01050010 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING A DDRFSS PERMIT NO.
• 2000 LUCILLE AV #_81-9 ROYAL ROOFING 0105001,0.
OWNER'S NAME: h APPLICATION SUR DATE^
TRAMMELL CROW RES SERVICE , 1345 WANDER•-61AY 05/01/2001
x • PHONE. SANITARY NO. - CONTROL NO,
(408) 279-2332
O c4YARCHITECT/F.NGLNP.ER: ' - - BUILDING PERMI'I'JNFO
I-0§ BLD6 ELECT PLUMB MECH
S H I ICI NSI D CONTRACTORS DFCL AItAI ION ,lob DCSCrIptlOn• •y
O y D 1 h by fl r that t I d d p : t-Cha pier 9(comma¢ng _
Ili wilhS i 700 fD Ibl3 at'IheRanders,and fmt'rioo ,Cade,and my license
If RE—ROOF REMOVE SHAKES 8, INSTRLL 1/2" C
aze.0 Datere I Lica-!_[v CERTAINTEED SHINGLES. . CARPORl-
3 a y Date C.mranor_ pyn._I .
ARCnI'1l be used DECLARATI) ! -
1 committed my plashall be J av public rttnN, •
'ed p O Licensed Professional ' -
6'im, OWNER-BUILDER DECLARATION
.,� I hereby ff tl I 1 d cmpl from thContra,, r License Low for lot
_ f• Ikrl g reason,(Seed 7031 5 l o d I I Code A Y il,amnly t'
• .>,,a 0
which m,moe,' p moll I c I 1.L II p I - P y shool no
u�3rem p' to it,' aI: I II ppfcon,f h peani,I,file a.'Endollemen
that he is licensed pt to the provisincrombe Contractors[Amuse L (Chapter9
(commencing with Section 7000)of Division 3 of ne Business and Professions(Ark) Sq. F[. Floor Area Valuation
or that he is exempt therefrom unit the basis for the alleged corruption:Any violation
of 5 by any all fnr a penmil wM1jecl,Om upplirnm to a civil pcnuhy
of not more Than fvnandred n.nare($ew). APPI Number _ - -Occupa
❑1,as owner of the propery or any employees wit wages as their vale compensation,
will do the work,and the demure k nm intended or offered fnr.sale ISec.7614, - -
Business and Profession,Code:Tire Cnatodor's Limm,Law don not apply nit an ` ,. . I R fired inspections '
owner of properly Who bold,nit improves mancon,ace who docs such work Inerwil r,
,'I Sh las own e pl Y e. I I idN Ih I inch on,movourall to, not`nnended nr
+ alffrr kor sale.If,n .the III o p ver is vold within one year of .1.. •,30= — FRAME.'.
or tpleuon,the uwnerhnilder will have the burden of proving and he did not mild or
Improve fmpmpmem sale.) - 307 -- INSULATThljr," .
❑La,ownerofthepropcry,amculusivelyconducting with licensed commemr,to 601 ROOF TEAR OFF
cnnsava to ini(See.70N4,Bmi.ns and Pmfessinns Cade:)The Con ercoW.
• License Law doe,net apply manowner ofpmpenywheheads orionpmvestere.., 602 — ROOF PLYWOOD NA.TL ..
and who contracts for such pnrjecls with a cardboards)licensed pursuant to the
Coalmemr,Lime,,law. 603 — ROOF BATTENS: •a - .
❑lore exerrpl a.arr sec. oils Pefor Kiri,rca1dr r 604 ROOF .TPI—PROGRESS
mr = Dove
. Ow ' r f ' •.
WORKER'S COMPENSATION DECLARATION' _ >v
• Ihereby affirm under penalty ofperjury one of the following declarations
❑ 1 nave and will maintain a Certificate of Consent to self-insure for Worker's c Ig Cp
Compression, as provided for by Section 3760 of the Labor Code, for to O '��
performance of the work for which this permit is issued. "9 F
��Jr have and will m.inlain Worker's Cnmpenwlion Insurance,ams required by Section
It of to Labor Code,for the performance o1'the wink Tor which this permit is
mord.My Warner,Cnm....s,mm l its mn<e<a,a,,It1dt Proll,mot heerr are:
7b . JAN , • .
Cu � tf_I.CGI'IU~N XF.MPTION 051 WORK_Rf5 Rs t ,,�11+1 �s'
COMPENSATION INSURANCEB{�e��l,v�
• (This section need Bol be completed if the pcmril is fnr one hundred Jalltn
fSlw)or lcssJ - r s
1 mart y That in the perfnmmnce of the work for which this permit is issued,
shall and employ any person in any rammer so as to hmome subject to the WorkerC ,
Compemntion Laws of Gdifornia.Aaq '
' Applicant 1
NO'I'ICLIO APPLICANT:It',armnnuRing this Cediflcnm nit Expaption,yon'A d
Smonreanbjeed t.the Worker's Cnngva,,ilrn previsions of the labor Crude,you must '
'. C 0 Ibnhwit comply with each pmvislan,or this permit shall be JeelireJ revoked.
F'CG CONSTRUCT ION LENDING AGENCY -
> I hereby of rat that Cert is a construction lending agency horde performance
of the work for which this permit is Immoral(Sm.3097.Civ,C.) - - -
CL ❑ Lenders Name
:� Z Lender's Address
1cen'fy lhit,il ldi ppl d ,are that The above infinmaden i, .
Gti ;: correct I agree to conall,ly o0h all city and county a I.li em I aine laws och"in,
QV In building cnin'tonOinno'cad huvhyiut r'e repre'u rt l'vwrfll',atyloemcr up. 1'
' wry the h I edp l ny T inattention mr,ow, r. -
�.I 96 (W) .,,.save.andourig andkeep hattleco, h C'Iy mCa,man against
Fr fn liabilities.judgments. t n I expenses which may In any way acerae against said ,
City in consequence of the gaming of this permit
ALIIICAN UNDERSTANUSANDWILLCOMPLYWII'HALLNONPOIN' Issued by: `� Date �"' �
LOURlOUR ERE ziszURH y at y'
Iaturc of Apphc HA7.[mcarr Data Re-rOOfS
' HAPA MATERIALSDIf cot handl
Will by(eppl,liaftonne bniICode,Chanl,tor�or handle Brainard Sri cryI'type Of ROOF '
as defined by Thr Cnpminu Munlelpu�Cole,Chupler 1).12.and the Henllh end S.Idy ♦ '
• Cndc,Section 25532107�,
Elva,' All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or Same building retained use equipment mdevice,which If a roof is installed without first obtaining an inspection, I agree to remove
emit n ommus air contaminant,us defined by the Bay Arca Air Quality Management .
IAdret, Ya v all new materials for inspection. Applicant understands and will comply with
all non-point source regulations.
L have read the haamro iv materials requirements under Chapter 6.95 of The - a
OI'Ijur in Health&Srely C 1 S coon 25505 25533 Ind25534 1 andersonjuddho,
i I I he mi ding t comicallyhi tenant,that it is y responsibilityt non ly the I
�-
I"t f ha,inq t: dand be air,pr i 1, ra CerIY Br ut
°e °p y gnatuce,of Applicanl ' • Date `-
A I roofcoverings s to be Class13
" " or.better
(Iwo tathoracd aged / Un g
OFFICE - `