03020103 CITY OFCUPERTINO '#3
BUILDING DIVISION PERMIT VCi(SNTR''CTOR,Ik'ORM = ON
BUILDING ADDRESS: PERMIT NO.
10101 N DE ANZA BLVD 03020103
NEWS NAME: PERMIT ISSI is DATE
TREND MICRO 02/25/2003
NE: SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BIDO ELECT' FLUME MECH
0 l�
�GLICENSED CONTRACTOR'S DECLARATION Jb Description
1 Mmby affl m that I am m
licensed under provisions of Chapter 9(comenO
cing p
will,Sac' 7 )of Division Sof the Busi Prof tns Code.mdmy auto
�lmfanf d ser ' �O NEW ELECT TO SIGNS
eases Dau mCi t contractor CONTRACTOR: MC-GILL ELEC.
E TECIB DE ATION
tend nJ ypmuahsll he used u public rcrords
J
y� Licamed Profnsintml
m OWNS
R.BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contrauah Lkenw Law for the
O o following mown.(Section 7071.5.Business and profession,Cole:Any city or county
$ which require,a permit to consumes,alter.improve,demolish,or repair any atucwre
Sn prior with Issuance.also mquircs tM applicant fee weh permit=file aaigned smoment
�< thus M m licensed pursuantw the provision,of the Carmine,Lure.Law(Chapter9 Sq.Ft.Floor Area Valuation
(ammcncing with Secdon 7000)of Division J of the Butluss and profeulou Cade)u $500
$ that he m exempt tMmfrom and the basis for fta legcdxemption.Any vloladoen of ppN N b
Section 7031.3 by any applicant for a permit objects the applicant to a civil penalty of 3 2 6 3 4(��r. 00 Occupancy rl)pe
not more than ffn hundred dollars($300).
❑I,u owner of Me property,or my employees with mgu U Job Sole eompeeu0on, pp�tHHSkppgg rr�aaqq�Dgggg}}�Nk
will do the work and destructors is not mundeda offered fu sam(See.70".Business 304 — ROUGH 'L^L+i'.l.�rC'ltili'li ns
and Profession Code:The Contraction License law don not apply w w owner of
property who build,or Worms and who does web work himself or through hu
Own empioyea,provided thauuch improvements tee not Intended or offered for ule.it, O1 - FINAL ELECTRICAL ENERGY
however,the building or Improvement is old within one year of completion,the oxnmr- ELECTRICAL
builder will have the borders of proving that M did not build or Improve for pagan of
um.). l
❑1,u twat of the property,.Business"clusborlyand pontasering with:)shed¢names e
couuuu we Deism(Sae.7a n otorofand property
who
cadet The matrons/,U.
nd
wtee Law dos notapply r to o ownar of property who sedN m impto t e thereon,and,
whocontractsLaeu for Inch projects with a conamer(O licensed pursuant to the Cantnclor'a
License Law.
❑Iamexemptunder ,See. ,BkPCfnrthlsmmW
XPI
i
u Dau
ED"
13700 WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury aro of the following dmhrulou:
have and will msimal a Certificate or0ommnt to salalnsum r"W~sComper-
n,u provided fee by Section 3700 of than Leber Code,for Jus performance of Jte
for which this permit I,inued.
have and will maintain Worker's Compensation Insumna,u required by Section
of we Labor Code,for the peRermma ortbe work fm which this permit is Issued.
Wadres Compensation Inwnme artier and Policy num er tee:
Ile
^RfIF4 ATE IF EXEMPTION FaQ1 ORKERS'
COMPENSATIONINS N E
(Tbk section coed not Mcompleud if the permit Is foram hundred&it=(SIM)
K legal
1 eenify that in the performance of the work for which this permit is lamed.1 shell not
employ any person in soy manner=u in Income object to the Workew Compeundon
Lam of California.Dau
Applicant
NOTICE TO APPLICANP.If,after making this Certificate of Exemption,you shwld
boom=subject to the Werra'¢Compensation provisions of the labor Code.you mute
,J Z foMwith comply with such provisions or this permit mail M domed uvnked.
z
rCONSTRUCTION LENDING AGENCY
I hereby slim that them is construction lendingagemy,for tho pMormance of
Ci i,. the work for which this permit Is lumul(Sec.3097.Clv.C.)
14Undoes Nemo
0 in Under'e Addrus .
t.>Q 1 ani(y that I have mad this application and rote that the shove Information Is
tortes 1 qme to comply with all city and county ordinances and smut laws relating to
p Wilding
endoneerian,wdhembyauwodmmpru=uJwa orthuCity ecnmr upon Nc
W slave-(WeonWpopeny(minsify sent
loop ha
(We)lyw ro cove,Indemnifyahakeep may
mJte Cityofe against
against
y7 IIab1110u,Judgmenu,costs and expenses which may In any myattue agalrm aid City
A
4APPLICAInconNDEI use RSTAMiL
NDSof Ihis ANDWILL COMPLY WITH ALL NON-POINT Issued by: Date
her Re-roofs
c HAZARDOUS MATERIALS DISCLOSURE Type of Roof
pplicant w future building attupantawre or handle hazardous material
Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
a,Secdan 23532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑You 4N.
Will the applicant or future building monitors use equipment u devices which If a roof is installed without first obtaining an inspection,I agree to remove
I
t hazardous air conmminams u defined by the Bay Arca Air Quality Management all new materials for inspection.
❑Yu ONuI have rnd he AarardansmateeaB mquimmenu underChapter695 ofwe CsiifonmalN&Safety Cadc,Semlons23303.33333 ant 253 IunJcrsmnd wulfweWilding
not cu ntly a ren=k wet 6 6 my rcsponslMllly 'ty meupor of the m wh u t dorh' ume.of.Curd Ontea Signature of Applicant Date
Ownerar. n De All roof coverings to be Class"B"or better