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04030083 CITY OF CUPERTINO ++' �r�.p ,k'� -•�3T']��TF" �k,� '` ,'•= BUILDING DIVISION PERMIT �kCOk�LIQ>CXTXQll�i O1Y1ATIy BUILDING ADDRESS: CENTEX HOMES 1111 N904030083 20596 MURANO CIR LOT 11 OWNER'S NAME: PERMIT LSUEDATE CENTEX HOMES E. SANITARY NO. CONTROL NO. (925) 415-1600 ARCHITECT/ENGINEEK: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH woo LICENSED CONTRACTOR'S DECLARATION Job Descri tion u I hereby affirm that I am licensed under provisions of Chapter 9(commencing P `a wife Section l0(p)yf on Sof Use BusinwandN o an m j =a immllf, AI S DWL-3 STORY (PLANA) LiccnSe Lic.p EFa Data � lr Co. , VING 1836/GARAGE 400 SQ FT W7 ARCHITECTSDEC ATION lZ,dandmyplansshallbeusedupublicrecord +REVISION--#04080130 (PROCH DETAILS) �yU G Licensed Pndcssionel 3 Out I a.OWNER-BUILDER DECLARATION ConTION i 1 hereby.sere Out 11. Bumps s an me Canmcmh License Law for the D O following moon.(Section RI]1.5,Business end improve. dei mi Calle:Any city or county 1 m which requires a Permit m ennRrueL alter,improve,dcmeliN.Or repair any sweture prior in its issuance.else requirns the applicant for such pmmil to file a signed sulement that he is licensed pursuant nthe pmvisiouofthe Contrxtor'sLi¢nmLaw(CNPLCT9 Sq. Ft.Floor Area Valuation z�m (commencing wife Section 7")of Division 3 of she Business and Professions Code)or $ Nat he u exempt therefrom ted de basis for the alleged exception.Any violation of $214700 Section 7031.5 by any applicant for a permit subjects fee applicant or a civil penalty of APN Number Occupancy Type not mere man five hundred dollies(M). P Y YP ❑I.uowncr of me property,or my employcu wife wagesas their sole campenution, will do firework and the ammmure isnot interned oroResW fmselc(Sec.7014.Buircss and Professions Code:The Commem's License Law docs not apply m an owner of Required Inspections property who builds or improv thereon,and who dors such work himself or duough his own employees,provided mat such improvemenuare not intended oroQered for sale.If, however,the orimprovementwithinone year of completion,the ower- ��L bander will have the wren ar proving that he did not Wild or improve for purpose or �® sal..). ❑1,u owner of Use property stn exclusively connecting with licensed contractors m construct the pmjen 15eb.70,14,Business and Professou Code:)The Coneracmea Li. crewc law docs not apply m in owner of property who Wilds or improv Unman,and MAY . who contracts for such prejeets wire a conuactar(s)licensed pursuant ro the Contributes 2005 License tan Ovm,, emptandas5ec BkPGfmmiareawn ��L® Owner Dem WORKER'S COMPENSATION DECLARATION _ 1 hereby eflinn under penalty of perjury one of the following declarations- Of have and will maintain a Certificate of Consent 10 Self-insure for WorkeesCmckm- .due.as provided for by Section 37M of the Latin,Code,for to performance of the, work for which this permit is issued. ❑1 haw and will maintain Workees Compensation hosrana,u mimed by Section 3700 of the Labor Code,for thc performance of the work for which this permit is issued My Works omp motion in/ nm carrier and Policy number are: M Carrier: - - Poll,No.: CERTIFICATE XEMPION FROM WORKERS' COMPENSATION INSURANCE 1 This section need not NcomPleted if the permit is fnrom hundreddollars(SIW) or leu.) 1 lordly that in the pmfixeranee of me work for which this Permit is issued,I shall not employ any person in any manner an as in become subject to the Workcri'Corepcmation Lawof California.Datc AppiI., NOTICE TO APPLICANT:If,after making this Cenificae of Exemption,you should become subject to fee Worker a Compensation provisions of de Tabor Code.you most .J O pfoMwith comply with such provisions or this Permit shall IN domed revoked. ( CONSTRUCTION LENDING AGENCY [-+ Ihereayafirm that inert iia construction lendingsgenry far the pedommceof a,1 me work for which this permit is issued(Sec.3097,Ci,C.) Ic7 A Lender's Name L, Lenders Address / V Q 1 cannily ly that 1 have read this application and sum that the above information lL F building I agree to comply with all city and county oNimnv and Cute laws relining e 0 building mendimdpre,and hembyamhonmmpmsemativof this City to enter upon me liaove-ms,judg dproperty for inspection purpewhich may F y (We)agree to taw,indemnify and keep harmless me City of Cupcnino against UZin Cr inequamgofthemuandoffail expenses which may in any wayeceme against said City in coreequencc of me granting of fess permit ^ APPLICANT UNDERSTANDS AND WILL gpMPLY WITN ALL N POINT "sued by: Dat 5 U ULT NS. Signature of Appbcam' tractor Data Re-roofs Signature MATERIALS DISCLOSURE Type of Roof Will the applicant or future building Occupant score or handle hamrdous material az defined by the Cupertino MuCode.Chapter 9.11,and the Halm and Safety Code. r-ly35333(x)? as All roofs shall be inspected prior to any roofing material being installed. tios Will mea ream or future Wilding If a roof is installed without first obtaining an inspection,I agree to remove pp g«vvpam tax cyvipmcm or dcviv which g P Oil haeafdous air contaminants as defined by me Bay Area Air Quality Management all new materials for inspection. District? / P ❑Yes �]Nu Ihave mad thehaaardous maesulsre33 and55 under Chapem6.95 thmitheCalding rias not urSafny Code Sectin,u355ifIt m33and35539.1 understand Uatifmc wilding dans not currently M1aw a tenan4 mm it iv my responsibility in notify tie Occupant t Nc require _swgich muub t rior i' a?cctCanOccu y. p�b attire of Applicant Date nerofauthomrcdagent 'pita All roof coverings to be Class "B"or better