Loading...
02120020CITY OF CUPERTINO -C ' ' "' BUILDING DIVISION PERMIT .CONTRACTOR INF.,ORMATION:4" BuIT102APPIdN DE ANZA BLVD J. M. O'NEILL, INC PERMIT N02120020 W—B, CHARD ELLIS 5880 W. LAS POSITAS BLV, 0r7L1CA1T 2'S V4Tj2002 PHONE: (925)225-1200 SANITARYNO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 j LICENSED CONTRACTOR'S DECLARATION 1 bunchy affirm that 1 am licensed under provisions of Chapter 9 (commencing O DEMO --(2 STOR� f � REMODEL) wish SuI o7fa(d I Drvishln 3tnbe Baai ne` d+nfea.,ianscaee, en,y reenm i.a in tull fomc an t. License Class t Lie. Dale ConVBCI V CHITEC'SDE . ATION 1 understand my plans shall be used as public records Licensed Prolbssnnal OWNER -BUILDER DECLARATION 1 bleary affirm that 1 exempt from the Conlacmr's License Lew for the $20000 fallowing rcama 703 1. Business and it Coale: AnY city ur county which io permit alter, ire pm ve, demolish, nr repair any Permit construct. improve. de demolish, Cares its sires re the statement poor he islcensere,olsomquiros the or or such Coloratura pursuanua Ne ofthe olorasmluo@rasLw hapterm thstlmencir manor and 3St16Bt3BIQi3 AfB© Valuation with Proclaw(Chapmr4 1,] Division he Code)or exempt Section 71and baisinn 3 t Buoaged est and PndAny I Na hr u exempt thertfrum and dm baso for the alleged cumplinn. Any violuion n( deal he is flue e al vi idim Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Occupancy Type nm marc than five hundred dollar 4500).A ❑ 1, as owner of the papeny, or my employees with wages as their into compensation, will do the work, and the svucam is not intended or ofBmd for ole (See. 7044, Business and Professions Code: The Comracmrs License Law does not apply to an owner of Required Inspections Nri who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements art not intended or tremor for sale. If, however, the building or improvement is sold within one year of completion, the owner. builder will have the burden of proving thin he did nal build or improve for propose of sale.). ❑ I, as owner of the progeny, am exclusively convecting with licensed conbanurs m FI w, /� �t construct the project (Sec. 71194, Business and Profusions Cnde:) The Conlracmr's Li. , V A G cense law does not apply m an owner of properly who builds or improves thruster, and, who contracts for such favic s with a conlactood licensed pursuant) the Contractor's -"2003 License Law. JAN0` I am exempt ander sec. . B et P C m for mann , r." Dare WOR KER'S COMPENSATION DECLARATION BUILDING 1 hereby affirm under penalty of perjury one of the fallowing declarations: 1 have, and will malmaln a Genlflcate of Conaem to self insure for WOrker'H Container. union, as provided for by Suchen 37M of the Labor Code. (or the pnforaence of the work for which this permit is issued. have and will aainuin Worker's Compensation Insurance, as required by Section 37 l of Ire labor Calk, for the performance of the work for which this permit is issued. My Workr�ya Compenfsation aumnce udicran Nicy numhen{rt:' OZ artier. a7fr' k f`' G P li o.: Isd CERTIFICATE. OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section Dred nut TSC cnmplcmtl if IM permil is Rome hundred dollars (S 100) or less.) 1 unity that in the perfaman u, of the work for which this permit is issued. 1 shall not employ any person in any manner so as an become subject to the Workcrs Comptemad n Laws of California. Dale Applicant NOTICE TO APPLICANT: 11; after making this Cenilicne of Exemption, you should become subject to the Workers Compenmlion powtsions of the Labor Code. you must , forthwith comply with such provisions or This Permit shall M deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction Inning agency for list perloamenO, of the work for which this permit is issued (Sec. 3047, Co. C.) Lenders Name Loo ding Address unify nity that 1 have read this uppliemion and sus that the above inlonetiun is coned. 1 agree Io Comply with all city and county ordinances and sum laws relating to buil building construction, and hereby representatives of this city m enter upon the action p fon inspection YbaVC men) afire to save keep ha We) egret to save, and and keep harmless the City of Cogent against expect which may in any way ammc against sail City Iia bililicajudgmcnh, Stan and If Aconscyucncc ohhcStan Ing d ANIJmil. APPLICA ND -H ANQ WIhL COMPLY WITH ALL NONPOINT Issued by: Date SOURCE :G / 2 14OZ Re -roofs Type of Roof S emu Appi n nor Dam HAZA DOUSMATERIALSDISCLOSURE Will ❑a pplicanuv fmuni building Sec handle harardound Safety crmetl by c Cupeninn Municipal Code. Chapter 9.13, and @e Iltellh and Sxfmy Chapter9.12, c. Section 25533(a)'! ,J ❑Tea �ylNa All roofs shall be inspected prior to an roofing material being p p y g g installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hamrdous air fonaminanee as dcbned by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yea NY O 1 halm mad the hazardous mann. )smyuirtmcnks under Chapmr6.95 of Nc Califur nit 11 MISS it Cis Sadtnv3 25533 and35539. Iundersundthnifth, building does nor curt Sy ,.Z t t alis my resp nsihility m notify tM rceupam of the rerItAndstnt i r( C IpI missmncc nfu Cc lirmo(Qcupaney. , Signature of Applicant Date 1 All roof coverings to be Class "B" or better non ma nae nt ag Date