06060205 CITY OF CUPERTINO f ME "` ^ '` '""-' W,
BmLDlnc OrvlsroN PERMIT rCONTRAGeT(?RINI?ORMQTION is
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BUILDING ADORES': DWK CONSTRUCTION PERMIT No.06060205
10319 MENHART IN
ER'S NAME: PERMIt LStJE DATE
PING PANG 18665 LORRE AVE 2006
OWN
NE:
SANITARY NO. CONTROL NO.
(408) 615-1508
ARCHIECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
IOp LICENSED CONTRACTOR'S DECLARATION Job Description
I beauty affirm that 1 am licensed under pmvisia,u of Chapter 9(commencing;Z wird Sec tion 7MQ)of Division 3 ofthe Business and Professions Code.and my license is
mfull ramaandefreeo 2 fly SFDWL 1 STORY 1845 ' , GARAGE 460 '
,qa Dow d Coma SANITARY IS SUNNYVALE' S JURISDICTION
'k- Date O Cowacwr
ARCHITECrs DECLARATION
i 1 understand my plans dull Mused as public records
ayU
o� Lwcnsed Prokessiowl
3 OWNER-BUILDER DECLARATION
iI hcmhy M.that I am attempt from Ne Contrzcmh License taw for the
O O following auazon.(Section 703 1.5.Business and Professions CO&:Any city in county
e m(L which requires a permit in contused aloe improve,demolish,rr repair any nower m
prior in its issuance,also requires the applicant rrrsuch Permit o rale a signed sutemenl
< than be is liccvcd purmuml to da,provisions of theContractor's llconm Law(Chapter 9 Sq.FL Floor Area Valuation
(eammencing with section 7").1 Division J oath.Buuraceswd Pmfessinm Cade)m $421447
_ this he is esempl Ncm(rom and the basis for IM alleged eseart Any violation of
Section 7031.3 by any applicant for a permit subjects IM applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars('.StB).
Lode.wok(Jail pm a.,amYotimanced wiNwgnned ortak, sok nom.Business
will do Ne work and Ne awctum ucwtintendede awe due,hot apply in an w.of
and Rty w1h bis Crede:The Contractors License law doe,ort apply w an Owner is Requited Inspections
Property who builds m ed dust
stearcon.impo and who dr not in work himselforthrough his
how a however.
d e Wilding
Nat such Lops mid wit tie not ear o c m Meront fossils.If.
however.Ne buildingb r improvement is sold within one year of completion.purpose
owe of
builder will have the Wrdcn of proving that M did not holed m improve fm puryose or
sale.).
Q 1,as Owner of Jae property,am nxdusively contracting with licensed mnvecmss on
covwct the projem(Sec 7(144.Business and Proportion Code:)TM Comnmers U.
cove law dna ms apply man ownerOf prapeny who Wilds or improve themrn.site.
who contracts for such projects with a cantranrr(s)licensed possession in IM Comuactota
License Law.
❑1 am exempt under SecB k P C for this mason
Owner Dit
WORENSATWN DECLARATION
I Mmby arRra under penalty of perjury oar of Jae following doela stirv:
I bsv =d will enainuina Ceniieterf Ccommooself.m.refmworkerYCOmpcn-
.satiom,as provided for by Section 3700 of in.Lamm Code,for Ne pedommanm Of the
work far which this pcsmit is hound.
❑1 have and will maintain Water',Compensation Insurance,az mquimd by Section
3700 of the labor Code,for the performance of Ne work for which this permit is issued.
My Worker Compensation Insurance,carrier and Policy number rim:
Cartier. - Policy NO.:
CERTIFICATE OF FXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need nut Meompleted if the permit is foranc hundred dollars(SIM)
m loss)
1 certify,chat in flan"Rennanec of We ppOh far//ww�i�h Nis permit is issued,l dull ms
emplganyperaon imanymans`� m cr,hcshbjecnm tM Workers Compensation
Laws of Csliforpia.
Applicant 7 L n
NOTICE TO APPLICANT:If,after making this Ccrtificate of Eacesptiam,you should
become subject in IM Worker's Compensation provisions of me tarter Code.you must
.J z faMwid,comply with ouch provisions or this permit shall M domed mvotrd.,
Z "'+ CONSTRUCTION LENDING AGENCY
4
[-v I hcmhycrnm is a construction agemy,Inc the pOrfurmame of
G' the web for which this permit is issued(Sri.)r3g'y.Civ.C.)
a,Q Lender's Name
D z L<ndeh Address
U Q 1 cmti(y Nan 1 have mad this ap,liemcm and note dw the afore information u
IL comet.1 agree to comply with all city and county ordinances and state laws relating to
Ubuilding construction.and li mby authome repmacnu,ivea of this city to enter upon the
a dtavc-ms.judgcdproPCM1y for inspection Iiiirpwhich ma
(we)agMC m ssve.Indemnify Nd tr P Mrmless the City of CUVeNn0 agalmat
rF-I h liabilities,judgmcnu.cosu and expenses which may in any way accrc against said City
U z in consequence of the granting of this permit L
^
APPLICANTUNDERSTANDSAND WILL COMPLY WITH
aALyNON-PPOINT Issued by: Date
SRM
�S�Uu/z5�_�A/,/
Re-roofs
Signature of Applicar,UCrnuacher f Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will IM applinnt m future building occupant store or handle havardov material
as defined by Nc Cupenim,Municipal Code.Chapter 9.11,and f ffealth and Safety
Code.Section 155310yy All roofs shall be inspected prior to any roofing material being installed.
❑Yv AN.
Will thea applicants or future Wilding Occupant mdse m, If a roof is installed without first obtainingan ins ction,I agree to remove
40 PP G P W 'pmat or dcvioes which Pe g
trait havamous air contaminants in defined by f Bay Arca Air Quality Management all new materials for inspection.
District?
Yet )�,No
1haveread Ne Mon c)usmawrialsmquimmennunder .Chapwr695ofIMCalifon
nu HralN&'afcty Coin.Smimu73S05.255JJ and 25534.11mdcssmmWmhazifite building
dices not crmendy have a tenant that it is my ropansibihty w notify Ne a:cupanl of the
rcquimmcnuw' hmmmberectpdortossu aaCertificatemraren Signature of Applicant Date
rd D6
Ownelormthori<dagcnt Dow All roof coverings to be Class "B"or better