00060090OFFICE
CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
-
PI?RMI'I NO,
OWNER'S NAME:
-
APPLICATION SUB DATE
1342 RDSEGARDEN LA
WING JIK CHF_A
00060090
HONL
SANI'l'ARY NO. CON 'I'ROI, NO.
KAO CHIA S AND JOY C
561 RUTGERS ST
06/14/2000
RCHITECIIHISCI NEER:
BUILDING PERMIT INFO
BLDG IiPLl1MB MliCll(510)481-3818LICENSED
7:�
CONT RAC'I()It's OECLARATION
,lob Descriptio❑
I hereby myth, Ihm I um Ileeawd undcopmvismoon ,I Clu,Pm, n (..smear n,Fith
Section 700X) ofDivision 3 oflhc Rosiness and 11 fin,ons Cloth. and my Ilconsoinfall
tome: 1 caicense CL6Dme6yq:
G
�nntmetnr_,�
a O
S
ARC II1'[Cr'g UECLARAI'ION
11mndcr.,mna may,flan, %mal be used a., mmhr viand,
/
RE—ROOF (V..
E
;��= o �Oi
I-kemed I'role.wiunal
e on
O❑UILOER DECLARATION
Our
I hereby aBm that I emmml from theContractor'. law for the
F'
=Z0
and Any c
ons h.or. Any city
111)15, lt,
follwhich raquiresa
0
$ o
Il t %tract re
which y permit .t I h r, p demolish. pi Y trmurc
alma, vat, de
GI
E —
prion t also y II ptlka t1 '1 p thio III, cosi'sed Pmment
loll 'instant' d ' ;i' IU ( t 1 (cnap;c y
Sy. Ft. Floor Area
Valuation
itcs I
Irammenain with 1 dl')ividon3atea Bmincetnod IYnl myons Codcl
cwithscehnnent for the alleged Any violation
li and tic
ar that is exempt Increment
by any applicant for a marmil wM1jrcts IM applicnm us a civil penahy
io mol applicant
of Action 1W applicant
APN Number
Occupancy Type
abbot marc mon B,_e nunama dnlmr.IssW).
m
$ 10000
0I, as owner of the properly, or my employees with wage%as their sole compensation,
Required Inspections
will Jo the work, land the simamr is not Intended or Offered by Sale (Sec. 71Wq
Bucmm, amt Prfm%inn, Code:'rhe C,mtmclm', I:ucnwe Law does nttt apply it) an
. .
r of pO,,c.y Woo nand, oo namove, mem,.., ,,,it who does loan work himself
36617042. 00
or through his own employees. provided that such improvements arc not included! or
_
offered for sale. IL however, the building or improvement is sold within one year of
'
completion, the owner-Fuilder will have the burden Of Proving that he did not build or
imp r... efor improve nf,alc.).
305 — FRAME
711, m owner of me mmpa,ty, am eselnsiraly amnneeng with licca"d emnrCln„ to
307 — INSULATION
ml Om pn,jcct (Sec. 70,14, limine,, and P,clt,4%tmI, C«le:) the Canlrealm ,
levmccenwe fatty does out apply to air Owner of primacy won build, or improve, thereon.
601 — ROOF TEAR OFF
and %he contracts for such projects with a contractor(.) licemea pursuwt hit the
Corms..... lI cen,e"it.
602 — ROOF PLYWOOD NAIL
0 l am exempt under See . B k Is C for this mason
603 - ROOF BATTENS
Owner Dme
woul<BR's cnmmarvs,rnuN uecl.nitnfR)N
604 — ROOF IN—PROGRESS
I marby arfmn under nearby, of pcjury ane of the billowing eealarations:
J I have and will maimain a CeniEcam of Consent to self-insure far Worker's
`
ComMn,aaian, as provided for by Section 3710 of the labs Ede, for the
parfornwnee it the work far which this tenon is I„mv1.
❑ I have amt will nmuintent Workers Cmnpen,atlan Insurance, m,eynind by Section
37W Of Ilse labor Cade. bar the p formavec of the work for which this permit I%
suet. My 'tk is Co nmtia I anec cartierl a' I, Policy nu�m�heeej(arc: ,f
isarier ) Policy NO �y
CIXI'1FICAi'ION < 1; EXEMPTIOry PROM W ORKIiR.
- CONII'CNSATION INSURANCE
,
('ILi, taction need not be camplemd if the teams( Iw for nuc landlord della,
ISIft or leas.)
,
1 ,nit, that in the performance of the work for which this permit is issued. I
shall not employ any persml in any manner en os to Mcome subject to the Walken'
Compematinn Lawn of Cnlimria. Date
APplicvnm
NO] ICI: APHACAN'1'.11: nfteo makingthis CaritSate.l Jim union. you should
comSubject at the Wodcry Conhpmualion provismas of or the labCo e. you most
seasonal,
Q Q
Z
fonhwith comply with such provisions or this permit shall IN dcenmst revoked.
^
AGENCY
ONLElual
CONSere
F”
Im
I ncmby chs, thin mere is a nmswSeen Icnding agency for Inc performance
ka
iFl
Q
nfthe wad Ibr whicM1 this Pcm'nmit is m.w,ucU (Sec 3091, CivCJ
Lender's Nun,
Ow
= Z
Icndcr'x Andres%
U 0
I cinify that l ham read Ibis application and slam that the above information is
carrca. 1 agree in comply with all cit, and county ordinaorm and ,.at laws mining
U
to building construction. and hereby authodit,representatives of this city to emcr upon
II
tic nhovr ...cautioned mnoparry for insurer o,m,uw%,
L•" pmt
(We) agmen, act. and ..nni f Mand k"" hi olevsma Chynf ca"'Ono vguin.0
,
m
banai,ie%. indsmnamns, auto Imo r.pen,w, wnian mn;,y in any way aceta m,gaimw ,ria
U Z
Cny in nm,eynence 0,l the hg o(Iii, me'rmil.
^
API CA NDERST � ANO WILL COMPLY WI H LNAN� NT
Issued by: Date '
Re-roofs
sisnmarc nfnppla ca ma1�`i Dme
nZANUOUg MATERIAhS OISCLOSURii
Will the a, linuni Handing tea %Inure or lI;vmdoan
Type Of Roof
a CChem
lmpl ud it Safety
a, der nest by the Cupcnino Municimal Code. Chapter 9,13, ane Ila Ilcallh dna Snfny
Code. Sea tion i55J21a1^
C3 e, El No
All roofs shall be inspected prior to any rooting material being installed.
Will on, applicant or lmute building mcupon use equipment or devices which
If a roof is installed without first obtaining in inspection, I agree to remove
,,,III hanudons lair conmmmamy its defined by the B., Area Air callboy Mvnagemena
I.,trietr
all new materials for inspection. Applicant understands and will comply with
C' yes Na
materials under the
I have rend the hty bst
all nolint source regulations.
505, 25ncnls
4. 1 un d
California Health &- Safety Gdq Scgiom 255(15, 25513 and 255lJ.l understand that
Code
if the building Utas not currently have a actual, that it I% my my nsibilitymnntify hit
Occupant of the requirements which must be met prior m ie7ze of a Cenl' ate of
eupV I / _ /��
Signature of Applicant Dale
Vw„ ��_-//
All roof coverings to be Class `B" or better
Co.nerji orcumnd,e age.., a
OFFICE