06070004 CITY OF CUPERTINO r, ` '�""
BUILDING DIVISION PERMITC� �. �T
BUILDING ADDRESS: v DOWNEY SAVINGS & LOAN ASS MITND'06070004
10381 DE ANZA BLVD
OWNER'S NAME: PERMIT BIBLE DATE .
DOWNEY SAVINGS & LOAN ASSO 07/26/2006
Eo SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECTO PLUMB
oo LICENSED CONTRACTOR'S DECLARATION Job Description
I`uI kk I Mmby+farm Nal 1 am 1k wd under pmvisians of Chapter 9(commencin{
withn iorcc 011O)sDIvlAlon7of Ne Bunnm and profession GOdC,aM my liccmcb
LI`cni�pc aMerhtl µ� Lld« T. I . -NEW ADA BATHROOMS AND ADD 2 NEW OFFICES
i Date +3I,.,_-r. Contractor
ARCHITECTS DECLARA 0
i [understand my plana shell be used a public=Ord,
ig
•c
Licensed Pnresslanel
OWNER-BUILDER DECLARATION
I hereby alarm o n I am,usin from Ute Contractors License Law for Ole
D O whichfollowing u mason.(Section 7 comm Business and Pronetnews.
deform Code:Any oily or county
which requime issuance.pctmil re vires das Alen nt frow,demolish,or e a.ir any structure 1 t]n (]0
.z i prior to its ense Alsoeon,to ma Urmishocam for such comm roe,Lice s LAA, statement Valuation
that to en licensed pursuant to the of DitlomafNe Conveners Lkemehaw(chapter Code)or Sq.Ft. Floor Area
l�D
(commencing with Section 7000)afDivai.n3af the Business and Proremion Cade)ar
thn he b mempt themdtom and the basis for the Alleged eaempdon.My violation of
Section 70315 by arty appllcenl rm a permit subjeeu the+Ppncenl e a evil P=ItY OI er Occupancy Type
net mere than five hundred dollus($700).
0 1,As owner of that property,or my employm with wa{es AS Bak auto—Pemdan•
win do the work.and she structure b not Mended ar offered for ask(Sec.7W.Busims, Required Inspections
Nd Pm/cesiON Cade:The Contractor.Lit=Lew dore net Apply to M owner of q p
property who buil.rimprom Imem nand whodoessuchwarkhimself Or through his
awn employe,provided Ihmaah improvements are notinanded orolfem l fmak.It.
however,the building or improvement is told within ane year of completion.the caner.
builder will love the burden of proving that he did Ml hand m Improve for perp.e of
sale.). .
0 1,as owner of the property,am esclusively contracting with Beamed oonnacen be
convect the project(Sec.7014,Business AM Profession Code:)The Concurs LI.
come Law doe not apply to an owner of pr.yeny,who builds or Improves temau,and.
whocontracta(or such prejecle with a rnnua mr(s)licensed pursues m the Contractor.
License leve.
0 1 Am asempt under Sec .B k P C for this rtaaon
or
Dao
WORKER'S COMPENSATION DECLARATION
1 hemby affirm under Pvalty of perjury ane of site following d Aradsix
❑I hammed will mnnWna CeniO000r Ccnemte-114nnue fa Workcra Compeer ,
anion,a provided for by Section 3700 of the labor code,Tar Nc perrormana of Ba
work for which this permit b Wood.
❑1 haw and will maintain Workers Compensation importance.u required by Section
3700.(de tuba Code,for the perrmmanreef the work forwhldh this permit b road.
My Warace G mpenAdon l c.a/�mVaA,gnd Policynumber are:
Cartier., E Policy FROM
OR ERS' D�
CERTI• TEPE COMPENSATION INSURANCE WORKERS'
COMPENSATION INSURANCE
(TW;section need net becanpleved If the permit is furan hundedd.lbn($10()
or leas)
1 canny that In the performance of the work for which this permit Is blued.I atoll not
employ anyperon In any mennerso As to become subject to the WorkerCompensation
Jews of CWforois Date
Applicant
NOTICE TO APPLICANT;If,afar making this Certificate of Esempdon,you should
become subject ed Na Workers Componsetion provisions of that Labor Code,you must
O formwith comply with such provision or Nb Permit shill be deemed revoked.
