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06060126
CITY OF CUPERTINO rrsm+g ..r Cr BUILDING DIVISION PERMIT kCQIVTRA,GT R.INIt'ORMATI< N BUILDINGADDRESS: r ARGONAUT WINDOW & DOOR """""0-06060126 11166 ME:LINDA ER'S NAPERhGT ISSUE DATE AO ' KI 10624 S DE PHONE: SANITARY NO. CONTROL NO. (408) 378-4018 ARCHITEC MNGINEER: BUILDING PERMIT INFO - BLDG ELECT PLUMB MECH Sop LICENSED CONTRACTOR'S DECLARATIONUW lz Job Description hrtby affirm Net 1 am I1m00 under provisions of Chapter 9(commencing his Section 701D)ofDiHaon 3 ofdre Badness andpafeseaw Cade,was my license is iamRfatceandeffect. /pO�ZZS WINDOW & SLIDING REAR REPLACEMENT LIKE FOR LIKE �Z LkenmC tic 0 S I Dao �/ r/!r Contractor ![9 Day+ DC3V(Z, IT ARCHECTS DECLARATION 1 unamsund my plans shat 6e wed as public=men It Jy- IGJ Lad Professional .7 OWNER-BUILDER DE Ce ConuoON I hereby affirm that 11. uusin from the Cam.Co License(.sew for th o o which re ueama Permian 7 Construct, Business;and Profwdum Cade:MY airy m county $ which its issuance. •permit m conrvucL alar,ImProw,do Permit t or mash any umeum $7000 `Acomia censrc0.aburtNuirn the applicant forsuch Cmuccmitmcense file a LnWststamem F O (comms tingwJPuntion7 the prDielowofthcCont mese ndPrmison.Codttt9 Sq.Ft. Floor Area Valuation a€$ 'bam is catenp, Sarefrom and of Division aftheeged mseepton.My of .- Net io ts 31.5 b themfmm and the bub for the subjects the eampdm.Any l imam of Section 7031.5 by anyhurt red dopa for a pnsnit rvbjects ate applicant to a civil penalty of Occupancy Type not mase thea An hundred daltsts(57007• ❑1,u awOcr of the pmperty,a my employes withwain u thek sale compenuuan, will do the work.and thestmnum b mtintanded denatured forsale(Sa.7044,Budmsa Required Ins retia and Projections Cade:The Commences Lienar n law donot apply m an owner of q p pmpenywho buildsaimprowa dtarom,and who daesauch work himudfmtluough his must employees,building gdedtMteahimprowmenuarc not intended .efc naiddedf ownatic.if. Wilder,ata how a improwmant b held Whin ane yea of mprove for art ase r. of Wilder witi have the burden of proving that h did cot build a improve far pursers of uss.l. Q C:1 1,u owner of the Property,am escladvely connecting with IiansW mnnamm in Q coma=the project(Sec.7004.Bottom and Profession Cade:)Th Conuames U. cane law does not apply to an owner of Property who builds ser unproven decrees.me who contracts for such projects with a eanumelor(e)licensed pursuant to the Conuactaea Lkarrs Lw. ❑lamexemplunner Sea ,B&PC Par Nb teases r Dna WORKER'S COMPENSATION DECLARATION 1 hemhy afacen under penalty of perjury arc of the following aadaradaac ❑1 haw W will maintain a CeniBsveof Comentm ulf-iuure fm WorktfaCompen- Adan,as provided far by Section 7700 of the Leber Code,for Ila performance of the _ work for which this permit Is Issued. ❑1 hew and will maintain WormI`3 Compensation Insurance,as required by Section 7700 of the labor Cade.for Ne pedmmamm of the wort for which thu permit is Ismael My Wmkees Campenaim buutsnce amu and Policy number am: Cartier.Cf rkt t'flDolt.) Policy No.:© ✓ sA;2 CERTIFICATE OF EXEMPfiSON FROM WORKER COMPENSATION INSURANCE (fhb action need nosh completed if Ila permit Is fmars handed artists($100) or leu) I certify that In the performance of the work for which this permit Is issued.I atoll trot employ anyperson in any mmuarm u to become subject m the Workrts'Cmnpeuanion Laws of California.Data Applicant NOTICE TO APPLICANT:IL afar making This Certificate of Exemption.you should become subject to the Workees Compcnsauon provisloua of the labor Coda you must .J O forthwith comply with such Pro 42mod Of this Permit mall h aamea revoked. ti CONSTRUCTION LENDING AGENCY (-+ Ihmhyafftrm the,dare b acmutrunim lending agency far da padan once of fY,> the work for which this permit It blued(Sec.3097,Ch.C.) �W Q Larches Name O z Landefe Addmu U O I maify that 1 have read this application area suss the am adi Infmmadm ts Ifo F^- coram I agree to comply with all city and county ordinantte and ma laws mining In OU building emmuctim.and hembyauthorire mpmsansmiwof this city m camr.un the C1a move-mentioned property for imiNcum P.q.. LL (We)agree to use,indemnify and kap humleu da City of Cupertino aSlim, w.t rn liabilities,Judgments.costs and expenses which may in any way acerae agautmid City t.1 Z in consequence of the Swung of this Permit. ^ APPLICA NDERSTANDS WILL MPLY WITH ALL NON-POINT Issued by: . Date SOUR LATIOR S. SP � r/�lh Re-roofs S Apptleant/Cantnearte HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant ser futum building Occup ens oro or handle huarmus materia as e,In,,by des Cupertino Municipal Cone.Chapter 9.11,arta t Health and Safety 01Q1 Section 25532(a)7 �f,mQ�pN All roofs shall be inspected prior to any roofing material being installed. . oyes / �o Will the applicant or future building occupant um equipment ser devices which If a roof is installed without first obtaining an inspection,I agree to remove emit huardow all cmuminmu as defend by the Bay Ara Air Quality Mangcmmt all new materials for inspection. District? y/,�� C]Y. Ihaw mad thehu intoes/ materials requimmew mderChapar 6.97 of the Caifor• me HulIII&S yeode,Section 25505.25577 md25534.I maetsused that If the building dew not c y hew a tan It b my pomihllity to codify the Occupant of the require hkh9tuRh t w ar.eerUrataar / Signature of Applicant Date or authadred ages, �ta All roof coverings to be Class"B"or better