06010071 CITY OF CUPERTINO 7T,7717 c « _ (�+a �"
BUILDING DIVISION PERMIT �C,OItACTORIN .�U, RMATIO, NI�a.
BUILDING ADDRESS: _ EMANCON INC PERMITNO.06010071
22066 HIBISCUS DR
ifR'S NAME: PERMIT ME DAM
ODETTE & AYMAN ABUKHATER 1480 RAMON DRIVE 01/20/2006
PHONE: SANITARY NO. CONTROL NO.
(408) 739-2114
ARCHITECfrENGINEER: BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
I� I� Q 0
X00 LICENSED CONTRACTOR'S DECLARATION Job Description
w I hcaby affirm NoP
at I Am licensed under provisions of Chapter 9(commencing
n with Section lllIXBaf Dlvlsion Sof Mc Bushoucand Nofcai...Code,mcimyliecnse4
in full force Andcffen. t2 IM32-71 REVISION--FOUNDATION/FOOTING DETAIL,
%'pz
License
Clw Lie ADD GIRDER UNDERNEATH WALK IN CLOSET
=t,•p Dam Container
! � ARCHTECTSDECLARATION NO NEW PERMIT ISSUED/ORIG. #05110129
5�< I understand my plans Mall be used u public records
O Licensed Pnrtnsiansl
OWNER-BUILDER DECLARATION
COO hereby Maso affirm on I am exempt from he COmm�Co License law for tic
COO fallowing uires A Permit
t RD LS,BLLUnW and w, a moll CWC:My ally of county
K$ which its requires a panic w eovtmc4 tlmn improve,demolish,m e a sig any m anon
yZ�, Pham Mits caned e,akw aqui res tiro Applicant foe wchperW,'.ti l..Law ttasement
NarheucttnwJ pursuant TOM)of Diviavol tife oBusi est nwenselaw(Chepmr9 Sq.Ft. Floor Area Valuation
i �s (cat he is(commencing Section TOM)the
thadison 3 n(NC egad Business and Proesson.Any vl Crede)an or $214
e3— Net he 4 exempt IMafrom and the bats for the sikgrA exemption.Any violMan of
Section 7031.5 by any Applicant for A Manic Subjects the AppllcanrM a civil penalty of AISN Number Occupancy Type
.at more Man Rw hundred dollen($500).
❑I,As owner ofthe property,or my employees with wages AS their sole compensadon,
00
will do Me we-And the structure isnot Mended ofaRCRd for sale(See 7644,Bushes Required Inspections
and Profensev Code:The Canuactor's License law don not apply e m owner of Q p
property who bui Ida or im proves thereon,Anti does such work himself ser through his
own employees,provided Mal such impro,amenu as notinended ar Offered for ale If. C�
however,Me Wilding or improvement is sold within oro year of completion.the owner.
builder will haw the hmden of proving that he did nm Wild or improve for purpose of \
ale,). S
❑I.a Owner of the property,am exclusively containing with licensed centracma At \'`
customer Me propel(Sec.7044,Busimen ad Professions Cade:)The Conmammt Lt. V
cove law does not apply in an awmr of property who builds or improv Merron.and,
who contracts for such projects with a contrecwa(s)licensed present a the ConlranoYs
License Law,
❑lam exempt under Sec. ,B&PCforthhmaaon
IF Dale
WORKER'S COMPENSATION DECLARATION
1 hereby of on under penalty of perjury am of the following declarations:
❑I haw And will maintain aCertiOnte of Covent M seT6lnsum for Worker's Compen. -
sMon,as pmvlded for by Section 3700 of the labor Cade,for than perfomtanee of the
work for which this permit is issued.
❑1 haw and will maintain Workers Compensation Insunnce,AS acquired by Section
37W of the labor Code.for the performanee of the work for which this permit is Issued.
My Works( ompevatisn lnaunntt cortin and Policy number {. N
Cartier. Polity Na.: �Q�
CERTIFICATE OF (Icia ON FROMWORK S'
COMPENSATION INSURANCE
(Th4section need notheeompkted If the permit 4 foram hundred dollars($100)
or en.)
I modify dust In the performance of the work for which this permit 4 iaad,I MAI]not
employ any person in any manner M as in hecvme subject M the Worken'Compensation
Laws of Ca111oro4.Dam
Applicant
NOTICE TO APPLICANT:jr.after making this ocnincam or Exemption,you should
become subject M the Worker's Compensation provisions of the labor Cade,you must
.J 0 forthwith comply with such provisions or Mia permit shall be deemed ranked
Z ti CONSTRUCTION LENDING AGENCY
(~ I hereby affirm that then 4a coasuuction endingagency for the perrurmoree of
CC the wurk fm which this permit Is Issued(Sec.3091.Civ.C.)
Qlandch Name
z lander',Addax
U O 1 emify that t haw red this aroplicadan and tum that the Chow Inronnnen 4
gy F contact.I agree to comply with all city end county ordinances and sum laws mining e
0 U building construction,and -by mtharim apresenutiws of this city a cnmr Open do
4 action, Toned pRpen for iv pion Purposes.
( c)agree ishan ify And keep botanists the City of Cupertino Against
F"N liabilities. .cos and me whichmayinuyvnyac vagainstatd City
U z in covegn see of t tmnt This
permit.
APP IC, UND. NDS AND WILL COMPLY WITH L N NPOINT Issued by: Date
SOURC R L NS.
W Y/ Re-roofs
Signal pplicanVComacmr see
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
II Mc applicam or fuwm building mcupent atm orhandle havudous maedal
u ne y the Cupertino Municipal Code,Chapter 9.11,and the Health ad Safety
e,Astro.2553:(.)7
❑Yes ❑Nu All roofs shall be inspected prior to any roofing material being installed..
Will the applicant at future building occupant use equipment or d"Ims which If a roof is installed without first obtaining an inspection,I agree to remove
emit haardous air conaminanu AS dcOned by Me Bay Awa Air Quality Management all new materials for inspection. -
District?
❑Yu ON.
llh soul Me him apamrials o,td=g xCluper6.95Ofthe Csiifon
nu Hcalgifcmy C�de.Se pN 25x05.255]7 aru1255N.Iundemad11u1 if Ne Wilding
does Out dddddd mly haw a te(n4 Net it u my aapovibihly no IMufy M occupant of Mc
M4ummen ands a npriarwiaamceoraccd0estaofocnpary. O� Signature of Applicant Date
Owner or m cd age t I Gd. All roof coverings to be Class"B"or better