07120253BUILDING DIVISION PERMIT
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BUILNGA DRESS:
PERMITNO.
T95U1 STEVENS CREEK BLVD FRNT
MENLO EQUITIES CPRTNO HSNG
07120253
NER'S NAME:
PERMIT ISSUE DATE
MENLO EQUITIES CPRTNO HSNG
2901 TASMAN DR STE 220
01/24/2008
PHONEn mmna
SANITARY NO, CONTROL NO,
ARCH=IENGINEER:
BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTORS DECLARATION
l Job Description
p
1 Mmby affirm that 1 am licensed undo proWsians of Chapter 9 (commcrein{
with Section 7000)afDivhlion 3d11had Budness and professions Code, am my license is
ADD SHAFT TO VNT THE TRASH CHUTE
in full forte and effort
License Class tic, 0
Dam Contracser
ARCHITECTS DECLARATION
I uncenam! my pdna ahall W used u public menNS
Lic.wed Pnrfeesi... I
OWNER-BUILDER DECLARATION
1 Mashy olTirm that I am exempt from tho Consumes License Law for the
following moon. (Satan 703 1.5, Business and Profduione Code: Any city or county
which Metal. a permit m comsat, alto. improve, demNkh. or et any orae..
prior as I% issuance. also acquires tit applicant for uch permit to file a signed monument
he is licensed o the of the Common's lixve Law (Chapmr9
Sq. Ft. Floor Area
Valuation
that pursuant provisions
0 0 0
(commend nS with Section 7000) of Division 3 of the Business and Professions Cade) or
$15
than M b acempt therefrom and Ote bub for the alleged eumptiom My violation of
Occupancy Type
Section 7031.5 by say applicant far a permit subject, the opplkam in a civil pointy aIumber
not mo. than Rw hundred dollars (SM.
3 16 2 0 0 8 7.4%1
C] I.M ownvofthe property. ar myadploycat wit mgt, u Neasolecumpeusedon,
Required Inspections
wi0 ca Ce work and Rha avuaum b nainmuded m offered fwaale (Sw.70a4, BudM••
aM Pmfessloru Code: The ComencmYs Liana Law does ret apply he an awrsr of
paapertywha buildsorimpmvutM.on, and whodoesawh weak himselfortroogh his
awn employees, provided that inch improve accu ve not intended araBered for sale. If.
however, the building Or improvement is said within eau year olcomPletion, to dener-
hullder MB have the buNen of proving tat k did Out Will ar Improve fin purpose of
tib.).
t7T• as mare, of doe property, sus exclusively mmuscting with licensed cremate. b
coumn the project (See 7064, Business and Professions Code) TM Cenusaura U.
ttme Vw daocotpr md,carerofpaope.y wasseiliaor Improve Corton,ane
witscantrwKS)Ilaated Pwaum
who e a<uteraah project, u
antthe CConstance.LLicensedL
Licensed Law.
❑tun uemps drier See B&PClea this won
nor N•l. Dli Dam
WORKERI-COMPENS21fiTION DECLARATl0
I hereby air= under penalty of perjury arm of to following declarWom
I have and will maintain aCci iBwm dictators no self-iuu. fin Workers Compere-
otitn, as provided for by Sedan 37M of the lahw Code. for the puforman. of Ce
work for which this permit is load.
0 1 have and will maintain Workers Compensation Imaance, ore required by Section
3700 of tire labor Code. far the mcfawance mf rhe .it fin which this permit in bsred.
My Wa ton's Cempenoddn Inswance cart and Policy number art:
Carrier, Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(This weaken wed not bocompleted if tit permit Is fmone hundred callus (SIM)
or leu)
1 ani(v that in the pafneen. ar the want for which this permhs b Wood. l aml nw
employ my Pena. in myman ran begome subkulCthe Workers' Compensation
Lam Of Calrfomia IG-E
Applicant g a a
NOTICE TO APPUCA m o Eacmpuogyou Mould
haeme subject m the Workers Compensation provisions of Bus labor Cade you mm
famwide comply with such provisions or this permit shall k canted advanced.
CONSTRUCTION LENDING AGENCY
1 Mr a(xrcy far dm pMormana of
din the. ba cdnunc.30
whaRirm
7, CIv{
tin art far which this permit b ivad (sec. 309'1, cis. C.)
Lacs Norma
,
letindeesAcaw
1 I catIfy out 1 have and this applicsom and Stam that the thaw information I.
. .
coma. l agree to comply with all city and coumy ordinances and rude lam rt1Nng in
Wilding construction. and hereby mfoodse representatives of this city in caw upon the
above-mentioned properly fin inspection purpwes
(We) agree to save. indemnify and cep harmless the City of CupeNino aPim
i liabilities. judgments, cam and expewes which may in any my sewn Malmo, said City
in consequence of the granting of this permit.
r APPLICANT UNDERSTAND AND WILL COMPLY WITH ALL NON-POINT
Issued by: Date
SOUFMLXTIONS
Re-roofs
Si{nu on Dam
a
HAZARDOUS MAIIBUALS DISCLOSURE
Type of Roof
Will tint applinnt or to= Wilding oa.panLancre Or ha.ae hasardow material
an, defhmd by tis Capacious Municipal Code. Chapter 9.1; and Ce Health ad Safety
rAllca, Se❑cti25532(a)? l
YbaWill
roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
the amlica t or future Wilding aaopnt use equipment w devices which
emit MvsNous air conuminanu as dcOncd by tit Bay Area Air Quality Management
all new materials for inspection.
District?
❑Yat BTT
I have real the hansdmiumateriala.quim ncr i mlerChapmrd.95 of tit Califdr.
nb Health& Safay Coda Sccdau7.5505,25533 and 25534.1 undismnd thuifthc Wilding
can not c exam, that It b my responsibility m notify the occupant of the
by=
require., beme PH mIsCcshfa:amofOc.Pmry
Signature of Applicant Date
14 gig
All roof coverings to be Class "B" or better
ownor .r..tnan s n ,m