„zs y CONSTRUCTION LENDING AGENCY
[+ Ihereby almm that dam is a construction funding agency for Oa performanco of
a> the work for which Ih s permit Is issued(Sec 3097,Civ.C.)
GQ Lenders Name
Lenders Address
U I certify that 1 low reed this appliestion W sera dem the above isormWun IF
cortcct.I agree to comply with all city and county ardim us s and stag laws relating 10
U building construction,and hereby audorim mpresenouivea of this city to enter upon the
[i7 above-mentioned pmpeny(of inspection purposes.
LL (Wo)agree to taw.indemnify and keep barrrlese the City of cupcnino against
,4 Iiabilikojuitmenm,cats andeapenma which may in any my Accrue sgalntold City
U Z in consequence of the{Mndng of this pees. �^Gw
.. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: 6a Date r.2
S URGE GU TIO
sign. canVCn � — 7-DateRe-roofs �L---�
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will W applicant or future building decupalstom orhandle harardous material
As deRned by the Cuperrom Municipal Code.Cbaper 9.12.and the Flotilla and Safety
Cold.Section ul3x(+)?
[3y" All roofs shall be inspected prior to any roofing material being installed.
•UNo
Will the applicant or mere bonding occupant use equipment or dolor whim If a roof is installed without first obtaining an inspection,I agree to remove
emit handon air cone tons u' by the Bay Area Air Quality Management all new materials for inspection.
District?
0 Ves
I Mw mad Be hesardmamalcrials requirements underehaper6.95ufthe Wifor.
nb Health&Salcly Cade,Sn7iaes713S05.23533 vW 25534.I mubnand nouns a Wilding
dm out comedy have a¢rues.that it b my responsibility to nmify the occupant of the
° 5nm Khmapbemetpd.,toin..of.OcniraaaarOccupancy. Signature of Applicant Date
`i ` rAb' All roof coverings to be Class"B"or better
Owner or authorized agent ijaw
CITY OF CUPERTINO r, ` '�""
BUILDING DIVISION PERMITC� �. �T
BUILDING ADDRESS: v DOWNEY SAVINGS & LOAN ASS MITND'06070004
10381 DE ANZA BLVD
OWNER'S NAME: PERMIT BIBLE DATE .
DOWNEY SAVINGS & LOAN ASSO 07/26/2006
Eo SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECTO PLUMB
oo LICENSED CONTRACTOR'S DECLARATION Job Description
I`uI kk I Mmby+farm Nal 1 am 1k wd under pmvisians of Chapter 9(commencin{
withn iorcc 011O)sDIvlAlon7of Ne Bunnm and profession GOdC,aM my liccmcb
LI`cni�pc aMerhtl µ� Lld« T. I . -NEW ADA BATHROOMS AND ADD 2 NEW OFFICES
i Date +3I,.,_-r. Contractor
ARCHITECTS DECLARA 0
i [understand my plana shell be used a public=Ord,
ig
•c
Licensed Pnresslanel
OWNER-BUILDER DECLARATION
I hereby alarm o n I am,usin from Ute Contractors License Law for Ole
D O whichfollowing u mason.(Section 7 comm Business and Pronetnews.
deform Code:Any oily or county
which requime issuance.pctmil re vires das Alen nt frow,demolish,or e a.ir any structure 1 t]n (]0
.z i prior to its ense Alsoeon,to ma Urmishocam for such comm roe,Lice s LAA, statement Valuation
that to en licensed pursuant to the of DitlomafNe Conveners Lkemehaw(chapter Code)or Sq.Ft. Floor Area
l�D
(commencing with Section 7000)afDivai.n3af the Business and Proremion Cade)ar
thn he b mempt themdtom and the basis for the Alleged eaempdon.My violation of
Section 70315 by arty appllcenl rm a permit subjeeu the+Ppncenl e a evil P=ItY OI er Occupancy Type
net mere than five hundred dollus($700).
