07110134BUILDING DIVISION PERMIT
Rc,ON.RACT�ORINFQRMATIQN
BUILDING DDRESS:
117 CANDLELIGHT WAY
TBD - TO BE DETERMINED
PERMIT NO.
07110134
IER'S NAME:
PERMITLSUEDATS
RATHNAGIRI ARUNAGIRI---
03/26/2008
PHONE
SANITARY NO. CONTROL NO.
ARCHITECf/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Q
LICENSED CONTRACTORS DECLARATION
lb Description
o
oof Chapter 9 (commercial
1 hurm cby s1BNat I am ticeveE under pmvitim
with Srctirn7OD1Rofoiviaon3ofiMBsammmd ProfcaaonsC andmyficcnau
SFDWL-2 STORY 2,240 LIVING, ATTACHED GARAGE 443'
In full force and .flea . �•¢/ �/ ¢
License CCCCCCyyyyyyyyyyyy ������ Lte.1
Date�ComracC Y
kC
// (( ARCHI'IECTSDEuar'_R ION
I understand my plans mall be used as public mends
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm Nn 1 am exempt from tic Contractor's License taw for tic
following mason. (Section 70313, Business and Professions Code: Any city or county
which ro bihea a Permit as construct, cher. improve, demolish. a repair my structure
Prior to its Women, also requires to applicant forsuch Permit to Jilt a signed stammenl
is licensed Ban of Conuacturi Limme Law 9
Sq. Ft. Floor Area
Valuation
that the pursuant o previsions the (Chapter
$480000
(commencing with Section 7000) MDivision 3 of the Business and Professions Code) or
that he is exempt therefrom and the basis for the alleged assumption. My violation of
�DT�r Number
3 6224054
Occupancy Type
Section 70313 by any applicants for a permit subjects to applicant to a civil penalty of
not mom than nue hundred dollars (SSW).
17 tf
❑I,asmmorof Ne propury,ormy wploymwith waRasstahanle eompenatan.
Required Inspections
will dotheworm and the doraw N, Busirf
does Out apply m
and he Conamnur's Lim Law dem Out apply lf a" owner
Ceder l7c CoOwcm.,
q p
is
propertywho and who aauehwork himselfedtarsals def.
who
propertywhobuildsorimprovch
improvements we restinun aro@red fmalao.
suchentI mid
ownemployers,ping
fced
wham
hmvawa Ne building m improvement 4 cold within me your of completion, the owner-
or i pr
huildor will ave the huNen of proving that he did nos btW or Improv for purpose of
tile.).
❑ 1. as awns of the Property. am exclusively contracting with licensed wnuscton 0
construct me project (Sec. 7044. Business and Profession Code:) M Cwuaur's Li -
crown taw dons am apply m an owner of property who builds or improv th mew, and .
who conuacu for such projece, with aconsumerist) Beamed pursuant an Ne Contractor's
- -
LlcerceLaw.
-
❑IamexemptunderSm. , 88 P C for this master
Dau
WORKER'S COMPENSATION DECLARATION
1 Icmby aBlrm under Penalty of pedwy arc of the following declantiou
❑ 1 ham and will maintain a Cenifimu"f Cament to self -insure fm WmtrhCompen-
ration, as provided for by Session 3700of he Labor Code. for the performance of tic
work fm which this permlt ie issued.
❑ 1 have and will maintain Woraae. Compensation Insurance. u required by Section
37M of the labor Code. fm the perfmmmce of thus work(or which this permit is issued.
'
My Worker's Compensation Wurance carrier and Policy number tie:
b7a h,nla4/S?' �
G EIIry No -
CER71MCATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Cited seeMn wed wind completed i(t a Permit Is frrwo hundeaddollm (SIM)
or Mu)
I certify that in the performer¢ of do work for which this Permit is issued. I shall net
employ any person in my counter an as W become subject to the Workers' Compenmt at
Laws of Califomia Dam
Applicant
-
NOTICE TO APPLICANT: IL after making this Ccdinmm of Exemption, yrs should
become subject to the Woher's Compensation provisions of Ise labor Code, you mus
formwith comply with such provisions or thin Permit shall M deemed mwsked.
I
'
CONSTRUCTION LENDING AGENCY
I hereby affirm that Nem is a c"nsuuNnn lending agency for the performance of
the were for which this Permit is issued (Sue. 3097, Civ. C.)
'
Landuss Nunn
'
i
lender's Address
j I certify that I haw mad this appliwiw and sum that the above information is
corrccL 1 agree b empty with all city and county rrdinYKm and gam laws misting to
building conswcuan, and hereby anNartse representatives of this city Or enter upon Ban
l above-mentioned properly for inspection purposes
(We) agree to wave, indemnify and loop harmless the City of Cupertino against
j IisNlitea JudgmenW cats andexpenv which may In anywsy4mw agamLssid City
in consequenw of the alranunal of this permit.
f APPLICANT UNDERSTANDS AND WILL COMPLY WIT11 ALL NON -POINT
Issued by: Date '3
SOURCE REGULATI LL''
3/az/6d
:)====
Re -roofs
Type of Roof
Sitn pp caa/Co rr ate
HAZAISDIOUS MATERIALS DISCLOSURE
Will the applicant or future building uccupanatlom Or handle heardous materia
nned by the Cupertino Municipal Code. Chapter 9.11. and No Hwtth and Safety
13331(')7 ��
life.BecameDy.
All roofs shall be inspected prior to any roofing material being installed.
❑Yes Lyryo
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or futurebuilding occupant ata equipment or devices which
emit hrdnus ale contaminants as dented by the Bay Area Air Quality Management
om
all new materials for inspection.
Disrict7 /
❑Yes 0<
1 have read the Wesmou eracodals requimmanu under Ompm6.95 of Ne Calif.,
nialWidt& Ss(myCodc. Stxdcvu 13505.15533 am1735M.1 undersuM thssifdc building
due wt currently ave • mnanL thus it is my oapmohility m wdfy the occupant of do
requtmmenuwhichnsabacan 'ormissumccofaCM111 terCDC piney.
Signature ofApplieant Date
15/6 �y
(1
All roof coverings to be Class '%{." or better
Owner orae onaoda Date