06080005 CITY OF CUPERTINOa ?>ki>, .raq ,rd• +P2
BUILDING DIVISION PERMIT <CONTfRA ITTORII�'E'URMATIUNFy,
pais, ,, mFmn. a .'.»..'
BUILDING ADDRESS: s BEST HOME SUPPLY CORP ""NO-06080005
7873 LEONG CT
EWS NAME: PERMIT SUE DATE
CLEO CHANG & REX WRIGHT 7335D BOLLINGER ROAD 08/01/2006
PRONE: SANITARY N0. CONTROL NO.
(408) 255-4088
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
�0o
—LICENSEDCONTRACID0.'SDECons cfOON Job Descrl tion
I hereby )of Nat I sea II¢nwd under d Proliu of Chapm 9(rnmmendng P
with Section]IXIII)of Dividon 3 ofthe Business and Prafesaions Code,are my license is
Inrmlraweandeff— S�fybrF� a THREE BATHROOM REMODEL NON STRUCTURAL
Littman Colo.
l a Lte.0
Dam — Canuaclor , L
A CHTTECTS DECLARATION
1 understood my plans shall be used u public records
18 t; Licensed Professional
OWN F-R-BUILDER DECLARATION
a 5 I hereby alRm that I.1. exempt from the ConmmCo License taw for the
O O which req reason.(Sadat 7031.5.Business and Pinn.dem ns Cade:Any city or county
5$ which requires a permit re Bares the alcor.bnprove,demal44 o repair sty mucture - O O
we mitaiesuanceatmrequires nceppltsant for such permit BmaeLucdmmmem
�< du heulken licenced pursuant pm smuo the Conuacm tLicense ow(Chapter 9 Sq,Ft. Floor Area // Valuatio
9 (commencing with Section 7000)of Division 3 of me Budnms and Profminns Code)o
Nat he 0 exempt therefrom and the basis for the alleged exemption.Any violation oftw
Section 7031.3 by airy appliant war a pr:rmit subjew the Rpplkant In a Civil penally ofr ancy 1YPe
not mom thus five hundred dallas($5(10).
O
❑I,as owner of me property.Or my employcu with ws{m u ncv sale compewdon,
will Cut the wort adand somehow iecut,mmtmedaoffered mra.m(Sec.70",Become Required Inspections
sem Profewom Code:The Conbmwes U=w Law does at apply man owner or 9
property who build or im pro.a Hereon,and who dace auch work himself or through his
Own anpmym,provided the such Impranment art notinmded ooRemd!orale IL
however,me building or improvement is mid within ore you of completion.the aww-
builder will ban the argue,of proving that he did nm build m Improve for purpose of
sale.).
0 1,on owner of W Property am amluelvely commuc ng win licensed cant mearm m
construct the prejm(Sec.7044.Business and Rofnsions Cade:)The Conuacmra Lt.
cense taw does at apply man cornu of property who builds or Improves thermn,and,
who contraw for such projects with a con4mmKs)Ikansed pursuant to the Communes
Lkeasa Lew.
❑Iomuemptunder See ,BkPCformurumn
IN, Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under purely of pedury one of the following dulentiou:
❑1 b.,cmd.111 maintain aCerdOc is ofComentm self-Iuum for Warkera Compm.
sa m,.provided for by Section 3700 of that Lobar Code,for man performance of the
work for which this permit is Issued. '
0 1 hew end will maintain Workers Campensadon warrant.as required by Section
na0ofthe Latour Coals.for rteperfomuteeofthe vmkw rwhich this pnmitislogged. .
My Warktr�.Cbmgy-�yspadw,lmurmtt carrier and Paliryn ber
Cartier. .,a-J `-�Qd
Policy N.
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
CMis section reed at he completed If the permit is foam ho uraddo0en($1001
or leu.)
1 coolly that In the performance or we work for which tie permit is issued,1 shall not
employ any person in any matter m as m become subject to the Workers'Compensaton
".a of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this CeNRcam of Exemption.you should
become subject to W Warkert Corep(NISWOn provisions of the tabor Code,you most
.J z foMwtn comply with each govism.or this permit shall he domed mated.
LZ•M OcobrmUcrION LENDING AGENCY
[-M 1 hereby'Mon
nu nem is a ca etrout a lending agency for the petwon.of
C> the work fur which this permit Is caned(Sec.3M.Civ.C.) .
aO Lendrta New
]z Undoes Address
U0 1 Certify that I haw reed this application and state that the men information is
rs,F corm.I agree to comply with all city and county ordinances and sure laws relating to
0 U building construction,and hereby aathorine represenutins or this city to cover upon the
r 0. almn-mcmioncd pmKrty for tnspectian purposes.
(We)agree to saw.indemnify and kap bamless to City of Cupertino against
ME"y rat Itabilitim.judgments.tofu and expenses which may in my wry aces agaiml said City
in
U APPLLIICCANTeof the UNDERSTANDS ANDof WILLWWILL COMPLY WITH ALL NON-POINT Issued by: Date
SCURyy��REyyLATIONS.
/ e op —1- Re-roofs
Sig rtofu� ApplionYConsteng Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will me applicant or future building ocmpemsmm orhandle haeudous wage
as defined by the Cupertino Muni -Code,Chapter 9.12.and me Health and Safety .
.
Sued.255324)? All roofs shall be inspected prior to any roofing material being installed.
CYes No
Will the applicant or future building Occupant use equipment t dcAns,which If a roof is installed without first obtaining an inspection,I agree to remove
emit hauNnu air commons u as Qefmed by de Bay Ama Air Quality Mmagcmcnt all new materials for inspection.
District?
CYes No
I have mad the huardous mamiab mqui..ano under Chapnr 6.95 of the Caliror-
niaHealnh5afctyCade,SeclCi=25%5,25533and25534.lunke dnnifde building
does not currently haw a tenant,was it is my responsibility in rattly the occupant of the
rtgn nta tehmug bocut poor mtataanceofaccrOcsteofOccupancy Signature of Applicant Date
Owner or moloureed sic—m Dam/•v All roof coverings to be Class"B"or better