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BUILDING DIVISION PERMIT
; CONTRACTQR INFORMATION
BQI.?TbAPPRER FOOTHILL BLVD
lV
TBD — TO BE DETERMINED
PERMIT NO.
08060075
W NIER''S NAM1E: 'PERMIT
ISSUE DATE
FOOTHILL CONDO ASSOC.
06/10/2008
PHONE:
SANITARY NO. CONTROL NO,
AR CHITEC7r/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTORS DECLARATION
Job Description
P
1 henby affirm Nn I am licensed under provisions of Chapter 9 (commencing
with Section70W).f Division 3 of the Business and Profession, Code. and my license In
RESTRIPING PARKG STLS FOR HANDICAP, EXISTING COMM
in full force and trim.
License Class Lic.g
BLDG
Dale Comrmor
ARCHITECTS DECLARATION
1 understand my plan, shall a need an public records
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Conlactofs License Law for to
following maaon. (Section 7031.5. Business and Professimu Code: Any city of county
which requires a Permit to construct. alter. improve, dcmnitm, or repair any structure
prior to its issuance, also sequins the applicant (orsuch permit to file asigncd statement
' thaWinfounetdpmomamtoft mviauua(the ComtrxebrsU.. Law (Chapter 9
Sq. Ft. Floor Area
Valuation
m 3 Business Professions Code)
b
$12000
(commencing widen Section 70M) of Division critic and or
We he is exempt tesehom and the bun for the alleged esemptiiu Any violation of
3 4 2 4 9 0 2 4 Number
Occupancy Type
Section 7031.5 by my appl'rcasn for a permit subjects Nc applicant o a civil penally of
not roam Nan five hundred dollen (55007.
.*
❑ I. u owner of Ute property, ar my wploycu with wages a their foto compensation,
will do the won, and the a.,.. in nntimende i maffeted formic (Sec. ]DM, Business
Required Inspections
sod Professions Code: The Comraclars License Law eau act appy as in owner of
proper who Wilda mimpmves do mon, and whoducamelowo,khi oux1f or Wough his
mere employee, provided thatsuch improvements are not intended moRertd forsala 11.
howevm. the Wilding or improvement is sold within one year of completion, the comer -
builder will have to burden of proving that he did not Wild or improve for purpose of
sale.).
❑ 1. as owner of the property. am exclusively comae ring with Ocen,ad mnuacsors to
Construct the pmjm (Sec. ]OU. Business; and Pbfession, Cade:) The Conuxuats U.
come law does not apply b an owner of property who Wilds or improves thereon. and
who contracts for such projeN with a conuracba(s)licensed Pursuant to the Contractor's
License Law.
❑tom nem Sec B&PC for the teawn
n Cl Date 'ra
WORKER'S COMPS SATION DECLARATION
Ihereby affirm under peoaLY o in one of the following declaraen,:
❑ 1 haw and Colli maintain aCu rimmof Comas b wlf-insert for WohcesCamp[n-
pmvidfar Section 3]00 of rte labor Cade. far the pcaorman¢ of the
Coivmvos,
n forr which Nis Permit is isnot.
❑ 1 have end will maintain Workers Compcvation Insurance. an requited by Section
377M inc slater Code, for thc pcifurmanm ofthe wort for which Nu pcmhtt is issued.
My Worker's Compensation Insurance carrier and Policy, number art:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thesmion need net x completed if to permit is furore hundred dollars (5100)
-
or los)
1 certify thus in Ne perfnmme. of the work for which this permit la issued. I she net
employanyp[Ren//'n an mamlLfm if b become fubi[Ct b to wenw, Gampenfaime
Laws of Ca'rnm6' roe ,.f.
Applicant
NOnC L after making thin C[niBate of Exemption, you mould
become s rect b the Wohe!'a Cumpen,ation provisions of IM Lamm Code. you mull
forthwith comply with such pro,moru or this permit mall a deemed mmkod.
CONSTRUCTION LENDING AGENCY
1 W slut there is a agenry fm the peaormanceof
r which ant (Scct 0 7, Cing
rte dura for which the p[nnil a issued (Ste 309'1. Civ. C.)
� ndm'f Name,Le
Lend[ff Address
1 unify that 1 have read this apPlifbiw tad mute the the mese infmmatiun e
Comm I agree to comply wit all city and county oNinancef and sou laws relating to
Wilding ecrour ton, and hereby autharim repruenudves of the city to unter unto the
aWv[-mentionedous.co (m i
(We) agree to save, indemnify and limp harmless the City of Cupertino against
epttvon which may
IiaCoisesjWgmenheforming[xpen,esmit. may in any wase accrue a{autsald City
di
b Consequence of the of this permit.
RTAforming
APPLICA NDERSTAN AND WILL COMPLY WITH ALL NON -POINT
SOURCE
Issued by: Date
ON
6 CvaUP
Re -roofs —
finallife afApph Data
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will to applicant or future Wilding acupantsbrt or handle huvdous materia
as defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety
. Semon 15532(x)?
r] Yu 01hrr
All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future Wilding occupant use equipment or devises which
If a roof is installed without first obtaining an inspection, I agree to remove
emiI hayu mums air contaminants u defined by the Bay Arca Air Quality Management
all new materials for inspection.
Dis mT
Oyes P115—
115—Ihave
thanreal the hvaedwsmaurialstequimments under Clupter6.95 o(theGlifor-
ne HcalthkSafcty Cade.S[cuoru25503X533 and2553. lundcrsund thadthe Wiling
docs nit currc ty Mia • lenan4 Nal it a my nupan,ilsililY b mtifY IW omhpms m( the
mquirem which must h I prior m issuance of a Cenlfieaw of Occupancy.
of Applicant Date
G'!oSignature
All roof coverings to be Class 'W' or better
o nor i etithonxd agent Dm[