06050075 CITY OF CUPERTINOs s = +Z' "`" "
BUILDING DIVISION PERMIT NFORMAION
�3UILDING ADDRESS: ALL SEASONS REMODELING PERMIT NO-06050075
1479 POPPY WY
OWNER'S NAME: PERMIT ISSUE DATE
JITESH & MANISHA VADHIA 219 DEMPSEY RD 05/09/2006
14 NE:
SANITARY NO. CONTROL NO.
(408) 946-4744
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
:00 LICENSED CONTRACTOR'S DECLARATION lob Description
m 1 mreby affirm that 1 am lianud under provisions of Chapter 9(commencing
�< with Secfian70(10)of Division 3 oftho Business and Professions Code,am my license is
infullfaroeaM=ffect G B INSTALL ICBG SUNROOM AT REAR YARD OF SFDWL 264 '
a,va? license Lic.g
eF° Date o Convacer
e ARCHITECTS DECLARATION
f 1 understand my plana shall be used ss public records
PyU
:O 3 Licensed Professional
OwNERBUILDER DECLARATION
in 1 hereby affirm that I am exempt from th=Convector's License law for the
a o following meson.(Section 703 1.5,Business and Psoficarmm Cede:Any city or county
which nature,a permit to construct,age,improve,demolish,or repair any structure
prior to its issuance.also requires the applicant for such permit to File a signed.sutem=nt
< that he'isliccvcdpumnnuoNcprovisionsoftkodometerilJamelaw(Chaptn9 Sq.F[. Floor Area Valuation
If ° (commencing wide S=nion7000)of Division 3 of the Business and Professions Codi)or $14884
Nat he is exempt therefrom and the buts for dee alleged eumption.Any violation of
Section 7031.5 by any applicant for a permit mhjccs dee applicant to a civil penalty of APN Number Occupancy Type
rat mart Nan five hundred dollars(5500).
❑I.as owner of the limpsny.or my croployess with wages as their sole cmnpensodan, 99
will do the wort and the structure Is nes intended or offered for sad(Sec.700,Business
and Pmfessim" Communities ThCommunitiesw
r's License law does not apply to an owr of Required nspections
Property who builds w impmws Hereon,and whodoessuchwork himself or though his
awn employees,provided that web improvements are not intended oraRerid(orssle.If.
however.the building ar improvement is sold wid inow year of wmPledan,themacer.
builder wig have the mrden of proving that M did ret build Or improve for purpose of
sale.).
❑s,as owner of the property,,Business udus and crooning wide li The
ronvators U.
�/
cmuwn dee project(See. ,an werofand Profrho but Codei The Cmnlamage.aid
ecru law dwa not apply b an owns of property who milds or imposes damage.and. /
who contracts for such Pmjees wird a canvasiong)licensed pursuant to the Conusstor's
Licence Law.
[31 am exempt under Sec. ,B A P C for this rtamn It,
I 1
Owner Dau }�
WORKER'S COMPENSATION DECLARATION40 V
I hereby affuo under pcnalry of perjury mo of the following decumuons:
E3 I have and will maimam isCerditeam or Consent to self-insure far Warkcr's Camper
cation.u provided for by Section 3700 of the labor Code.for dm performance of the
work for which this permit is isswd.
❑1 have and will maintain Workers Compensation Insurance,as required by Secimn
3700of the Lobar Code,for the Performance of the work for which this permit is issued.
My Workers Compensation Insurance carrier and Polity number art:
Cartier.J g"� TOF EXE Paltry MOM OMWORKERS
CO OFEXE
COMPENSATION INSURANCE
(Thu section wed norm completed ifthe Permit is furore hundred dollars($100) r
or lea)
1 artifv the,in the performance of the work for which this permit is feswd,l wait mi
employ any person in my mammy aro u to mare=subject in the Work=ti Compensation
Laws of Califoria.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption.you should
become subjm o the Worker's Compensation previsions of the tabor Cada you maw
.J z foMwith comply with such provisions or Nu permit shall be decmcd revoked.
zO CONSTRUCTION LENDING AGENCY
r�
[—t 1 bemwY which
thi that three is a c d(Sce.30 lending agency for dm Performance or
!� the work for which this permit u usucd(Sa.309],Civ.C.)
CL Q Landers Nam=
=z I<nder's Address
U Q 1 certify that 1 have read this application estimate deet the trove information is
Uy P council.I agree to comply with all city and county ordinawes and sum laws relating to
0(, building construction,and hereby aushorim representatives of this city to enter upnn the
move.menuwod poptrty for mmpeedon pumpmes
in. (We)agree to save,indemnify and kap harmless One City of Captions,against
fn Lobilidenjudgmcnts,eom and expense,;which may in any way mcwe agamet said City
U z in consequence of the granting of this permit.
^' APPLIC UNDERSTANDS ANQ WILL COMPLY WITH ALL NON.POINT Issued by:,) Date S l G a
5011 GUL fT10
T//v6 Re-roofs
Signature ofAppli HAZARDOUS MATERIALS DISCLOSURE Oase Type of Roof
Will Ire applicant or future building oeeupantan o or handle We mous material
as defined by the Cupertino Municipal Code.Chapur 9.11.and the Health and Safety
Cafe.Sceuon 15537(1)?
❑Yat $Fro All roofs shall be inspected prior to any roofing material being installed.
41 Will the applicant or future building occupant use equipment or dcvim which If a roof is installed without first obtaining an inspection,I agree to remove
emit havardnm air contaminants as confined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes P(Fu
1 have mail the heramnusmaterials requirements under Chapter 6.95 night Califor.
ria Head"Safety Codc.Sceuons 25505.75533 and255M.I understood thuiftbe building
J=ets not curremh ort a tenant W,i,u m r=sponsmbility an nodl'y the acupam of the
rew�ire�m(ep'�/ynim�my�Pm�m rm araC=rtinamafat Signature of Applicant Date
owmerwaathorircd agtnt �� All roof coverings to be Class "B"or better