08010108CITY OF CUPERTINOF:.aA
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BUILDING DIVISION PERMIT#
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C�,NTRAOTOIWWORMATIQ�
BUIt.TUD�13 E"bTEVENS CREEK BLVD
MINA TREE SIGNS
PEa 08010108
MR'S NAME:
PERMIT ISSUE DATE
ORAE AVENUE PROPERTIES
1233 E RONALD ST
01/17/2008
PHONE:
SANITARY NO. CONTROL NO.
ARCHTECTPNGINEER:
BUILDING PERMITINFO
REMOVE EXISTING SIGNS BLDG EIEC' PLUMB MECH
O O O O
LICENSED CONTRACTORS DECLARATION
` IpilOn
I hereby affirm the l are limneed under provisions of Chapter 9 (commencing
" �: �T-'�- �_ _ _ • • � _ _ • � • _
with Section ]0110) of Omit..3 of the Business and Prafuesion. Code, and my license u
in full face and off s!
LigniteCly. Lk,. g
Date Camru:wr l
ARCHITECT'S DECLARATION 15/
I understand my plans shall he stud as Public records
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am aacmpt from the Contractor. Us,.. Law for the
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following mason. (Section 7031.7, Bush. and PmfcW.. Code: Any city or manly
which requires a pun,ir W co ands , suer. Improve, demolish, in mpar say structure
,
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prier to its toren. also mquires the applicant fanuch permit to file a signed swement
that he is licensed pumunl W the provisions of the Con4vcter'sLlcense Law(Ch.p¢r 9
Sq. Ft. Floor Area
Valuation
(commencing with Scotian 70W) of Division 3 of the Business and Professions Code) at
that M Isesempt therefrom and the basis for the allegedte
cmptian. Any vloladon of
APN Number
Occupancy Type
section 7031.3 by arty applicant fora permit subjects the applicant in a civil penalty of
rot mom than five hundred doll. (55001.
❑ I. as owner of the property. or my employees with wages as their sok compensation,
Required Inspections
will do the work, and the structure is net intended or offered forsake (Sec. 7044, Business
and Professions Calc The ConuacWrs Li. Law good not apply W an owner of
property who Wilds orimpmtea d¢rron,and whodasauch work himselrarllunugh his
owe emPloyrn, provided that tech improvemmss art not inmeded coffered (mala V.
tmwwr, the Wilding a impmserovints hath ote leer of mpreve f rite
a didr
toddler will hale the When or proving that k did rot Wild or impavn for purpose of
ole.).
❑ 1. u owner of the property, am escludwly contracting with licensed ronrranlaa to
comtruct the project (Sec. 7014. Business and Preresdans Code) The Canaactues W -
cease law does not apply W an owner of property who Wilds or improws themon, and
who contracts for such projects with a contractor(s) licensed porous, W the Contractor.
License Law.
❑ I an uemp, under See ,B&P C for Nb msmn
Can
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penally of factory one of the fallowing declaWaN:
❑thaw and will ar fomentmCok,fomat WarkCYaG%of to
by
for
atlas, as povided rte hY Sectwn 370U or Ne labor code, ra the prfarmeae of the
Section
wart for hieh this permit is issued
have and will maintain Workers Compensation Inanrance, as mal by Section
PID of Ne labor Cada for V performance of Ne week far which this permit is luued.
My pa wes mierPaonldiry Policymher an:%D
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D D
CartWieorI� A ZOO
CERTIGMON FROM WORKERS'
COMPENSATION INSURANCE
(fids section teed and he completed if he permit 4 face hund eddoBam ($100)
N les)
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I unify the, in ted performance of the work for which this pari, is blued. 1 Nal ru,
employ any person in any manner an as u, Wc'moe subject in the Workers CompCNatia
Laws of Cmiromis Date
Applicant
NOTICE TO APPLICANT: IL net making this Certificate of Exemption, you should
become subject to the Worker's Compensation previsions of the labor Code, you most
faMwith comply with such Provisions or this permit shall be decreed rooked.
CONSTRUCTION LENDING AGENCY
1 hereby same Thu dart is a construction lending agency for the puformance of
tM work for which this permit is issued (Sea 3097, Civ. C.)
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Lenders Nam
lender. Address
1 unify that t haw mad this application ane runic the the mount information is
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canect. I agree a comply wins dl city and county randomness and role laws miming W
building construction. and hereby anhodm representatives of that city to enter upon We
aouw-meouaned properly for inspection purpaaa.
(We) agree to save, indemnify and kap harmless the City of Cupertino against
j 14hilities,judgments. cats and expenses which may in any way seems against said City
in consequence of the granting of this Permit.
APPLICA UNDERSTANDS AN ILL COMPLY WITH AL NO POINT
Issued by: Date
SOUR GULy7DNS. y
1
Re -roofs
Type of Roof
A.-� ce 117 Of
Sig.... of Applian✓Conlueor Date
HAZARDOUS MATERIALS DISCLOSURE
Will tite applicant or future Wilding oavpant s,om ter Wndle hnalloas materia
de0ned by We Cupertino Municipal Cod, Chapter 9.13, and the Health and Safety
Section 25532(x)?
P�
All roofs shall be inspected prior to any roofing material being installed.
❑res
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant sax equipment or devices which
emit haurdnns air contend nanu as defined by the Bay Area Nr Quality M ...... so,
all new materials for inspection.
District?
0Yet u
1 haw mal the harudous maeridsrtquirtnaw under Chaper6.93of the Cairns.
ntsHulth&Sacty Cod,Sations25M5,35533a 25534.lunduaandthalfthc Wilding
dao net currently have a anion, that It b my reasonability W ratify de em Put of da
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mqulrtna�y which in= he met poor ar,Cerdfcateof
?7/7
Signature of Applicant Date
�lh /A �
itl
rte
All roof coverings to be Class "B" or better
Owner Urmthorixd agent Da