02050075 . CITY OF CUPERTINO..,BUILDING,DIvtstON PERMIT CONTRACTOR.INFORMATION:
87,531ADNEWCASTLE DR ALLIED AIRE SERVICE INC TERM o. 02050075
r' i�s AN 661 SINCLAIR FRONTAGE R M/'T1G. nbh
j" PHONE:•,.'-•->-;; SANITARY NO.> CONTROL NO.
O .,.':., ,. '. , ...r•' (408) 934-8844 , ! ..,f.-�'`'+',.':': .. ....:... :: :....•' ...:
0`O ARCHITECTMNGINEER: _ BUILDING PERMIT INFO
BLDG ELECT. PLUMB NECH
<Z� Pp-• I-� I_I O I -1
,,_..;. LICENSED CONTRACTOR'S DECLARATION J ❑
'.I hemby aRnn that l am licensed unde,,ovisions o(Chapter 9 ociann cing 220 AMP SERVICE V]J�iKfil
q with Section 7")of Division J of the Business and Professions Code,and my license
is in full force ioii``f i fc l
[p at J7 LLicentiateLicentiateC) 3: G . 'Lie s-int 2 u
3 3 a Da /t�e� cortr
ARCHITECT'5 DECLARATION
'. Lun�er}yvld my pl nTshall be, sW as public moods
®- ■ -I '""^
]' p Litt 9 d Pm(ess dual, � Le
OWNER-BUILL DER DECLARATION
u = •.I hereby.(Bim that 11. exempt from the Contractor'snCoLicense Law for the FEBO �oo�
1611owing reason.(Section]11)15,Business arta Professions Code:Any city or county r $1060
E,tp D wh ch q trt a peon t to co st et alte p demo) h o pe ny suuclum
�3� .pct t issuance.nal requires theapplicant for such Permit 11 asgned statement - - - . .- -----. -
Inlnotslm dpureivi) N provisions fIM1ft 1 t es and Prlki (Chapter Cod9 fy z. ,t3Cstaa,BWL:D1 G' Valuation
(c mmenc g mSee n]in an (he 'i.ion3 of Business andion.Any
Cade) i,,s ,- 1+ .. .. . .xi .%C
or that he It exempt thertrmm and the basis forthealleged etemptmn Any violation -
-nfnot moreohan iv any applicant(ora permit subjects the applicant to a civil pcnahy
,of not more toga Eve hundred mpan(s500). � 304ARN AOIil66H ELECTRI AL,,.,r -•-:. Occupancy Type
Cl 1,ex nwner of the pm,,,,,or,ny empmyaen whlt ,.,a,an their tela compensadon, 501 - FINAL ELECTRI AL ENERGY
'rwill'do the'work:'and the'mrucmre isnot intended or offered for sale(Sec.]M4, ------50-5 - FINAL EARA J UWectionS'.,S`
';will
and Profcssions Code:The Conuactor's License Law does not apply to an y... .'..,r.,
rthrough
owner of property Who builds or improves thereon,and who does such work himself
or through his own employees.provided that suchmpr improvements an not intended of
_or
for sale IChowevcrahe Wilding ire einem issold-'ithin one 6f "' _ _ .._.__ .._ ._..._._ . _ .._-....___ __..... ._. — ___._...___-__
iimprove for purpose dWilderwill have 1pe burden of p'rovingthen he did not Wild or _ _ ,. _
i. improve for purpose
of sale.).
,P ns f the property nm'aclaBusiness
ely contracting loo&)licensed The Contractor's m
Lin ns et the p.jeai(Sec ]040.owner: and ery wh b Code:)The ve nmcmr s .
