08040031 CITY OF CUPERTINO ��s,�� � a '! av77 �-^s7t�a�y '�^'yg�A''p"*7<�,.%��L
BUILDING DIVISION PERMIT V014QhZt�rvl�lY1lYi�1\ '`av
BUILDING ADDRESS: PERMITNO.
10605 GASCOIGNE DR TBD - TO BE DETERMINED 08040031
NER'S NAME: PERMIT LSSUEDATE
WINNIE S LEE 05/05/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITF.CTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
O O LICENSED CONTRACTOR DECLARATION
4iF I Wmby allirm that L pee locoed under Provision of Chapter Y(mmmcncin, lob Description
W withScedon7")ofDivision3oftheBusinessandProfcssponsCode.andmylicensis RMODEL GARAGE,ADD 264SQ & ALTR 341SQ
in full farce am effect.
j Z License Clpea Lac.10
Dam commmor
eARCHITECTS DECLARATION
e I understand my Pro shall W usJ u Public rtcoNa
pe
g am.1 Licensed Profal
siana
3 OWNER-BUILDER DECLARATION
Z O C 1 hereby v0hm that 11. =sempt from the,Contractor's Co :A License Law for IW
i O O following moon. emdan 71D I.S,Business and Pmfenioli Cale:Any city m county
emne
$ which its iU a permit m construct.alter.improve,do Permit
i fie-sig hay swctme
ty priormmsscensed mau mi the the itim o for such permit m.a Law(Chap.9
`o (mon,bc commed Ostormon'
rh=gwithsmommthcproviiamnfm canp><mrsuanael,wfchapm Y Sq.Ft. Floor Area $ Valuation
(commencing with Semon 7000)Of Division3 of the Business and PmfMyvi CaEc)per 8000
9
that io r exempt therefrom and the aper for Ne cas dic eaempdon Any it peraa.of
Section 7m13 by arty red!doll for a penny abjew dm applicvSt m.civil pwlty of Number Occupancy Type
rct mme thm Rw hundred!dollars 11500). 37528013:°'l7 U' P Y YP
❑1,as owner of the property,or my employes with wages u Weir sok compensation,
will do the work,and the smmom 6Out Intended!or offered for sale(Sec.1016.Business
and Professions Cade The Costnnah License Law don Out apply in an owrcr of Required Inspections
property who Wilds or imp over Worn,andwW daessuch work himrelforduough his
own employees,pmvlded that such improvements are not mounded or offered for auk.It.
however.the Wilding or improvement is sold within are Year of compkJov.doe owner,
Wilder will have the When of proving that he did rots Wild or improve In,puryose of
sak:.).
El 1,as owner of the property,am exclusively contracting with lic reed comm r s to
construct the project(Sec.7001.Business and Profetioru Code:)The Contranmri U.
tense law does not apply m an owner of property who Wilds Or improves Merton.and
who mnteaets for arca pmajems within eommnorts)11eevnd pumuam to the Ci moanoh
Ivens Law.
❑1 on commit under Sx B At P C for this reason
W.�LKFJfS LVM. A ON DECLARATION
1 hereby affirm under penalty of pi one of the following declarations:
❑1 bare sand will mains.•Certifiomol Covent m salfinsurt for Wor4Ys Conium
suit.u provided fm by Smdon 3700 of the V WrCode.fm the pmfarmanm.f the
work for which this permit is issued
❑1 have and will maimain Wo ice,Compensation Insurm¢,as required by Sema.
3100 of the Labor Code,for the pcorormmen of the wort forwhich this permit is issued '
My Wm1me.Compamescom ho u.caner and Policy numher -
Gmier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thrseemen need Sot W ccnplened if the permit is fororchundoed doll=(SIM)
or lata)
1 verify thvt in the performanm of ds work for which this permit is issued.I shall not
cmPIOYmy'peraoninmYmmc —__w tywwemaieetm Ne Workem'Compensado
Laws of California-Dam '
Applicants
became suomp y the Worh K Campensahis pmvWo11 of do deemed
Cade.you most
.J O faMwith mmP1Y with such provisions c Wr permit shall ac dtcmrA rtwtW
Z rn CONSTRUCTION LENDING AGENCY
F Ihomey affirm than dart is a construction lending agency far the performanm of
C> the work for which mass Permit is issued(Sus.3097,Civ.CI
Q Lanni Name
0.
0. Ltrdefa Address ,
U Q i anfy that 1 have read this application utd use Wu the above infonnau.n r
II. cones 1 ages,m co.ply with all city and county ordlnunxs and stale 1.maid.,in
.� Wilding construction,and hereby NWallm representatives of this city in over upon We
F17 shove-mcndm cd property for inspection pugws0
G (Wer)agree to save.indemnify and keep harmless the City of Copetha.
against
r� Iimilim,judgmenu.cots and experases which may in my way meman almost said Cry
U z in consequence Rfthe,rhadng of this permu,
APPLICANT[4114DERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �'t f— I
SOURCE R IATIONS. _ _ _• --SAA)a
t, Re-roofs
Si.um Appli on Cob
Ob ALS DISCLOSURE Type of Roof
Will the appli tmf��um Wilding ottuphaumrc of bndle ha'vrdow maerial
side dcftned by tW Cupertino Municipal Cade.Chapter 9.13.and doe Holth had Safety
.sclye.us3xa)7 Hca All roofs shall be inspected prior to any roofing material being installed.
Ely.
Will to applicant or future Wilding Occupant use cquipmmt or devies which If a roof is installed without first obtaining an inspection,I agree to remove
ecNo it huanair co muminmu u defined by the Bay Area Air Quality Management all new materials for inspection.
Dyes O'fgo
1 have cad the hvamakes materials m,poomcnss under Chapter 6.95 of dm Cables.
w Head thh$W uycodc.Sesvcu nw5.25533 hall Mu .I anaemmane one if mc Wilding
dope rot c.SLFLfour have a omni that to r mK.povibility to unity d¢occupant of the
requ+-- hichmust metpiort SSp c-fa Ccnificm.„1 n........
t S S fz Signature of Applicant Date
ownersanth dog=.t r Da All roof coverings to be Class'W'or better