06120002CITWDF CUPERTINO
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BUILDING DIVISION PERT®py,y�yC?F�R��^IOl,r�e
BUILDING ADDRESS:
ARGONAUT WINDOW & DOOR
PERMIT No. 06120002
11013 SkIEFT OAK ST
O' ER'S NAME:
PERMIT LSSUE GATE
'KAY TOLOMEO
10624 S DE ANZL_BLVD
12/01/2006
P NE:
SANITARY NO. CONTROLNO.
(408)378-4018
ARCHI ECDENGINEER:
BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
lob Description
1 hemby affirm Nat 1 am licensed under Provisions of Chapter 9 (commencing
p
with Section 7") of Division 3 ofmhe Business and Prefemione Code, and my license is
in full force and effeeL
WINDOW REPLACEMENT LIKE FOR LIKE (6)
License Class Lic. d
Dam Contamar
ARCHITECTS DECLARATION
1 undersand my plans shall he used u public records
Licensed Professional
OWNER-BUILDER DECLARATION
I hereby oMrm Not I me exempt from Ne Ca .tear's Licence law for Ne
fallowing mason. (Section 703 t.5, Business and Professions Codc: Any city ser county
which requires a permit to 1..4 cher, improws, demolish, or repair any etrucmrt
$10214
prier to its issuance. also requires, the applicanffor such Permit o file a signed samment
is licensed of the Contractor's License law (Chapin, 9
Sq. FC Floor Area
Valuation
Nat he pursuant o the provisions
(commencing with Section 70M) of Division 3 of the Business ads Prokssions Code) Or
that h< is eaceapt therefrom sod the basis for the alleged camps an. Any violation of
r
Occupancy Type
Section 7031.5 by arty appliam for a permit subjects the applicant to a civil penalty of
not areNan five hundred dollars (15(10).
1, u owns of d. ptopety, a my wployca with wags u U.'v sok compensation,
Required Inspections
wt 1 do Ne work and Ne iwmum 4 not inmrtded ser oRert0 forsak f1tt.70x4, Buunas
and Pmfessime, Cada: The Convacmes rs License law dooat apply to an owner of
progeny who builds orimprow d.rcon, and who doessuch work himself or through has
awn employea, provided that such imp ow menu arc,rot intended or offered for als. ff.
however. the building or improwsma, is mid within an Kar of completion. Ne owner-
builder will haws the burden of proving Nat he did at build or improve for purpose of
sak.).
1, u owner of Ne property, as caclmm,ly contracting with licensed cauramrs an
o street the project (Sec. 7044, Business and Profcssioro Code:) The Comoctor's Li-
«nse law doss not apply an an owner of l mpeny who builds or improves thereon, ad.
who con.. for such pmjeeu witha causar(a) licensed pun.am to the Curvatures
—law.
lam ezempr un ,Sec. ,B k PC for�.a reason
Z /6
r Date d,
COMPENSATION DECLARATION
I hereby affirm under penalty of perjury enc of the following declarations:
e,m and will maintain a Certificate of Consent m self-ho ure foe Worker'sCompen-
IMVI/ClUCEFUS
, as provided for by Scctian 37M of the Labor Code, fur Ne purforma ce of Ne
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for which Nu permit is issued.
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aws and will mountain Wmkcrs Campcnaatian Irtasnna, as rtyvirtd by Section
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37M of the lather Code, for the performance Of Ne work for which this pemmit is issued
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My Workers Compensation Insurance artier and Policy number are:
CaniccPolicy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
men; section need not M completed if the permit is lure. hundred dmllan (SIM)
or less.)
I eenlfy Net in the WrrOrmanee aI the work for which Nis Pe,mhis issued. I shall not
employ any person in any manncJ ay/ bFinmpc sublet to the Workeri Compuuation
Laws of California UV
NOTICE TO APo NT�Com making this Ceni6a. of Exemption, loo, you should
biome abject the Worh Comp sets of Ne labor Code, yw menu
y it fro
forthwith comply with axle provuiev or Nu permit dull be deemed revoked.
or this eoeit
I
CONSTRUCTION LENDING AGENCY
1 hereby arum Nat Neff u a coutmctinn lending agemy for the pc,fonnance of
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Nc work for which this permit is issued (Sec. 3097, Civ. C.)
tinders Name
Laders Add.
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I certify that 1 have tend this application and sum Nat the above information is
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correct. 1 agree to comply with all city and county ordinances and sum laws relating to
(wilding emswelen, and hamby a.theire rcprcscmativcx of this city to cme,,nn the
ahove.jdgmentioned pmpeny, for inspection purposes.
(We) agree to ase, indemnify and keep harmless the City of Conn... against
j may in anyway attrvc against aid City
m
incoisolumgmcn¢cosuandof this Permit.
of the granting of Nis permit.
APPLICANT
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
Issued by: Date
SOURCE REgyeATIONS, � p
Re-roofs
Signature o�ApplidnUCanuactdr .
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Wit] ft applicant or future building occupant more or handle haorelou material
m defined by the Cupertino Municipal Code. Chapter 9.13, and the Health and Safety
.semi.. 25532(a)7
�Yu �Na
All roofs shall be inspected prior to any roofing material being installed.
Will din applicant .r fuwrc building aceupam sew cyuipmcm ser devises whits
If a roof is installed without first obtaining an inspection, I agree to remove
emit h.,ardma it a.uminany u defined by Ox Bay Arca Air Quality Management
all new materials for inspection.
District?
❑ Yes
I have real the hmardeal ma.rialareg.ma cess under Chapme 6.95 oft the Califon
nu Halth k Safety CodoSectians 25505.25533 ad 25534.1 undersand Na ifdx building
docs not c.rmndy have a tenant Nat it u my respomibility m notify d. occupant mf thO
requiremcn ichmum etpdorwissuanccofaceedifcat,orOccup
Signature of Applicant Dale
All roof coverings to be Class "B" or better
Owner Or .N; dage.t D
or