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02120014 CITY OF CUPERTINO' r" z:>•` - a BUILDING DIVISION PERMIT CONTRACTORINFORMATION teas.,, taxx«„e�as•✓v. BU I&E+9aP4RESSTEVENS CREEK BLVD SARATOGA CONSTRUCTION PERMITN02120014 R.MAM1,N0R0UZI 12201 SARATOGA—SUNNYVALE �r1.ICATT'2"J"T22002 ONE: (408) 996-1711 SANITARY NO. CONTROL NO, ARCHITECT/ENGINEER: BUILDING PERMIT INTO BLDG ELECT PLUMB MECH Op LICENSED CONTRACTOR'S DECLARATION - 1 hmch affirm that I am licensed under provisions of Chapter 9(commencing �, wiNScaion]NB)nfDivi5inn3ofNc0B.�5sanJPnlfcsrionsCoJe,and(mylicen g REVISION--IN HOUg�scrl I�{nONLY Now int°I f eandef t. I/ 'jZ'rJ 0 n ORIG. #01010108, NO NEW PERMIT ISSUED 66{ us Lice lass U,, 'S -] Oz�O D nn 'IDI ARCHITECT ECLARATION r�yYi -a I understand my plans shall . Jas public namJs _ KO U Yl�LLi'� I.ICCnSCd PInfCS5111na1 C a OWNER-BUILDER DECLARATION Contractors Fd e f I hereby.(Bra that 11. exempt from the Cssions o :License Law for ay i se O which re ream".(Section 9(111.5.Business and Professions h,Code:Any tiny or county X,o which its requires a e,alsl re cores the alms improve.demolish or repair any tuuaum $5000 Fz< pdamshomance.aluant toithe irmym reantfor such etmr'sit)Licfile asigned smmmcnt Oat menti gwitpumuamtolheprovisionsoftheGonwnndProclaw(Chaplm9 Sq. Fl. Floor Area Valuation c (cat he is in with Senioon XXEand O basison 3fee O the ageBusiness aad in.A Stens Code)or i 3� that he is exempt ILerefmm and Ne basis for Nc alleged ezemptinn.Any violasinn of 34212 036 . 00 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of APN Number Oeeu ane e not more than rive hundred donors($500). 101 — FOUNDATION p y Typ I,as owner of the properly,or my employees with wages as their sale compensation, will do the work,and Ne suvaure is not intended or offered for sale(Sec.7(an,Business 3:02 - PIERS and Profcssioms Code:The Contractor's License Law fres not apply to an owner of 103 - UFER Required Inspections propcny who builds or improves thereon,and who does such work himself or through his own employees.provided that such improvements arenot intended or offered for sale.If. 104 — REBAR however,the building or improvement is sold within one year of completion,the owner. /� builder will have the burden of proving that he did not build or improve for purpose of 105 .— ANCHOR BOLTS < sale.). 106 — SEWER & WATER 01,as owner of the pmgeny,am exclusively contracting with licensed contractors to 202 — UNDERFLOOR PLUMBING construct the es not apply (Sec.]fano Business and Professions Codei The Contractors Li. whocraft, contra Juror such plyman with a CDfprepenr who wu pursuant improve themnctors 203 — UNDERFLOOR MECHANICAL S ` whence Lo contracts for such projects withaconmanmr(s)licensedpursuanum the Convamoh 204 — UNDERFLOOR FRAME l License Law. O l im ezempt under Sec. .B@ P C for this reason 205 — UNDERFLOOR INSULATION at Dam 301 — ROUGH PLUMBING WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER I moan,affirm under penahy of perjary,one of the following declarations: 303 - ROUGH MECHANICAL 1 have and will maintain a Cerlifcate of Cnnsenl to self inure for Worker's Compcm tion,as provided for by Section 3700 of the lecher Code.for the performance of the 3 04 — ROUGH ELECTRICAL work for which Nis permit is issued. 305 — FRAME ❑1 have and will maintain Worker's Compensation Insurance,ss required by Section 3 06 — HOLDOWNS 3700 of the labor Code,for Ne pertormance of On week for which Of,permit is issued. My Worker's m n5admn m5"ranee comer aria`ahoy namberare: 307 — INSULATION ca ler: L / Py�JNa: 308 — SHEETROCK o ERT FICC 7 CAQMNI�AONFRON EORKERS' 309 — EXTERIOR LATH (This acninnneed no,the mmpleted ifth,permit is formic hundred sells.(S Its)) 310 — INTERIOR LATH mless') 311 — SCRATCH COAT 1 certify that in the performance of the work for which this permit is issued,I said not 313 — ROOF NAIL employ any retson in any manner se as to become subject o the Workers'Compenselion Laws ofCalifornia.Date 501 — FINAL ELECTRICAL ENERGY Applicant NOTICE TO APPLICANT:If.after making this Cent Teale of Exemption,you shnulti 502 — FINAL PLUMBING ENERGY become subject o Ne Worker's Compensation pavisinns of the Labor Code,you muss 503 — FINAL MECHANICAL ENERGY ,Z forthwith comply with such provisions or this permit shall he deemed revoked. z Q 504 — FINAL BUILDING ENERGY .N. CONSTRUCTION LENDING AGENCY rIwom,affirm Out Of.is"command..lending agency limhc performanceof 505 — FINAL ELECTRICAL C > the work for which this permit isissued(Sec.3097,Cry.C.) 506 - GAS TEST LLl 0 Under's Name Z Lenders Address 507 — FINAL PLUMBING U O I certify Nat I have mad Nis application and stem that the alove Information is 508 — FINAL MECHANICAL !yF correct,I agree to comply with all city and county committees and stan,laws relating to 5 FINAL GRADE building construction.and hereby ardlamea mpmunutives of Nis city to cnmr uqm the Wabove mentioned properly for inspection purposes. O — FIN I G (We)agree to save.indemnify and keep havnless Ne City of Cupertino against �( F-'h liabilities,judgments,costs and expenses which may in any way amac against said City 5 N L WORKS J z inconsequence of the UNDERSTANDS anting of AND WILL COMPLY WITH ALL NON-POINT Issued by6s prounif 0 NAIL Dale / l SOUR E REGU TIO a �p apasakp� ���� Re-roofs604 —k-ROOF IN—PROGRESS amof Appaan a oacmr Oam HAZARDOUS MAT(RIALS DISCLOSURE Type of Roof Will Ne applicant m Tuan building occupant store or handle haaardous material fined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety .send.,25532(a)7 ❑Yes All roofs shall be inspected prior to any roofing material being installed. t Will the applicant or future Wilding up m use equipment mrd vices which If a roof is installed without first obtaining an inspection, I agree to remove it harardous air contaminants as dcGned by the Bay Area Air Quality Management all new materials for inspection. shier? ❑We It ave mad the IanNnus materials mquirements under Chapter 6.95 of the Cxlimp rustication Cndc.Smti.ns25505.25533 and 25511.1apJcrsmnd thuiflM Wilding Jrex nm cunemly ba c a tenant Nm it is my respemihility mlµ'(y rhe omupam of Nc requimmenks which mustbe tp rtoismammefa Ccniw r0.cupancg Signature of Applicant Dale Ark 41) //$ OamNemedagem Da All roof coverings to be Class "B"or better