08060056 CITY OF CUPERTINO �/t^a*Y!�•��ss� '�r ia.a+'*"�"rF(�'' "*?
BUILDING DIVISION PERMIT �VR_o 11�LiG-TOW1 vPERMIT NO
"".?Tf6,fgR NORTHSKY SQ TBD TO BE DETERMINED 08060056 .
40 NER''SyNAME: PERMIT ISSUE DATE
YOUNG CHRISTINE 06/12/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITEC IENGINEERu BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
u
0, LICENSED CONTRACTOR'S DECLARATION Ib Description
m 1 hereby+Rico w that 1 licoucd under provisions of Chapter 9(commencOeBCrIP
ing
with section 7")of Division 3 ofthe Business and Professions Code.and my decade is ADD ACCSBL ATTIC SAME ELVTN AS KTCHN CEILNG FOR
i Liccl Classndeffeec LkR SITE STRG(132SQ)RMDL (E)BTHRM FOUR NEW STAIRS TO
=£:ovfARCHITECTSFG
D,k Commuter
DLARATION ATTIC, STRUCTURAL(25SQ) -DOES NOT INCLUDE REROOF.
F.W< I undcmand my plans ahall be used as public records
g LL y 4Km1Y'd PNmasion,I
SO OWNER-BUILDERmDECLARATION
C 0 C 1 harehy,affirm that 1 1. .Becom from Jm Contractors Co License Any c Law for the
p O followwhiching equ scon.res a permit
17 o I.S.Business and P .d..u Cook:Any clay as county
$ which requires a permit re cores he alcor.nt fmve,deermit t or e a sig any structure
pat heor Is tamed puresuntas ft tw applicant o forthe such Contractor's
icese Lawdsokmcot
< Na mencin�dPurauntkJsofDiviomofNeComrsiness luavehw(Chapm9 Sq.Ft. Floor Area Valuation
y�s (commencing with Satian 7000)of Divcion)af the Bulinus orW Professions Centel or
$20000
.- Nat he is eempt themkmm and this,bode for the alleged exemption.My violation of
Section 703M by any applicant for a permit subjects the applicant m a civil penalty of
ot mre Nan five hundred dollars ISM 31640044 .�dpS4 Number Occupancy Type
❑I.esowner of the properly,ar mY emPloyces with wags etheirmkcampeveJan,
will do thewnns dna the he Contra noUnknded or Law
do Tomsk(See. owner
of
and ertywhobu CWC:The Catheme n.and
Law does or apply lf rt PNMT Ok Required Inspections
property em who s,Code
u uss thereon,and who dos not in work himself edor through his
awn employes,p Wilding
w i pm ch improvements are not intended W aRemd forsake.a,
builder ,the building orimprovementshatwithinarc Wild of compkdon,thepose of
builder will have Js wNmr of proving Nn k did not build m improv for purpsue of
oyyak,,).
ill"•as care a the property am exclusively comracdng with licensed eenuactors no
conduct Js project(Sec.7044,Business and Pro(esslou Cade:)The Contnemis U.
come Law does not apply he an owner of property who builds or improve thereon,and
who contracts for such projects with aconussmr(s)licensed pursuant in the Contractors
Licence law.
❑I am exem t under Se ,B k PC fur this won
1 I
D,re6rl
WOIF 'S NS NDECLARATION
I hereby affirm under pnWty of perjury one of Js following deleraJorss
I have and will maintain a CcAfaom of Consent m selNusum for WorkersCompen-
sstion,as provided for by Section 37W of the labor Code.for Jm performance of do
work for which this Permit is issued.
❑I have and will mairsom Workers Compensation I...as not,fired by Scetlaa
3700 ofthc Labor Code,(or the pcdmmance ofthe work for which this permit Is issued. '
My Wurkrfs Compemalou huuranco Orrin and Policy number am:
Carner, Policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu onion need Out becompleted If the Permit is krone hundred dollars(SIM)
or les.)
I cmufv that in the perfsmarst ce a the wart for which this permit is issued,1 ahull nm
employ any person in any man o boeo subject m the Workers'Compensation
Laws of Cal'foryp. 9C�,s/!
Applicant /� �/ 4p I
NO ICET APPU NT If k 1qVeCf fEx P y should
become subject w the Workeri Compcnsalian previa m of the Tabor Coda you must
.J O forthwith comply with such yrovistom or this permit shall be deemed rewked.
z N CONSTRUCTION LENDING AGENCY
[—i I hereby affirm that them is a cansuuctinn lending agency for the pedurmanee of
Cli the work for which this Permit is caused(Sec.3(197,Civ.C.)
WM Q Lenders Name
Z)z Lenders Addw
U O 1 certify that 1 haw mud this application and some the the above information If
[L Carnett I agree in Comply with all city and county ordinancesaW sum laws missing to
.O building construction,and herebyauthno
ies mprcnodves of this city to color upon the
r L57 shove.mentioned property for inspection proposes.
t„i C (We)agree to can.indemnify and keep harmless the City of Cupertino opium
Vl liabilities.judgments,costs and expenses which may in any way accrue against said City
U Z In conscpuenee of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date l(/l
SOVRC®U ATIO
Re-roofs
ipaum of Appi on par
D 5 M
NAZA A ALS DISCLOSURE Type of Roof
Will Jae applicant or comm wilding ocelpnl Stare of handle haaccoua maWrW
as"fold by the Cupenien Municipal era.Chapter 9.12,and the Heslth and Surety
py.zss32(.)' VNO
All roofs shall be inspected prior to any roofing material being installed.
'�N If a roof is installed without first obtaining inspection,I
Will the applicenl or forum willing occupant us equipment or aviee,which g an agree to remove P
emit havaNnua,I,conominan "fined by to Bay Area Air Quality Management all new materials for inspection.
District'
❑Yes Nu
1 have mal Ne hvardws maerialso ptimmcros under Chapter 6.95 ofthe Califer.
nc HcaW h Safety Code SecUnts 15505,25533 and 25534.1 understand!thairthe wilding
doer rot cunendy have a Imunk Nat it k my responsibility in modify the oceupent at the
myulre Uwhi meal me "armi mneconCmufieek.10emparcy. Signature of Applicant Date
Y�
wnC.,inilhmaa agent D,re' All roof coverings to be Class'%{"or better