08090059 CITY OF CUPERTINO ' aha x sb e,do i z *f�•' e�' '
BUILDING DIVISION PERMIT CONTRACT(TRINIaQRMA'TI0 �'.
:
PEBM7 NO.
BUIL.pItiQAQQRTOLUMBUS AVE ARGONAUT WINDOW & DOOR, INC 08090059
L'R'S NNA` I.- 1. PERMCIISUEDATE
dACINTOSH JOSEPH R AND SUE C 1901 S BASCOM AVE STE 800 09/11/2008
PHONE: SANITARY NO. CONTROL NO.
(408) 378-4018
ARCHIfECTIENGINEER: BUILDING PERMIT INFO
BLDG EIECr PLUMB MECH
0 0 LICENSED CONTRACTOR'S DECLARATION
iF 1 bortby affirm Nat 1 3 Ihenxd under and
froom of Chapter 9(mmmcnsi is Job Description
nu
with TOM) Diviuonlof Un Business Profwiom Cote.mdmylieenx is OLD WINDOW REPLCMENT (6)
_pyd, in full faux andefrem.
> Z liccmc Oau
F Dato Contractor
g ARCHRECrS DECLARATION
ZZ 1 mserstnd my plana shall he used As public ranNs
k6
L O rr Licensed Pmfesaonal
3 OWNER-BUILDER DECLARATION
C O E Wroby,(Sero on 1 A.1. exempt from the Contractor's res L cense Law far ft
county
COO O fioll.wwhich imi matid.A e mit t 70 1.5. t,a1w. p Pe.dooms Cade:Any city or county
whim mind.n permit re enmft alcor.impmw,h permit
i fi ea sig any summers
_i c that Iits iamnl plaLsainreclaims Wpor applicant Centimeter's
file Law(Chapter
E GthatWUci,witpursumttodamDisInmairunConvxtor'Wcoroulaw(Chaptm9 Sq.FC Floor Area Valuation
Section lnd of bods,n]o(Necjmlcaa pt Prafmaimme,adof Costs)or $5018
— the he 7 campy any appra and ulo buns(m this alleged exmant to MY violation of
Section than
by dry applicant rs(a permit ablecu the applicant to a civil Penalty of Number Occupancy e
rwy mart Nvn Rae hundred dollars(5300). 35618036 .� P Y 3YP
I,u owrc of use pmperty.mmY wplayees wah wgesuun"v sole compewuon,
will dothewont andun TW
License
awdo To mas(Sec.8311,Runners
and era who ku Case:The Conmctoh Lk.1m Lew dam not apply to an owmr of Required IDSpeCtlOns
owns
property who WiMr mimpse such improvements
who Am
mwmkhimselredthrough his
awnempbym,Provided prsashimprowmcouart not earofiamortrmd for dales,
however.Ne building or imgoprovin4xid did Out
year or cmmpletian.tlloose of
builder will haw Ne buNur of purring Nal M did riot Wild or impsow for purpose sur
tile.).
1911,As awnm of Ne property,am exclusively contru5ing with Emceed contractors to
mum the project(Sec.7014,Basin=and Prefectures Cade:)The Convenors LF
came Law does not apply to an owner of property who Wilds or improv thereon.and
who conuacufor such pmjecn with Aeomrtmor(s)licensed p ormum to ft Contrxtora
Um.LAW.
lam cepa arSee ,BhPVC rear is mapyn
Dan
OF gWORKER'S COMPENSATION DECI.IRATION
mbY Alrtrm under penalty of perjury aro or un following dmluatiortz
❑I hawaM wVl mainwn a CenifiesN of Comcnt to self-Waco Ito Wohds Comprn-
Won,u provided for by Section 3700 of the ubor Code,for Na perfermaco of due
wars for which this permit is mind.
❑I have and will murm in Waiters Compensation Inauvux,as mgNred by Section
37M of Ne Labor Code,far the performsn¢of Ne work for whim this permit is issued.
My Workers Compenadon Insurance carrier and Policy number tie:
Curler. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thusemlon mN my W completed tithe permit uforeae hanasdaohas(SILO) .
mleu)
1 certify Not in tbo performance sur be work for which this permit u Wood.I shall am
cmpl%any person in acyl manrcrs bbd subtest togs W.Aterr Compensation
Laws of Dailrorson D 7c su U
NOrI ant
NOnCE TO APPIiCq .1,etm making Nu Cenifrun of Exemption,you should -
hmome subjm m IW 'takers Campeuatim provisions a the lahm Code,you mud
.JO forthwith comply with such pmvtiom mNu permit shall W domul invoked.
'Z
[-r r 7 CONSIRUC`DON LENDING AGENCY
Ibor which nn Nn Vert uaed(Sm,3W7..Chr. agerry(m use perfosmuaxM
W the work for which UO3 permit u issocd(Sa.709'1.Cir.C)
GQ Lenders
z tenders Add Addw..
U O 1 marry,We I haw read this application uW sun des,Inc above Information is
Ig, torted.l At=to comply with all city And county ardinancu and some laws relating N
Wilding construction,And hereby Authorim mpresemena of Nu city to color upon Ne
shove-memuoneddgmi property for inspection purposes
tom„y (We)agree to an.indemnify and keep hssmlms un City of Cupertino against
VS in consequent Of the �utind nxpeueewitch may in My way urnx against Wit City
U z in consequence sur the grouting of this permit
APPLICA UNDERSTA DS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Z5;,
SOURCE ULATLONS. fI
' Re-roofs /
SrgnuSigns=sur ppli uCo rackotore Date xnzSRDous MATERIALS DISCLOSURE Type Of Roof
Wallen Calcium
mlMuni Wal Cgoavpatnomor Media Health and
-
firedSuc by the Cupertino Municipal Code.Chapter 9.13.and Ne HnIN uJ Sa(ety
•.Duan 15572(.)+ All roofs shall be inspected prior to any roofing material being installed.
Y. kSNo
Will Nc applicant or rwmre building metr nt use a nl If a roof is installed without first obtainingan inspection,I agree to remove
pp e W q pmcnt or devices which P
mall ariardnm air comakivanu''''a*road by the Bay Area Air Query Mamagcmant all new materials for inspection.
0Yes IfLNa
1 have mal the hautius materials requimmcou under Chapxr6.95 ofthe Califon
ria HOW&Safety Cade,Smsmas 3550.125533 Am135531.I uMnsuM Naif h.Wilding
eau not c nuY haw a lonanL t it u my seapontihilitY to notify un occupant of Ne
regmmm h'h uuWme r iauu�ccaf.Ccrurn.ucOfOkcvv�y. Signature of Applicant Date
%/G 9� /
Owner an itlimisAd.,ma Dalo All roof coverings to be Class'J}"or better