06050015 CITY OF CUPERTINO ) �r =yr.�. ^�r�'g.> �}�i �♦
BUILDING DIVISION PERMIT y, ,�LY'v1, V"'f.1., A�-+, FP N$,"R
BUILDING ADDRESS: WARREN CONSTRUCTION PERMITNo.06050015
22350 HOMESTEAD RD
OWNER'S NAME: PERMIT ISSUE DATE
0E.
THOMAS E HARRINGTON 3707 EL CAM
SANITARY NO. CONTROL NO.
(650) 494-3288
ARCHITECT/ENGINEER: BUILDING PERMITO
BPLUMB
O OOMECH
goo
LICENSED CONTRACTOWS DECLARATION JbDSCi1 mon
�s 1 hereby affirm Ww t I Hemmed 0
ed under provisions of Chapter 9(commencing P
with Section 7")of Division 3 of the Business and Profaslum Code.and my lice=Is
,mow mfull force and effm REVISION-PATIO COLUMN (2) RELOCATION
1 z oamseClass1.4c.9 erORIGINAL PERMIT #06010127-NO NEW PERMIT
ARCHITECTS DECLARATION
i < 1 understand my plum Mall he used as public records
;jou
G ti Licensed Professional
OWNER-BUILDER DECLARATION
<S 1 hereby affirm that I am eampl from the Contractors License Law for the
:D O following mason.(Section 7(131.5.Business and Prolesnom Code:Any city at aunty
7_ which requires a permit to consuucL alter.bnPrmm.demoliM,or repair any structure
-Z a, prior m its isuanco.also requires the applicant for such Permit w fie a signed summer"
< d,uheislkcaxdpuwantmthe Pmvisensofthe CamrsctaraLkemelaw(chapter 9 Sq.Ft. Floor Area Valuation 0
Z95' (eneung with Section 70001 rf Division 3 of NC Business and Prormsiam Code)w
r3 amNat he is aempt thendrom and the basis far the alleged exemption.Any violation at
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of N Number Occupancy Type
nes m Nfive moan hundred dollars(5500). 3 P 01018 . 0 0
0 L asowwr of tie property,lir my employees with wagesu Neo wleampeautian,
will do the malt.and the structure H mahuosed lir onemd faaak(Sec.7044,BeAhmer Required Inspections
and Professiam ns
os Cade:Tbo Contractors License Law dact apply m an owner of q P
Property who builds or improves than.and who does such wart himself or demugh his A
own employ..provided Net such improvements art net intended lir offered for tale It. C'
however,the WildingtrimprovemannAthat wilh(non XuOramoveforNCower-
builder will hew de Widen of prov(nt the W did at Wild m Improve far purpose of \
aka.
®-1,ru owner of the property.aro exclusively and contrasting MN licensed contractors l-
construct One p.not (Sec.7094,wner of and property
whciam dada:)Tiro Canuaeors Ll-
nd \
awe(ave dam notapplyje an owns al proper(who Wilda lir imptow Nercon,and,
whocontractsI for each projects with acmnv¢ror(a)Ilanwdpursuant to the Contractors
License Law.
[0:]114. uncle a .BkPCfjrupreason
err Date G t/0161
PENSATION DECLARATION
I here rounder penally or perjury ono or da following dalwtiom:
C]Is.. 'II-mmudna Ccod MofComentwulf-insumfmWaherIC=Wn-
.do.,a provided fee by Section 3700 of that Labor Cade.for the perfamana of the
work for which this permit is Issued.
❑I haw and will maintain Workers Compensation Insurance,as required by Semon
3700 of Ne labarCode,for the performance of the work for which NO permit is lewd.
My Workers Compensation Insurance artier and Policy number are:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thissectlam wed angles completed lithe permit Is foram hundred dollars($IBM '
or las.)
I artrfy that la the Performance of NC work for which this Perch 1.laved.I shall at
employ any personIn aY anerro boo a �
NOTICE
Ia Ne Workcam
'CoPensada
Laws of California d—
nl /
NOTICE TO APPCICXW ,a r making Nu Cen(lkeo the
Exemption,bayou Nauta
bucawi subjectsoit Wo sCmrpemation Permit
of Nelabor Code. mus
.,O forthwith comply with such provisions or Nu pemilsMllWdomed rewtad.
'Z y CONSIRUC1ON LENDING AGENCY
f+ Iherebyan.
dawi Nem isacammc"InnkMini agmnry far Nc perfamawe of
C>
the wart for Which titla perch Is i owd(Sec 3097,Civ,C.)
G^n. lenders Name
�z lenders Address
U O I goodly dust 1 have read this application and sham Nu that above infom.don I.
U,f--' toren.I agree 0 comply with all city and county ordinances and state laws relating m
0U Wilding construction.and hereby athoria mpmxntr"iws of this city to eager upon the
>"Is1 above-mentioned property for inspection purposes.
(We)agree to an.indemnify and keep harmless the Cty of CUPenino agaiml
sF+,a y ii It ties jud mena sts ad apensawhichmayinutymyucmeagaimtsaid Cib
U2 in comegw arNegon nt or his permit.
APPLICA NDER N D WILL COMPLY WITH ALL NO -POINT Issued by: Date
SOURC ULATI
A o Re-roofs
Si mofA li ger Dae
AZARDOUS MATERIALS DISCLOSURE Type of Roof
Will thea kantorfuture Wilding aavpantmre or handle hazardous material
u deRutl by Manion Code,Chapter 9.13.and the Health and Safety
Semon 3553:(.)7 `' All roofs shall be inspected prior to any roofing material being installed.
r]Y. �rvu
WIII the applicant or future building aaupant taw equipma"t lir tkvlma which If a roof is installed without first obtaining an inspection,I agree to remove
emit haaNnw elf contaminants u do and by the Bay Ama Air Quality Management all new materials for inspection.
Disrict7
❑Yea u
I have mud Ne hwNaw materials requirements under Chapter 6.95 ofthe Califor-
niaHal"hd& dctyCode, a 35505.35533md17734.1undcmmdNulfthe Wilding
dao,cot en sly how uman Nat It 6 my responsibility m".dry use oeeuponl lir Ne
require. hichas lbe ormlssuvsecaf.ccNftenicroc p Signature of Applicant Date
0 ger " lige Dam.
All roof coverings to be Class"B"or better