01030154 CITY IOFNcUP ISION o CONTRACTOR INFORMATION:
PERMIT
HU H.DING ADDRESS•. PERMIT NO.
10861 MAXINE AV 01030154
k UWNER•S NAME: APPLICATION SDH DATE
VAVAK FRANKLIN J AND LOI3 J 03/28/2001
ONE_ SANITARY NO. CON'I'RUL NO.
GC2 ARcinIEC/ENCINIJiR: BUILDING PERMITINFO
cc BI.DG ELECT PLUMB MECH
5
CI 1=1 I_1 IJ
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S o=i j LICENSED CONTRACT oOK'3DECLARATION lob Detierlptl0❑
I hereby 7000)of
thin 1 am licensed model p ad low ro of CllCode.and
(commenting se
wFtu wont Section](MXgaf Division Jnft Itu,iness anJ Pmfessinns G.Ic.anJ my license
xs i•inmHfamean I p � 72- 160 SO. FT. ALUMINUM PATIO COVER.
s Liccn,c 1.py���a_ e Lic.
o Wi Uum X/}} _ _— comrndor_
�ug u.a k//+ ii/ nRC111THCl"SI)KLART
.J 1 maim o nA soy Pkms shall be aloof to,public record.,
so
ti <S LicensN Profc,sinnod
e aOWNERT, II-DER DECLARATION
H I herchy afhmt that 1 ran csempt front the Contractor's 1.4ense I-aw for the
I Z lidlowing rot n.(Section 7031,5,homeranti Profcn,ons Code:Any oily.,county
'FO which 4 wralitt(I onnomet.'I p denalli,lb,or cin ,lamotme
m
niorin its 'I q th [fpl' II I(R '.l id a. t, ciao cn,
�3=
11.1t he is lical,edpmrwutt thc ono,si.rvoifl C...am,on,1.ccroc Low pChapma9 Sq. Ft. Floor Area Valuation
Ic.nnncncmg ,,It Secant 700(pof Division 3 ut due Bwlnexx.iml PInt,ximu Cole) $1600
or mal he i,exempt Ihef.In I and the nasi,fl,dm alleged ceeanp I.Any...Ilion
of Seenom]031.5 by any applicant lour a scroll%objects the npprcmn In a civil penalty
of not mom than live hundred dollars ONA. A PN Number Occupancy Type
D1.as owner othe properly.or my employees with wages a%their sole carnaasation, 32602015. 00
will do the work,and the sIm,t.rc in n..intended nr uttered far sale(Sec.7W4,
Hunfums and Prolcs.ioa.Cole:The Contractor.License Law duct,our apply,.an Required Inspections
urv ,.f mop.ny WI I iw,m iotpr:wax emreon,mad who d«..xv,h v)o,k huo,df 516 — FINAL BUILDING -
ntrongh hon awn cntployccx.pnrviJcJ Ota,sues intprovancnL,me not imcndcd or
omeed for vale.IL however,the building or Impmvemrnt is sold within one year of ,
completion,the.wnc.btaider will have the burden of proving that he did not build of
improve for NII of
D 1,as owner of me pmpmy.am eaclusively contracting with licensed contractors to
m%wd the project(Sec.71W.Husincss and 1'rofeoinn%Code:)'The Cuntmcmr',
commoner
I,aw docs not apply to an owner nt pmpuny who build,or improves thereon,
and who antral%fm x,cl, to gjem,x with a Caamucmnx)hLealw l ).doom v,the /
r rinr',License Law.
D I an,exemun
pt der See. .B h P C for fin,navour
o
Owner
tea/
owlet Dine C/J
WORKER CO}11'ENSKI'ION DECLARATION O
1 hereby affirm under penalty of perjury one of the following declaration%
J I have and will monflain m Conifcase of Consent In wd Giulio IL,Worker's X�
'Comfnnsation, as provided tot by Section 37(X1 of the Labor Cale. lot the
podbrmmnte ol'thc wod,Eu.it h this le nti,is lxsucd. .
011 have and will maintain Worker's Cannpenstumn Insurance,as required by Section
37(X)of the Uhur Cole.for the performance of the work for which this permit is
:,wed.My[Workers�Co+m-pensation Insurwum carrier and Policy number am:
Carrier:�(A_TC�G.�Posey No
CHRII FICA PION OF EKLMpool]ON I7ROM WORKERS'
L'OMPENSAIION INSURANCE?
(Tho.section need not be eorracted If Nt gena:,is for ane arldred dollars
(511X).,loss) ,
I certify that in the genome nce of the wad for which this permit iv i...ed.1
shall not employ any person in any manner so a%a,boroane%object to the Workcn'
Coonplar,non law.of California.Dam
Apprcaa,
NOI'ICf..TO API'IACAN'E.11:aRcr neding mix CcNEcme of H,troption,you should
M1caoanc sub,c,,m,he W.n.ar'v Compa„mt]on pr..sit of flue LaCalc,you am"
CO Pard rd,nnnply with...h p,a,i,ioo,.Ithis pllai„hall be deemed mvukod.
Z
CONSTRUCTION LENDING AGENCY
F' I hereby affirm that them i,x construction lending agency for the pcnannancc -
of the work far which his pe.III is issued(Sec.3197.Co,C.)
L Q Lender's Nanta
= z Isndcr'x Address
V O I certify mai I have mad ml,aPpllcat int,a^:I YWl,mw the abo.e int mna,ian In .
Lz enrzect 1 egme to..imply with u11 city and tummy mdlnomex and some In,I redwing
V mm
bailding construction,and hereby u
orim marsciddive%ohi.s city t.enter a n.
the movemcmmucal pm,l for inspection pumall..
F S (W'e).,me"'sI,,,indenmity mad keep harmless the City of Cupertino against
Vl liabilities,judgments.casts and expense, Each may in any way ac,oam again,,sail
U Z city in vonsequenceIll the granting of this permit. .7
APPLIC . 'UNDER ANA XD IL1.CO LY WITH ALL N`�Y PoIa/ Issued by: Dale /•”
'i• amraolnpplicunU..nt I>a�= Re-roofs
HAZARDOUS MTI'ERIAI S DISCLOSURE
Will the applicant or fn building ox'c'uent store or handle hamNous mamnid Type of Roof
an dehned by me Curc^inu M opal CNc,Chapin,9.12,and the Ilmlthand Sof ty
Cale.Section 255321st'! t
D Yex L No All roofs shall be inspected prior to any roofing material being installed.
Wdl he nppre,mi or foram bulding oatpmn use eloirvmmn or duviee,which If u roof is installed without first obtaining an inspection, I agree to remove
mit hnearrino,alt c.n,:uaar. tem Acis-d by Ie Iny Aro,Air Qu^Ii,y Manugcmmn
all new materials for inspection. Applicant understands and will comply with
DYe. No all non-point source regulations.
I have mad me hvmdous mamdals mquircmems under C'hmpmf 495 of the
California Health F,Safety Code.Sections 25505,25533 and 8534.1 understood mat
if the building does not currently have a tenant.that it is my resp.mihility to notify the -
ecupan d the req 'ancon,which rot be met s or 1t.:%,ounce of a Corriticate of
Dee` ey' _ Signature of Applicant Date
.all,1,, g,�� All roof coverings to be Class`°g., or better
OFFICE