08070199 CITY OF CUPERTINO _k,41 '
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BUILDING DIVISION PERMIT dC01 TRA QR TN'FURMATION '`.
BUILDING ADDRESS: PERMIT NO.
20860 DUNBAR DR BEST HOME SUPPLY CORP 08070199
NER'S NAME: PERMIT ISSUE DATE
CATHERINE LIU 7335 BOLLINGER RD STE D 08/05/2008
PHONE: SANITARY NO, CONTROL NO.
(408) 255-4088
ARCH=/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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'Ing,z' LICENSED CONTRACTOR'S DECLARATION - Job Description
iI u G 1 herem dust affir1 uv limed under provisions of Chapter 9(rnmmrncing P
^�G6+ with Section?O(M)of Division Sof the Business aM Profession,Code.and my Ikessels REVISE HIP SIZES FM 12"DP T0101IDP SEE 2&CALC. S &
n full font mo ogee,
�q: LicenseClus Lk.g' REVS SME FLR BMS FM 16"DP TO 11
"= Date ter
TSDE1/4"DP(ORG#07100207)BUT PLS—SEE CALC BHT 8 TO 14,
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ARCHITECI-S�ECION
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W I understand my plans shall be used as Public records
Ir no t; Licensed Protest anal
OWNER-BUILDER DECLARATION
I Mreby affirm that I am exempt from the Contractors Uccnse Law for the
p O following mason.(Section 703 L5,Business and professions Code:Any city of county
so! which require a permit w convect,eller,improw,dcmalLah,or mpair any stmctum
prier In its issuance.also require the applicant for such permit to file a signed statement
< that Immanent is licensed pnr ,nt m me provisions of me Comrseers License Law(Chapter 9 Sq.Ft.Floor Area Valuation
I�$ (commencing with Section 7000)of Division 3 of dm Business and Professiom Code)or $0
e F F that he Is exempt therefrom and the basis for Ne alleged exemption.Any violation of
Section 70315 by any applicant for a permit subjects the applicant to a civil penalty ofNumber Occupancy Type
not come rem five le admd dolls s(S300), 32630144 .
I,uownv of me pmputy.or my employers with wageume'vule compewtion,
will da the work,and the structure u rot intended moffered forsale(Sec.70/4,Bus.
and Professional
Code:The ComaxmYa License Law does WE apply toan owner of Required Inspections
Property who Wilda orimqores dcrsn,andwM doessuch wort Warmed.through his
awn employrn,provided Thu such impmwmmu am not intended reoffered(wale.if.
however.the Wilding car improvement Is mid within one year of completion.me miner. -
builder will leve On burden of proving that W did rot Wild or improw for pulp.¢of
L u owner of the property am eulusiwly contracting with licensed contractors to
corsumct the project(Sec.7014,Businessand Pmfoasiotu Cede:)The Contractor's U.
card
Law doss not apply to an owner of property who builds or improves thereon,and -
wW comacu for such projects with a conuwm*)llvnsed pursuant to the Conuxrnh
License law.
❑tom ex�et�un�Sp�ee .B&PC(er Nis moon
ror I F�LNXiY(A/CD ?,fA Dna
WORKER'S COMPENSATION DECLARATION
1 hereby atom under penalty of perjury We of due following decimations:
I haw and will maintain a Certifuam of Cortsem to self-invent fm WahefsCanpen-
cation.as provided for by Section 3700 of the labor Code.for the performance of she
work for which this permit is issued.
1 have and will maintain Worker's Comporudon Insumce,as required by Section
37W of the Labor Code.for the per(omanaof the wort forwhich this permit u issad.
My Worker's Compman den Women.artier and Policy number am:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thusecdm road not W completed if the permit is form hundred dollars($100)
or tens)
1 earthy rent in the performance of me work for which this permit ls issued.I scull not
cmpi,m,persan in any munersou Wbec�e Uo Un Wohen'Compensadon '
Lauof CMif. IDale JJ X
N(MCnt CA
We ne. TO APPLICANT:If,cont making mu Certificate of Law oe,you sham
Wcome suomp y it Workers Compensation provisions of the Isber Cade,you must
.,O forthwith comply with meltpmvisiov or this permit shall Wdermed reveled.
'Z^' ^ CONSTRUCTION LENDING AGENCY
[-vim I bereby affirm that them u a construction lending agency for do,perfomame of
fY, > the work for which the permit Is issued(Sec.ID ,Civ.C.)
1.0
A Lender's Name
=Z Lenders Add=
U Q I excel 0.11 have mad this application and sou mu On aWve infem urion is
U, ;'". comet.1 agree to comply with all city and county ordinanccs and sou laws misting to
.0 SV' Wilding crosuuctiot,and hereby authorise representatives of this city to user upon the I -(�/-t-\btu(/{////
r tel a Wee-motioned property,for Inspection whichpurposes 1/""!/
gyp (We)agree m save,indemnify and kerp bamless dm City of Cupertino agsimt
UF'h Iiabilide,JWgmcnU.casu mdexpen,e whichmryin any way acme,gmvtstld City
,Z, in consequence of IW gmdng of the pcmoia
^ APPLICANT UNDER ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �'—,f'� '-G
SOUR5 E EGU
/ te� �� Re-roofs
�ign'uum of Applican✓Contractor Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding occupamsrom or handle harnsdoe material
u defined by the Cupertino Municipal Code,Chapter 9,11,and the Health and Safety
or. ❑Ye Ri section zss3z(,)7 ,,7 No All roofs shall be inspected prior to any roofing material being installed.
Will the,applicant or futurt Wilding occupant are If a roof is installed without first obtainingan inspection,I agree to remove
pp g p Area
Air Quality anawhich P
emit hvAWae aircmtaminants u dcUncd by d¢Bay Ama Air Quality Management all new materials for inspection.
District?
Dy. 3�No
I have rear the Wondrous materials requirements umkrChamer 6.95 afore Califor-
nuHealthkS,Icty Cade.Sccti.25%5,25533uW25534.IuMvmndmuiflW building
des note tly law•mel the it u my=rp Mlity m.dfy do aeupant of dte '
motel Whichmsm nmt
7 eacenneamer�xco�arsey,
Signature of Applicant Date
44z �
TAll roof coverings to be Class'%"or better