06070023 CITY OF CUPERTINO at'+ w.>3 �,h�?dsa�a Ike `�' R�"
BUILDING DIVISION PERMIT •^.lCi]NT"A -TOR INFORMATIO
z i71.art,Y+/fr v"R rtsA'A.A!+a d,v,u°tra 3e+•�+i.
BUILDING ADDRESS: ' ALLEN SIGNS INC PERMIT 110.0 6 070623
0745 S DEANZA BLVD
PERMIT LSSUE DATE
R'S NAME:
ORECK CLEAN HOME 1982 STONE AVE 07/07/2006
PHONE: SANITARY NO. CONTROL NO.
(408) 280-6500
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDGELECT O PLUMB WECH
O 0
loo LICENSED CONTRACTOR'S DECLARATION lob Description
4�he 1 hereby affirm Nn I am licensed under provisions of Chapter 9(Commencing
with Section 7M)afDivision 3 of the Business W Professions Code.m l my license 6
In full face and Off — INDIVIDUAL CHANNEL LETTER SIGN
M6 aM,-'qq, Lkemc Class Lic.N
Cousor
387 Oau ARCNffECrS DECLARA ON
f c� 1 undcmand my plans shall be used a public mrnrN
l
aG Lwenmd Pmfcasional
OWNER-BUILDER DECLARATION
1 hcrthy aRrm
that 1 am exempt from OR Contra roes License Law for the
a0 fallowing maann.(Section 703 1.5,Business and Profession,Code:Any city or county
$ which requires a permit to comeruct,alter•Improve,demolish•Of repair any mNmum $5000
iy pdorm its imu me.a0o requiras Ncapplicanl formch permit.file asignN OYLL'menl
€D IMtheislicensed purmmttothe provisiomofthe ConuecmfsLicenmlaw(Chapmr9 Sq.Ft.Floor Area Valuation
$ (commencing with Section 7000)of Divulon 3 of Nc Business And Professions Code)or
— dot he is exempt therefrom and to Wig for the alleged eaempdon.MY Mtlulon of
Section 7031.5 by arty applicant for a permit subjeeh,the applicant to a civil penally of er Occupancy Type
nut more than Ric hundred dollars
❑1,as owner of Ne property,or my employer with worm As their role compensation,
will do Na work and the suuemm is not inuuled or offered forssle(Sec.70M,Busimem Required Inspections
W Profession,Cede:T1e C.Mme m's Lke,me Law don rot aPply m m owner of q P
property who builds mimprows statement.and whodoessuchwohhimttlfmthrough his
own employees,provided that such improwmenu Am not inunded maffered forssle.If.
hawawc,the buildingor Improwment is mid withinam year of cmapution,thee wrote-
builder w111 haw the burden of proving that he did not build or Improve for purpose of 7/
Ask.).
❑L as tweet of project
Property,.Business exclusively canmmins with:)Th.C nti mes . `�
ecase La toes not (Sec. s x4.wnrOfand Professions Cade:)The Conhacmah, of u
come law dem not appy m ts owner of prole^Y ace builds rs antrowa Connex W
whence Lacca for such projects whit a conwcmr(a)licensed pursuant m Ne ConuecmYa
License Law.
Iemexempt antro See .BkPCfor Nh,reason
Dau
WORKERS COMPENSATION DECLARATION
I hembY Amon under penalty of Perjury,ono of Ne following dcelarWons:
❑(haw aM w111 marry Section3700
Scam of Conxem NCode.Arefm WorlcY.Ctm1Re
work(r provided far a Scotian 3]00 of Ne labor,Cade.fm the perfomence of Ne
work for which Nu permit is issued.
❑1 hew and will maintain Worker's Compensation Insurance,As required by Section
3700 of the Labra Code,for she performance of she work for which this permit is issued,
My Worlds Compensation In,urance curl,and Polity nu`mbe/rre�am:
Cartier.�'tl1.rMP 1'$!AMOK
Policy No.: �-1''f
CERTIFICA•fB OF EXEMPTION FROM WORKERS' '
COMPENSATION INSURANCE
(Ibis section and mthecomplete l ifte permit is foram hundreddollam(S100)
or leas.)
I cenify Not in the pmfomaom of the work,for which this permil is Usual.I shell enhe
employ any person in my manner so As to hemme subject to the Workers'Compensation
lawn of California.Dau
APPlicanI
NOTICE TO APPLICANT.If,after making this OuslR eam of Exemption.you should
beenme subject m Use workers Compensation irmisim of Into Labor Code you most
O fonawiO comply with such pravirions m Nu permit Nall be domed mwked.
„Zy^ CONSfRUCnON LENDING AGENCY
1 lumby AM.Jas fere la a connrmtnn lending agency for the performance,of
rhe> to work for which this Permit Is issued(Sm.3097,Civ.Q
A Lmdml Name
z Lender,Address
U 0 1 sonify that I haw read this application W sue that Ne show information I.
D, comm.1 agree to comply with all city and county ordinamas and zone laws muting In
0 U holding Construction,and hereby authame mprescnutiws of Nis city to enter upon the
ab
h,1 ove-mmnuored property for inspection purposes.
(We)agree to saw,indemnify and temp hamleu the City of Cupertino against
faA liabllitias,judgmcnh,,cash,and expcmm which may in anyway acmm against said City
U,'� to consequence of Ne granting of this permit.
"-' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE gE! gATI NS.
i ~ Re-roofs
Signaturen Ap'pli VC n sur are
US MATERIALS DISCLOSURE Type of Roof
4WeWill the applicant or fretum building occupamstae orhandle hammous material
Bud by to Cupertino Municipal Code.Chapter 9.13,and to Health and Safety
Section 35533(.)7 All roofs shall be inspected prior to any roofing material being installed.
r]Y. Ill NO
Will the applicant or future building omtpant use equipment m dcvicca which If a roof 1$installed without first obtaining an inspection,I agree t0 remove
emit hmardnua air communanu As donned by the Bay Area Air Quality Management allnew materials for inspection.
Diatric,7
GYca 12W.
I haw mad OR has Nm,mauMa4 mqu iremems lemur Chap sO6.95 of the Cali for.
nu Health k Safely Cade,Sections 35505.35533 and 35534.I understand Nmiff building
Jamrot cu IY haw a unant.tut it u mY ttspon,ihilltY m notify Je mcupant of Ne
roquion u icY/re le tpriortaiuunnc.f.cettireaetffkcupancl'' Signature of Applicant Date
On '06.
em mm - All roof coverings to be Class'B"or better