08080127 CITY OF CUPERTINO r' a+ �.aR '"'�" % �'" `` r)' ^'*'•
BUILDING DIVISION PERMIT rACgO1�IT"tT0)V'�TF�UR
BUILDIN PERMIT NO.
) PDR RK MEADOW CT SOLARCITY 08080127
R'S NAME: PERMIT ISSUE DATE
,01_,D DE LEON 393 VINTAGE PARK DR STE 140 08/25/2008
SANITARY NO. CONTROL NO.
ARCHITECDENGINEER: BUILDING PERMITINFO
2 . SKW ROOF MOUNTED FLSII BLDG ELECT PLUMB MECH
3ereC
LICENSED CONTRACTOR'S DECLARATION
rdd 1hereby alliinthan 1amRestated uWcrnd Prolusofaads. 9 my license
Job Description
z wballto=7 it
of Diviuses]afOe Business end Rofeada,u Codo,aM mYliceRau
^< in full(oras effas
'z ucen"cl". C I-`a r., tiro Lk:.w
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A HTIECTS DECLARAS'ION �
it 1 uMewnd my plans shall be used u puM1lie rtenrds
y0 Licensed Professional -
^ OatSUER-BUILDER DECLARATION
30 9 1 hereby arum than 1 1 exempt from she Coa en Co License Law for Ne
C D O following reason. erraft NJ Id,Business roti Improve,
d apes Cade:Any do staunty
9 I"i which requires a perch re c�res duc slur.W prove,demolish.mea sir any taructurt
ipy pdmmsl iensnm.ehurtha the de eisionsofanuchpermiuo0leasigned Law(uumem
F�
that Wincing wit pSewent u the provisions3theeBu inessaiavelaw(C Code)
Sq.Ft.FIOOC Area Valuation
g
(commencing is exe pt Section7")W thisof basis far ofthes aged Business and pt Proon.An vi Code)or
r3�
that he b exempt shemfrvm and Ose Dsa4 for the alegetl exemption.Any violation of
Section 7031.5 by any applicant four a permit subjects Ne applicant he a civil penalty of APN Number Occupancy Type
not mom and five hundred dollars(55001.
❑1,"owner of the property.or my employer with wages u their sole campensddw.
will do thus work and the stromuse u not intended or onerW forsau(Sa.700,Susi^•••
and Professions Cade:The Coamothes License Law don nut apply m an awner of Required'Inspections
property who Wilds or Improves Hereon.and who does such work himself or though his
own employees,provided that such improvements art not Immukd whitened for sale.If,
however,the Wilding or Improvement I.old within oro year of completion,the owner.
builder will leve tin Women of proving that he did Out Imild or improve for purpose of
"In.).
1,as away of tW property,and exclusively conlmiing with licensed anuwlors in construct the Ne project(See.700,Boonton and Profession Code:)The Commences U.
new law does not apply 0 an owner of property who Wilds or improves demon.and,
who concocts for such projects wish a canu"wr(q licensed pursuant m the Conuactar's
License Law.
❑lam esempt undo yes ,BhpCforrhIsmxou
Dau
WORKERS COMPENSATION DECLARATION
banally shim safer pointy,of parjtuy,was of she following decla rdwee
I Its.and will manWn a Cenifiate^f Cement ro self-insurt far Worice.Compeer
"flan,u provided for by Section 3700 of the�r Cade,for she pediumana of de
work far which this permit is issues
&I�I have awl will maintain Workets Compensation Wurana,u required by Section
of Ne Labor Code,for the pesfmmeec of the work for which du Rn^It Il.issued
My Workefs Campensatioe Insurance earria and Poliry number art:
carrier. MCQ& l'TC Poliry Nm:C-GI00-)041 701
CE fWIFICATE OF E%EMPfION FROM WORKERS
COMPENSATION INSURANCE
Crhtssevich wed not W canpl<ud if rhe permit Is fenorm hundred dollars($1001
or le")
I cemUy shot in the parformawv of the work for which this permit Is issued,I Nall not
employanypersonin"ysom reasons can jeermthe War""'CompeuWon
laws of Csiif L Dale _
NOTICEITO APPUNi:IC aP1eFr m�ikin�g�N~CeNRou of Exemption,you should
became object in the WartrYs Compensation provisions of the labor Cauls,you mute
.J O fordwilh comply with such provisions or Nis permit shall W deemed mated.
Z y CONSTRUCTION LENDING AGENCY
[ti 1 Wrtm Nu u
by affirm there a commmedon lending agencyme for terromance of
E
i thO woh(a,which tiffs permit Is imaed(Sec.3097,Civ.C
aQ Loder's Name
=Z Lendefs Adder"
V0 1 cudfy Nal l have road!No application and sure the the above information u
Ix.E carol.I agree to comply with all city soul cowry ardinoces and sum Iowa mining m
O SVS building construction,and hereby adadre representatives of this city in war upon Na
Lxl aWve-mentioned property for inspection purpnses
(We)agree to eve,indemnify and trap bamless Ne City of Cupertino against
Iloilidesjudgmenrs.crou and expenses which may In any way science against sad City
U Z res consegawe of me,gnome of this wmic
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
g�p.V'1 A Q!t "(j Ct n X1 S-aS-EIAr Re-roofs .
Sig"mrt of ApplicoVConuacur Dad
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or far.Wilding occupot nom or bandle hazardous materia
dclinalby"o Cupertino Municipal Code.Chapter 9.12.and me Health and Safety .
.seed.sss3x(.)7
❑res .2 K.- All roofs shall be inspected prior to any roofing material being installed.
Will de applicant or future building Occupant uo equipment Or dcviw which If a roof is installed without first obtaining an inspection,I agree to remove
It hmvvdnus air containment,as warted by Ne Bay Ama All Qusii'iy Management all new materials for inspection. ,
Clausal
0 yes
I have read thehazaN^usmw essequimmenuunder Chapuur6.95afde Califon
nine Hnithksafctyeade.Swti"uss5W.sss33e Z534.lundemanddu BNc Wilding �a5 sus n� /5s n g'�S
dor wt cmrtndy have a tenard.than it ts my nowshility m wtify tie weapon of the V / s _A1.C_A a'
requirements which mu"W met prior an enhance ofa Cmificaa:of Occupancy. Signature of Applicant Date
0wnarorantharir<dagal Dam All roof coverings to be Class'JW'or better