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00110029 CITY OF CUPERTINO nut/u,&S'PeCH BLO-cEERNM CONTIt �(�I � F�N: p0i10�29 BUILDING ADDRESS: PERMIT NO. MORRIS JOHN R AND CAROL J 34428 MONTGOMERY PI_ 7. 1/06/2000 OWNER'S NAME APPLICATION SUB DAT1: (408) 946-2214 .IONG SANITARY NO, CONTROL NO. app K Z AHCIII'I IiCI/IiNGINEIiR: tlU1LUING PERMIT INFO O❑O❑ Ii LIyG 1}LEGI' PLUMB MliCll u l.I I=1 I--i Ll Gad y 7I LICIiNtiE i l 111co ACad" UIi fano rd z S L heathy dlirm Dere trial licenced under prnvixionx of Chapter9 kmnmeneing pp ,� ON oTEAR OFF x� F���0��1p4� 1B FELT ELI: TORCH D Fs witn lull Section 7000).f a... of❑ivixion3hrme tidiness r l' CoJa — h III lists force and I. 3 [�I Z- zw¢ Lic.n.vc CIgw Lic.p y� xoa [)are Gnomons—. F < __ ACI IT= T S UECLARA 11 I� I tend,,tend my plan,shall bacilli as public rccnnl.v ca � a w—O O Licensed Professional z OWNER;BUILDER DECLARATION _ X e ILLI, I hereby ultirnt that I ant cectnpt frons the Contractor's License Law for the Z< follow a,.,.a (Station 7131.5.Business and Profeavions Code:Any city or county Y 3 o which y pc nit r n t h r, np tkn ish.mo,,bri.any tm,l rc d 3tcs priors t 'lot y theapplicant 1 1 pc int file -BnN.statement drathe is licensed a nna n the pawkionsot11 c t acs r'sL 1 Icnnparo Sy, Ft. Floor Area 18 (torah angwith Section 7M))hr Doision lofthe Bmmessand Pmfias,iow Gde) o that he i,e,nnpt merel'mtn and the boo for the alleged c,andbon.Any'torsion or Sectlmn 71315 by any applicant to a parous aubj,,,,the appticbt m a civil penally of ant tnone than Rvc hundred dollar,asses. A'VNf MlberV1_ 1710 c t)aanney`Type 01.as owner of the rouser,or any employees with wage,as their role cmnpensmiun. (✓ will do the work,tmal the rtmcmrc is not intended or offered far sale(See.71),14. Burina,,and vmfe,aons Care:'rhe Comrvchnr,Idecmm Law deer nett apply I,, m 305 — FRAMIFeyuired Inspections r of property Who builds or improves thereon,and who does such work himself or mmogh hi, an employ«,provided that such unpn.vemmn,aft not intended nr 307 — I NSULAT I Ohl mlfered lot.vale.It,Aowa'er, he Mlilding or improvement is sold within one year of eompldihn.the nwner.huimer will nave tine burdennf powing that he did not NmIdnr 601 — ROOF TEAR OFF inupowe mrparl.,,c of°Ile.'' 602 — ROOF PLYWOOD NAIL 01,a,nwncr of the property,:lm exdnsivaly contracting with licensed contractors to corwoull the patcul(See.7fn4,tlminen,and Prvle,,nu,Coda:)The Contractor', 603 — ROOF BATTENS Liehm,aLawdoc,mat a"fly to lin ownat or property w ho builds or improves bCfoon' GOA — ROOF Ih1-F'ROGRF_SS and who comma.s for such projects with a comracurb.)licensed pursuant m the C'hntrncor,Lihano Law. 01 am exempt under Sec. .R&1'C for this mason Owner Dale W ORKIiR'S COMPCNSM[ON UECLARAUUN I hereby aid.In muter penalty of perjury ant of the htllawing ii,darreunns: 401 0 11 J .It inionahn ;I Cenifilca.or L r t suds W.kers FINALED Conmemation. : proided lot by Section 17101 of th• Labor Cute I r the - 01 fel work f 1' this 1 serrail I ❑1ho, and sill maintain leorthe ,Contact nIn.am in, rryhflahY .bilin (� 7 I..X)of the Labor Gd.,for the a.tfhnnat<a If he nark toy which this pennil is Issued.My WorA Con uta t.tater and Policy number are: Cafrier: S h J �n �r No, © Sol�2'40 BUILDING CIiRTII'IGAI'IDN PEXEMPIION FROM WORKIIHS' j COMVENSAI'ION INSURANCE Thi,section need not he completed it the lerroit is for clic hundred dollars �✓ �� ISISh or I certify that in the peffnrm:utne of the work for which this permit i,issued,I ,hall not ennploy any person in any mantmr.ao x,to hacnnse subject to the Workers Compen,atimn Laws of C'alitania.Dane Applicant NOTICE 10 APPLICANT,11,nrler making this faulted,of Lxenmtioa you should hectntom w object the Worker,Gnnloensa aprovisionor,al the Iain Coit,you rot Q O Ibnhw hh comply with,uch provision,ror on,permit shall be deemed revhkel. z . L� ry CONSTRUs acono anon NO AGENCY •`�' I hereby admit that them is a nan,wnien leading agency for the perl'onnance made work slit welch Ihir assns I,inslW ENT..Civ.C.) 0. G Lender's Num. ;z Z LCnJCr's nJJfe.vv - V O I certify that I have mad del,application and state that the above information is (i. rr. correct,I agree to comply with all city and county d as and%late laws aclaning Q (, to building 10.111THIIIII.1,and C,J4% 'OU RECUIATI(Jby rualionic mlic,wainivuss/lf u—tcity .-I o enter a t tqm the abuse f p perrd for no.,section �w caw (W,)agree 1 ly a lA ,11 l .,, he y it C p I gear (4 liabilities,judgments.Cost J pen. :which may in any way accrue a8uinr said City in I)of thegruntg ohae APPI1 N1UN.)ERSTINUSA DLI COMPLY WITH ALL NON-PON ed by:- Date /�a { -u' d1ISSU lAppilz U(-- Re-roofsSigumcn .... � Urne IIALARUOUS MATERIALS DISCLOSURE Will meapprcau,late,-hurtingoccupant.rnaon handle abladnmmratedal Type of Roof ' it,Refined by the Cupertino Mm,w!pI Coat.Chapter 9.12,and the Health and Safely ' Cot1c,Section 25512(u)" , 0l'e' (2No. All roofs shall be inspected prior to any rooting material being installed. Will tire ap,d a,ormlumWlildungaced,:otu,aa,ulynaemordevwe,which If a roof is installed without first obtaining an inspection, 1 agree to remove emit hvurdno,air ct ntrntin sal,as Jclined by tire A e tiny Area n Quai Quality Manage Di,nict'r all new materials for inspection. Applicant understands and will comply with ❑Yc, all non-point source regulations. I have reald, the 1,,Code notion,v 505,25533Ndrude,54.1 tui LJ$of the if the uian,it.. ..Icorecdybaseaaural.gualitismy ,pools ail,. tandthat if the Wi Win,Jo.snotarcianly haveaLesbos.Ihatitie my r,rome,i if wtn��ty the ectad dont rcyuhutnene whim stuns,be toes pdhf is,i„nlan.c ora certificate of y i / 3Signature of Applicant Date (�ti 6� to be Class `B” or better All roof coverings owner, 11 vast agcttt Date OFFICE