07120217 CITY OF CUPERTINO 7.!«��ayp�$,&ks
BUILDING DIVISION PERMITCl[t�� QR jAf g7�'V1.�an+ A� 1\
BUILDING, DDRESS: PERMR NO.
U;�1 / N STEI.,L1.NG RD LANDMARK DEVELOPMENT 07120217
W NER'S NAME: PERAVf ISSUE DATE
I.AS PAI.,MAS STELLING LLC 1307 S MARY AVE STE 120 09/03/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHI]ECf/ENGINEER: BUILDING PERMR INFO
NEW TWO STORY-TO HOUSE BLDG ELECT PLunIB MEcx
O O O 0
�Op LICENSED CON'TRACTOR'S DECLARATION ' Job Description
WE I hereby affirm that 1 an licensed under provision of Chapter 9(commencing P
x NSectioa70710)-T..sa.3 ofthe Business and Professions Code.and my licensee
^=H nrfull forte and effect. �( 33C 7
p2'Z Lima= fY.N T
o l- Dam Conlractar D
RARCHRECI'S DECLARATION
e oqT 1 un icresnd my plana shall he used In wblic r cods
3yu eQ�
g0� Encased Pm(rssionl
3 OWNER-BURDER DECLARATION
1 hcmby,afrrm that 1 am exempt from the Contractor's Licenm law for the
00 fallowing mason.(Section 7UJ 1.5,Business and Profesnbns Cade:Any city or county
3 8! which rmuima.permit to construct Alar.improve,mntoluh,or repair any structure
_iprior its issuance.alar,requires the applicant for such permit w Bk asignal summcnl
Ia w
ss ti tom he is licensed pursuant to the provisions of the ConBaaters License law(Chaps 9 Sq.Ft.Floor Area Valuation
Is I-a (commencing with Section 71100)ofDivision J of the Business and Professions Com)or
that he is exempt therefrom and the basis fon the alleged exemption.Any violation of
Schon 7071.5 by airy applicant for a Permit subjects the applicant to a civil Penalty of APN Number Occupancy Type
trot¢ort teas lave h rndmJ dollus(5500).
0 I,In owner of the property,or my employees with wages In Neo sale compeaallon•
will do the woe,and the wucwm la nor Awarded ouRmed for aab(Sec.7014,Business
Required Inspections
And Pro W leu Cade Tee Conracwh Liowe law does not apply 1f an owner of q P
pmpem w•ho builds serimpuveach improvements
r andwhe doessure woe himself edthrouae his
owe employee•provimd that antro improvements are m1 yarded mo nion,dosaln If.
however,Ne Wilding ha improvement 4 said Wthn et year of mproe far Ns r,wmr-
builder will have the anther of proving that he did not build w improve far wrpose of -
0 1.O owns of the property.w caelwively contracting with Bowed omtraoms w
construct the mojm(Sec.706x.Business and Professions Cade:)The Countesses Li-
ve Law does not apply to an cancer of Property who milds or improv thereon,and ,
who contracts far each projects with a emmax wr(s)licensed punom w de Guarantors
Isena Law.
O lamuemwunder Sae ,B&PCfothis.
saner Date
WORKER'S COMPENSATION DECLARATION
I hwebY affom under Penalty of penjury cam of the following declaration¢ -
❑I h,m and will maintain•tion 37 teof Cr,nsem w xelRinua fm weM1sta ce of the
Oban, r provided for ni Section 7]00 of the labor Code.for the Pertormeetce a(the
wont far which Nu permit is inued.
0 1 have and will maintain Workee.Corepersssiun Insurance,as a ialred by Salim
3700ufdec labor Cab.for the perfomtanccor the work for which this Permit is issued. '
My Wankel''ComPenatim. sueas.carrier and Policy number Are.
Carder-. Poliry N^.:
CERPIF'IE�'IEO XPIION FROM WO ERS'
COMPENSATION INSURANCE .
fAbumcdon nccd rotbecompleted if t e Permit is Inrcam hundred Oil=(SIWI
ter leu)
1 cadfy Ihet I.the perfone.of the work fon which this Permit A Wood.l shall not
umploy,sy person Iran,manmrw In In become subject to Lie Workers'Compensation
Laws of California Dan
Appian,
NOTICE TO APPLICANT:If,afar making this Certificate of Exemption,you should
become nd,j.as Ne Wohch Compensation provisions of the tabor Code,you mew
.J O forthwith comply with each provision or this Permit shall b=damcd mooted,
EV) CONSTRUCTION LENDING AGENCY
[-+� Iheneby,fDrm that then u a conslru:tinn lending Agency fm the Performance of
6i the work fon which thus Permit Is Wood(Sm 3097,Cih,C.)
W�Q lender'.Name
=z Lo me.Address
U O I gratify that 1 have rod this application seed sure this the above information is -
IL`Icorrect.l Agree,w comply with all city sad county ordinances and state laws relating to
0 building construction,and hereby aubonm¢presentativ of Nu city w enter upon do
� I37 anew.-men lmad property for Waded.purposes.
'•t G (we)al to Ove•indemnify and trap harmless the City of Cupertino against
V Z Iiabllltin,judgmms,cots and expenses which yin y way.mucagalwt Gid City
In e C of tandn of thn all
t-^ APP ERST LL PLY WITH ALL NON-POINT Issued by: Date
nun
gl�_d(�j Re-roofs
tgewum of App son wcwr Data D=b MATERIALa DISCLOSURE Type Of ROOF
Will y t applicant a fMuni building occupant rwm o And the
h Health
a ntaterisi
In mRSec by 01 CuPenim MUMnwI .Chapter 9.12 and the Health and Safety
ode.section usJz(.)]
❑Yu a All roofs shall be inspected prior to any roofing material being installed.
`1 tem N=app0=anerr meso Wilding a cawrt we=gmpmem a ma es wrier If a roof is installed without first obtaining an inspection,I agree to remove
eemithandoas air conuntionts O der d by the Bay AeaAir(ulWiLY Managemcm all new materials for inspection.
0y.
lhavewvlda by materisie mquimemata unser Chapter b.95eflheCsiifo-
niaHeallh&SdciyC=d4Sccdats15505.355 556.IunticrsuetlthuifNc building
21h&n.d
mx mobilityw¢drytheocculasmorNe
I ens roe of.Cewrc.warampanjSignatureofApplicant Date
*Otero,or n1 Dia All roof coverings to be Class's"or better
i