04060255 CITY OF CUPERTINOu >,A :a :*a+�. �x -=�
BUILDING DIVISION PERMIT QONTR:A.CTOR INFORMATION "
t 4c <*� :� x �. vex•; ?.�..N„r
BmLDINGADDRESS: ALL BAY CONTRACTORS, INC, PERMITNO.04O602SS
A92 STRITRNR
WNER'S NAME: PERMITLSSUEDATE
E: SANITARY AB 1 OL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LpZ LICENSED CONTRACTOR'S DECLARATION O O O O
W lob Descripti
U I ion? )of that 1 am liaucal under provisions or Chapter 9(commencing I.
Z WlfullfulOnndefec DIVIYOn JOfdIe BLLLIMSi said PfOrCaaiYN COdC.and my license Is
< in full forte and effect.
^'z License Class Lic.N TI--INTER. & ADA UPGRADE OCT G 2003 Date Contractor
ARCHnECI-S DECI-ARAT1ON
�i 1 undcrsund my plans shall the used u public meards
J U
G
Licensed barony mol BUIL®r `�
OWNER-BUILDER DECLARATION I\Y,
�m 2 I hemby.(lion on I em exempt from tis Conine Cou Any c Law for the
0 o following mason.(Section](D L0. r.simas and Nvfcaimm Code:Any city or county
$� which requiren a penin m consumer.alter,improve,demolish.m mpoir any awewm
Fly inner N its issuance,also mquimu the applicant for such permit m file a signed statement
< Out he is licensed moment mNepmvisioeofthe Commcmr'sLicense Law(Chapter Y Sq.Ft.Floor Area Va90000
at1On
F $ (commencing with Scction7”)of Division 3 of the Business and Proreainu CNe)or
3.. cut Its is exempt themfmm and On thou for Ne sHc,cd exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the spuicant to a civil penalty,of
not mom NaEe hundred dollars(M). 3 2 wddbI5bqT O 0
Occupancy Type
❑I.u owner of the property or my employees with wage as their sole compensation.
will do the work end theswnum is wtintendetl motfered(orale(See.70N,Busines
and Professions Cuda:The Committers License Law does not apply to an Owner of Required Inspections
Property
who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements arm not intended or offered for Wes.If.
however,Ne building or improvement is to within one Xu of completion,the owner- '
Wilder will have the burden of proving that he did wt Wild or improve for purpose of
sale,),
go/1.a owner of the property,am exclusively contracting with licensed contractors to
Itoilz the project(Sec.7W.Business and Professions Code:)The ConmaneYs Li-
ceee law does not apply to an owns of property who builds or improves thereon,and, .
who convects for such projects with a comm etor(s)licensed pursuant to the Contractor's
License Law.
B.— ,B d:PP C�for
�this moon
o Date O•W
ORKER5 C PENSATIO DECLARAAT�TIIO/ON
1 hereby affln under penalty of perjuryorc of the fol(JZ
dalentions:
I have and will maintain a Certifiak of Consent k self-insure for WmrkcYsCompen-
sation,as pmvided for by Section 37011 Of Ne labor Cotler,for to performance Of the
work for which Of,penin is:sued.
❑1 have and will maintain WorkeYs Compensation Insurance,a required by Section
3100 of the labor Code,for the performance of the work for which be
permit is laved.
My Worker'.Compensation Insurance Gamer and Policy number am:
Center. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not the completed If the knit is forane hundred doll..($IN)
or las.)
1 aNTy dust in the Performance of the work for which this permit In issued.l shall not
employ any person in any muncr an as in become subject to the Workcri Compenfation
Laws Of California.Desk
Applicant
NOTICE TO APPLICANT:fr.after making this Cenificem of Exemption,you should t
biome subject an the Worker]Compensation provisions of the labor Code.you mud,
.,O forthwith comply with such provisions a this Permit shall W deemed revoked.
Z"" CONSTRUCTION LENDING AGENCY
[-a .�. I hereby arcmn that them is•convection lending i gmy far the perfrrmance of
f! ti alk wont for which this permit Is vertical(Sat.3091,Civ,C.)
ILl Q lender's Name
D z Lender's Address
U O 1 certify that I have mrd this application and rete that the above inf nommi Is
rI.E coni 1 agree k comply with all city and county ordinances and sus taws meeting to
C) Wilding convection,and hereby auetoAm mprommadva or this city to enter upon the
W .have-menuoned property for inspection purposes �y-
fy. (We)agree to save,indemnify and keep harmless lie City of Cassano.against lY
i..t i,i liabilities judgment,Goss,and experews which may In any way accrue against mid City
U Z in consequence of tie granting of this penis
PPLICANT ERSTAND L COMPLY WITH ALL NON-POINT Issued by: Date v
Ott HA N .
Re-roofs
gnatim erAppli HAZARwu DISCL Desk Type of Roof
Will the epplkmt ofrumrc building occupant atom or M1an cherallous makdel
a defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Section 25532(s)7 All roofs shall be inspected prior to any roofing material being installed.
r-7 Yen VNO
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It Wearm.oil cmumairimu u dcfincd by tee Bay Ame Air Qu.lity Management all new materials for inspection.
