08010011 BUILDING DIVISION PERMIT pCONTRt1.CT0I2` ATF,ORI'IATIN
BUIL�ryr,.AgT'fiOMESTEAD RD #107 DRAEGER CONSTRUCTION INC P08010011
NEWS.NSA3ME: PERMIT ISSUE DATE
HOMEOWNERS ASSOCIATION 605 COMMERCIAL ST 01/22/2008
PHONE (408) 536-0420 SANITARY NO. CONTROL NO.
ARCHnECT(ENOINEER: BUILDING PERMIT INFO
BLDG EIEC( PLUMB MECH
o o LICENSED CONTRACTOR'S DECLARATIONO O O O
I Wmby Lnmi Nu 1 sm remand under provhiom of Chapter 9(commencing Job Description
gi withSection7")ofDivWons3oftheBusinessandProfeceimuCttde.andmyliccomis EXTER PATIO RAIL WLL INSTLTN OF WLL SUPPT 4 UPPR
^D or
in full forte W ones v
serol Class Lk.a UNIT BALCNY & RMV/REPLC DMG DECAYD SIDING—TRM &
' Dam acxIlECTSDDECLAa ON PARTL FRM
I se rad my prom Nall M used u public records
i0 Licensed Professional
N OWNER-BUILDER DECLARATION
I hereby.(Term Nei I I.S.exempt from the Conions Co License Law for the
O O following mama Permian ROIBusiness and ore.dk u l Cadc:Any eiry st county
$
which rtqubn a permit an requires
the Who.Improve.h Permit
t or e a siany umetum
z1^ thatpriohe its issuance.pursuant
to dm applicant the forStich Pmmil bicanusigned(Chapter9
< (hammercingwiit Section
retic provisions;ttt the cBusinaralitrtnselsa(Chapmr9 Sq.F[. Floor Area Valuation
O that heI..g with Section]BOD)of basis f 3 th theeged Business and on.My
Cnde)of $6900
$ thu io le exempt therefrom and the bum for bj subjects
me exemption.Any it peWan of
Section 7then, by eiry red Mt fora permit+ubjttss Ne applleant m a civil penalty of umber Occupancy Type
rmt mom than nye hnnama dttllvs(ssm). 3 2 6 5 9 9 9 9��
0 I,ss..of die property,or my employem with wags as Neo sole compemNan.
will do the work,and the sauctum is not intended or offered for We(Sac.7044.Bum—..
and Professions Caau The Canvacmh Liana law dam net apply in an owner of Required Inspections
Property who Wit&or impmesthemon,and are damatch work himWfarthmugh his
Own employen,provided that such improvements are not intended oronemG for Wain,If,
however,the building or improamanl Is sMd within am year of t ampieuon.Ne aware.
Wilder win have the burden of proving that W did not Wild or improve for purpose of
stale.).
0 1,all owner of that property,am exclusively contracting w'im licensed commnon to
construct tic project(See.7014.Business and Normal..Code)The Cmuaerora Li- _
come law dam not apply In an matter of property,who Wilda or improve+Nemen,and -
aWcontnctsforauchprojenswilhaeomcumr(O licensed puramnt us ft Cantrumrs '
Lmens law.
0 lameaemptundersec. ,B&PCfor Warewn
wmr Dam
WORKER'S COMPENSATION DECLARATION
1 hereby seine mulct penally of perjury,am of dm fallowing declarations:
❑1 here end oral mein Wn•Cutifinmof Comoro m¢If-Imam fm Workers Compcn-
sWon.u provides for by Section 37M of the Labor Code.far the performance of IK
work for which this Permit is issued.
0 I have and will maintain Warkeh Compensation Iranians,as required by Seerim
3700 of the labor Cade,for the Performance ofthe waste for which this permit is issued. '
My Workers Compewdan Msmancc artier and Policy number art:
Camcr. Arick PoIIry No.: 3-11LJG IZ)%X f
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
mus seNme need not be completed if Ne permit is foram hondreE dollar(5100)
or leas)
I certify that in Ne performance of tad work for which this permit u issued.I shall nn,
employ any person In any manner an as so become mbjecl m tie WOose rl'COmpcmadan
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject an the Worker's Compensation previsions of the labor Coda you muse
.J O roMwiN comply with tach frovisiam Or Nu permit shall W dced mro
meked.
Z "
CONSTRUCTION LENDING AOENCY
[—i 4 1 bureby still.that dem Its cmuvecunn lending spray,far IW ralles came of
Qi �: the work for which this permit is issued(Sec.3(191,Civ.C.)
W Cl (.enders Name
z Lenders Address
U 0 1 cmtify that 1 have lead his spi,licaumn and mm that tad aWve information u
6.!+ coram 1 agree in comply with all city and county monomer and made[am relating to -
.� Wilding construction.and hereby aONorim rtprtunuuvu or this city in nous upon tic
above-menbouW pmpny for inspection purposes
te,
(WO)agree m aindemnify ad keep harmless the City of CuP(olagainstino against
i—I M liabilities,jmudgments.core and eapcmu which may In any way scam agalmt said City - /
V z in coegm
me Of Nran
e granting Of this permit. '7 l
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REISULA NS.
& , �L //�7r,"0 Re-roofs
Signature ol'A r oneacter Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant Or future Wilding Oempent amus or handle haardam material
as droned by dss Cupertino Municipal Code,Chapter 9.11 and tis liulth and Safety
mm.Section 25532()? All roofs shall be inspected prior to any roofing material being installed.
El Yea IV No
Will the applicant Or future building Occupant use equipment or dcvim which If a roof is installed without first obtaining an inspection,I agree to remove
emit huardnm air contaminants as dcfimd by the Bay Ana Air Quality Managcmerll all new materials for inspection.
District?
DYm fQ u
1 havemad the hui mmdri mquimmenuunder ,Chaptu6.95ofdoCalifor-
nuHW NkSafety Coda S.-U.25545,25533 md25534.1 uridcmand Wtifdw Wilding
don rot curmntiy have a tenant.that it u my responsibility m mufy da asupant of dw
requirements which muse tent primranissnattc ter,ctnirmam arrYcu Signature of Applicant Date
O /
Ownermentnar'ue ant Dam LZ All roof coverings to be Class"B"or better