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04060104CITY OF MPERTINO - "' co. TfOR rnF,©t BUILDING DIVISION PERMIT .xlaN .+ But LDINC ADDRESS: STEPHANO HOMES INC PERMIT "0406010421 1821 MQ 2T.R.T.T.AN RD OWNER'S NAME: PERMIT IBSUE DATE PHILIP YEN & IR E: SANITARY NO. CONTROL NO. 650 949-12'8 ARCHITECT`ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONfIIACB]R'S DECLARATION Job Descrition p 1 botany and Nal 1 am licensed under previsions of Chapter 9 (commencing - with Section70IgBor Division3of Nc Busi�,,: Proicamons Cock.end mylicence is ' it, chisaceyssberreel. LicenceCluLi p REVISION--MAIN PANEL PUMPS/SANITARY SERVICES NO NEW PERMIT ISSUED/ORIG. #02060143 Dam—Calmer ARCHITECTS DECLAICATION 1 understand my plans shall beused as public records / Licensed Prsfessienal OWNER -BUILDER DECLARATION I hereby affirm Nat 11. exempt from the Cootns License Law for lbe soli Code: Any city or county following meson. (Section 7(131.5, Business and Co which improve, di chure 1.construct,also. imforsudemolish, or repair anyswment itsisssapemso prior toitsissuance,also requires the applicant for ouchpctors fileasigned sammdm licensed pursuant ofNc CleanseLaw (Chapter 9 Sq. Ft. Floor Area Valuatio 1107 (Matcomma cBusimen (commencing with Section7000) of Division 3 of the Beninese and Professions Code) or cMm70DMof ivbk I that he is exempt Neinfrom and Ne buffs for the Atcgetl exemption. Any violation of Section 7031.5 by anry applkanl(orepemPit aubjccu Ne epplkant to a<ivil penalty of APN Number N NJ Occupancy Type not more Nan to. hundred dollars (5500). 35714042.00 ❑ Las owner of the property, army employees with wages u their sale empenntian, Required Inspections will do the workand theswdued is not Intendedaroffend formic (Sec. 7044, Business and professions Code: The Contractors License Law don not apply to an owner of property who builds or improves OPetaon, and who doea suc h work himself or through his own employes. provided that such Improvements are not intended earoffend for said. If. however, Ne building or improvement is sold within ane year of empleuon, Ne ower. builder will have the burden of proving Net he did not build or improve for purpose of coin.). K" I. es owner of the Poulson, am exclusively comoddi ng with licensed contnemrs to et the project (Sec. 7044, Business and Professions Code:) The Contractor's Li. ccnan Law docs not apply to an owner of Forestry who Wilde or improve dPcnon. ad, who contracts for such projects with a canb dd or(a) licensed pursuant to Ne Contractors Li,Law. ❑ I am exempt under Be B & P C foi�&ddpn ' r ORK ICS C MPENSATION DE ATIOPF 1 hereby Aline under penally of penury one of de following declarations: - heveaced will maimuld a Certificate of Consent to self -insure for Worked we provideA for by Section 3700 of the labor Code, for Ne edrfornim. of the work for which this Permit is issued. ❑ I have and will maintain Workers Compensation Insurance, m acquired by Section 3700 of Ne Lobar Code, for dm performance of Ne work forwhich this Permit is lamed. kers Compennsioo mums ttcertiennd Poliryn tuber am: - YMyW r. PoRay CERTIFICATE OF E%EMPfIONF MWORKERS' COMPENSATION INSURANCE This decline need notbe completed little permit is Action hundraddollars ($100) car less.) 1 ttnify that in the performance of Ne work far which this permit is issued, I shall not „ employ any person in any manner an as in became subject to the Workers Compensation Laws of California. Dare Applicant NOTICE TO APPLICANT. If, after making this Ccnifmam of Exemption, you should become subject to the Worker's Compensation provisions of Ne Labor Code, you must ' forthwith comply with such provisions or this Permit shall be deemed invoked. CONSTRUCTION LENDING AGENCY I hereby thi Net theta is a e ore lending agency for Nc performance of , which d (See. ' Ne work for which this permit is retied (Sec. 3097, Civ. CJ Lenders Name Lenders Address 1 cenify that I have road Nis application and sate that the above information Is cordis. ) ogre to comply with city and county ordinances and Cute laws dating to construction, and hereby mpraenutivp of this City to cnmr upon the scothutilitarian showng shove-mentionedpropcny for emnify an fff I )rep Ind (We) agree to cove, indemnify and keep harmless theCity of Cupertino against d expcas which may in any way accred against said City j liabilities. judgments. enae in consequence of the granting of}b Permit. s APPLICANT ENDERS NOS'AND WILL COMPLY WITH ALL NON -9011 T Issued by: Date I SOUR REGUL'A S. Re -roofs Type of Roof 4 - /P (/ S atumo HAZ It IALS DISCLOSU RE D Will thc applicant ter fume Wilding Occup rtoore ter handic hav<rdous material defined by the Construct Municip Code, Chapter 9.12, end the Health and Safely Code, Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes o If a roof is installed without first obtaining an inspection, I agree to remove Will me aep0aant car future Wuai�s attapant en equipment or deymed wmm� ail humardaus air contaminanu as defined by Ne Bay Area Air Quality Management all new materials for inspection. triCl? ❑ Yea I have mad the haraMPms materia srequimmcau underChapmr6.95 ar Ne Califon ria H.0"SActyCcdc, tions255)5,25533.d25534.I.nd. dNatifthc Wilding does not cure Piy,h tenant. tma it a my,msspo 'bilitym notify tho vxupant of the i requiremcn act the !acerinivaan.. s odea teraepanry. Signature of Applicant Date All roof coverings to be Class 'B" or better -- Dole