mtiramaaf.emniBm,mafommapamy. Signature of Applicant Date
s4acQ �`Dac' All roof coverings to be Class an"or better
Owner or authoaro e e