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01120025 CI BUILDING DIIVISINO ON PERMIT CONTRACTOR INFORMATION: BUILDING ADDIU SS: PERMIT NO. 7451 FALLENLEAF LA ALTON AIR CONDITIONING & HTG 01120025 " AINE F AND GENE S 45300 INDUSTRIAL DR ##4 A21G y B DATE PHONE: /05/2001 I PHONE: (510) 490-5655 SANTIARY NO. CONTROL NO. 0 O ARCHITECT/ENGINEER: BUILDING PERMIT INFO <U BLDG ELECT PLUMB MECH < 8 v=mi Z LICENSED CONTRACTOR'S DECLARATION lob Description Z- lhcrtby vtBlm that lam licensed under provisto of Chapter 9lcommencing REPLACE FURNACE w e_q with Section 70001 of Division 3 with,Businessan less y cense e Y 4 n is in full twice a fif.2 `7 11 is < Liter.Class e, z© Lie,. ( g�Unp n n ED u LLN Date SDEC A IT C�YBW IVm O CHITECT'S DECLA A Iunderstood my plans shall nc used uz public recd r1 RALi[en.ed Pmfessiwmal U t C 0 6 2001 $ti OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the Z_G lullowing mason.(Section7031.5.Basinsand Professions Code:Any city or county IOD1'�®'SVpg/�LW $3O87 z which q . per apeutt construct,she improve.demolish,o um pair any ttro BUILDING I�u � prioSits :ace,also dequn,be applicant for such petmiti file signed stumment. Nat In licensed - ant to the -" -- pSe prw wisomfth C Vapor ls (Chapter Icw mac i with Section 70(1(8 rDibs n7 of he i.iNd aidMi.AnyIaCode) r;Cg;";f;;35S92�S,d���9i4?.±;_raj;hip. . Valuation or that he n03L5 b m y pidomm,ricar,Mad the basis for the cts he eaempdon..civil violation of Section 70J1�.5 by anyapplicant torn permit subjects the apPlicannw a moil penahy- of nmmorcthan fivebuodreddollars($500). 301APNKGPGH PLUMBIN II"'_•t Occupancy Type ❑L-A—net of the properly.-I myerapt°,cvswhhwages s,hdrmlecompenmllon. 303 - ROUGH MECHANI AL H do the..A.and ma structure is not intended or°rterad for sale'Sax.p614.' 3 04 - ROUGH Err� n'Wad� Business and Professions Cade:The Coronation's License Law does not apply to an IJB VA�Lctlons' .Amer of property Who build,°r immnrea m,rcwn,and who does sum work himself 505 — FINAL ELECTRICAL nr mmngh his own employees.provided mut such improvements am not intended nr .ofrerad for sale If.however:the hi ildins or improvement is mid within one year or .... 507 FINAL PLUMBING. completion,the owner-builder will have the burden of proving that he did not build or " improveforimposeofsalr,). 508 - FINAL MECHANICAL ❑Les owner of She (S n y commctssi with licensed, m,a m '- - p pe y,vin esdusivel - conswct me project(Sec.7611,Bminess Ind Professions Code:)TM1e o,, mmo, - -' Liccnu law does nm aPP1Y to en owner of propcny who builds or improves mown, and.who conuacm for mch projects with a wmmnorts)licensed pursuant to me ❑lam exempt ndetaw. p underSa. � � � ,B&PCfor Ibis meson , 't ownData' . -,- R' WORKER'S COMPENSATION DECLARATION I hereby aRrm,under penalty of perjury one of me following declarations: pl 1\ 1 have and will maintain a Cedifcale of Cmadvnt S°sellinsure for Worker's Compensation, as provided for by Section 37W of the Labor Card,, for She Performance of the work for which this permit is issued. + 3700 v t and will maintain Worker's Compensation Insmance,as r uired b Section he Labor Code,for the performance of me work for whc h this y rmi ' y W es Compe�tada nsuTake carie, d Policy n be pC,,I s ' `Policy uu d.M Gorier. . C TI CATION OF FXEMPI'ION FROM WOR RS',- + COMPENSATION INSURANCE ' s ssttimS need not be camplcmd if he permit is for orrc hundred dollen ' I verify that into,peifmadMacc nerhm work fpe winch hmhis pe o the Wo . .. _ shall not employ any person in any J dr,rsl' . -- Compensopon Laws of Califomia.Dam' Applicant NOTICE TO APPLICANT:If utter Cent n - ..- .. ._. ._. _ ..- _. ... -. mthis ips z become subject y the Worker's Compenswatiauon provisionss o oof Exemtion,you ,cold f the Labor Code,you men Z 0 forthwith comply with such provisions or This permit shall b,domed revoked. ' - CONSan,is a ION LENDING AGENCY a I hereby which that mem iss aonnruace. lending agency forme performance r of mi work for which this permit is Issued(Sec.3097,civ.C.) . 0. Q lande(s Name'.. . . . . . .:. V I vanity that 1 have read this application and state that the above inform anion is ' W E. coiled.I agree So comply with all city and county ordinances and state laws relating V to building construction,and hereby amboriie refo=natives of this city to enter upon >S.W the above-mentinmed property for inspection purposes. .W (We)Agre,to save,indemnify and keep harmless the City of Cupertino against Vi liabilities,judgments,costs and expenses which may in any way accrue against said V..Zi City in consequence of She granting of this permit - APPI'ICANI' IN'DERSTAND \ND WILL COMPLY WITH ALL NON-PO1NY s0v IRF Issued by: Date Si mat asd 'edb the applicant Wilding rdino Charter Alt.and HealNand Rl:-i00f$ Date ' HAZARDOUS MATERIAI;s DISCLOSURE' ,1. ...' ggpantluxe of handle le hauNom moerialType Of Roof, Cine:Secti n 25s321h)T r. _ ❑Yes . �. �No 'r t C. s ).i. •, '. .. (�- , All,roofs shall be inspected prior to any.roofing material being installed. ra IIthe I,contaminants cant rants As taldmg by occ pansuseequiir Qu a, A.,nwhich If a roof is installed without first obtaining an ins ection,'I'a ree to remove 1 emit ho b ua ei comaminams ss defined by She BayAreaA Quality ry Menegemem g p g ^ JD1""" 13 all new materials for,inspection. Applicant understands and will comply.with- pY "° - all non-p6intsource regulations. - I l a ',cad he h vrd . met rich rcq rcmem6 antler Chapter 695 of the ' Calif a H elm&Safety Cade,Sections 25505 25533 and 25534 1 undentaod that tf She bmltlmg does nm cuncndy have o mnem:met it is my responsibility m notify She - --- � - occupam of the rtquimmenSs which men be man prior to issuance of a Crnifcem of ' enc �., _� Signature of Applicant _ Date _ ndaed pgenl Data All roof coverings ro be Class "B"or better