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02070174 ITY OF C BUILDING DIIVC,ISIONVOPERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 19191 PHIL LN 02070174 OWNER'S NAME: APPLICATION UB DA KAM CHU 07/26/2002 pp PHONE: SANITARY NO. CONTROL NO. O o ARCHRECTIENGINEER: BUILDING PERMIT INFO FF BLDG ELECT PLUMB MECH L= U Z y= LICENSED CONTRACTOR'S DECLARATION Job Description Z 1 hereby aff nn that 1 am licensed under provisions of Chapter 9(commencing O O<Z E with Section]000)of Division 3 of the Bu'mess end Professions Cade, it my license GEN L ELt�T G}AL Y y m< Lin fy I(ecce andakct. �I - eco�6 Dee Clms {••/ Ltizz Cic.M t D� O ARCHITECr'S OEEB[ ,#-J' R ta x nxa n pa rams � 6 0 o teen s OWNER-BUILDER DECLARATION I hereby affmm that 1 am exempt tram the Contractor's License Law for the --- _ I:Z< owing reason.(Section 7031.5.Business and Professions Code:Any city or county $6000 I F❑ which rcquirts a permit m conawn,eller.improvq demolish,or rtpeir any swctum 3 ..p or ora--,a ance,al ortquhesNeappl a...... fo s hp mut bileatigrcdamxm m [hatit5 is licpn9ed punuanll¢thb pmvlsfan of N<ContrecmrY Licenx lsw(Chepmr9 '•', Valuation (commenup8>with sec,jon,j000) fOivision Sof the 8us�neppa'nd Pwaasmms code) �b,j�t'k 3YTL]�f�+V" A• .�aki1:":1 7.3., at Nat fie Is exempt therefrom and the breis for the elle$nd ckemp,ion.Any viehtion -of am.9031.5 by any applicant ter a permit subjects the ti heves bad.,pang ,�Ta,a�n{a P Y TYP .nr nnemore,han five lam dollars 15500). 304 APNAbIff7f{ ELECTRI L""" : `O Occu ane e O 1,n owner of the pmpors,ur my employees with wages as their sole compensation, 501 - FINAL ELECTRI "waime:thead Pim.ars, gi Neme:Theure Contractor's nocimended Lice a eredLaw for salenot(SeCapply to an - '- - - �,t,-�,-I- ownerss end Any Who b Code The vestheLicense Law dos m[apply tom 505 - FINAL EL$@{Pii eJ[IQils�eenons owner of property Who builds or improves thereon,and who encs such work himself or m inmugh his awn employ re provided ilial such improvements enot intended or -[offered for isle.If.howaver.th,wilding or improvement is sold wnhm aria Yeer or completion,the owner-Wilder will have the burden of proving that he did not build m ` improve for purpose of sale.). ormarrcttWmjw the pmpcny,am excBusiness and ntrdnisi-withCode:)The, oninguto nt'I'; q ".: ". tett concis the Project(Sec.)014,Business and Profession CodoO The vesMe o, , e F I. '3 •'l.l d. P Licene Law ems,wt apply wan ounce of a.property who builds or improver Merton. _red.whitr`,Liatla.for suchaw. , roia[s.wiN.11 1. torts).Iicensed.Wraumtwtne_.._.__ .._. ____..._..__ .. ..__._ _..._._.._.__._._.... ..._i.._._....._.—.......... —..___...___.__._... 131 an extra License Isw. ._ - - ❑lam<umpt usdcrsx.�, �� .., ',(B'&Acfor Nis rearm Ower" ``Date .. WORKER'S COMPENSATION DECLARATION I hereby atlinn under pemlry of perjury one of[he fallowing declarations: 0 1 have'and'will maintain i Ceiuficate of Consent w self-insure for Worker's Compena,I... . provided far by Section 3700�or Ne labor cone:for Ne atde of ad woh for which this permit is iss perfonnued., - 01 have and will miamisin R'drkei's Compensation Insurance,u required by Swim 9700 ofW Labor Cafe for the perf.magic.of the work'for which this pemut I, issued.-bWark,es C pc von las. artier and Policy nuirdia e: am eTFi4'T-vI .. ((". POI cygY (�. ( s`- s, 1 ! \ i'.;1 'rCERGFICATION OF EXEM N FROM W4 !'_ RANCEIO OMPENSATN INSU .. _ .. ':..v. . ,H,...- .....__. .._... __. . . __ ."_,_._..... _..._._ .__ ._..�.,...,..... (This section need not be completed if the permit is for am hundred dollen s yC. ^•a , s )i-'1P.. ., a, , (5100)or less.) 'I cbtify'thu m the perfo'rmrde itFhe ark fm wNch th is is,mut is shall,Ant employ-my Person in any manner w as in become subject to the Workers Compenadon Laws of C.1ifnmia.Dam, N CETOAao dae ,H,agermaking tiit thisCertificateof Exemption.youu mum , . become mbjeci y the suchdmrrx pr C'mpensathis permit shalt me Labbr Cade,you must cc (onhwiN comply with such provisions m this permit shall be dame-rcva- �- CONSTRUCTION LENDING AGENCY " ' '"�• a > !h mby affimn that Mere is a construction lending agency for the performance - L Q of me wank for which this - -permit (Sec.3097 C)_", Lenders .Cn .` _.__.� Name--.--+.— [rs,ssud:...__... ..,._ .. a'.v':-..::-..i, ...._.._....__...__. _. _. _ _ ...__...... .__.. _ Z Lenders Atltliess".,.. •. . . .. h1 cenify Had I have read Nis application and state Nat Ne above mfomwion is t ILi[r corieei bagree arcomply with site ind county ordinances and state laws relating - (7._r, t convection.aid hereby rout msrnd,ives of this ciry as entcrupan Gt) _epw ntionedpropestyfo^nx on puryoxs.. agnx to saw. keep ion harm),ache Cni of Cupertino against liebili,ies, udg nine ros penx. wheA may,in any way xcrve against said s..� ' U Ci -uence of Ing of s penniL "' n �JV� PL A ER A.- AND COMPL WITHALLNON. INT i u cE a AT v Issued by: Date o - nose .: - _ .. Dab Re-roofs US MATERIAIS DISCLOSURE ,' W de-ppl ret a fumrt wild ng ace pmt store m harWe material ..')Type Of Roof.. .... .. ..... ..� y�.-._....,..,.. las deli by Ne C pervno Municipal a Chapter 9 I7 d the Health end Safety f _ i +s• t.• S Cad ot:us3ua , ar ... , -gr ' ' IV r. " 1 i.' t . tl 4f 'air�•' All roofs shall,be mspected.prior.to_any_roofirig,material being.ins,talled.,,_ will wit peen an,or future Wild vent tau q .pm t device,whim If a roof is installed'without first obtaining an'inspecnon'4 agree tdremove emir bessid s air coma,mtwms as& by Ne Bay Arta Ali Qualtry Management Drink,a all new materials for inspection. Applicant understands and will comply with p „ _ all non-point source regulations- it have iced Ac'hanrdoui 'els rtquiremrnti under Chapierr5.95 of the Cdifo in Hcahh&Safety Code05,35533 and 25534.I understand that i0 1 it cunen a am,thati[ismyresponsibilitym..,i%Me rep of tIt - qa meats m s he met poor to issuance f a Cenflf. of .. ^ Oce "Al Signature of Applicant Date 6,z; _. _ .. „ All roof coverings to be Class"B"or better , - - _. . . ..