06050051 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTORJINF,ORMATION
BUILDING ADDRESS: ARGONAUT rWINDOW & DOOR PERMITNO.06050051
10016 SPANISH OAK CT
'R'S NAME: PERMIT ISSUE DATE
LEE CRAIG M AND NANCY J 10624 S DE ANZA BLVD 05/05/2006
NE: SANITARY NO, CONTROL NO.
(408) 378-4018
ARCHTBCT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
ioo LICENSED CONTRACTOR'S DECLARATION - Job Description
w F I hcrcbY.Mart out 1 am IiccusN under pmvivaru of Chapter 9(rommcncing P
e<� with ll(mHx and affect.
3ofNC Business and Proles iota Code.aM my lieeveis
L License Class
REPLACE 3 UPSTAIRS WINDOWS
.N�. License Clus Lk.N
it: IT
Dam TSconDECLARATION /
ARCHITECTS DECLARATION
£moi lutldcrsund MY Plans aWlhcused u public record
JyU
ewo r^ Licensed Profcuianal
5
OWNER-BUILDER fmm d DECLARATION
ON
0 C I mouton.
.(Tete that 11. cumpt from Nc Comms Co License Law for the
up o following mssan.(Scedm 703 1.5.s.War. and Pro.domim Cade:Any city at county
m which rcquirea a permit m consensus.alar,impmse.demolW,or repair any suuctule v $4000
_I< prior to its issuance.also torsi.Neapplicms far such permit to 6hasigned statement
this he is licensed pursuant o the pmvisions of Nc Conuactari license Law(Chapter 9 Sq.Ft. Floor Area U ioI
e1- (commencing with Section 7000)of Division 3 or the Business trod Professions Cork)or
i
52 that he is exempt thele(rom and the basis fa the alleged uempdon.Any holaion of
Section 7031.5 by ary applicant for a permit subjects the applicant te a civil penalty of Ci anC Occu T e
nuc mrt aNan five handled dalla,01500). Occupancy YP
❑I,u owner oldie prvposy,a mY ernPloYcs with wage ss thew tele rompewtioh,
will do the work and du svumum H natinuMed or aRaed forsek(Sec.]044,Business
and Profewiau CodeCom
macho's The Coactere License Law N dors mat apply an owner of Required Inspections
property who Wildmimpmws dumom.and wh.daasuch.,k himselfarthmugh his
own unPloyces,provided that such improvements art tet intended moRemal fa sale If.
however.Ne building or improsmnms is old within arc year of mmpkum.the owner-
builder will have she burden of proving that he did tet build or improve for pis,.of
irk.).
1,as owner of the Progeny.am extlmively contracting with licensed ronuacton to
won Nt project(Sec.nano Business and ry wh iota Code:)The as ft...
who ontr dons out apply N os owner of grope'(who sed p or improves Cetera.ted.
who se Law. for such projects with a ronuxsor(s)Iiarue0 Wratant w the Conuanola
E]I.Law.
❑lam exempt un�3ec. � ,BdPCfor Cu rtsson
Dau
ORKER' O
PENSAnuaN DECI.A ATION
1 hereby affirm under ty of perjury me of the following dWara mnic
❑1 him and will maintain aCerd vatic of Consent he self-insure W Workers Campion.
urian,as provided for by Semi..3700 of the Ube,Code,far tho perfonna en of the
work for which this Permit is owned.
❑1 have and will maintain Workers Compersadmi I.,as required by Section
3700 of Ne Labor Code.far the performance of use well,for which Nu permit Is issued
My Workers Compensation Insurance carrier and Policy number art:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
('Ibis sections need nut Wcompleted if the pemit is foram hundred dollars(SIM)
or Icss)
I comfy that in be Performance of the work for which this permit is issued.l shall not
wnPloyany perron in any mannerse o ec c 'eco u Warke.,cianNamom
hws of Califami AA
Applicant (,(444
NOTICE TO AP ANY:If.aajj / g this cmi t ¢ cmptian.you should
became subject w she Wahers 6ot�i c atom pmvisians o die Labor Code you muss
,J z faMwiC comply with tach proviaiam w Nis permit shat be deemed revoked.
z O CONSTRUCTION LENDING AGENCY
[--i I hamby alOrm that Cert ua construction kndingagenc,far Nc performarxs or
FL thus work for which Nis permit is issued(Sec 3097.Civ.C.)
�W Landers Name
zLeness
Lenders Addr
U Q 1 canify Nat 1 have read Nis applicadon and suis dial Ne above infatuation u
LL PeonecL 1 agree N comply with al city and county oNinamee and state laws relating m
QU building coossmetion,slid hereby autharim mpummiives ofthis city to enter upon
F 1 oho .mcnuoned pmperty for inspection purposes.
(We)agree m uses indemnify and keep h hay in W the City Hi Cupcnins against
h i.emidea,judeorthecam and expenses which may in WY Way accnu aganasad City
U z APPLICANT
of DERST il of NDS-ANDis WILL
^-' APPLICANT UNDEItSTA�tD$J.ND WILL COMP Y WITH ALL NON-POINT Issued by: Date
SOURCE REGUUcvS,U/
Re-roofs
Signature ofA s a RDO te
HAZARDOUS MATtaLaISCLOSURE Type of Roof
Will ft applican,iar futureWildingCge.Chanumrtar handle haardommaterial
delleee by C¢32("),na Municipal Cod.Chapter 9.13,and Ne HW N uJ Safety
.0YG 25532(x)7 No All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaininginspection,I agree to remove
Will the applicant r fumm building occupant one equipment or devices which an P g
it hovsdW1 it canuminanu as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
El Yes. Nu
I have read aMnus materials lequirommus under Chapter 6.95 of Ne Califon
nix HcalN&SarmyC .Scctioru 25505,2533 am125534.1 ndcrsund Caif Ccbuilding
din notunent ave a Clara Nat it is my resporuibil" mdfY tM ceupant of Nc
rcyu"mc mustbemetprioia iuuanecof 'team or Ocapancy. Signature of Applicant Date
Ownaa as ari,ndagms Date All roof coverings to be Class •'B"or better