08090159 CITY OF CUPERTINO �ma..^ .aeuai" Y -a°'! X.
BUILDING DIVISION PERNUT CO ,, T,A '1 R-- TION,
BUILDING ADDRESS: \ PERMIT NO.
21406 RUMFORD DR CUSTOM EXTERIORS INC . 08090159
R's NAME: PERMIT ISSUE DATE
NIKHIL JUNANKAR 440 BOULDER COURT, STE 400 09/24/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHRECTIENGINEER: BUILDING PERMIT INFO
REPLACE 10 WINDOWS LIKE FOR BLDGO EO PO O
uOp LICENSED CONTRACTOR'S DECLARATION
UC 1 hereby arum Nat I w lireved ander provisions of chapter 9(,a mmucing ^••-•-^^ Job Description
with Sucuon70(kif aroivislon 3 Brum Busineasad Prof�3o9c,md my license is
in ran torte and e(rM. (gyp
i Llexma ` !L Lle.g
-F❑ Dam Can
n w ARCHr1ECr'SDEC ATION
e 7 1 understand my plans shall be nsd sal Public records
?;u
le"
Licensed professional -
OWNER-BUILDER DECLARATION
f I amhy affirm Nat 1 am exempt from is Contractors Incense Law for to
r p o fallowing won.(section 7031-5.Business and Pmfeadoos Code:Any city or musty
$ which mention•Permit to eonsoucl alter.improve,demolish,or repair any swctum
-i< prior m its issuance.esus sequim the applicant for such permit to rik asigned satemat
Exch Nuheislimmadparsuanttadepmvisknsofthe Carer wesum=Uw(Chapw9 Sq. Ft. Floor Area Valuation
(commcncingwiNS=dm7ID0)o(Divuion3of Ne Busin mdPmfrssiom Cade)or
$ Nu W ts tempt therefrom std the basis for the allegd exemption Any violaden of
Section 7MI.5 by airy applicant for a Permit mbjcas the applicant o a civil Penalty of ane APN Number OCCU
not mart than fin hundred dollars(5500). Occupancy Type
❑1,u owner or de moperty,m my employeon wish wage ss Heir role compevauon,
will do the work and Ue suucmrt is not intended aroRcred forsak(Sce.7014,Busi"•.•
and Pmfeadav Ccdc This Contractors License Law does act pply m an owner of Required Inspections
property who builds orimpmven Nercon,and who doessuchwork himselrorNmugh his
owns cmploYr<s,provided Nat such improwrnens art not in¢ded malfared rorsale B,
bwewr,Ne Wilding m Wpro pravinu sold within of Weer or Improve
euf r IW owned
builder will have jos WNcn of proving that W did not Wild or improve for purpose of
tile.).
❑1.u owner of the Property,am exclusively contracting with licensed contractors en
covtmcl Ne project(sec.7(14.Busies...and Prolessians Code)The Contrmsors U.
cave law docs not apply an an awner of property who Wilds or improve thereon,and,
who contracts for such pmjccs wish a comraclor(s)licensed pursuant no the Conuacmrs
Lkenm law.
exempt undo Sec ,B&P C for this rtAma
oro a
Data
WORKER'S COMPENSATION DECLARATION
1 hereby aRm under penally of pnjnry one of the folkwing declsrstiov:
Ilaw mW vontmar by section
37M of ft Labor Cods.aumrun Woerse Campan-
suian,as for
h thi run by SeNan 3700 car d¢Labor code.for the performa�car the -
wars for which this P[mil is issued.
ave and will maintain Workers Compensation Ivunnm,u mgaimrm
d by Seon
700 of Um labor Code,for jos performance of Ne work far which Nie permit is issued. '
My Workers Compensation lvursnse artier ad Policy number are
c,rrie .WCk�.av 6�,CG Polity No.: Argr(g17z
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
mnismctim need net W completed if the permit is(mune hundred dollars(SIOM
or less)
I certify joet in the perform.of to work fm which this pemi,in ivud.I shall not
employ any person in any manner so as to amore subject to to Wmken'Compensation
Laws of Califomia Dam
Applicant
NOTICE TO APPLICANT:IL after making this Ccrtinca a of Exemption.you should
became subject no to Workers Compensation Provisions of Ne Larson Code.you men
., O forthwith comply with such provisions ar NU Permit shall W doemed revoked.
Z y CONSTRUCTION LENDING AGENCY
(~ I amby aRlm Nat Vert is a construction lending agency for the Performance of
C4
the work fm which this Pemit1.iuued(Sec.3097,Civ,C)
1 Q tendon's Name
Z: z Lenders Addw
V Q I certify dual I have nod this application ad sum Nar Ne mase infomuum is
cortecL I agree m comply with all city and county oNinmee5 and some laws misting to
0 rV^ building construction,and hereby sojourn rtpresenudres of Nu city to enter upon Ne
H ysaw-medoned Pmpcny,far inspection perpmes
(We)agree to save,indemnify and keep hamlest Use City or Cupertino against
fin liabilitin,judgments.cors andesperuon which may in any way arum against said City
U z in consequence,of the gnnung of this Permit.
^ APP ANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date S?-
SO REGUTA7IONS, (�
23L e�"y,_ `1�-,>Y-op Re-roofs
Signuure car Appnan✓CenaactarDam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant car(umm building occupant sure m hadk karardaas material
MIned by due Cupertino Municipal Coda.chooser 9.13.and the Harsh and Safety
.section 255320)?
r]Yon All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection,I agree to remove
craWill es applicantor,alum building occupant Aequipmentordevicnwhich g p
D iiui �ov err mnuminans as defined by IW Bay Ana Air Quality Management all new materials for inspection.
DYon MNy
I have and Ne hanNsw materials mquirtme rs under Chapter 6.95 of the Calilor-
ntsHealth&SafclYCadc.sessions 25505,25533 and 25534.I mdersund Nuifde Wilding
does not correctly have•tenmL Nat it is my mFeasibility m tmufy the occupant of the
mem.
5 whichm W la .a
k"toissaanccoraccrtirmatearoccapavy. Signature of Applicant Date
A. 9- v OP
Owner arantarived an Dam All roof coverings to be Class'W'or better