05090035 CITY OF CUPERTINO -77777777777777777,7777777777T77« '
BUILDING DIVISION PERMIT C�N<CRACT(jR�IATFORIVIATIO,N�` L_
BUILDING ADDRESS: TAYLOR WOODROW HOMES PERMIT NO.05090035
10280 PARK QRFFN IN A-1
OWNER'S NAME: PERMIT ISSUE DATE
TAYLOR WOODROW HOMES 2300 C
SANITARY NO, CONTROL NO.
(925) 365-3100
ARCHT ECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
IO0 LICENSED CONTRACTOR'S DECLARATION
'.I U C 1 hereby amrm do,I am lima d under pmvismans of Chapter 9(commencing Job Description
E. iNMp Ecction70of Divison 3 oflne Businu+vW Pmfamos,OndO.and my license is
+� mmllmmeadeHm r> REVISION-MOMENT FRAMES/STEEL PLANS
j a z License Clan Lic.a
Datalr�Q5 ContractorNO NEW PERMIT ISSUED/ORIG. #05030081
ARCHTIEC'S DECLARATION
< I undenand my plans shall W used as public rcomis
byU
iu0 Licensed Professional
5 OWNEftBUILDER DECLARATION
ot
1 hereby alum that um
al 1 am cmph frothe Cantractors License Law for the
O o fallowing reason.(Section 703 1.5.Business and Poor..I..Cade:Any city or county
5$ which rryuires a permit to cm mast.other,improve,demolish.or mpair any stmcum
z o prior to its issuance.also requires the applicant for such permit to rile a sigud statameu
< dwheislicensedpursuanttotheprovisansoftheContractor'sLi¢meLaw(Chapter9 Sq.Ft. Floor Area Valuatiol$2 14
eFe (commencing with Seedan 7000)Of Dbeuian 3 of the Buri.and Professions Cads)or
y Nat he is exempt therefrom and the bais far the alleged hemption.Any violation of
Section 7031.5 by arty applicant fora permit abjecu the applicant to a civil penalty of APN Number Occupancy Type
out seam than BK hundred dollars(53 L 36940017 . 00
P y YP
❑I ss owner of ti d property,or mY intended
0,
wages a their role eampemation,
will Pr the work.and that structure ra nutinsended Law Ila s set a(Sec.70/4,Busowner
o.
and Profesho code:The Cantractur'sthereon,Limosho Taw doh cot apply lf ri nwmr of _ Required Inspections
propertywbos,proarid atsch imn,andmono ticssuetended imselrorNrougn It.
is
ownemployers,provided prsuchim is sem within
not intendedmpletion.oroffered!for aleer,
builder the Wilding orhnprovemhtlusold within at year of mprow,fore the owe of
sale.). will base tic Wrdcn of peering that,W did cot Wild m improve far purpose of
vk.).
Q 1,as Owner or the property,am nd.omly commalmg with Hamed mnuumrs to
mhtn.h the pmjec(Sec.7044.Business and Professions Code:)The Cmuamer's Li.
cense law dos at apply to an owner of propanywho Wilds or improv dmrton,and,
who commute for such prejems with acomrmlm(s)licensed pursuant to the Contractor's
License law.
❑l are tempt under See .Bal P C for this.awn
Do. Due
WORKERS COMPENSATION DEC RATION
I hereby affirm under Ne my of perjury am of the following dedamdov:
7(37W.f
ham and will maintain a Certificate or Consent m self-insertforWOeker'aCompen-
,h provided for by Section 3700 of Ne Labor Code,for the performamx of the
for which this Permit is issued.
have and will maintain WOrtcYs Compensation Irwran¢,as required by Sccdon
Ne Lerner Code,far Ne pedormanee of Ne wok far which Nis permit u issuedorker'sC qt emotion lnauruc cortin and Policy number ire6'-�er. Policy No.:/��yQ(—�L�1t(!'
TEOF PTION FROn1 V/ORKERS
COMPENSATION INSURANCE
(lhu aectim need mlbecompletad if Ne permit is forms hundred dawn(SIM)
err less)
1 reify that in the performance of the worll for which this Permit is issued.l"I an,
employ any person in try mannor so as to became subject on the Warners'Compensative
Laws of California.Data
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Esempi m.yon should
bctome subject m the Worker's Compensation provisions of Ne labor Code,you muss
.J O foMwida comply with such provisions or this permit shall he deemed mwked.
Z y CONSTRUCTION LENDING AGENCY
[-+ 1 hereby a1Brm that Vert is a construction lending agency for Ne pedurmance of
l5 the work far which this permit is issued(Sec.309'1,Civ.C)
1 Q Lender's Name
r7 z Lender's Address
U Q I certify Nat I have maid Ws application urd sum Nm the W.information u
[s. canna I agree m Imply with all city and county ordinances and state laws relating m
0 building construction.and hereby autharim mpeescntaims or this city to enter upon Use
abom-mentioned pmNrty for inspection purposes.
1, gy (We)agree to ase,indemnify and leap hu ohms the City of Cupertino against
Iiabiliies.jWgmcnu,costa and eapenses which may In any wayamuc agsnshstid City
U vZ in comsequ me of the granting of this Permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REG ONS.
A &--."S
Signs.of ,fcmVCau Data Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or rum.Wilding occopam some or handle haardous material
ss .=',he Cupenim Municipal Code.Chapmr 9.13,and the Health and Safcty
❑Yes
5532(0)? ! All roofs shall be inspected prior to any roofing material being installed.
o
If a roof is installed without first obtainingan inspection,I agree to remove
Will Ne air licamintutu.Wilding by 01Duse equipmentilhvanawhich P g
Dual hvardous sin cmtaminsnu u dcfatl by Nc Bay Ara Air Quality Management all new materials for inspection.
District?
❑Yes rl Nu
1 have read the na>a damn amnala requirements under Chapmr 6.95afthe Califar
ria Hcalthh Safety Cale,Seciwu 25505,25533 md25534.1 umkrsumd that lithe Wilding
does Out cuaready hast a mount that it u my responsibility to miry the mcupaal or dm
.gd.ments xmelpvi m nracetdrmatapra Signature of Applicant Date
Owner or aulhomed.,an( g
All roof coverings to be Class"B"or better
Oata