07090205 CITY OF CUPERTINO
BUILDING DIVISION PERMIT
PERMITNO.
elnL1�I1 � BESS;.AN LEANDRO AVE BEST BUILDER, INC. 07090205
OWNER'S NAME: 5 PERM17ISSURDATE
PO BOX 361215 03/24/2008
E: SANITARY NO. CONTROL NO.
(408) 834-6889
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
t� EIS
PLUMB
MECH0
3 0 o LICENSED CONTRACTOR'S DECLARATION .. Ib Description
�a 1 oeby stain tot 1 am twonsad m
under provisions of Chapter 9(camencing OOSCCI p
wish 9action 7IXIU)nf0ivwan3ofthe Busintaa and Promssiov Cane ndmy1weme4 SFDWL 2' STORY 3 , 555 ' GARAGE 432 '
in full farm ana.Tea
License Cl see.« SEE NOTES 3/18/08
Dam Comactor
ARCHITECTS DECLARA O
e U 1 understand my Puns shall W used as public men,*
t°
Licensed Pvfasaional
OWNER-exempt RD won ConTIDN
0 1harch,
resso .(Tian that 11. exempt faro tiro Cssions o :My c Law for the
i,a o following mann. peed n 70 31.5,Easiness and Pm,damns Cade:Any city m mum.
$ ,do, mqulmt•permit re cures ft tor,improve,h Permit t,or.,Air any madam
iy pa I M I.
issuance.alert In LOC aovisios Of for suchPermit70 filcasignad statch(Chapter
@ c tot he islicensedpmoment 701(1)provisionsofthe CamramrllleanseLaw(Chapmr9 Sq.Ft. Floor Area Valuation
X g that he isexemiN3ttdan70ndtMbut&fon ro allegeincuandon.AnynnsCoh)of $786441
S lot he a campy themfrom and the aper far the alleged aamant W Any l penalty
of
Sudan.703-5 by hanyurt applicant for•permit abject see applicant m a civil penalty of Number Occupancy Type
not msec than fiw namaed aallm(g5W). 3 5 7 0 5 012?(��
❑1,u owner of die Impurity,army employees withwagta as Bmir sok eommoaadon,
will do the workand aeawctue is nountanded OcnRaed faraale(Swe.70th.Business Required Inspections
and Profedons Cade:The Convacme,Liceone Law dues not apply a an Owner of q P
properly who builds or i m proves theamon,and who does such work hhnself or d owe lh his
ownemployees,provided that such improwmana am not intended aroRerad forsala If. ,
bawevv,the Wilding or improvement I.said within am you a completion,see owner. Ry
oilhr will law Ne burden of proving Nat he did at dtik m improv far puryose of
MI1)J.
❑1,u Ons,of ct s ePartY•aro exclusively co llessi ng with )The
mnuaann m
[:]1,. the Project(Sec.7044,Boniness sew Proftaaloa Cade:)am d amemara U. z�AN
rove Law duce not apply to an owner of property wo builds or improves daemon,and,
who contacts for such pmjeets with a ernaacmra)licensed personal tome Contnnofs
Lleense Law.
❑I am exempt ands,Sae .B&P C far this mato
Owner Dam
WORKERS COMPENSATION DECLARATION
1 herby affirm under pevity of perjury mm of we following declarations: -
have-ad will maintain a Cautiivm of Covent m self-Loma for Wooers Carlem-
cation,a pmvihd for by Section 37M of the Icor Code,An the performance of am
work for which at,permit is issued. -
❑1 have ad will maintain Workers CompevWon Insureace,as required by Section
37M of Its Labor Cook,for the paaoOance of the work forwmch this permit is issued.
My Workerpa am an insurance wav and Pali number
Center. 71Q1 C /-L1/7 PapulleyNa.: 3Q 1m:7 31
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Intoxation need ontbecomPlelea if to permit is franc hundmddellm(RIM)
Of less)
I cavity that in to performams of ac wah far which this permitu issued.I awl not
employ any Paan in any..an re as to been.subject 70 tiro Workers'Ornmeaahn
Laws of California.Dam
Applicants
NOTICE TO APPLICANT.If,star making this Cenifimm of Exemption.you should
become anbje n to the Worke's Compenakdan provwov of the Labor Cade You must
.,O forthwith comply wia suchiaes a
provaor u cleared shall be nrd ewkcd.
'y'� CONSTRUCTION LENDING AGENCY
[.r I hereby affirm that time ita construction lending agency far the perfmmenmor
r4> thewartfar which w1)proutIseowed(sec.3097.Cil.C.)
W Q Lenders Nate
Z
Lundeen Addrax .
f,Q 1 lenity that 1 have mad this application and mm that the save information is
meec-1-P. to comply with all city and county ordinances and sale taws reading to
Q tS.'J Wilding conswction,and h1)mbymthmia epreanudvet ofthis city to amerupnn dm
+hove-mentioned property for inspactron purposes
(We)agree to saw,indemnify and keep hismkes the City of Cupertino against
aE"i r/J Iiabilides,judgmmu.cotu and expenses which may in any wry accrue against said City � ,v
.U in cauxe a of the granting of this perm!I, NN//pp L
APPLICANT UNDERSTANDS AN L MPLY WITH ASL NONIPOINT Issued by: Date
SOURCE �Sv/J L, O Opp
Sigmet"o of pp uppyy a c7�pp Data
Re-roofs
�HAZARDDUS MATERIALS DISCLOSURE Type of Roof
Will the applicant v future building MCUPUL90M orhandlc baandov mammal
an dcOned by the Cupertino Municipal Cade.Chapter 9.12.and see Health and Safety
Code.Section 255324)1 All roofs shall be inspected prior to any roofing material being installed.
❑Yon a
WIII the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,,I agree to remove
t he'rsrdnw air Ionamin a a dcOvd by the Bay Area Air Quality Management all new materials for inspection.
rstr ct7
❑Yes u
1 have mad aehmendousmalcrialsmquimmena unhrompterh.95 of tea Califor-
nia Health&Safety Cods,•Secdwu25505,25533 atu125534.1 undmmd amitthe building
data rot cweady bow alevan- c nwpovibllay to mdf do accuptent of the
requirements which a r ssuvmc of Cadfimm taw �I Signature of Applicant Date
ownerma omrAagcnt D m All roof coverings to be Class'J�{P or better