06080033 CITY ORGUPERTINO a
BUILDING DfVIs1ON pER1yIIT CONTRACTOR INI ORMAT19�I
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BUILDING ADDRESS: NEHA DESAI PEaMrrNO06080033
7513 HEATHERWOOD DR
0 NEWS NAME: PERMIT ISSUE DATE
NEHA DESAI 09/07/2006
E: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG EO PLO MO
�op LICENSED CONTRACTOR'S DECLARATION IOM DaSCrI U00
F 1 thereby affirm Nal 1 ao licensed under provivons of Chspmr 9(commencing Job
with Section 70110)of Divlsion3 Cram Businecsand Professbns Code.and my lkense4
o infull to=and e(fe. ADDITION 360 ' -2 BATHROOM, 2 BEDROOMS
License Class Lm. REMODEL 180 ' - KITCHEN
a.ppp
Data CO-bromm
I ARCHITECTS DECLARATION
i 1 undersand my plans still he used u public records
i
G
Licensed Professional
1s OWNER-BUILDER DEMe RATION
f n o 1 hereby affirm,Nm I am exempt foes the Canlneloh License taw for the
:19 whicfollowing reason. (anion 7031.5.Business;and Improve,
dafuns Code:My city or rnunty
bet2i which re9usuaapermit m<nres Me Wu.ht forsu deermitt fie repair my ptmwm
.psi Priorwi4 Issuance.aim requims the applicant(auuch pemiva fikasLwdmammem
that he is licensed pursuant ties provisions of Ne ConUm:tori Licerm law(Chapter Sq.Ft. Floor Area Valuation
(commencing with Section 70DO)of Division 3 of dm Bushaosand Prof nedom Cnde)or $95308
China
he 4 exempt therefrom and the basis for the alleged exemption.My violNon of
Section 7031.5 by any applicant for a Permit subjects the applicant m a civil penally of APN Number Occupancy Type
oat mom Man five hundred dollars(53110).
❑1.as mwm of Ne property.or my employees WU wages a dealt sok earipenadon,
will do thew ill.and Mescrmme is rest intended oeanered for ask(Sec.70th.ButiM•• Required Inspections
and Profmadom Cade:The Contaacmrs License Law does est apply m an Owner of q P
propeny who builds or improves Narcan,and w ho does suc h work himself ser through his
awn employees,provided that such improvements arc not inlendd manered for ale.If,
however,the building or Improvement is sold within am year of completion.the owner.
builder will lave the burden of proving that he did but build or improve for purpose of
ate.).
o•1.as want of the property am axclumvell,contracting with licensed mnuactors m
conetmcl the project(Sec.7064.Business and Prafeations Code:)The Cmuactm's B-
eane Law does am apply as an owar of property who builds or improves thesean,and
who com am for such projects with a comounor(s)licensed pursuant he Me COmwmarf
License law. ,
❑1 am exem'p't turad�erSege, -,B&P C for Nis mason
r f�6'0_' Data q
WORKER'S COMPFNSA77aM�TION
1 hereby affirm under penalty of patjury obe of the following declarations:
71M4,
,as provided far by Savona 3700 of the labor Cade.for the performance of thefor which Nis permit is issued.
how and will maintain Worker's Compensation Insurance,a required by Section
of Ne labor Case,for Ne performance of Ne work for which this Permit Is issued,orker's Compensation Insurance carrier and Policy number am:
er. Policy Na.:
CERTIFICATE OF EXEMPION FROM WORKERS
COMPENSATION INSURANCE '
(This means wed oat W completed if Ne permit Is from hundred dollar,(SIM)
or less.)
I certify that in the performance of Ne work for which this permit is issued,)shell ml
employ any parson in any rrmz psmpQgme abject to the Workers'Compensation
Laws of Cslffomia Date
Applicant ,1iI imp
NOTICE TO APPLICANT:If,after making this CesiDuam of Exemption,you should
become subject in Ne Workers Compensation provisions of tic LaMar Code,you am
.JO forthwith comply with such p ravoions or Nis permit shall he dcemcd rewind.
z CONSTRUCTION LENDING AGENCY
(-� I hereby afOm that Nam 4 a construction herniae agency for Ne performance of
ai the work for which this permit is intrad(Sec.3W7,Civ.C.)
14 Q Lenders Name
.7 2 Lenders Add.
U I certify that I have rad this application and sum den the show infomadon is
ty F comet.l acme to comply with all city and county ordinances and mile laws mlning Ir
�U building construction,and hereby authorize representatives of this city to enter upon the
U shove-mentioned property far inspecuon purposes.
LL (We)agree to save,indemnify and keep harmless the City of Cupcsino against
lA liabilities.Judgments,costs and expenses which may In any way scene against said City
U Z in consequence of the granting of this NOMIL
.. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATI q OG
Re-roofs
sienatuse serApplian fur DO oak
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tiNtt
Vas applicant or am building aupatetstorc9.1 ser handle Health andSafrmaterial
a defined by the Cupenlno Municipal Cone.Chaplet 9.12.and dm Health and Safely
de,Section 255324)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes 56No
Will she applicant or future building Occupant use c ulpabou or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hvardnua air comaminsnts in de0wd by tic Bay Asea Air Quality Management all new materials for inspection.
District?
❑Yua S7 No
I have mad the bavrdousmaterials requimments underlChapmr6.95 o(the Califor.
ria HcalN&SafclleCdc,Satiom23505,25533 and 25534.1 understand NRafthe building
docs not currently haw a lenanL Nn it is my maponibllily in nonny,the mcupant of the
mquiremcn__a whJbIt bemelpnarmissumceoll Cenfrmalearr;rcl Signature of Applicant Date
1' "AZZ q 9�06 All roof coverings to be Class "B"or better
Owner Or author da cm Dale'