07120223 CITY OF CUPERTINOss,
BUILDING DIVISION PERMIT CCIVTBAICTOR INF,UItMATIf1Ai *s
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BUIMINpf.pDgFSS' PERMrr NO.
. UrsL`J N STELL�ING RD LANDMARK DEVELOPMENT 07120223
NEWS NAME: CORPORATION PFRMrr ISSUE DATE
[,AS PALMAS STELL1NG LLC 1307 S MARY AVE STE 120 09/03/2008
PHONE SANITARY NO. CONTROL NO.
ARcxnEcnFNCINEER: FO
NEW TWO STORY TOWNHOUSE BLDG BEIECT' �R mum MECB
o c LICENSED CONTRACTORS DECLARATION 2, 399O O O O
I Mcby afrim that l an lioenaed color provisiaae of Chapter 9(commencing Job Description
i vin Scotia 70(IU)ofDi"'on3afdm Budrw vol Prafcsdam Code�}solmylicnvseu
n<d in full fortt and erccm. �{ 33�F/
��_ ucemea . sec.•
p, Da¢ Comractor �}
eSDECLARATION
munI
e�< I uolcJ my plain Mall W used u Public rtcorth /
JyU C
y o licensed PmfcssionH
5 OWNER-BUILDER DECLARATION
1 hereby a=rm that I ma exempt from Ne Contractors License Law for 0m
i O O following aeon.(Sce ion 7131.5,Businm and Proressium Code:My city or county
u m r which mquiv a p rat to cnnswct.altar,impmw,demulia.er mini,any tuammc
Z'nprior b its issuance,als�nquhml the applicant for catch pemit m file a signed smmmeni
lhatheislicenwdpunwntwNepmvisiomoft Conmw'sLtenselaw(Chapmr9 Sq.Ft. Floor Area Valuation
x (commencingwin Scctim70D0)ofDiHsion3oftbe Businmmd Pro(miom Cole)or
y $ dun he u ea ropl thuerrom and the buil for Ne alleged exemption Any viola,an of
Section 70313 by any applicant far a permit abjccu the applicant in a civil penalty of APN Number
m1 mom don few 6ulMmd dollars flim Occupancy Type
❑I.uoww of dm papmty,mmy mvploy=wipa wagmuthev ale campematim,
will do dm wart and the rmucturt is not immnded croRaad far ole(Sec.7064,Buvnam
ad Pro(miam Coe:The Gntracwd L.. law dose not appy an m ovn r of Required Inspections
proprny who builds m improves Neman,and who does such wad himalf or Through tis
awn ampioyru,provided that tach improvements oto not intended manned fmsala.a.
however.the building or improvement Uald within an year of oompktian.the awrom,
Miller NB low the Mden of paving dot M did inn Mid or improve fm pugom of
ole.}
0 1.ss owner of the properly.am eaclusiwly contracting with Halmal contactors Or
comtaa the project(Sec.7044,Baram and Prafesaom Cade:)The Contrxwrs U.
mnse law does at apply w a Dams of l rapeny who Wilds or improv demon,and
who cmlrmt,for tKh plateau with a eantraelarn)lima d promant at the Gntraewrt
Lima law.
❑I an memps undo See ,B d P C far pais moon
Poor Dan
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty,of perjury oro of the fallowing mOrmattioac
❑I haw and will maialain a Cartifimn of Cogent to saINauw for Wader'sCompete-
cation,u provided for by Section 3700 of the labor Code,for eve performmm of the
work for which this permit is isaed. .
[ 1 have and will maintain Waders Comp autdon luunme,u mquimd by Scotian
3700 of the labor Cade,fm the performance of the work for which this permit is issued. '
My Worker CompemaIt Inas artier ad Policy numbcram:
Crier. Policy Na.:
CERTIFlG O %EMMON FROM WORKERS'
COMPENSATION INSURANCE
(Thi,sectio road not be completed if eve pooh Is far ane hundrd dollars IS 100)
or leu)
I certify,dint in the pmfomartcc of tW wad run which this pe,mil u conal.I shall not
employ any permn in any ma nor w u On become mbjcet in the Woria m'Compewtlm
Laws of Califamia Dam
Applicant
NOTICE 7D APPLICANT:If.afar mating that CcniOnm of Eacmplim,yin Mould
become snot=Or the Woders Campenuuan pavlaom of dm labor Code,you muse '
.J Q fornwith comply with alb proviaom Or this pemil man W doomed mated.
zt CONSTRUCr10N LENDING AGENCY
r
f^v MOby which=than there laaod(Scc.3097. r. agency for tiro peNmname of
ai eve work for which pads pemit u issued/sec.7197,Civ.C.)
QLenders Name
= z lenders Addrev
U Q 1 certify nal I have mad thio it'licaan ad sun teat eve aWw iNonutian u
Fcartttl I agree w comply with all city and county ordir amen and sow laws totaling it
_0 C) building construction,ad totally mnoria mpmxnuum of this city in color upon ft
I17 .haw-mentiamd propeny for impaction purposes
py (Wc)agme to sew,indemnify and Wap harmlm pate C" of Cupcnino agaiml
z incoitim.Judgmenu,coN and exile Elm. a=run agamtsaid City
V z in conseq fMet of m
APPL N AND N WITH ALL NON-POINT Issued by: Date
S ONS.
,00 Re-roofs
that,
Sign o Applimn ontraca
HAZAR USMATERIAISDISCLOSURE Type of Roof
Wlil tiro applicant or funurc Wilding occtimm swan orhandle baurdom malorial
u defined by dm Cupenim Mamci 1 Code.Chapter 9.13,ad dm Health and Safely
m4.Section 15533(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑rat a
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant (sew W)Iding by ft nay AMI i it QWft Manage hick pe g
Di iarict? m air tmtaminmu defiimd by pac Bay Area Air Quality Managemcnl all new materials for inspection.
❑Yin No
T haw road the ha calaus m ncialssequitoments uoler Chapmrh 95ofnc Glifar-
nulicald,&sa
clyC , ,a. 550S. 533W25 .Tnottirvnpabuilding
oilfdievngdminit' y I
mmireGhc P2t e
Diss of f B �fon2-4
a aruy.
tea? D Signature of Applicant Date
Dain,. an .g n Dan All roof coverings to be Class'%W`or better