06020039 CITY OF CUPERTINO � v� ` v s,
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION•'
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BUILDING ADDRESS: WELKIN INTERNATIONAL IND Sfe4IT NO.06020039
7811 ORION L
ONER'SNAME: PERMIT ISSUE DATE
s
TIAN HUI TEMPLE 19925 STEVENS CREEK BLVD 02/23/2006
VrrJNE:
SANITARY NO. CONTROL NO.
(408) 733-0,-88
ARCHITECTIENGINEER: BUILDING PERMR INFO
BLDG ELECT PLUMB MECH
apZ' LICENSED CONTRACTOR'S DECLARATION Ib Description
u C 1 hemby affirm Nal 1 sm limed under pmvisiwu Oe$Crl of Chapter 9(commencing P
U withknion7")uf Division 3 of Nc Business and Professions Code.and my license is
y in full to=and affect. REVISION-LOCATE EXHAUSE FAN FOR TYPE 1 HOOD
License ass ClL ic.
bio Dam Conumeor ORIG PERMIT #04060040/NO NEW PERMIT
eQq',f' ARCHITECTS DECLARATION
d a< 1 understand my pians shall be used as public records
JyU
k G; Licensed Professional
9 '12
OWNER-BUILDER DECLARATION
4 i I 1 hereby affirm that I am exempt from the Conlranor's License Law for the
O Ou
pp following muga(Section 7(01.5.Business and protectionist Coale:My city or county
5 LL which mores a permit l0 commodes.alter.Improve,deronhsh.M repair any structure
_Z< poor its issuance,also requires the applicant(or such Permit file a signed State
mem
Nat he is licensed pursuant wthe Provisions of the Contracmri Li¢nse hw(Cooper9 Sq.Ft. Floor Area Valuation 1
E a (commencing with Section 100M)of Division 3 of the Business and Pmfounimu Code)or
.- dial he is exempt thelefrom and the bona for Ne alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not mom dun five bundled dolbox(SSW). 36218010 . 00 p y YP
❑1,u owner of Ne property.a my employers with wages on their sole compensation,
will do An work,and the sbucore is not intended or offend No sale(Sec.7014.Business Required Inspections
and Professions Code:The Conbwwr's License Law does not apply w an mwhoe nsr of Q p
property who builds or improves h emon.and who does such welt himvlf or though his
man employees,provided that such improwmenu are not intended or offered for We.If.
however,Ne building or improvement is sold within one year of completion,the owner. <7 \
builder wig have the burden of proving dot he did not build or improve for purpose of
me.). \0V
&L as owner of the property,am exclusively contracting with licensed contractors to
constructaLad project(Sec.pOta,Business and Profession;whho Code:)The Com onions.Li. \�who
Law does for
such fr je an owner o(pmpertpwbo sed p or improves Comon,and,
whence Lacts for such pmjeets with a contractor(s)Iiamed pursuant w the ConuxtaYs
License Law.
slam exemptvundo Sec. ,B&PCfor this town
GW0_rz1L z4'w DamD L.
WORKER'S COMPENSATION DECLARATION
1 MrcEy aRom under pmulty of perjury,one of the following dmluauostc
❑I how and will maintain a Certificate mf Consent to self--insure for Workers Compen-
sation,on provided for by Section 37W of she Labor Code.for the perfo rnou m of the
wok for which this permit is issued.
❑I have and will maintain Wokeh Compensation Insurance,as tequiled by Section
POO of me Labor Codc,for the performance of the work for which this permit is issued,
My Work es Cmmpassuion Insurance carom and Policy number ale:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This smite hoed Out becompleled tithe permit is foronc hundred dollars(SIM)
or less.)
I mwfv Out in the psrfnrmance of on.,it for which this permit u issued.I shall not
employ any prrson in any manner so a to bbaaoomf ubjen m the Workoi Comperuatien
Laws of California,Date d'a�' y�nJ.
Applicant
NOTICE TO APPLICANT:If,miler making Nis Cenifume of Exemption,you should
become subject m on Worl Compensation provisions of the Untur Code,you muse
.J z forthwith comply wit such provisions or this permit shall be dcemrd Invoked.
zCONSTRUCTION LENDING AGENCY
(-� I thereby affirm mu there is a construction lending agency for the performane,of
7. the amok for which this permit is issued(Sec.3097,Civ,C.)
fg7 Under's Name
6.
z Lander's Address
U
V Q 1 certify Nan I have mad this application and state that due above information to
O building I agree to comply with all city and county ordinances and sole lawss relating he
U building construction. forcbyactimimmoses. lists of this city menlerupnn the sS
W abbiliksmioned pmpcny for inspection purposes. V"w!/Vg/�/
py (We)agree to save,indemnify and keep harmless the City of Cupertino against
Uy inconsequencmcnRcmauandexpcmesahich may in any waya<cnm agmnsl said City
V.Z A APPLICANT
NDERSTANDSNis per mit.
APPLICANT'UNDE ANDS AND WILL PLY WITH ALL NON-POINT Issued by: Date
SOUR EG5.
SignawmmfAppueamvc ���� �� s Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will me applicant or future building occupant store or handle hmsrdous malerial
as definrd by tine Cupertino Municipal Code.Chapter 9.12,arta me Health and Safety
.Section 25532(a)?
❑Yca QNo All roofs shall be inspected prior to any roofing material being installed.
Will mea applicant Or future building ucem rat mar If a roof is installed without first obtainingan inspection,I agree to remove
pP B W c.Ail u o devim which P
emit ict? us air conmminanu u defined by the Bay Arta Air Quality ManaCement all new materials for inspection.
Disbicl?
❑Yo 9'fdo
I have mad the hessrdousmamrials requirements under Chopter6.95 of the Califor.
now Health&SafelyCode,Sections 25505.25533 and 25534.1 understand thalifthe building
dors not currently hos:a tenant my It 'F .,bit,y to notify the occupant of the
mq� rets. mustbcmnpriw mot.ccnificamof Occ
berupancy. Signature of Applicant Date
Or -44—
Owner oramhoriacdsSEcnl n`� ` All roof coverings to be Class "B"or better
/pale