06010175 CI TY OF CUPERTINO ' � ��." ' ^y)�a"y� - ' ' *I♦ ��y"l��
BUILDING DIVISION PERMIT' 01\ V1A1���,.�, ff •,TV.1\
BUILDING ADDRESS: PERMIT N0.
7553 HEATHERWOOD DR
.R'S NAME: PERMIT ISSUE DATE
NIKHIL AND BINA BHATT 03/22/2006
HONE: SANITARY NO. CONTROL NO.
ARCHITECrBNGINEER: .BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30o LICENSED CONTRACTOR'S DECLARATION JbDescri tion
V 1 hereby affirm rm Nat I lunder provisionso
of Chapter 9(commencing P
n� withlltoce ndefecDivi.ears3aftheBminusudPofessinmCade,andmylicenseia ADDITION TO KITCHEN & DINING ROOM & REMODEL
m full force and effect.
5� U.anse Clan uc.g WHOLE KITCHEN & DINING ROOM, RECONFIGURE PORCH
"e Date
ARCHITECTS DECLARATION ENTRY. ADDING 1 NEW GAS LINE.
K 1 understand my planshall be sed as public records
5
Ap0 Ltecmcd professional
OutNE.BUILDER DECLARATION
9 o o I hereby.(five Out 1 1. exempt from the Cdnbacro o :Any c Law for the
too following moon.recruit
t 703 1.5,Business and Rt.de oli Code:Any city or county
$ poor i rtyuira•permit oc construct,atter.Improve.demolish,t nr marsh ad awnum
S^ primmits issuance.edp.lent to the do options for sohpewitmfileesSigned atatemem
<
Was
murrowcgwithSresu..7M)ofviuffim3NeCmfeanessancemcLaw(Chapter 9 Sq. Ft. Floor Area Valu
ttf/p9000
that he Is attempt therefrom
Satfro oud of basis for
of the 1.&.d except Pe.fessilAny ns Cnde)ter
that he le eumpt therefrom and the buts far that alleged eumptim.Any violatim at
Section 7031.5 by any applicant for a perm,subjects the applicant W a ciVll pointy of APN Number Occupancy Type
not mora than ftw hundred dolWs($50B.
❑L u owner of de pmporty,m my employes wise wages u their mise mmpem,lon, 35.926056 , 009"4b-
and Protectionist Code;The Contractors License Law tinea rot apply to as owner of suctions
property w ho builds m ompravea thercon,and who dwa such work him i cef or through his
two employca,provided Na such impors menu aro not intended moOerM fineala If.
however,Ne building or Improvement is sold within one year of compledon,the owner•
builder will Mw the burden of proving that he did not build or borrow for purpose of
�ulcJ. ���aas V
u owner of the property.,Business sielusively confessions with:)seemed confeamon i- v
camwenhe poke.(Sec.w sumrofand Professions Code:)The Com arson. nd
Li-
cents law dos notch apply a summer of property who huilda re ompowa theroon.and,
who contracts for such projects with a confeanor0)licensed pumm�t in the CanfeacmM1
License law.
❑lam exempt under Sea�-�,P� .B&P C for is moron
r UC.7t�ix..r9 X lac
WORKERS OMPENSATION DECLARATION
lip I harobY aDiw under penalty of perjury orc of the following declaedmu
❑ihaw and will mainuinacenlnmmof Comentmself-IncumfmWoeaesCommn-
ration,as provided for by Secdon 3700 of the lahor Code,for On performance of the
work for which this pewo,is used.
❑I have and will maintain Workers Composition Imuruce,a inquired by Seclfm
3700 of the Labor Code,for the penfr mmo of Ne work for which thio pool,Is how.
My Workers Compensation Insurance carrier and Polley number me:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This ruction used not be completed if the pewit is foram hundred dolls t($10)1
or leu)
1 unify,that in the performance of the work for which this perms is oared,I shall no
employ Any person in any manorst,as to become subject to the Workers'Compensation
Lawrof Califomia to -'
Apploant �^✓t
NOTICE TO APPLICANT:IL ager making this Certificate of Exemption,you should
become subject to the Worker's Compensation previsions of the Labor Code,you most -
,'O forthwith comply with such provisions m this permit shall Ise domed rounded.
zyCONSTRUCTION LENDING AGENCY
[� Ihamhy Aliiw Nat them is a construction lending agency for the performance of
ai the work for which thts pewit is issued(Sec.709'1,Civ.C.)
G no
Q Lower,Na '
.7. z lander.Addma
U0 1 ceNfy the,I haw read this application and mte that the above InfowAon h
I,, correct.I egroo m comply with all city and county ordirences end Aute taws slating to
OU building construction,and hereby euhorin repraenwiws of this city to enter upon the
W ahovc-mentioned property for inspection pugases.
y (We)agree to save,indemnify and kap hawlea the City of Cupertino!gaunt
y liabilities judgments,cents and expenses which may in my wy¢sera against sued City /
U 7 in consequence of the inning of this Pewit. 3-, 2`L-V[j
F7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE RbGUunpNS.
6 Re-roofs
Signature of Appl clmVConuanar
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant nam or handle haardow material
defined I.Y.tie Cupertino Municipal Code,Chapter 9.11,and de Health and Safety
Swo25531(.). All roofs shall be inspected prior to any roofing material being installed.
OF ❑Ya
Will the applicant or future building occupant use equipment m devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haardous air conuminuts as defined by the Bay Area Air Quality Management all new materials for inspection.
Di,hicl7
[3 Yes
1 hew mad We huardos.=data requirements under Chapter 6.95 of the Cao ice.
nix Health&SafctyCeda,Seniom 25N15.15533 and 25531.1 mdermnd that if the building
dos not currently have a unapt,that of is my moonsibility m nodl'y We acupent of the
myuimmcntsw'hmus`hmn ' rmlau aCeniRcateofo�,t cr' Signature of Applicant Date
Owners mtharimd igen. S p,e 0 All roof coverings to be Class"B"or better