06020065CITY OFCUPERTINO
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BUILDING DIVISION PERMIT
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BUILDING ADDRESS:
SMI CONSTRUCTION INC
PERM17'N0' 06020065
19628 STEVENS CREEK BLVD
OWNER'S NAME:
PERMIT MUE DATE
WILLIAM CHUNG
595 MONTAGUE AVE
05/23/2006
SANITARY NO. CONTROL NO.
(510)351-3288
ARCHITECTIENOINEER:
BUILDING PERMIT INFO
BLDG
O O O
LICENSED CONTRACTORS DECLARATION
Job Description
I hereby arum that 1 am licensed under provisions of Chapter 9 (commencing
with Section 7000) or Division Sof the Business mod Profession Cade. and my linen in
in full fame and effecL 8
Lkenm Cl
T.I.-INTERIOR (MERLION MARKETPLACE RESTAURANT)
Dam Comrutor
ARCHITECTS DECLARAPOt
[Amin rend my plena shall fe used u public,anrd
Lkcamd Pmfcasional
OWNER -BUILDER DECLARATION
I hereby affirm that I Am eacmps from im Conuanorg License Law for dm
following moan. (Section 703 1.5, Business and Prefessium Code: Any city or county
$700000
which mqulru a permit lex construct, After. Improve. mat011sh, , repair any someone
prior M its issuance• amu at cures dm applicant fonuch permit ro file A signed ssamncm
Contractor's License Law (Chapter 9
Sq. Ft. Floor Area
Valuation
that he is limned paramount the provisions of the
(cwnnrming with Section 7000) of Division 3 of the Business and Pmfaiau Code) or
than he m exempt thwfros, and the Buis for the alleged exemption Any violation of
Section 7051.5 by any Applicant for a permit subjects the applicant to a civil penalty of
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Occupancy Type
ret mare than Rw hundred dolmn ($5001,
1, u mvrcr afire pmpmty,, my wpbycn with rages u the'vmk wnpensadon,
Required Inspections
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wBl do the work, And thetuuctum mnotmkndad,oRemd forsale(Sec.70N,Busina
and Profusion. Code ThA COntacens I tints law don mat apply to u nwxr of
propenywW builds ,improwsth ocam,and toed dausuehaort himsdrutheouth bre
mwwploy,es.proA&dintaeb Improve Uweatimmndad,oResed(meal' If.
however• the building or Improvement is aid within one year ouewpletion, the awner-
builder will have the burden of proving that An did rot Wild , improve f, purpose of
sale.).
❑ 1, u owner Of the property, am aeclusively contracting with Ettnsed cenum,s b
construct fin project (Sat. 7044. Busing ami Professions Cade:) The Conmewr's U.
nesse Law dna not appy to an owtmr or Property who Wilds or improves themen, and
who cone m,far such pmjeem with Aeonusctar(s) licensed purauan at am Contactor'.
License Law.
❑ I am exempt under Seo , B & P C for this mason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby &Man under penalty of perjury am: of the following declarations:
I have and will mountain a Certificate of Conant M self -Wort f, wo er's Cwpen.
Ando., u provided for by Section 3700 of dm labor Cade. far the perfawamx of the
wort for which this permit is Issued
0 I have and will malreas Warriors Carpreuulan Insurance, u mgvimd by Section
.
3700 of the Lamar Code. fer me perfmmanee of site wart for which thio Permit u loved
My Wa'Imescmpetuall buyss rn�mn Arm Politynumber am:
t•...:..-� /-I�/ J Polity No.:^
CERTIF1 7E F P ION FROM WWWORRRTTT(PPP!l1S
COMPENSATION INSURANCE
'
(Ibtseerlon need nothe compleaxi ifft permitm foram hundmddulm (5100)
or leu.)
1 ee tify that in the performance of sire wart for which this permit ts intend, l Arab not
employ any Pana. I. my manner a u to heron. abject to the Waricat Companion
LAWS Of CalffOadL Data
,
Applicant
NOTICE TO APPLICANT: If, after making this Ccniamm of Eumption, you should
become subject to the Wafer's Cwpendon provisions of de, lab, Code, you muss
forthwith comply with such provmlons or this permit shall be domed Armond.
70NLENDING AGENCY
CONSTRUCTION
1,a lending agency for the Performance of
I herebywhalfithi thou dna I. k
ed (SeNnn
the wart for which this permit 4 issued {Sec. 7097, Civ. C.)
Nwe
Lender's Address
=try that I Mw read this application And exam one the Above Inf,nafiOn m
I .gree to comply with all city and county oouWnco and state laws misting to
building nonaction. and hereby athorim reprnenmtiM of this city to enter upon the
'tat
above-mentioned property for mspc purposes.
(We) agree to saw, indc Y and out harmless the City of Cupcnino against
Iiabilidu.judgmAAa&mrA.d panne whi,hmeymarywayaccroca,m1masaid City
in cona,spa rce of the {roofing this ���ttt��arrr
APPLICANT UNDE Atl S AKD_ L OMPLY WITH ALL NON -POINT
Issued by: Date
SOURCEREGULa /
Re -roofs
Type of Roof
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Signature o[Afplim r ow
H US MA DISCLOSURE
WiBthespplcm, rAmem Wilding Oanpalstore or handle huvdous martial
As defined by the Cupert a0 Municipal Code. Chapter 9.12. and the Healer and Safety
code,Ya2ss3uA)7
C] Ya 3NO
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All 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
WIII the appllcut or fumm building occupant n equipment, dcvicu which
t l,umb.s alr canlmimm an defined by the Bey Area Air Quality Man.gcmenL
all new materials for inspection.
Disuict7
❑Yes XP O
Item mad the hazardous matodats m lulmments undcrChapmr6.95 cribs Califon.
niaH..10&lately Codc,Secd 2550525533ad25534. IundcnwdtheUfthe Wilding
docs nut cumntiy how a y maponslhilly 0 Autry the aceuPut of W
hcertifkam
Date
mgaimmemm wnkhm tpri, Oram
Signature of Applicant
;Dam
All roof coverings to be Class "B" or better
Owner ar. ariemd. e t