05080189CITY OF CUPERT[NO
' 7'
dy
BUILDING DIVISION PERMIT
COIVTRAC'Tt?RiTNP'ORMAT(
BUILDINGADDREss:
FINN BROTHERS CONSTRUCTION
ERMIT NOO 5080189
HE'S NAME:
PERMIT ISSUE DATE
FINN BROTHERS
1475 SARATOGA AVE
01/20/2006
O NE:
SANITARY NO. CONTROL N0. .
(408)252-9131
ARCHITECTIENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
lob Description
1 amby affirm that I am licensed under provisions of Chapter 9 (commercial,
whis Seetian 7000).f Division Stardom Business and Poxes¢ ns Code. and my Im.. ts
in fun farm and effect 3S 2 IZ
NEW CONDO -9191
Llcento w Lk Is
DamContracer
ARCHrM9S DECLARA N
I understand my plans mall be used as public records
Licenced Professional
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from tiro Contractor's License law for the
following mason. (Section IID 1.5, Business and Professions Calc: Any city or county
$197006
which requires a Permit he construct, eller, Improve, demolish, or repair my structure
prior m its issuance, else mquims to applicant for such permit to file a signed Cocement
Ft. Floor Area
Valuation
that a is licensed pursuant 10 the provisions of the Common. Licence Law (Chapter 9
Sq.
(commencing with Section 7") of Division 3 of Ne Business and Professions Code) or
that he Is exempt themfram and Ne basis for the alleged exemption. Any violation of
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant in a civil penally of
.at mom than firs hundred dollars (5500).
0 1, asowner of the property, army employees wha wegas as their sole Compensation,
e
Required Inspections
will do the work, and the structure lsaol intended or offered foram, (Sec. 7044, Bnsircss
and Profession, Code: The Convenors License Law does Out apply m an owner of
q p
property who builds or improve Herron. and who doessuch work himsel f or through his
own employee, provided Net such improvements am not Intended oroRemd forsale. if,
however. the building or improvement is sold within one year of completion. Ne owner.
builder will have dm burden of proving Net he did not build or improve for purpose of
sale.).
0 1. as owner of me pmpeny, am exclusively contracting with licensed commemrs be
Constmn Ne project (See. 7011, Business and Hafessions Cade:) The Contramrs L -
cane raw does not appy in an owner of propany who builds or improves themm. and
who cmntraeu per such projerm with aconuxmr(U Restated pmauam to the commetces
Licomm Law.
,BkPCfrddsrason
DamWORKERS
COMPENSATION ECLARATIONI
hereby Arm under penalty of perjuryarcof the followingi
IMyIamexemptunderSec.
haw and will maintain a Certificate of Consent m self-inaum fa WoftesCompen-
on. u provided far by Section 3700 of the Ida, Code, far Ne performurc of the
k far which this permit is isaad.
1 have and will maintain Workers Compensation Insurance, a required by Section
0 of the Lamar Code. far Ne performance of the work for which this permit is issued.
am�peda"i Inwmmm canier and Policy number sm:
Wodeers C941"0"
-'MA 1 _'LCL
Curler. �" Ll. t Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Tax section need not acomplemd iflhe Permit is fmoac hundmil dnllsrs ($100)
nr kas.)
1 cenify Not in the Performance ar the work for which this permit is issued, l shall not
employ any person many msaneran as in become subject o the Workers: Compensation
Laws of California. Dam
'
Applicant
NOTICE TO APPLICANT: If. mar making this Cenifiam of Exemption, you should
become subject 0 the Workers GOMPensatiOn Intonations of Ne Labor Code, you must
forthwith Comply with such provisions or this Permit shall be doomed revoked.
CONSm ON LENDING AGENCY
I ar is a construction, agcnry I'or Nc aerfonnence of
Nat Nem Is
whichnm
s 307, Cing
the work for which this permit h issued (Sec. 3077, Civ. C.)
'
Lender's Name
Lenders Addmas
I I sonify, Nat I have mad this application and sum Nu the gave informatim is
' coms. l agme m comply with all city and county ordinances and sou laws mixing m
WOamsconswction dfamby auNorin mpresenmivas of this city to cncer mann the
i above-mendoned p ny for insisted ryocs
(We) agrte an. Indcmnil and p amdev 0m City of Cupertino against
i liabilitiu,judgmc caaYmdex rates ch may in my way amue against said City
i in contact cc ' o i Pe it.
APPLICANT E STA ILL PLY WITH ALL NON -POINT
Issued by: Date Ld W
SOURCERE A NS.
�/ �
Reproofs /�
Type of Roof
-
Signature A gnuContrecmr Dam
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or (alum milling acuaantamm ofhavmaterial
Ocfined by 0m Cupertino Munciaal Codc. CAsamr 9.13, and the Hcailm aand Surety
. Sccdan 355320)7�/u
All roofs shall be inspected to any roofing material being installed.
❑Yca
prior
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant of future building Occupant use, equipment or device, which
It havardoua air Contaminants aadafincd by Nc Bay Area Air Quality Management
all new materials for inspection.
Nue
Kara d, rials uimrommumarChepmrd.95ofthe Califn.
4ffi&o'
234413,3 33 as S34,lundcratand thetlfNe alliin{
oCodc,Sati
n ,Nat It I y resp ihillty m notify IheOccupantn(dmata
¢prior Taman a f.CoulfwmnfoccupstoSignature
Applicant Da[e
6
of
All roof coverings to be Class "B" or better
aest t _ Dam
M