06070080 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CANT'RAC'-'�U., SIN, 'lS, tM'r1,TYfyf,)
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BUILDING ADDRESS: SA & RAVI KUMAR PERMITN0.06070080
7967 FOLKESTONE DR
PERMIT ISSUE DATE
OWNER'S NAME:
SATHYA & RAVI KUMAR 06
E: SANITARY NO. CONTROL NO.
ARCHITEC IENGtNEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
tCI tT
o a LICENSED CONTRACTOR'S DECLARATION lob Description
ti I lamby of on Nat 1 sm lite under provision.of Chapter 9(commencing
aidm Section 7000)of Division 3 of the Business and Professiom Code,and my license is
I y in full form andeffem REMODEL INTERIOR TO EXPAND MASTER BATH
;qzq aencClw
Dman
Data OoADD 2 WINDOWS AND REPLACE FRONT DOOR.
~7 Dnumter
ARCHITECTS DECLARATION 550 ' TOTAL REMODEL
1 understand my plans shall W umd as public raords
and
'Wt; Licensed Professional
I O3 Oat I am c ompt from
DECLARATION
or
I Wmhy.(flomSect on I em exempt s an Nc Cution, o Lucnrc Law for Nc
%DO following moan. erten t 7 construct,
Business and improve.
de nn Code:Any city or county
$ which aquina a permit re comwet alter,ntprow,demrail u or repair any suunum
Zy
prior tesl iansodreWu requites Neapplicant for suchpermit te Olea Law summate
Q
that mends nwi resonant 7 Ncpmviswm of theCBuumftl3cc f..i.(Chapter9 Sq.Ft.Floor Area Valuation
$ de:MisexampthSenion]Ondthe vision)afNceedeempton.AnyuCode)of $40000
.. Nat ha u.tempt Nemfrom and the Esau for the Waged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects Ne appimant te•Civil penalty of APN Number Occupancy Type
not mart Nan fiw hundred duller.(5500),
❑I,a wrcr of Ne property.err my eroployem with wages at UNCOMIC mmPemdon,
will do Nework.and"Munum is.1 hummi dcronemd fonam(Sec.7044,Bund. Required Inspections
and Professional Cade:The Commences License Law don not apply to an owner or q P
property who Wildsor(roproves f..and wEodoe.suchworkMmselfor Waugh his
awnemploycea,provided thatsuchimprovemmuore notimanded oroRerWfnsak if.
havever,that Wilding or improvement is mid within arc ycu of completion.the owrcr-
builder ,will have Cie burden or pm,m,That W did tet Wild n improve fn papaw of .
ak..
1,u owrcr of the property.am acleively coutrnning win IlcentW mnuecters to
mntmct IW Project(Sec.7044,Beaman,and Profeasioa Code:)The Canuaeter'n Li.
roue Law Coes nut apply an an owrcr of property who Wilds or improves demon.and,
who cansrans for such pnojaal with a ronhmYm(s)Ikemad pumnnt m Ne Convenor's
Lie'.Law.
❑Ism emptun er ee ,B&PCI. inmate
der Dam
WORK• COMPENSATION DECLARATION
I hereby arm un penalty of perjury oro of the following declarations:
❑I have and u-0l mar by Section
3av of Ca Labor Code.
fur fn Performance
l Ce of Me
wtion,r providedhhi(or mi Section 3700 of Ne labor Code.far Ne peRormemm of Ne
wady for which this permit is unatl.
❑1 have and will maintain Worker's compensation Insurance,u required by Section
3700 of the LaborCode,for Ne perfarmutee of the work for which this permit is issued.
My Worker's Compasatlon Nsuntus Carrier and Policy number ma:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
CITU auction reed not W completed Uma Permit la fmanchundred dialler.(SI00)
or less)
1 certify that to the poformenc of Ne work for which this porous is Issued.l shall not
cmployanypermninan milnrcr an u an become subject to the Workeri Ccmperuation
Laws of Calia.Da! 1
ATICEOTICE
ina. AA
NTO APo the :If.a r making Nu Certificate of Exemption.you Nauta
baome subject y it Worker'. cion Or
provit Mai of Ne Labor Code,you met
.J O foMwin comply with such provision m Nu Permit Nall W dametl rewked.
Z V) CONSTRUCTION LENDING AGENCY
(..m 1 hereby eRnn that Nem u a ronuructinn Lending agony for the perfomunm of
C4 > the work for which Thu permit is iuued(Sm.3097,Civ.C.)
W Q Lender's Num,
Undoes Address
t.p 0 1 certify that I have mad this application and sum that the above infnmatiun it
U,E coned.I agree te comply win all city and county ordinances and suer taws missing to
0O building construction.and treaty muorin representatives of this city to enter upon the
131 move-menduned property for inspection purposes.
(We)agree to ave,indemnify and kap harmless the City of Cupertino against
ry Ilahllitieajudgmenu.cosuandeapeme whichmayinanyway.lipe;nlso or /
C.3 in consequence of Ne tooting of Nu permit.
z :F,
4 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON.POINT Issued by: Date
SOURCE CU TIONS.
Re-roofs
Si erre a Aiplian manor D
N USMATEtIALSDISCLOSURE Type of Roof
Will Use appliam orfuuau Wilding oevpantseem or hole henNNous mammal
as deftrcd by Ne Cupertino Ma ecipai Code.Chapter 9.11,and the Hca1N W Safety
ado.Section 25532(x)? All roofs shall be inspected prior to any roofing material being installed.
°You '`')mo .
W01 the applicant or route building Occupant ere equipment or dodcea which If a roof is installed without first obtaining an inspection,I agree to remove
emit hvaNne air coumninsnu as de0nd by the Bay Amo Air Quality Management all new materials for inspection.
District?
0Yn 19Eu
I have mad the too uNautTnWc ials require r coal under Chapter 6.95 clubs Ciliforn
nia Heal"Safety Code.Satins,1550525533 and 25534.1 understood NO ifine Wilding
don tet carte try he a tour,Nu It u my responsibility te notify dm oaup.,of ds
ms,dramcnus se .:,.(priorm;uuamceafa Ceruft" fa parmcy Signature Of Applicant Date
on All roof coverings to be Class"B"or better
owner mmNarivca, t