Dismict7
❑Ya kNu
1 have mad the hamolous materials requirements under Chapter 6.95 of the Califon
nia health&SafetyCotle,Sections 25505.25533 and 25534.1 underamnd Oat if the Wilding
dos not c am mu mithility m notary etc Occupant of the
be met eof.Certificate orOccupancy. Signature of Applicant Date
Z� Ot
0 All roof coverings to be Class"B"or better
wn rauthonmtl egem \ ate
CITY OF CUPERTINOu >,A :a :*a+�. �x -=�
BUILDING DIVISION PERMIT QONTR:A.CTOR INFORMATION "
t 4c <*� :� x �. vex•; ?.�..N„r
BmLDINGADDRESS: ALL BAY CONTRACTORS, INC, PERMITNO.04O602SS
A92 STRITRNR
WNER'S NAME: PERMITLSSUEDATE
E: SANITARY AB 1 OL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LpZ LICENSED CONTRACTOR'S DECLARATION O O O O
W lob Descripti
U I ion? )of that 1 am liaucal under provisions or Chapter 9(commencing I.
Z WlfullfulOnndefec DIVIYOn JOfdIe BLLLIMSi said PfOrCaaiYN COdC.and my license Is
< in full forte and effect.
^'z License Class Lic.N TI--INTER. & ADA UPGRADE OCT G 2003 Date Contractor
ARCHnECI-S DECI-ARAT1ON
�i 1 undcrsund my plans shall the used u public meards
J U
G
Licensed barony mol BUIL®r `�
OWNER-BUILDER DECLARATION I\Y,
�m 2 I hemby.(lion on I em exempt from tis Conine Cou Any c Law for the
0 o following mason.(Section](D L0. r.simas and Nvfcaimm Code:Any city or county
$� which requiren a penin m consumer.alter,improve,demolish.m mpoir any awewm
Fly inner N its issuance,also mquimu the applicant for such permit m file a signed statement
< Out he is licensed moment mNepmvisioeofthe Commcmr'sLicense Law(Chapter Y Sq.Ft.Floor Area Va90000
at1On
F $ (commencing with Scction7”)of Division 3 of the Business and Proreainu CNe)or
3.. cut Its is exempt themfmm and On thou for Ne sHc,cd exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the spuicant to a civil penalty,of
not mom NaEe hundred dollars(M). 3 2 wddbI5bqT O 0
Occupancy Type
❑I.u owner of the property or my employees with wage as their sole compensation.
will do the work end theswnum is wtintendetl motfered(orale(See.70N,Busines
and Professions Cuda:The Committers License Law does not apply to an Owner of Required Inspections
Property
who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements arm not intended or offered for Wes.If.
however,Ne building or improvement is to within one Xu of completion,the owner- '
Wilder will have the burden of proving that he did wt Wild or improve for purpose of
sale,),
go/1.a owner of the property,am exclusively contracting with licensed contractors to
Itoilz the project(Sec.7W.Business and Professions Code:)The ConmaneYs Li-
ceee law does not apply to an owns of property who builds or improves thereon,and, .
who convects for such projects with a comm etor(s)licensed pursuant to the Contractor's
License Law.
B.— ,B d:PP C�for
�this moon
o Date O•W
ORKER5 C PENSATIO DECLARAAT�TIIO/ON
1 hereby affln under penalty of perjuryorc of the fol(JZ
dalentions:
I have and will maintain a Certifiak of Consent k self-insure for WmrkcYsCompen-
sation,as pmvided for by Section 37011 Of Ne labor Cotler,for to performance Of the
work for which Of,penin is:sued.
❑1 have and will maintain WorkeYs Compensation Insurance,a required by Section
3100 of the labor Code,for the performance of the work for which be
permit is laved.
My Worker'.Compensation Insurance Gamer and Policy number am:
Center. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not the completed If the knit is forane hundred doll..($IN)
or las.)
1 aNTy dust in the Performance of the work for which this permit In issued.l shall not
employ any person in any muncr an as in become subject to the Workcri Compenfation
Laws Of California.Desk
Applicant
NOTICE TO APPLICANT:fr.after making this Cenificem of Exemption,you should t
biome subject an the Worker]Compensation provisions of the labor Code.you mud,
.,O forthwith comply with such provisions a this Permit shall W deemed revoked.
Z"" CONSTRUCTION LENDING AGENCY
[-a .�. I hereby arcmn that them is•convection lending i gmy far the perfrrmance of
f! ti alk wont for which this permit Is vertical(Sat.3091,Civ,C.)
ILl Q lender's Name
D z Lender's Address
U O 1 certify that I have mrd this application and rete that the above inf nommi Is
rI.E coni 1 agree k comply with all city and county ordinances and sus taws meeting to
C) Wilding convection,and hereby auetoAm mprommadva or this city to enter upon the
W .have-menuoned property for inspection purposes �y-
fy. (We)agree to save,indemnify and keep harmless lie City of Cassano.against lY
i..t i,i liabilities judgment,Goss,and experews which may In any way accrue against mid City
U Z in consequence of tie granting of this penis
PPLICANT ERSTAND L COMPLY WITH ALL NON-POINT Issued by: Date v
Ott HA N .
Re-roofs
gnatim erAppli HAZARwu DISCL Desk Type of Roof
Will the epplkmt ofrumrc building occupant atom or M1an cherallous makdel
a defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Section 25532(s)7 All roofs shall be inspected prior to any roofing material being installed.
r-7 Yen VNO
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It Wearm.oil cmumairimu u dcfincd by tee Bay Ame Air Qu.lity Management all new materials for inspection.
Dismict7
❑Ya kNu
1 have mad the hamolous materials requirements under Chapter 6.95 of the Califon
nia health&SafetyCotle,Sections 25505.25533 and 25534.1 underamnd Oat if the Wilding
dos not c am mu mithility m notary etc Occupant of the
be met eof.Certificate orOccupancy. Signature of Applicant Date
Z� Ot
0 All roof coverings to be Class"B"or better
wn rauthonmtl egem \ ate