08070016 CITY OF CUPERTINO
BUILDING DIVISION PEI2IVIITC�PIE„T„R'AFC Tt3R I,1�i1`'ORMATIO, ;
PERM T NO.
aU1Lgl�clu3QR ROYAL OAK WAY C .C.K. CONSTRUCTION CO 08070016
NER'SbNAME; PERMIT ISSUE DAM
YU-CHU PWU 806 THORNHILL DR 07/01/2008
PHONE:
SANITARY NO. CONTROL NO.
(415) 992-9168
ARCHTfECT/ENGiNEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
up'z LICENSED CONTRACTOR'S DECLARATION lob Description
1 hereby affirm that 1 am lteenxcd under Provisions of Chapter 9(commencing p
with Section 7")ofoiwslon 3 of me Room.and Prefcuiam Code.amd my license is REPLC WNDWS & SLDNG DOOR, KTCHEN REPLC CABNT
in fun farce and effect.
Licansc Class Lic.0
C t,O Dam Contractor
FF ARCHITECTS DECLARATION
CI understand my plans shall xused As public records
JyU
k o In Licensed Professional
5 OWNER-BUILDER DECLARATION
iz 1 Manby aRno Nat I am escmpt from dee Camractar's Uccnw Iew far the
p O following reosan.(Second 1011.5,Business and Professions Cale:Any city or county
Sag which mquirea A pamh m cnnmrstea,alter,improve.dcmniW,or repair any sNraure
z> print to its issuance.aiso roquires do applicant for such permit to file a signed mammal
that he is licensed pursuant to the pmvi¢Imns of the Comrusore Lice.Law(chapter 9 Sq.Ft. Floor Area Valuation
i~$ (canmemingwtlhSection 7000)ofDivisionSofNeBusinessAnd PrefessimrsCode)., 40 00
e 5l that W is wi mpe therefrom and dte basis far Ne alleged exemption.Any violation of
Section 7031.5 by cry applicant fa a permit anbjcea deo applicant to a civil penalty ofNumber Occupancy
AM mom Nan five hundred dollars(S500). 3 4 2 3 213 0. p y Type
I,asownerofthepmpmyormyernployeeswithwrzw ebwlecompemadon,
windo Newark.mdNeavuctumismtlnmndedoroffc W forsale(Sm.7 .Busimu
Add Profeadmis Code:The CanmmmrS License Law does nos apply to an owner of Required Inspections
property who builds,improves Nereon,arW whodeef mets wart himstlfor Waugh his
own employees,provided Nn such improvemenu are not intended oro@red forsale.IL
bowews,the building or improvement is said within ane year of completion,the owne-
builder will haw dre buNat of proving dist W did tet build An improve far pati n¢of
1.As own of dee property.am exclusively conwaing wide licensed anuxtnts to
m met the project(Sec.7044.Business and Professions Code)The Convacmes U.
cause Law does not apply man coma of property who builds or improves demon,and
who comaacu for each projects with A eamAActM(,)licensed pursuant At the Canuacmr's
License Law.
❑l am esempt mmullto gee .B&PC for this reason
//Y/.2111fi/,r'/ r Data LOAK
ORK 'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury am of the fallowing declarations:
0 1 him and will maintain a Certificate of Count w salFinsum fa WorkcesCompen-
salon,As Provided fa by Section 37W of the Labor Code.for the performane,of the
work fa which this permit is issued.
❑1 have and will maintain Workefs Compensation Inman.As required by Section
3700af Ne lsbm Cade.for the performan¢of Ne cork far which this nomak is issued. '
My Worker's Compensation Insurance arrierand Policy number are:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS' -
COMPENSATION INSURANCE
(Thissectlao need not becompleted ifdte permit is fmrom hundred dollus(5100)
or kas)
I certify that in the performance of W work fro which his Permit is i ouc4l shall not
employ any person in any manor an as to haeme zubject As liteWMicaraComparmantion
Laws of Califomia.Dam 'a/I I e,
APpiicant
NDDCETO APPA :IL aftermaking this Cenifream the
Exemption,You should
,J Obecome scoop y it Workero Comptes this provisions of the Labor Cnde,you mum
fothwith comply with such provisions a this pcnnit andl nd lamed revolted.
yM CONSTRUCTION LENDING AGENCY
� +
I liciaby affirm that there iia Mosuwainn leading a
C4 Ne work for which this permit u issued(Sec.3097,Ch,C.� for Nc perferman of
W�Q Lender's Name
z Lender's Address
U O 1 Motif,that 1 haw,read Mia application and sate Na the show thfomatiun is
DL F cam.',.I agree m comply with all city and county ordinances and sum laws relating he
OU building construction.and hereby auNodm repmsenceives of Nis city to enter upon the
IT.1 alcove-mcadoned property fa inspection purposes
(We)agree to an.indemnify and kap harmless the City of Cupertino against
fn liabilides,judgemma.coms And apeues which may in any way atone ASMML=dCtty
U,Z in cantequence of Ne granting of this permit.
ti APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b Date
SOURCE REGULATIONS. 7 / O y'
Reproofs
Signatu IAppIL.Xonuacmr Date ,
HAZARDOUS MATERIALS DISCLOSUREType of Roof
WIII Meapplicant or m building nant storehandle Nuuoes dmated
as dcflmd by 25 Cupcntno Municipal Cade.e.Chapter a 9.11,and the Health and Safer,
de.sectiam zss3z(a>7
41 ❑Tes All roofs shall be inspected prior to any roofing material being installed.
XNm
Will the applicant or future Wilding occupant use equipment At&Am which If a roof is installed without first obtaining an inspection,I agree to remove
emit hav,Nrus air conuminanta u defied by the Bay Area Air Quality Management all new materials for inspection.
Disuict7
❑Yes u
I have mad the mdcrChapmr6.95ofdte caller.
Ma HcalN&SafetyCade,Sectiau15505.25533 and 15534.1 understand dedifNe Wilding
does tet currently haw a tenant,Nat It is my responsibility an notify dee Occupant of the
raquiremenu which mum M net Finer issuance of a Certificate of Qa
- Al D�'/f�/�� � � Signature of Applicant Date
ower aadeari id ag lit Dam All roof coverings to be Class'%Q 'or better