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08020064 CIT RTINO I�Z, Y OF CUPE BUILDING DIVISION PERIMT ONTRFIGT©R�INI`OXtMATI,. N, BUT PERMIT NO. BUIL DR ROBERT PALMIOTTO 08020064 NERS NAME: PERMIT ISSUE DATE ROBERT PALMIOTTO 21946 HYAMISPORT DR 02/12/2008 PHONE: SANITARY NO. CONTROL NO. AICHITECTfENGINEER: BUILDING PERMIT INFO BouO Lou PET MECH Sop LICENSED CONTRACTOR'S DECLARATION Job Descri 4 ted I hereby affirm that I she licensed under Prevision of Chapter 9(commenting tion with Section 70M)of Division 3.17ths B".and PrfOW.Codo,and my he..is PATIO COVER REMODEL in full forte and eflrse pbZ Liamuss Class_Lic. ARCHITECTS DECLARATION Date.Conloutcor I undussund my plans Null The used as public reconts; Sy s ted Licensed propound...I OWNER-SUILDER DECLARATION w I hereby M.that I sam exempt from und Controctor's Uccnw Law for the 00 following (section 7MI.5,Business and Profammas Cot Any city or county which requines.Permit to construct..1ter.impareve,demolish.or rami,my "Mo. PH.,to its issuance.alizo ral.fires doc.ppli.sal(a,Such Permit to file u'rad suacrumm that he is licensed pursuant To the Provisions of one Contractor's Lacmase Law(0.puer 9 Sq.Ft. Floor Area Valuation (cammemingwiLhSe-aOGfDilan3offtRusiwd�fmiamC�)or $500 tht he 4 torempt therefrom and the bull far lFic alleged exemption.My violation of Section 7031.5 by any applicant fora permit subjecut The applicuH to a civil penalty of hotmom than five hundred dollars(STOTT), 35614055AUbINumbe, 0ccupancy'fype 0 1,as owner of the property,or my employees with wages as Their sale compenudon, will do the wart.and thad.umuce i not intended.,.ff..d far sale(Sec.7044.Business Required Inspections and Profissakwo Cade:The Cmanactar's License Law does Out apply in an M.of property who build,otimprove thereon,and who does such work himselforthrough his own emplayeas,provided that such improvements,sce,not intended oraffeasul for We.If, however.the Wilding or improvement Is sold within on year ofcomphnion.the ownse, builder will have thus thunden of proving That he did ON Wild a Improve for purpose of 911"..ner of the Property..maladvel,caovdng with flecosed comanctuat to cont act The project(Sec.7W.Business and Profession,Coda)The Commerce.U. cave Law dean not apply in in owner of property who Wilds or finprom theaccan.and .1m contacts far such projects with licensed pursuant to use,Ccuturacter's Lice.Law. ❑ No noTO u� ce, B P C rour this reason gc— rm g' Wo S ON DECLARATION I hereby am.owner pers,11,5 ofperjuryand or dus relieving declaration: nur asadmo,.provided far by Seem..37M Of We Labor Code,far da part....Of the work for which This Permit is Wood. C)I have and will maintain Worker's Compensation fractions,as,required by Section 3700 of The Labor Code,for Lk performace of the."k To,which This permit is issued. My Werke,Ctur,whouton I...esuviO,and Policy munbc,NO: Carrier. Miley No.; CERTIFICATE OF EXEMPT10N FROM WORKERS' COMPENSATION INSURANCE (77tissuction beed of an completed if Ne Permit is farone,hundhoul usell(SIM) or leu) I=Wry Thai in The performance of The work for which this permit Is issued,I OWI not employ any P.M.in my manner rst�"..subject cone'rumthat Law or shin NOTICE TO APPLICANT.If,after making this Cerfificanc of Esemption you should become subject ut ft Workers Compcmdon provisions of line Labor&�you rated z forthwith comply with men prGrohnorm or This partnit-maN ho decurned revoked, Z 0 [-r�! that CONsrRucrioN LENDING AGENCY I hemby sham at there Is.commuction lendial.gency far the performance of The work far which thin Permit Is annual(SO.,300.Civ.Cd 0. Undoes Name Z z Ural Address U 0 1 certify 0.11 Imre rcact This application NOT mato that use,above iff..do.It correct.I.Poe,u,Comply with all city and count,onyhrusucesi and suac laws raising ut building construction,and hereby malloorim,mpressetaflims ofthis city to enter upon the shavO-ammitmed property for impaction imposem. (WO)agree To saw.indcamily and lmap harmless the City of Cupertino again - I CA liabilities,judgments.cost,and expanstas which may in NY My mom against mid City )Z in censcuitionot of the grantingof This permit. APPLICANT UNDliRSTANDS VID WIL PLY WITH ALL NONPOINT Issued by: Date SOURCE REON! 6�-/ Re-roofs Sitingthe Of Alrplican Data =D 01KATE RIALS DISCLOSURE Type of Roof W111 the applicam,at future building occormasurre or handlehamortious mmuisd .nenaMbyftC��oaMu�pICane.Clllm,1.11,�ftHeaiNand Safety Section 25532(.)7 [_]Y. on All roofs shall be inspected prior to any roofing material being installed. Will the applicant orutters Wilding occupant use equipment ardevicas which If a roof is installed without first obtaining an inspection,.I agree to remove emit basurdrus air conwhimunts at defined by the Bay Area Air Quality Management all new materials for inspection. Disurict? 0 Yes —a. I have revel LhehaYNusmuoiglsmqaim=nuunder C]upmr6.95afLhcCalifor. -i,H.IN&S.I.tyC.de,&c-=25505.25533"25534. Wilding does not currently haw th I Nat,mprvc_�,7,u,W or,the ocetmem of the P Signature of Applicant Date Ovmer.A6dhmi,red,cm� Dow All roof coverings to be Class"B"or better