06050079 CITY OF CUPERTINO �'°�' '"+S +• �'Q s ��"
BUILDING DIVISION PER ?"l RA.CTOR INFUMATI,
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BUILDING ADDRESS: ` BEST HOME SUPPLY, CORP PFEMITNo.06050079
831 CANDLEWOOD DR
OWNER'S NAME: PERMIT ISSUE DATE
YEN-HAN HUANG & YIH-LING T ENG7335D BOLLIN
/ NE: SANITARY NO. CONTROL NO.
(408) 255-4088
ARCHn ECT/ENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
100 LICENSED CONTRACTOR'S DECLARATION IOb Description
i 1 hereby affront that 1 m licensed under provision,of Cluplor 9(commencing
with Section RKIII)of Division 7a(me Business and as0 aC m Tice anh
in full to=an!effect. KITCHEN REMODEL NON. STRUCTURAL 1 PLUMBING FIXTU
u'am
w Lla.g
Dam — CoronEC .
HITECI-S DECLARATION
1
[no mond my planusshall he used u public reemds
-� Licensed Pmfaaammal
w, OWNER-BUILDER DECLARATION
>•SS I hereby afRm that 1 am exempt from the Contractors License Law for me
C 6 following mason.(Section 7031.5,Business and Profession,Code:My city of county
ff which mquima a permit to common.site,hormone.ne.dmoodim,or minor try structure $15000
xEn prior at in,issuance,also rtqubea@e applicant for such pemitm fila a signed mcamm
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that he lalicensed paramount mme,provisions;aftnecontraemralicense Law(Chapo,9 Sq.Ft. Floor Area Valuation
Ila (commencing with Section 7000)of Division 3 of me Business mm ProfeWnns Come)or
IlCa mat im LL comps tbereffom and the bull for the alleged emmpdon.Any violation of
Semon 7031.5 by any applicant for a Permit aubiccu the applicant in a civil penalty Of r Occupancy Type
On,mom man five hundred dollen(5300).
0 1,u awmor of the pmpmt3•,w my mployeu wire u'agca u mob anla compenmdon,
Required Inspections
Moll Profwlnw Code:The Connector,Licmue Law does MI apply to an Owner Of 9
property who builds car improves themon,and who does each wart him W f ar ti m et his
own employ=.provided that such Improvement am not inmMed arorterd for axle U,
bowuemWilding urLmproaemantLL uat not within yearofcompledm,tlmown,r-
builder will haw me burden of proving this he did a ddW or Improve for purpose of
ulad.
0 I.as owner of the property.am wcluedwly cantrMing with licensed comfsemm to
con,nron the project,(Sec.70",Business and Poefeuion,Cade:)The Comment U-
caw Law done no,apply to an owner of property who or Mprow rand
who contracts;for such wakcu with a canrecmrslicensed phnu.m m oto Othra¢mr.
0 1 am Law.
0
lam exempt under Set
,Bd:PC fm this retract /
Owwr ( ✓��
W RKERS COMPENSATION DECLARATI
a@m rc Ifo ON �/
( 1 hereby under penalty of perjury aof following dectmtione
I ham and will maintain a Cernifiwm of Con,ant to aclf-Imre for Wingers Coupon- <
utiom,u provided fm by Seeden 3700 of tin Labor Code.for the per roman a of die p
work for which this permit is isstnd.
0 1 have and will maintain Wagers Compensation Insurance,u required by Section
3700 of the Labor Cade.for the performance of the work for which this permit Is lashed.
My Workers Computation Weauss a carrier and Policy number m:
Cmj" Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE v
(nmLL scorn some antbecompkud Utie permit is froom hundred dosses($100)
m lass.)
I mrdfy mot in the performance of the waft for which this permit is issued.I shall not
employ any person In any manner m as be became subject"the Workers'Compewdon
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,arm,making this Ccniacato of Bomption,you should
became subject to dila Warkces Campewdion provisions of ren LAW Cede you most
,J O formwith comply with such provisions or this permit ahall be daemon mated.
,Z,a y CONSTRUCTION LENDING AGENCY
[r I hereby affirm that them is a eomucfint lading agamY for the performance of
rl> me waft(or which this permit U issued(Sec.3097,Civ.C)
W� Q Landers Name
Z Landsm's Mdrw
U I cardfY that I have and this application ad sato mat the above information LL
coma.l agree to comply with all chY and cauntY ntdinanco and sum laws relafing In
C) building consuuction,and homey amhmim mpreumtivw of this city to color upon me
W above-mcndutted property for in,pccti011 purposes.
(We)agme to eve,indemnify and keep hamalw the City Of Cupertino against
tiy liabilltin,.Jdgmenm,cow and expressos which may In any any same against said City a
U,x in consequms a of the Standing of this permit. /
r.t
APPLIq&NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU ECU ONS.
ler
-f--/O Re-roofs
Smainam 0O A licaWCo"memr Dale'
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Wit the applicant or future building aechpantatort or handle haurd°w malarial
as defined by the Cupertino Municipal Cade.Chapter 9.13.and the HWM and Safety
Code,Section 25532(1)7 All roofs shall be inspected prior to any roofing material being installed.
` ❑Yca e
Will me applicant or room building Occupant u¢equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mli Wurdous air comemin,nm a deMd by me Bay Area Air Quality Management' all new materials for inspection.
District? �/
0Yca j No
I have maul the hauN/ow�matWals requbemenu under Meter 6.95 of me hlifor.
not Nosier k SafmyCodc.Secuon,25505,25533 and 25534.1 mulereand that if the building
dais nti lananl mat Itis my responsibility to ndfy me Occupant of the
Icemen et armissh aclrolingra Signature of Applicant Date
Owner or authorized 1911, .J DaleAll roof coverings to be Class "B"or better