0 1,As owner of that property,or my employm with wa{es AS Bak auto—Pemdan•
win do the work.and she structure b not Mended ar offered for ask(Sec.7W.Busims, Required Inspections
Nd Pm/cesiON Cade:The Contractor.Lit=Lew dore net Apply to M owner of q p
property who buil.rimprom Imem nand whodoessuchwarkhimself Or through his
awn employe,provided Ihmaah improvements are notinanded orolfem l fmak.It.
however,the building or improvement is told within ane year of completion.the caner.
builder will love the burden of proving that he did Ml hand m Improve for perp.e of
sale.). .
0 1,as owner of the property,am esclusively contracting with Beamed oonnacen be
convect the project(Sec.7014,Business AM Profession Code:)The Concurs LI.
come Law doe not apply to an owner of pr.yeny,who builds or Improves temau,and.
whocontracta(or such prejecle with a rnnua mr(s)licensed pursues m the Contractor.
License leve.
0 1 Am asempt under Sec .B k P C for this rtaaon
or
Dao
WORKER'S COMPENSATION DECLARATION
1 hemby affirm under Pvalty of perjury ane of site following d Aradsix
❑I hammed will mnnWna CeniO000r Ccnemte-114nnue fa Workcra Compeer ,
anion,a provided for by Section 3700 of the labor code,Tar Nc perrormana of Ba
work for which this permit b Wood.
❑1 haw and will maintain Workers Compensation importance.u required by Section
3700.(de tuba Code,for the perrmmanreef the work forwhldh this permit b road.
My Warace G mpenAdon l c.a/�mVaA,gnd Policynumber are:
Cartier., E Policy FROM
OR ERS' D�
CERTI• TEPE COMPENSATION INSURANCE WORKERS'
COMPENSATION INSURANCE
(TW;section need net becanpleved If the permit is furan hundedd.lbn($10()
or leas)
1 canny that In the performance of the work for which this permit Is blued.I atoll not
employ anyperon In any mennerso As to become subject to the WorkerCompensation
Jews of CWforois Date
Applicant
NOTICE TO APPLICANT;If,afar making this Certificate of Esempdon,you should
become subject ed Na Workers Componsetion provisions of that Labor Code,you must
O formwith comply with such provision or Nb Permit shill be deemed revoked.
„zs y CONSTRUCTION LENDING AGENCY
[+ Ihereby almm that dam is a construction funding agency for Oa performanco of
a> the work for which Ih s permit Is issued(Sec 3097,Civ.C.)
GQ Lenders Name
Lenders Address
U I certify that 1 low reed this appliestion W sera dem the above isormWun IF
cortcct.I agree to comply with all city and county ardim us s and stag laws relating 10
U building construction,and hereby audorim mpresenouivea of this city to enter upon the
[i7 above-mentioned pmpeny(of inspection purposes.
LL (Wo)agree to taw.indemnify and keep barrrlese the City of cupcnino against
,4 Iiabilikojuitmenm,cats andeapenma which may in any my Accrue sgalntold City
U Z in consequence of the{Mndng of this pees. �^Gw
.. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: 6a Date r.2
S URGE GU TIO
sign. canVCn � — 7-DateRe-roofs �L---�
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will W applicant or future building decupalstom orhandle harardous material
As deRned by the Cuperrom Municipal Code.Cbaper 9.12.and the Flotilla and Safety
Cold.Section ul3x(+)?
[3y" All roofs shall be inspected prior to any roofing material being installed.
•UNo
Will the applicant or mere bonding occupant use equipment or dolor whim If a roof is installed without first obtaining an inspection,I agree to remove
emit handon air cone tons u' by the Bay Area Air Quality Management all new materials for inspection.
District?
0 Ves
I Mw mad Be hesardmamalcrials requirements underehaper6.95ufthe Wifor.
nb Health&Salcly Cade,Sn7iaes713S05.23533 vW 25534.I mubnand nouns a Wilding
dm out comedy have a¢rues.that it b my responsibility to nmify the occupant of the
° 5nm Khmapbemetpd.,toin..of.OcniraaaarOccupancy. Signature of Applicant Date
`i ` rAb' All roof coverings to be Class"B"or better
Owner or authorized agent ijaw