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08060033
CITY OF CUPERTINO s p -rxxuz sd ,m3'r BUILDING DIVISION PERNUT CONTRAC` TOR INFORMATION BUILg16DRESS: PERMIT NO. PARK VILLA CIR HORIZON ENERGY SYSTEMS 08060033 R'S NAME: PERMIT ISSUE DATE MATT THOMAS P 0 BOX 320612 06/20/2008 PHONE: SANITARY NO. CONTROL NO. (408) 395-9060 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMS MECN 300 LICENSED CONTRACTOR'S DECLARATION - Job Description " cmby arfirm that 1 am Iictnxd under Pmvitiaa of Charm,9(commencing P n�� wimse6m7")ofDividon3diteBudms ftfcssiouca .aedmylicc=is ADD PV(SOLAR ELCTRC)GRID—TIE SYSTM—NO SANITARY a, fullfdmcandefw Limax Cis l C0^uracusr 5 '`7 CONDITIONS/REQUIREMENTS. ARCHITECTS DECLARATION Sy/5 < 1 uedcruand my plans shall be used u public recon JyU g G i; Licensed Professional OWNER-BUILDER DECLARATION S 1 herehy a1Rrm tot I am exempt from the Conermaor's License Law for the O o following mason.(Section 703 LA Baines and Professions Code:Any city or county which requires a permit to cowrun.alcor,impmw,demolish,or mpolr my umcum pnof o its issuance.also Rgalrn the appllCmt for such permit to file a signed statement < that he is licensed pursuant odmcprovisions ofthe Contactr''aLiccveLaw(Chapter 9 Sq.Ft. Floor Area Valuation x�$ (commencing with Small. 000 m7 )of Division 3 of tedsiness Buand Pmftesiom Cede)or $39800 Nat he Is exempt t iv re(mm and the hats for the alleged eacmpuon.Any violatfon of Section 7031.5 by airy applicant for a permit subjects the applicant to a civil penalty ofNumber Occupancy wt sumo tan fin hundred Miami(S500). 35610092 .ETYPe L she wait. o(ux pmpmty,re mY emnloyen with wage a tc(Sm. . 0,k,Business udon, will dmfework ands: he Combnotintendedorawreds,ale(Sec.in an wo rot property professions code:The Co duarec'.Liew -law cera rot appy lf a owner of Required Inspections manemploye Wildsmed thatsutimproundwho mnsucmanded offrmduou[hhis f. own employees,provided or i pr such imprsemenuin not heededatolrered for uta r- however.to building or impmvemwt Is hath within ane year of comove par the owoer- builder win luw tlm burden of proving Wt W did not dolt w improve(m puryose of sale.). O 1,as owner of the propcny,am exclusively contracting wit licensed contractors as wtuuuct to pmjnex(Sec.706,4.Baines and Prrestiea Code:)The Oomncmta U. cense Law does not apply to an owner of property who Wilds or improves demon,tend. who concocts for ouch projects with a contrmtor(s)licensed pursuant m to Conmmtori License law. I am nempt underSec.. .B 8 P C far tis rtason to Data WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury cox of um following dechustimu: ❑Thaw and will mtlnwna CeniOnm of Comenud self-insert for Werkerte Compen- sadm,u prvidrd roe by Section 3700 of the Labor Cade.foe to performance of ale work for which Otis permit is haunt. 1 have and will maintain Wmker's Compensation Insurance,as ha uined by Section 3700 of the Lahr Cade.for mW performanw drum wants for which this permit is same. My Wmkn' oro i adna Inmrancee carrier Polity number am: p Carrier. _ G urnAMlicy No.: _"10( 71 — �©O CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This xcuw need Out W completed maned permit is feronc hundred centers([100) or less.) I cenif-v that in to performance of the work for which this permit is issued.)shall not employ any person in my coarct W as at become subject to the Workers'Compensation Lawn of California Due Applicant NOTICE TO APPLICANT:If,ancr making to Ccnincen of Exemption,you should become subject to the WmkCs Compensation provision of the Labor Code,you muss .,0 forthwith comply with such provision m this Permit shall be ecem a mwkcd. 'E� CONSTRUCTION LENDING AGENCY [—m I hemby anionsdist them is a conswcuon lending agency for ted perromtence of ai> to wmk far which tis Permit B issued(See 3097,civ.C.) 0Landers Name 7 z Lancers Address V 0 1 unify that I have mad this application and sum to to show in[mmathan is - Lp wrtcct.l agr n t comply with all city and county oNinaucn and sum laws rending to 0 Wilding consvucdan,and hereby autoriae mPsesenuuws of this city a enter upon the W aWw-mmuarcd propnny fan ie pccdon which s. may (We)agree to an.indemnify ad keep harmless the City of NPeniao against rn incoiuutherm, f ue costs adof this esmit. maY in any wyaecom against sit City C)z A PLICA uce of to gaming of this permit ^' APPLICANT UNDERSTANDS AND W]LL COM WITH ALL NON-POINT Issued by: Dale G 5 'An" Re-roofs Signuurt of ApplinnUContnctor am HAZARDOUS MATERIALS DISCLOSURE Type of Roof Win to tepplicant dr futum Wilding occupant smm or ham eno became.manorial Rmcd by the CupeWno Municipal Code.Chapter 9.12,and tk Health and Safety Je,Section 25532(.)? ❑yrs ErNd All roofs shall be inspected prior to any roofing material being installed. Will to applicant or Intro Wilding Occupant cox If a roof is installed without first obtainingan inspection,I agree to remove PP B P ea Air m m devices which P emit hoaNnua aur contaminants u defined by to Bay Area Air Quality Management all new materials for inspection. .110 ❑Yrs &Au IhawmadlWhzamucous 2mdaure33 and!wu4.1 mad oustal95 Rode,Wilding nuHalthawmaan,hexandma25erials g0tamc5536.1chipudthu ifte,Wilding don not curcnd ase a mmanL taut it u an,respdaihtliy an Ito'y the=up=,or dc requirenterm'hmuup tiuu faC Occupac Signature of Applican Date ow or authorired agent Dam All roof coverings to be Class'A? 'or better