06020040 CITY OF CUPERTINO "-•-T* ,' '- �" '�- °"` 'g" "' •`'
BUILDING DIVISION PERMIT CONTRACTOR3INFORMATION
'M
BDILDINGADDRESS: KITCHENS BY MEYER PERMIT N006020040
10017 SPANISH OAK CT
ER's NAME: PERMIT ISSUE DATE
PETE & PATI PALMER 278 CASTRO ST - 02/08/2006
�NE: SANITARY NO. CONTROL NO.
(415) 968-8318
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
upp
LICENSED CONTRACTORS DECLARATION Job De n
4i K w 1 hereby affirm that 1 am licensed under provion
iss of Chapter 9(commencing
n< ishScedonTOIMI)of Division 3 of the Business and Professions Code,md my license is
in full force and eRecs KITCHEN & 1/2 BATH REM RAL
_ LicevcC Lk.N �2I
�Fp DateCon DEC ly Yrs
7W
ARCHITECTS
q�,
Diu IundcrsunJ my plans Shall he used as publicrernNe JUN '" / 1006
Diu
o Licensed Pmfcssional
3 Oat I iso IIDEfr DECLARATION
Cmu ecu
I I naso affirm that 1 am exempr from the Csibro C s License law for Ile
is e o following recon.(Section 751315,Business and Pmfdemoli Codc:Any city at county
5 B which nequines n eenlso re comes the alar.Improve,h Permit
t ri e a sig any structure 55156
_I<
prior its issuance,am reto the thovisio antsof for sucGrupe rmiuo Erma Lim,(Chapter
££ (co he eslicensed pSemenUn the provisions of the Cammncautnd Professions
sCode)
Sq. F[. Floor Area On
(commencing with doomfon s and of Division 3 of the Business and Pmfmy vi CMS)ter
y�$ that k u exempt Ilrene(rom and the hues for the alleged cxernption My violation of
Section 7031.5 by any applicant fora permit mbjecu the applicant in a civil Penalty of
not more Nan rim hundred dollars(SSW). r Occupancy Type
❑I.as owner of the property,or my employees with wage to their sole compression.
Oil)do Ne work,and the mmeture is not intended or offered Russia(Sec.7040,Business
and Professions Code:The Conmaemes License Law does not apply in an owner of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
Own employees,pacified that such imprommenu are ant intended cautioned fortitude.if.
however.the building or improvement is mid within mre year of completion,Ne owner-
builder will have the thumb.of proving Nat he did not Wild or improve for puryone of
sale.).
❑1,in owner of the progeny.am exclusively convecting with licensed contractors to
construct the project(Sec.7614.Business and Professions Cade:)The Contrmmr's U-
oove law docs not apply in an owns of propene who builds or improves thereon.and,
who contracts for such projects with acontnnons)licensed pursuant un ft Communities
License law.
❑l am cmmpt undo Sec. Bk PC for this resson
ItData
WORKER'S COMPENSATION DECLARATION
1 hereby afnrm under porosity of Penley one of Irk following decWtions
.m and will maintain a Certificate of Come..alf-imme for Workeea Compen-
,as provided for by Section 3700 of the labor Code,for the performance of the
for which this permit is issued.
ave and will maintain Worker's Compensation Insurance,as required by section
of the Labor Code,for Ne performance of the wank for which this permit is issued.
My t: sCmmpowtitin lnsunrcecurier and Polity number sec:_ra�s✓ RT11Ic TEO Polity No. WO1>0`3RKERt$_
CERTIFICATED EXEMPTON FROM WORKER '
COMPENSATION INSURANCE ,
('Oto section need notWcamplcwd ifthe Permit isforone modreddi lan.(SIW)
or loss.)
I certify that in the perfom once of the work for which this Permit IS issued,1 shell not
employ any person in my manner so as Or become mbjecl in the Workers'Compcnssuon
Laws of Califomie.Date
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you shuuW
become subject in the Worker's Conformation provisions of the labor Code,you most
.J O forthwith comply with such provisions or this permit shall be doomed remked.
Z try CONSTRUCTION LENDING AGENCY
E" I wicbyulnrm that there iaaconstruction kndingagcncy for the performance of
a the work for which this permit is issued(Sec.397,Civ.G
V4 Underi Name
=Z lander'.Address
U C) I codify that I have mad this application W state that the abase information u
Lu r' cones.I agree to comply with all city and county ordinances and sou laws relating to
0 building construction.and hereby authorim mpresentatims of this city to enter upon the
mum-mentioned progeny for calicoes,
purposes.
W (We)agree to save,indemnify and keep harmless the City of Cupertino against
hatrith in
Of ts.the Staving Of this esron. may in any way ettmc against mid City
U z in cornegnenec of the Starting of this permie
w. OCE REFS�fLATI�ANDDS AND WILL COMPLY WITH ALL PON-POINT Issued by: Date
til Re-roofs
ignaWre of APPOSIAMmumetal I Detc
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ihu applicant of future building oceupansmre Or handle hvardous material
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
.Salmon 255320)? All roofs shall be inspected prior to any roofing material being installed.
❑Yu u
Will the applicant or future banding Occupant tree equipment or devices whim If a roof is installed without first obtaining an inspection,I agree to remove
rardmus air conaminants as Johne!by the Bay Area Air Quality Management all new materials for inspection.
D,
II
�c-
❑Yes `IN.
I harm mad the hmaNrws`mawriels requirements under Chapter 6.95 of the Califor-
niaHealth&Balmy Code,secdubt 25505,25533 and 25534,1 undersard in.ifthe Wilding
dot ttttttO888r,currently a LL' ,that 1t Is my mm nslhillty b whoI die aY ml mf the
y nits wire mtr(tamet p r les issumcc of a CerdOcate of Oc
1 (2 � Signature of Applicant Date
er amh "ad gem Date All roof coverings to be Class 'B"or better
' i,