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08010012 CITY OF CUPERTINOf = - BUDIVISION PERMIT CUNT]kA§7 OR I1�T+rO TI A'I?I©N., m, u � t BUILDING ADDRESS: PERMIT NO. 22330 HOMESTEAD RD #207 DRAEGER. CONSTRUCTION INC 08010012 NER'S NAME: PERMIT ISSUE DATE HOMEOWNERS ASSOCIATION 605 COMMERCIAL ST 01/22/2008 PHONE: SANITARY NO. CONTROL NO. (408) 536-0420 ARCHTECTIENCTNEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 300 LICENSED CONTRACTOR'S DECLARATIONO O O 1 thereby M.that 1 son licensed under provisions of Chapter 9(commencing Job Description with section 7")nfly ivision 3ofine Business and Pmredaatw code.and my license u REMV/REPLC LIKE 4 LIKE SIIDING & TRIM,REPLAC DMG ^ I.full force and effCcL�qS On. tZ Contractor n FRAME & BEAM 9 ARCHITECTS DECLARATION 1 undermand my plans shall he usetl u Public decodis � u ho Licensed Pmfewianal i OetNEBUILDER DECLARATION 1 hereby am mat I am exempt from the Contractor's License Law for me p O following moon. etch t IIT sir Business and improve. de am Caln:Any city or roomy $tui which requires a permit m cnnmuct alter,impmw.xmnluh,or mpeir any strucwro Zi prior to its Scome,also requires theapplicant fanuch permit ro rile a signed statement < that he u licensed pussuanuo the pmvisionaf ft Cmhacmrl LICCmc law(Chm1a 9Sq,Ft.Floor Area Valuation �s mrsumcneing with Settled 70W)of Divulan 3 ofthe Business and Profession,Code)or $7500 that h s to exempt therefrom and the btu for Me Staged eutnpdm.My violation of section 70313 by arty applicant Ice a permit Subjects the applicant to a civil Penalty of �p�,Number Occupancy Type trot mom Mum Ow hundred dolt.(S500). 3 2 6 5 9 9 9 9 .'LIT Y ❑I,u owmr altlie pvpenY•m mY nmplaym with wgn u Meir eats<ampeesation. sedPo fa tion.C d e-he Con ra not s Ekins m aro dev fm WCpply.M an BIWKL and Noressloes cox:The cnninnoh License law kite.not apply m.m owner of Required Inspections property who builds m ism prow merman,aM who does much wart himself or through his must employee,provided that amh improvements are not inend& oroncredfur Welf. however,me building mimprovement Is mid withinoro year ofavespl irm,theewms- builder NB haw W burden of proving that he did rot build or improve for purpose of wuJ. . .. O 1.u owmr of Ota property me exclusively contracting with Imsmad mommas he meslroct ee Projem(Sec.704E Business aid Prafesdmu Cade:)The Cmmmors U- came Law does not apply m Sat nmter of propeny who builds or improv tome n,and, who contracts;for such projects with a mntramoRO licensed purwant m that Convenor's License law. ❑Iungemplundet See ,BkPCfmmimexam te Data WORKERS COMPENSATION DECLARATION 1 hereby Linda under Penalty or perjury ossa of me fallowing xclandons: 1 haw and ail maintain ecdon 37 m of ft Labor Code. rte Wmkefsme of the wean,r provided fpemi Ssis u 3700 ar the labor Code,for W perfomanm of MI work for which this permit is issued. 0 1 have and will maintain Wof es Compensation Imuran.,u required by Schon Tao ofine tabor Cade,for the performance afore work rorwhich Can permit in is,ved. ' My Workefs Compensation Insurance cooler and Policyouumber me: rti Caer. AIC ' A Policy No.: &J L/Zl 7'080/ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thuyas mread notbu completed ifine permit Is rteoro hundred dellen(5100) or ICU.) I certify that in the performance of Mta work for which this permit is issued.I shall not employ any pante in my mannan u to become subject to MI Workma'Compemadon Lam of California.Oats Applicant NOTICE TD APPLICANT:IL after making this Ca ineam of Exemption.you should become subject he the Worker's Compensation provision,of the labor Cade you most O O forthwith comply with such provisions or this permit Shall bre rimmed revoked. CONSTRUCTION LENDING AGENCY (—t4 1 hereby aRrm mat thin u a conmucfion lending agency I'm the Performance of CS> Mtc woh for which this permit is issued(Sec.3097,Civ.C.) Win~. Isndeh Name 7 z LeMees Addmu V 0 1 certify that I have read this application and rota Wt the above information I$ ., IL F ConRL 1 xgrme to comply with all qty and County Criticise;and sum tM Riming to .G C) building conscruction.ad hereby Simmons opressemadvos orthis city ca coam upon ft W a1mve-mendomd property far Whitened purposes. Pk. (We)agree to sow,indemnify and keep harmless the City of Cupertino.&CCu rq Ilabilitafodgments.cute and expenses which may In my soy seem Mdtut said City (,Z in cor equeme of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date7--- SOURCEREGUI.ATI � i�alf' Re-roofs •^�'" Sittetun of Apint vContrsnar ^— Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building ocmp ntsmro or handle hmerdoes material as xOoN by the Cupertino Municipal Code,Chapter 9.12,and the Hulce and Sdmty Sectiom2"32(a)7 m All roofs shall be inspected prior to any roofing material being installed. ❑Yes 0 Na Will me applicant or future building occupant um equipment or devlas which If a roof is installed without first obtaining an inspection,I agree to remove emit harallous air contaminants u de0md by me Bay Area Air Quilty Management all new materials for inspection. District? J. ❑Yes bNu 1 have real the huardous materials requirements under Chapter 6.95 of the Califon .is Hcal"Safety Calc,Seavw 255D5,25533 and 3553/.1 understand Mm if me building does not cmrnndy have•co ml me,It u my re Nmhiliiy he notify the occupan,of that requirements which mum be met pri7 iwuanccofa cenifcam of Signature of Applicant Date lic Owner or toduldsedagent D,m All roof coverings to be Class"B"or better