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02080134CITY OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS 19507 HOWARD CT. OWNE�TOR SNAME VI WOO PHONE ARCHITECT/ENGINEER: , LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (cournamm"'ll with Section 7") of Division 3 of the Business and Professions Code, and my licarcim is in full force and effect. License Class - Lac. # Date Contractor ARCHITECT'S DECLARATION I understand my pins shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby offirm that I am exempt from the Contractor's License Law fur the following reason. (Section 70315, Business and Professions Code: Any city or county which requires a fampit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such Permit to rile a filleted statement. that he is licelikal mrsularl to ilii bobvisions of the Committees Lice. Law (Clamber 9 -of Section 7031.5 by any applicant for a permt subjects the applicant in a civil penalty f of not more than five hundred dollars ($500). C1 1, on owner of she P.,art, or my employees with .,an as Outline emonamsaham, will do the wolix'Ard the structure if no, intended or offered for t.1c (Sect 700.1: 4 Business and Professions Coale: The Contractor's License Low deal not apply to an owner of property Who Wilds or improves themon, and who does such work himself .1 through his own employees. parmaidsvi that such improvements sum not intended or offered fmsal x. If, however, the building or improvement is within one year of completion, the owner -budder will have the burden of proving that he did not Wild or improve for Purpose of twin'). 11 - an tnto ias owner of the proper; am exaTtus nljaonm�jinj with iia,nied n I _;aW swot the pruitext (See 704,t, Business and limitations Code) The Contractor's License Law docs not apply to an owner of property who Wilds or improves dommi, am exempt under Sec. ''.B`& P C for this mason W nel-Maa;e WORKER*S COMPENSATION DECLARATION I hiretry all,. an&, natty of Pudinry one of the following dealarations: EI I have and will maintain . Cmiflarve of Consent to self insure for Worker's I Compensation, as provided for by Section 3700 of the Labor Code. for On performance of the work fur which this permit is issued M I have and will maintain Worker's Courripmraikin insurance, as rkaimd by kiietion 37M of the Labor Code. for the Performance of the work for which this permit is issued. My Worker's Compensation into ancif cattier and Policy number am: Policy No. U't 1 f CERTIFICATION OF EXEMPTION FROM WORKERS% COMPENSATION INSURANCES"-'' MIS union need no, be completed if On permit is for one hundred dollars which t his Par init is issued: I 0 ZI MOMCSUDJWIOInCWOTKersCom�n�tionpmvisionsotimuwrCwe.) Z forthwith cmnPI1 with such Ponsimmus or this parraft shall be, deemed revoker CONSTRUCTION LENDING AGENCY a.7"" 7;of the I I herebyherebyaffirm that thice iiia work for which Ok Permit is M Lender a Name'- '--"" Z ❑ Lender'sAddress carnicL1111 a fy hot I hall acad Oil ag to antraplyiffi .111 Valuation fob �fdjh annitz.fion, and thereby Occupancy Type Ll a a I!au, for in ="Yenicif C6 (Wei agme to FINAL ELECTRICAL ENERGY liabilities, judgments, calls and as, FINAL -PLUMBING ENERGY City in amoseclausica, of the Arantiall APPLICANT UNDERS pA Dsr AN FINAL MECHANICAL ENERGY IRC j A,ATION ---,-,FINAL-- ELECTRICAE fitibuture mAppitcant/Contract or FINAL PLUMBING HAZARDOUS Will the appleant or furft'ti la. hen ser he1; 0 yzx� WII the emit hazardous air contaminants as Di", - in"Ib Yes I has, mail he hazardous California Health & Safety Code, 5 ed stai. 3W7, Civ. C.) ' ` . C' icat ion and state that the abrove information is and county ordinances and state laws misting onze raimesehmatives offlus city to enter upon bon purposes., d keep hationless in. Ciij ofCiqzenin. against ci which may in any way same tipaima said CONTRACTOR INFORMATION: CUNNINGHAM'S AIR SYSTEMS 1125 PANDOLFI PL (408)926-2879 02080134 APPLICATION SUB DATE 08/23/2002 SANITARY NO. CONTROL NO, BUILDING PERMIT INFO BLDG ELECT PLUMB MECH l= I I-- I Li -I L__j Job Description INSTALL A/C CONDENSOR FINALED OCT 0 8 2002 D WILL COMPLY WITINON-POINT' Issued by :l Date te Dale Re -roots AATERIALS DISCLOSURE I . , ildhol; occupare, store or nvWk harallous material T3 al Code. Chapter 9.12. and Om Health and Safe,,-'kiikf./ . roofs shall be inspected -prior, to, any roofing material being, installed.. jildia, occupant ti,a equipment of devices which if a roof is irstalied'without first obtaining an inspectiofiill agree t6.remove thfired by the Bay Am Air Quality Management all new materials for inspection. _Ap_ ant understands and will comply,,�yith a non plic, . ...... 11 -point source regulations. , �j .Us' he ma lition, Qm, or authorized agent' i he of Signature -of Applicant ' D _ate All roof coverings to be Class "B" or better . .... . -OFFICE, CON I Valuation 3 0 1APN kTMIrSH PLUMBINif: 303 - ROUGH MECIZN Occupancy Type Ll 304 - ROUGH ElfliqMR341APctions 501 FINAL ELECTRICAL ENERGY 502 FINAL -PLUMBING ENERGY 503 FINAL MECHANICAL ENERGY ---- -- --- -- 5 05 ---,-,FINAL-- ELECTRICAE 507 FINAL PLUMBING D WILL COMPLY WITINON-POINT' Issued by :l Date te Dale Re -roots AATERIALS DISCLOSURE I . , ildhol; occupare, store or nvWk harallous material T3 al Code. Chapter 9.12. and Om Health and Safe,,-'kiikf./ . roofs shall be inspected -prior, to, any roofing material being, installed.. jildia, occupant ti,a equipment of devices which if a roof is irstalied'without first obtaining an inspectiofiill agree t6.remove thfired by the Bay Am Air Quality Management all new materials for inspection. _Ap_ ant understands and will comply,,�yith a non plic, . ...... 11 -point source regulations. , �j .Us' he ma lition, Qm, or authorized agent' i he of Signature -of Applicant ' D _ate All roof coverings to be Class "B" or better . .... . -OFFICE,