06070078 CITY OF CUPERTINO
BUILDING DIVISION PERMITGONTR`AAGTORINNFORMA,�TIO�N
BUILDING ADDRESS: TAYLOR WOODROW HOMES PERMIT NO.06070078
10280 PARK GREEN LN
NEWS NAME: PERMIT ISSUE DATE
TAYLOR WOODROW HOMES 2300 CAMINO RAMON 2006
NE:
SANITARY NO. CONTROL NO.
(925) 365-3100
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECN
Op LICENSED CONIRACIOWSDECLARATION gIbDCIOn
I hereby affirWhorsed Oe$CT]
m t I ton o
d under provisions of Chapter 9(commencing P
: with Section7000)af Division 3 ofthe Business and Profesium Cada.and my License or
!�N mml(omcandeffecl. REVISION-INSTALL GRADE BEAM ON CORNER OF UNIT T
,gz License Class oCmb
Date AUGMENT APPROVED FOUNDATION ON REMAINDER OF UNI
t-o uyWARCHITECTS
� ARCHf1ECTS DECLARATION
Asa IundcrssanJmyphasshall the used uPublic mcorJa ORIG PERMIT #05030080-NO NEW PERMIT
iyU
°Q Licensed Pmfcuional
OWNER-BUILDER DECLARATION
<� I hcmhy.sero Nat 1 1. tempt frommNe ConaactCab License Law for be
p O following moan.(Section]II]IS,Bmes
ins and Pmfessians Calc:MY city car county
which mquima a permit m cmas the eller.improve,h rCrelsh,nr repair mY tamovem
;RC OriorM itsscensed Forecast
the isionaart far swhpctor'refilea Law(chapter ummcm
i F-e (Oat he,commencing hitSasoanuodmprovivionsofdfcCBusiamorandPnulswsCode)9 Sq.Ft.Floor Area Valuation
O Oat he is exempt
Sectiow tied Meof basis
forn 3 of the eg a coampt ons.Any
Cd,on or 0
� Nat he u eumpt tMrefrom and the buil for the alleged emmptian.Any violation of
Section 703 1.5 by any applicant fa a permit subjects the applicant to a civil pushy of APN Number Occupancy Type
not mom than Live hundred dollars(M).
0 L As owa4 of the property.or my employees wish wagea u thew sore campeoution,
will do the wank,and um serawme is amt intended an offered run sale(See.7016,Business
And Pro(suiam Code:The Contrume,L:,.Law don nal apply an m awwr of Required Inspections
property who buiMsorimpsovu Lumber,and who dousuch work himullor Wougb his
own employees.provided Our such improvements arc not intended oroRered far sale.IL
however.she building or improvement is sold within arc year of eompletion,the owner-
Wilder will lase shs burden of proving mat As did wt build or improve for purpou of
sale.).
❑Las owns of the Sks.7 y,am eu.And conuammg wish 0 licensed mnamrom i-
cause La it not (Sec.]Odd.Business toad rry who ns Cade:)The Cwhereen's d
Li-
cause taw dos not apply je an owner of trropcny who builds or improves Norton.and 1 f�
who mcu far mach proFms with acantracmt(s)Licensed pursuant mthe ConwnoYs V
0 Imo Law.
❑lam eumpl undo See .Bis PCfa Nis reasonlor
Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury ane of the following decmmtions:
0 1 haw and will maintain a Cesti0cate of Continuo elf-inure for WorkAYs Compen-
sation.As provided for by Section 3700 of the Labor Code,for On permnmance of the
wart for which Otis permit is iuosd.
Q 1 have and will main an Workers Compensation lrou i nce.As re vircd by Section
3700 of the labs Cods,for the performance ofthe wink for which this perankis Aerosol. '
My Workers Compensation Insurance prier and Policy number am:
Carer. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(TTuuemem wed rat beeomplcud store Permit is faonc hundred Mlles(SI00)
or less.)
I calory Nat in the Nrmmuwe of me work for which this Permit is bound,1 shall not
employ any person in any mmncrso as or become subject to the Warkui Compensation
laws of Cilirmsid.Dau
Applicant -
NOTICE TO APPLICANT:IL oMr malting Nu Cer irsate o(Esemption,you shwW
become subject 0 the Workers Compensation provisions of ths Labor Code,you mus,
.J O forthwith comply with such provisions or lois pe miL shall he dccmcol mvokcd.
Z M CONSTRUCTION LENDING AGENCY
(•+ l hereby alfism Nat then is a conswctinn Lending agency for the Performance of
the walk fa which this permits issued(Sec.309],Civ.C.)
QLenders Name
z Lenin's Address
U0 1 sonify thou 1 haw read this applicmior and cute that be shout infommtivn is
I, cored.1 agree to Comply with all city and county ordinances and state laws relating to
O V Wilding construction,and hereby authoriserepresenti of this city to roper upno the
r C saw,
shove-memioncd Pmpcny for peetion purposes.
(We)agree to ,indemnify and keep harmless the City of Cupertino against
rFi h liabilities,judgmevu.costs and capweswhichmryin any t+'aY accme againslsild City
Uz inconugoswe of the punting of this permit.
ti APPLICANT U ERSTANDS ILL COMPLY WITH ALL NON-POINT Issued by: 6i Date
SOactor
URC RE TION
^ r Q�(Z Re-roofs
Signature AppbcaHAZA HAZARDOUS
Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the Cupentor(Mum buildings.Chaptmoma handle hamdoanmateriel
As MOwd by the Cupertino Municipal Cade.[isopter 9.12.and the Health mJ Safety
.
Session
an zss3z(a)] a All roofs shall he inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection,I agree t
Will the applicant or future building occupant us,equipment a devices which P g o remove
'
emit Iw'ramnm air contaminants u de0wd by she Bay Area Air Quality Management all new materials for inspection.
District]
❑Ym
I have amt the hvandoM materials mquimments under Clutter 6.95 of dte Califor-
nia HuIN h SafctyCode,Sectors 25505.25533 and 25534.1 amkrsund thin ifshe building
does wt currently haw a torero Nat it is my responsibility m notify the occupml of Ne
mquimmcnu which menu �orm dd4aeeoftta
,Cemrwamoropaney. Signature of Applicant Date
`" " I ow Owner
Daug
All roof coverings to be Class "B"or better
or,uthoris0 agent '