License Law Goes niu apply to an owner of property who solids or improves thereon, -
f ,and;whocn fosuch projcco.wiN a contmaor(s) licenumm
d.puisnt the. .... __.. . ... _. ..._. _
'p Comracmrs License law. -��-
°I am exempt under Sm ' ",B&P C for this reason .
caner'"' Date' -
WORKER'S COMPENSATION DECLARATION
1 hereby air,.mi Penalty of pepuryone of the following deductions;
,
'TPI1 have arlq sLtll'roamm n C mfic t f Consent or If insure for worker's r f
Crimp n au n,1,as"p oVded'lo hY Sect J]o0.of'th Labor Cock, for the ;
'perfomm�ce oGne work for which lois Perrot is issued,
1 have'and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the perfomtance of the work for which this permit is
is
am Cu a" ImnsuranceN cam!pe�r and
r�Policy number arc. "• _
a3��'S -9 u. . ,. v.. ,- 1.9`1,: Sf j.F•, �i-._..c- ... .i', s.t; _ '-_ _
,,yc.CERTIFICATION OF EXEMPTION FROM WORKERS'T
COMPENSATION INSURANCE + ` -
n.. ..... .......,.,_ ,_____..._ _,_...._._... _._.
1 (This semmn need not be completed if the permit is Ibr one hundrN Jollers •' + s.J :'I s'
(1100)or less.)
.. 1 e m than the Performance :. ..: .. .......-_ ...
y n ce hn r work(poi whi h ub ct o.t e W d 1 - f
ihall mol employ any perxn m any mannerso as to become subject m the Workers" ' " ' I
Compensation Laws of Califomie.Date;" "
NOTICE iuOAPo the Worker's
oTIf Compener kmgthsCen Tcme fExa puome,you mind .,.,
)
tics -stem theta k rCisions or
his pmssonn of the Labor Code,you must f
O 'fdnh th comply with such provisions or tMs pertnu shell be deemed revoke]. . -
t„e 't+al `s ""CONSTRUCTION'LENo1NG AGENCY If
a 1 hereby M.that there is i construction ses, 07.C agency for the peRomt nee n .-
b(the o k f which this permit s issued(Sec JlN] Civ.C)
� res -I-ande sNeme :x ..a•,..,, .... . . ... .:'u_ .. . .. .._. _._.. _ _. . . ..... _. _ _ _ ..... .. .
U"0I unify Nai l have reedthis applicnimr end state that the above in(ormelum is
W'iF.. 'poorness 1 agree to comply with all city and county,ordinances and state laws relating
0iU to building conslmcti6n;mid herebyauthonae representatives of this city to enter upon
'W :he,obovc-mora ed progeny for inspection putryaso..
-'
I. (We)agree to xUeJ indemnify and keep hrrucsrthe City of Cupenmb against
0 .IivbJu¢s j dgments.c st and expense which mey in any way. clue against said
.City m comeeque"n i of the granting ofth s pe t " 1/
APPLICANT.UNDERSYANDS'" DWILL COMPLY WITH ALL NbN DipI' I O1
'SOURCEREGUEATIONS t o Issued by: Date
Signatareof ApaieanuComtacor . ': Date Re-roofs
HAZARDOUS ATERIALS DISCLOSURE
. t %II the applicant o faint.b Id g c P m sl handleh b mat nal ...Type Of.Roof
as def d by th C pen n M n pal C de CM1 pt 9 12 o d the Health d S f ty
a
cc J i°ad.Yes
25512(.)1 ti ( : - i t i, '1`, , e r'fx/, " i 'k
All roofs shall be inspected prior o-any,roofing material being installed _......
Will theapplicanx or furore building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
ad di murdousfair contaminants as defined by the Bay Area Air Quality Management
Dinict all new materials for inspection. Applicant understands and will comply with
°Yea �"° ' all non-point source regulations. '
._
1 I ha exad the hice,Y C Ous inai.6a 2 505,2 merits d der255 4.Ito est id the A'pf
C the building
dos Safety Code;Sections 25505,355]3 end 25574.I ty tomm�d that
ftheb Id ng dou not currentlyhave.Rwnl thou snyr Pon notifythe
of
tie
pan'
m of th� Aevi cmenn hi must b t 1 m is uance f v Cemfcam of '-
°tt pap ,3�3J Signature of Applicant Date
uioriwainialfplilDole All roof coverings to be Class `B" or better
...i. ',. OFFICE
.. .... .. ... .. . . .. ... . . _.. .. ._..
J`-res.•:-:.t n. .lis. +-� - ._ - ; . .