08030031 CITY OF CUPERTINO �s�,� +�@5� ,a• /� r«e�,'��^T�'�sr%*p€€€� �, aeT,gr'.
BUILDING DIVISION PERMIT CQy�y�C�VRIlII QLt �IOI\ :
. • �;
BUILDING ADDRESS: PERMITNO.
10638 MERRIMAN RD TBD — TO BE DETERMINED 08030031
IFER'S NAME: PERMIT ISSUE DAIS
MR . & MRS. JONATHAN HUANG 07/10/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHOECT(ENGiNEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S pmDECLARATIONhap lob Description
if I imexactorTO )of thu 1 am lifted under pmviuot or CMplu 9(mmmense in p
withllto=a fcflmDvidan7ofdmButinmandPrafcuionsCode.andmylicenmis NEW 2 STORY DUPLEX W/ATTAHCED GARAGE 3 , 676 SQ
6 in full force uW etten.
Licence Class Late.a FOOTAGE. 10638 & 10640MERRIMAN RD.
Dam Cotrim,
e ARCHITECTS DECLARATION
e < 1 undersand my piston thaI be used as public Mortis
Jy
y G Lhcemnd Pmfcssional
5 Oat I am tUTLDER DECLARATION
COI I hereby,ffirm second
11. .Bumph from Pr f ss on CO :cent Law far my
i❑O following.i.a-Permit
7071.5,Busiass and Profession dor ns Cade: pud carr'm manly ,
$of which regainer a prnnit m cmwraL tllu,improve dcmalLN,t repair any smcmm
-Z�, poor m its issuance.shod requires the applicant for such permit in file a sieved sidemen _
'hit he is licensed pursuantto the Provisions of the Contractor's License, 9 Sq.Ft. Floor Area Valuation
r�s (commencing with Section 7000)of Division 3 or the Business and Profmiam Conic)or $500000
that he is exempt tlercfnm and the huis for the aiklm e,empdm.Any violation of
Section 703 L5 by any applicant far a permit sobiecu the applicant in a civil possibly of umber Occupancy not mare than five hara ted dollars($5= 3 4 216 0 7 5 .4N3$N Pane Y T YPe
❑I.uowner of lhn pmpmty,fmy employer wire mgesu Ne'vsole compenaton,
will do rum work,and the structure is not intended or offered for sale(See.704 t.Business
and Pro(calans Cade:The Continence,License law does not apply to an Owner of Required Inspections
propeny who buildsarimpraw the end.andwho dossnuehwok himadfordmough his
Own employes.providrA that such improvements are not imehknd moffemd for sale.IL
however.she building or improvement u sold within ore yea of cmopkuon.the owm-
builder will have the burse t of proving that he did ret Wild or improve for puryom of
,saale.).
m.u awtr of the property,w exclusively contracting with licensed cuneritan to
construct the project(Sec.7044.Btmm and Protmem.Cade:)The Cmtr.ctm's U-
rete taw unit not apply is an oma of property who builds or;mproses Nermn.and
who comimu;for such projects with a conuacmr(s)m;,.•»d pursuant to the Contractors
License Law.
dem tempt_uoddm.S, ,B&PCfm Nismoron
s �w��/ 7 Dai
WOR PENSATIONDECLARATION
1 hemby affirm under partially of perjury of of the following declarations:
❑I ham and will maintain a Conifteam ofCoten to self-insumfmWmknesCompen-
wion,as provided for by Second 3700 of the labor Cade.for the perionoteree a tic
wok for which this permit is 191Cd.
❑I have and will maintun Wearters Compensation Insurance,as mqu'ued by Section
5700 of rum Labor Code,for the performance of Ne some,far which On permit is iammL '
My Worker's Compensation Insurance carrier and Policy number art:
carrier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE '
oriess). ml(Inds son need not
M completed if the North is for one hundred dollar(S 100)
I certify that in hhc lanfammarcn of the rook fm which this Permit is issued.I,hall not
employ any person in say moaner' p 1 m the Wurken•Compounds./
Laws of California.out,
Apptcanl
NOTICE TO APPLIIC afmr making @Mean of Dominion.you should
become subject no the Worker's Competldon provisions of Ne Labor Corfu you must
.J O forthwith comply with such Prorioot or Nu permit shall he decmnd rooked,
z'` CONSTRUCTION LENDING AGENCY
r
[-r I hereby ichO that Inert is•ed(Sm. 0lending stfiehcy for the puformanm of
lYi
the cork for which Nu permit V load(Sm.JW'1,Civ.CJ
aQ Lenders Name
7 z lender's Address
U C) 1 ratify Nal 1 hue read Nis application and sin On the above information in
tl. m m L l.gra to comply with W city sad county otin.rms soul aide Laws rehim,m
building conaountion,and hereby anthorim mprtmntatim or this city to coir upon the
W above-mcnimmul pmpcny for inspection purpou>
4 (We)stgrm to save,indemnify and keep harmless the City of Cupertino against
tZ] Ii,Mlitim,judgre. ts,emu and upmms which may in any way attic quite,a,City
V z in conrquenen of the financing of this remelt,
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT - Issued by: Date
SOURCEREGU�LAijfDNS
�I
Smfitlueo HiuuOoui$h �o 'Q Re-roofs
HAZARDOUS MATERIALS DISCLOSUREDa� Type of Roof / v
WIII tc applianl m future building occupant some or handle heinous material
fined by Ne Cupenim Municipal Code.Chapter 9.13,and the Health and Safety
Sect. cy. �No
25533(a)?
❑YAll roofs shall be inspected prior to any roofing material being installed.
en
vol the,applicant holding ams cquipmen If a roof is installed without first obtainingan inspection,I agree to remove
pp g pant use t m devima Mich
emit haannm air cmuminants as de0ned by the Bay Area Air Qmallly Mamecmcm all new materials for inspection.
Disuicti
❑Yes ➢Nu
I have mid the haudous;materials toquinemenu um e,Chapw 6.95 ofdm Califer-
nu Health&S,/ny COO,Sections 25585,25573 and 25534.1 unMmamd thatilthe building
ddm Out currently new a a nae,tha it is my mspnnchilily m mdfy ft oreuW,of ds
regaimmeni hichma
;2'&0_ �be met proem iuvanf or.cvti0estearOcmpancy. Signature Of Applicant Date
y— .
Our m iuchmi ed. D,te All roof coverings to be Class in"or better