08050092 CITY OF CUPERTINO # •s r +a�a"�k-jxi :��' ''�"�'=� �''.�
BUILDING DIVISION PERMIT „ .�CaNTRACT ,Ril” F'URMATION,
PERMIT N0.
""T'b"Y fE$SANTAU OPI COMMERCIAL BUILDERS 08050092
WNlER'SNAME: 1 PERMIT ISSUE DATE
ROCKWOOD CAPITAL 445 LEIGH AVE 06/03/2008
ONE: SANITARY NO. CONTROL NO.
(408) 377-4800
ARCHITECT/ENGINEER: BLDG B EILp O PERMITPLUMB MECH
0 0
app LICENSED CON'TRACTOR'S DECLARATION Job Description
�u w I hereby affirm Nal 1 am Ikenmd under provisions of Chapter 9(commencing P
iUl Secwm70f1U)oD, n Jof Um Businessanl Prokasiov Cmfe.caw rccrlmu ADD COVERED` PORCH AWNING TO ENTRANCE
j�� in full fora and.= (/
Livane Cl Ce.g _ 1
ef�} Dale — Otan thr
Y 6ARCHITECT'S DECLARA ON
Y a 1 understand my plain mall rte useA as public records
ed
Licensed Pmfeuional
c H 3
OWN ER-BUILDER m to Comi ION
v Q j I hereby.itfilm,Sect that 11. exempt from Ne Caston Co License Law for the
p O following resson.(Section 7th 1.5,Business aM Professions Code:Any LtiIY or county
$ which requires•pencil to construct. Jai improve.demulidt,or repair any suumum
prior to its issuance,also requires the applicant for well Permit b rim a smrmd comment
s< Thal W is licensed pursuant to me provisions of NC ContramrS ricer Law(Chapter 9 Sq.Ft.Floor Area Valuation
y!-$ (commencing withSauon7080)nfDivisionJoftheBusineuandProfessiovCade7ur $25000
e5— duaW u exempt dutchman and the basis for Ill alleged exemption.Any violation of
Scedan 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Number - Occupancy Type
.1 more than five hundred auTlus(SSW). 31619 0 61 .Po� P y yp
1,u owar of Ne poperty,a my wploycv with wage ss Heir sok campeweon,
will dafesons and Ne he,Coreanors LMede ave rodfar sale(pec.1014,Bayous
and Professions Cade:The,CantrmuKs License Law dais net apply m an trwar or Required Inspections
Own enywWbuildsvimprowch Improvements
sobsaM1waek M1imvlfadfarW M1k
howemPloyeu,por I provenat such improsemcnthincanon icor ordmplesiN Ow alll ,
build. the Wilding thnor Improvement k sold within as cur or completion.the awmr-
salsI. will law die When of pmvin8 that W did not boim m improve for puryoss of
sok.).
Q 1,ea Owner of the property am exclusively canuaming with licensed conaanan to
cmutma the projm(Sec.7014.Business uW Pmfessimu Code:)The Coaaamoh Li-
cense law does am apply in an sumer Of property who Wilds or improves Merton,and
who concuss for such projects with a co umacti Raved pursuant In IW Cumrantors
License law.
❑lam ucmpt undo See ,BlPCfathiascaaon
Dale
WORKERS COMPENSATION DECLARATION
1 hereby affirm under pi of pttjury,One of the following declarations:
Cj
Thaw and will mainssinaCmifiamo(Coucmmsslf-ivurtforWmrkclsCompcn-
sation,an provided for by Section 37th of the Label Code.for One performance of me
work for which this permit I.sound. .._
Q 1 have and will maintain Wo s Compensation Ivuuna,as required by Sci
JTW of dm labor Code,for the performance infuse work fm which Nis permit is issued.
My Workers Co 1pensation Isis u fries and Policy num
Cartier. Polity No.:
ERTIPICAM Ui MON FROM WORK S'
COMPENSATION INSURANCE
(This mcdon rad oulbecomplemd if the Permit is Toone hundred dalton(SIM)
or kis)
I"miry Nal in the performance of the work for which this Permit is Wad.1 altal not
employ any person in any manorm as to become subject to the Workers'CompcnWom
Laws of Calirmeis Date
Applicant
NOTICE TO APPLICANT:If,ager making Nu Certificate of Exemption,you should
become subject m the Worl Compensation provisions of tW labor Code,you mune
.J z forthwith comply with such pmvieov or Nis permit Lull W damW revoked.
Zr%1 CONSTRUCTION LENDING AGENCY
[� I hereby off.that there u a consnuninn lending agenc,for Ne performance of
C' the work for which this permit is issued(Sec.3WT,Civ.C.)
�W Q tender's Name
7 z Lenders Address
V O 1"rely that I have rand W.application and sum that Ute above information u
come"
1 ague m comply with all city and county on inaaeha s asum laws relating in
building couuuceon,and hereby numerics,representatives or his city to coal upon the
� hove-mentioned property for impaction purposes"y a (We)agree to ave,indemnify and keep hamdm de City of Cupertino.geivl
IA liabilities Judgments costs and expenses which may in any way accrue against said City
V z in comequeac of the granting of this Permit.
'+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:9 Date 2� N
SOURCE$EGyGA710NS. /���`
sighou Dam or - G Damm Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicaut or future Wllding recup olstom or handle haaasdov material
as defined by ft Cupertino Municipal Cade.Chapter 9.12,and Ute Health and Safety
me,Seen.
.25532(.)+ . All roofs shall bl inspected prior to any roofing material being installed.
Will the apPlivwnt or uthrt Wilding Occupant use equipment or devices which
Yes
If a roof is installed without first obtaining P g an inspection,I agree to remove
colt harcrdons all a mmminanu as de6m:d by the Bay Area Air Quality Managcmcm all new materials for inspection.
Disuict7
QYes w
I have mad the haanrdev materials requimmcnss under Chapmr 6.95 ofdm CLifor-
-I-Fkal"Safcry Cede.Secims25505.25533 and 25534.1 understand thishim Wilding
dab rml currently have a LLy1Nl mm it is on,responsibility 41 notify the..Wi or the
mgnirtmcnts wnkn mltNW�tmlpriarmia man"ar,c"lirKam ora ars, Signature of Applicant Date
owner or sum se Dam All roof coverings to be Class';W'or better