04020153CITY OF CUPERTINO
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BUILDING DIVISION PERMIT
.CONTRAC,TOR I1VFO,RMATION'�'
BUILDING ADDRESS:
BAY AREA CONTRACTORS CORPO
IINo04020153
OWNER'S NAME:
PERMIT ISSUE DATE
NE:
SANITARY 90, CONTROL NO.
ARCHf1EC 'ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
j LICENSED CONnsedunderpDECLARATION
9
JobDescri tion
p
(commencing
I hm7 afrtmn Nies 1 am licensed under provisionsofC.de.
Diviilon]of NC Busine aMPofessionc Cod .endmylicenx is
with SMrce
ndeffef
in full force and effect
I License Class Lk.Y
MS BATHROOM REMODEL
D.¢_ Contractor
ARCBfrECDECLARATION
public tards
C Iotand my plans sIW I he used u re
j
Q�
Pre
' Liscnsed Pnsfcssianal
ON
j OWNER -BUILDER DECLARATION
from the Cantnctors License for the
g I hereby .(fere that 1am Conu
1..Bumps
city o
D following reason. (Section ](171.5. Business and Roftstiom Code: My city m munry
which acquires a permit to Construct, altar, improve, demolish, or repair any structure
^ prior to its issuance. also requires(he applicant fnreAch perociuo flea signed suumenl
Wthc is licensed w the ftContncwril-i¢nse law (Chapter
Sq. Ft. Floor Area Valuation
paprovisionsaf
S (commencing with Section 7")of Division 7 of the Businessand Pmfessiom Cade) or
that he Is exempt therefrom and the but$ for On allcgcd exemption. Any violation of
Seedan 7031.3 by any appieh nt for a Permit subjects the applicant to a civil penalty of
37WN41bJ0rr0 0
Occupancy Type
oat ream the f m bueana mlwa (ss43o).
wW wageao tiAiraie mmpcnodae,
❑ Lanwnork.
adPmpmty,nmyemntendes
will dolewars. orathe swmumuAct inLt MOwchoforedo (Sac. in An. Business
Add Cade: The Canmcars Liable law aces not apply lf an owner of
Required Inspections
arty who and who doses htwarshimselfor through his
mammy who b. or ed
rs
own a providedOutuch improvements mOEercd for ole. If.
D that such improvements art not ear
ing or i
er. the Wilding of
however. the buildingh r improvement is sold within ane year of mpole far the owner.of
Wilder will have On buNm of proving Ws he did not build or improve fm purpose of
alt.).
u owner of the pmNny. am uclu my contracting with lim=d mnvamon w
wa Ne project (SC.. 74344. Business and Predications Cade:) The Conuacwrs U.
terse law dors not apply to an owner or property who builds or improves thereon. and
who contracts for such projects with a consonants) licensed pursuant to the Contractor's
License law.
❑lam Cappi under See ,B&PC for this rtason
r
o�.��- Dam r
W ER'S COATI FEN 10� EC ATION
1 hereby affirm under penalty of perjury LAI Nb foil g declarations:
I have and will maintain a Certificate orCmsent to elf-insum fa Workce3C=Nn.
pro SMuon 370D of Ne labor Code. for tiA portarmene a( dA
thi for
workr
work for which this permit is issued.
h mi
❑ 1 have and will maintain W.Am'a Crmpcmauon let... As required by Scednn
3700 of Ne tabor Code. for the pedarmance of the work forwhich this permit is issued.
My Wmau'a Compensation InsunrAc artier and Polity number tic:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thu treated oat W complcWd if sae morril is forom hundred dollars ($101)
AC kis)
I cattily that in Nc perfurmanec of the work for which this permit is issued, I shall not
,
employ any person in any manner an as An become subject to the Workeri Compcmation
Lsws of California. Data
Applical
NOTICE TO APPLICANT: If, after making this Ccnifcata of Exemption, you should
become subject In the WMkeri Compemairn provisions of the IaMn Code, you must
'
' foMwith CemPly with such provisions or this Permit shall be damned revalued.
j CONSTRUCTION LENDINGAGENCY
I hereby thi Nel them iasued(..30 lending.) for the Performance of
�
which
' theLe work for which this permit u issued (Sa. 709'!, Civ. CJ
Lender's Name
Lender's Add.
I cenify that I have read this application and sum Nat dA about information is
' Comm I arta to comply with all city and county ordinances and sum laws relating to
building construction, and hereby amhone, represonutives of this city to enter upon thc
above tmentioned Property pur,dwhich ex
t
fond
(We) agree a ave. indemnify and keep harmless the City of Cupertino against
i t ex ams anyway accrue against aid City
&G
incoitiequencc fthegassingof thisawhichmgin
of the gaming of this permit.
A
APPLICANT
' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by:Date
OURCE EGULATIONS. _
. .....
—
5; 1Re-roofs
"maAgXm, t Data
BAZAR S &TERIALSDI CLOSURE
Type of Roof
Will the applicant or future building occupant tore At M1andlc haamdays material
As defined by the Cupertino Municipal Cade. Chapter 9.13, and ise Health and Safety
Code, Saturn 35533(a)?
MY. xka,
All roofs shall be insnected prior to any roofing matrrfal hP:.,r ine4^neo
the applicant or future building occupant rex equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
sus air cmuminants As afined by the Bay Ana Air Quality Manapno all new materials for inspection.
:s ''
hove A Anand, Out h u my mspomihility notify the McArthur
I most Cc mel prior w issuance of Acam of Occupxv,
Signature of Applicant
Date
All roof coverings to be Class "B" or better