07120259 CITY OF CUPERTINO ' �/n�-�^s� *ps�` •v +«€'Tt ""�'`��F{6 'T'"' 7s"'
BUILDING DIVISION PERMIT •V,L\-11�L14TQ1 + `3+� 1IQ
PF3 MR NO.
eu"TTIi pD ?';STELLING RD HUANG, REX 07120259
OWNERS
S7NALLME: PERMIT ISSUE DATE
HUANG, REX 1352 S STELLING RD 01/09/2008
NE: SANITARY NO. CONTROL NO,
ARCHrIECffENGINEER: BUILDING PERMIT INFO
BLDG0 0 MFCH
o o LICENSED CONTRACTOR'S DECLARATION MIOb D05Crlp[IOn
�i hm
1 oby afOm that 1 am licensed under provisions of Chapter 9(commencing
M vice Section 70ID)afDivislon3ufthcBmsinesssedProfusionsCoic,sedmylicense hs REVISION LINE FRAMING STRCTRL ORIGINAL PERMIT
r in full force and oBed.
��'z Uses,Clean Lica 07050116 NO NEW PERMIT.
ppp Desi Contramr
ARCHITECTS DECLARATION
1 understand my plan 0111 but used a Public meems
6u
yO,a Llreaed Pmfeal...I
3OWNER.BUILDER DECLARATION
i F I Rrohy E.
the 1 am eampt from the Contravenes License Law fur de
ZOO fallowing won.(Sadao NO 1.5,Business and Profusions Cade:Any city or county
which uml.•Permit to construct,slur.imPmve,demaON,Or upsir my uruduu
prior to iuissuancc.Wu routines the appliesnt for such permit us file a signed wumcul
thra he is licensed pursuant to ft provisimus of the commmor's Uccome Law(Chapter 9 Sq.Ft. Floor Area Valuation
x1-- (commencing with Section 7000)of Division3oftheBusiness and ProfusionsCods)or
59
9 that he In aempt therefrom and the bwis for the alb:gcd sae ,do..Any vlaietion of 5500000
Section 7031.7 by airy applicant turn Perch subjects the applicant to a civil penalty of Number Oeeu
not mare man Bw hundred dollars(35410). 36617108 panC y Type
0 1.asowner of die property,m my cmployaa with wages.duo sole c..,mma am
will do the work-ted the structure lmotimended oroRead formalist(Sec.7044,Business Required Inspections
and Profession.,Code:The Consensuses Liam Law dao not apply m an owner of q p
property who but Ida or Improws thereon,end w ha does such wart himsel r orthrough his
oweemployous,provided that such Improwmmu ase not intended ora@red for ale.If.
howay.the building orlmproamcnl Is sold within one year of cumpkdon,the owner.
builder wW haw the burden of proving that he did Inst build or improve for purpose of
ale.).
0 1.as owner of the property am aclusively contracting wine licensed contractors to
consumer the project(Sec.7014.Business and Professions Code:)The Conmcmr's Li.
cense Law does me apply in,as owns of p,opmy who builds or improses thereon.and.
who contracts far such projects with amnuanot(s)liceused Immune,to IM Contracear's
License law.
0 I am aempr under See B&P C for Nis
Ower DION
WORICER'S COMPENSATION DECLARATION
1 hereby glim under penalty of perjury one of the following dechoulour
I hew and will maimate.CeNBam of Consent to¢If-harm for Wartees Camper.
adon•a provided for by Section 3700 of the labor Cade,for the performance of me `
work far which this permh is issued.
0 I have and will maintain Workeen Campensulan Insurance,as uquined by Section
3700afmu labor Coda,for the cafamseceofthe wast for which this permit is issued
My Wohees Corepertadon Laurance artier and Policy number ane:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu secdm need ser becompleted If the permit is picture hundred dollars($100)
or las)
I unify dist in me prfrmaac of me soh for which this Nmh is issued,l shall nes
employ any Nrsen in any mamrw_ µmbecome subiat m the Wormus'Compewdon
Laws of Celifomia.Dau aHS�nI O V
Applicant
NOTICE TO APPLICANT:IL ancr making this Certificate of Exemption,you shmW
become subject in the Worker's Compeesatim provisions of the labor Cede.you muss
.�z forthwith comply with such provisions or this permit shall be dcemed rowked.
Z O CONSTRUCTION LENDING AGENCY
1 hereby affirm the them is a combustion Lending agency for the performance of
CL> the work(or which this Permit is issued(Ser.3097,Civ.C.)
QLender's Name
7 Z Lundeen Add.
U0 me 1 Nfy th1 have need this application and suis the the W.information 1.
LLV Carred.l agree to comply with all city and COmty Ordinances and sum lawn minting to
0 building construction.and hereby mmodse upsecouivrs ofthis city to enter upon me
Isd alio ot-onedoned property for inspection purposss.
G (We)ague to ave,indemnify and kap harmless the City of Cupertino against
y liabilities,judgmcnu.cmu and uF..which may N any way cc..,.last said City
U Z in Canscu en..of the grating of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE0. L
Q- Re-roofs 2�—
Sigualum otAppfficanUCouthafter Dam
HAZARDOUS MAATS DISCLOSURE Type of Roof
Will de applicant or future building orsuPset owe orhandle haardo smaterial '
a donned by the Cmpertina Municipal Code.Chapter,9.13,and the Health and Safety
Cat:,Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
O ❑Yes 04441
Will me applicant or fuuu Wilding asuPaul Ice c ltd neum or ties=which If a roof is installed without first obtaining an inspection,I agree to remove
It haamna air com minmu a defined by the Bay Arta Alr Qm ity Management all new materials for inspection.
Diedd7
0Yes 0No
I hew tat the haardms material enforcement t ulnucepter 6.95 of the Califor.
nia Health&Safety Cade,Sccumnt 25505,25533 and 25534.1 understand the I(the building
does not CumnOy hew.unset,the it is my mspousibliity to nadfy de occupsen of me
requlmmem he metpian ' vacsI Cerunnto f0.Pan
Te � Signature of Applicant Date
ML'a�R
Owner or aulhomcd.gem Dam All roof coverings to be Class"B"or better
'