05090167 CITY OF CUPERTINO z ., , �" "'•
BUILDING DIVISION PERMIT ; C®NRA.C�'T�QR 11VFVIAT.aIUN.
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BUILDING ADDRESS: PERMIT N0.05090167
10470 OAKVILLE AV
'.WS NAME: PERMIT ISSUE DATE
RYAN LIN & DINHNGHI WU 02/10/2006
PHONE: SANITARY N0, CONTROL N0.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
0 0
X00 LICENSED CONTRACTOR'S DECLARATION lob Description
g(aj I Mmby affirm Nat I un li=med under pmvineas of CMpkr 9(rommcrbing P
with Section 7000)of Division 3 of the Bushman and Professium Code,and my license is
t to full tome and after ADD 317 ' -NOOK/FAMILY ROOM
2Rz License Class Lia.«raclor KITCHEN REMODEL
S te, Date T'S DELL
ee As shall
DECLARATION
a e� I mldekknJ my plans slWl be used u public records
y a.
AG Lionsurd Professional
OW
ay< NER-BUILDER DECLARATION f I bitchy.(Bras that 11. mempl s an Ute Contractor's r'a Lien=Law for the
o O following recon.(Section 7031.5.construct.
Baslteas and improve.
de inns Calc:Any city or county
$� which its irm•permit m cirm the pike improve,desuch errol,,are a slimed
ed tatemna
�Sa pdormits tensed e,also
andant uima the ilio of fa Contrermi'mimme,Lrbtl atakmcm
< bathe iscinS iJSadnW ma 7000)pf DiaW.m3.f B..i tar's Li=me Law(Chapkr9 Sq.F[.Floor Area VaIU "1B0
(comment xclopt Section70ndth Division]theleegedcs pt Professions Gaon of
.-
that he k e=mpl Hem(mm mtl We basis for the alleged tumptim.Any violation of
Section 7031.5 by any applicattfor apermltsubjects the applicarto anvil penalty of APN Number Occupancy
not mom than RK hundred daHam($500). 36913005 . 0 0 P Y Type
o I,as owner of the property,or my employees with wages As their sole campenution,
AM do the work end the structure is not intended or offered for sale Business Required Inspections
and Professions Code:The Convumfs License Law Orbs not apply Ane ns at owner of q P
property w ye bui Ida or ire proves Hereon,a rad who dos suint work himself ed through his
own employees,provided ar i Nnaeh improvements art tic invaded A,offered for sale owner-
builder
the buildingorimprovementissoldediinorbYAM of completion,the oveer
ntuilder w10 haw 01e burden of proving that M did Inst build or improve for purpose of
ukl'u owner of ct property,.Business esdus and Pomading with licensed minam is l.
mdconse La the project(Sec,7044. ofand Prowho Wi ds or The Comamerm. rad /
whoa Law once not ply m as owner of property who builds rs improv Commie and, /
who conuaC.for projects with eeonuumr(s)li=tato pursmmmme Conuactor's O/
Lim.Law.
❑lam uem a Sec. ,Bl PCfor Hi lesson
Dam G Ob
ORK 'S COMPENSATION DECLARATION
I hereby aiBrm under penalty of perjury am of the following decimations:
❑1 Nw and will maintain•CertiOesk ofCensem m mlf-imam fm WmkerSCampcn-
utlon,u provided for by Section 3700 of the labor Code.for the performance of the
work for which this permit is iss=d.
0 1 have and will maintain Warkces Compensation Insurer=,As required by Section
3700 of the labor Cade,fm the peffmmance of the work for which this permit is Intend.
My Worker's Compensation Insurance carrier and Policy number am:
Caller. Policy No.:
CERTIFICATE OF EXEMPDON FROM WORKERS'
COMPENSATION INSURANCE
(This secti==it notbecomplckd tribe permit is formic hundred dallam(3100)
ar leas.)
1 certify that in the performance of the work for which this permit is issued.I shall not
employ any person In my man �o Ir eco aaubjmi7 Worlaos Computaadon
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after mal ng thio enifiesk of Eumption.You should
become mbjml in me Worker's Campemation pmvisiom of the Labor Code,you map
.J 0 fafthwim cumP1Y with such provisions m His famnil shall de d=mcd mvoked.
z CONSTRUCTION LENDING AGENCY
'roc I hereby aOUm that mem isaconitruction lending agency for the Performance of
[Yi > On walk for which Hu permit IS issued(Sm.3097,Civ.C.)
rf1 Q loader's Name
Z Lmwer'sAdmess
U Q I country that I have mad this application aM wk that the above information k
I7.U correct.1 agree m comply with all city and county ommuses and!tale laws miming m
C) building convection,and hereby aumofim mprc=nmtiws of this city to enter upon me
above-mentioned property for inspection purposes
E (We)agree to ave,Indemnify and keep harmless the City of Cupertino against
Vj liabilities,judgments.costs and espcnes which may in any way=cnm against said City
V Z in consequence of the granting of this permll.
APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date _16 C."G
SOUR E ULAT10
D
Sigrawnhol'AlifficanfContractor
le
HDOUSMATERIALS DISCLOSURE a/a Type of Roof
Will the applicant or future building occupant slam or handle hundous material
defined by On Cupenmo Municipal Code,Chapter 9.12,and the Health and Safety
Section 25532[)? All roofs shall be inspected riot to an roofing material being installed.
oras Na P P Y g g
Will the applicant or rutum building occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haurdrm air contaminants as JcOncd by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yeas V.
I ltaw read the hwardnesmncrials requirements under Chapwr6.95 orme Califon
nia Heslthk Safety Code.Seen=25505.75533 not 255M.I understaM that amt building
deannot Andy haw a enmt.that it u my mspomibiliiy m nodfy tie accupmt of the
mqui ilk which man (prior ut issuer=or a Carol of occupancy. Signature of Applicant Date
wnor or w decd agent Dak All roof coverings to be Class"B"or better