08020156 CITY OF CUPERTINO � ? �
BUILDING DIVISION PERT kCONTRA.CT�O
MI ,RjNF0$MATI0N-.1
PERMff NO.
BUILDINOAOD6'b TANTAU AVE DEVCON CONSTRUCTION INC 08020156
WS NAME: 1V FE RMrr ISSUE ONE
TANTAU DEVELOPMENT LLC 690 GIBRALTAR DR 05/16/2008
PHONE: SANYTARY NO. CONTROL NO,
ARCHr1ECf/ENGINEE1t: BURRING PERM"'INFO
NEW 2 STORY SHELL OFFC BLDG BLDG ELECT PLUMB MEcx
O O O O
�OpSEE 8H
LICENSED CONTRACTOR'S DECLARATION '
N
U 1 hereby affim that 1 am limned under Provisions of Chapter 9(Commencing ^_ ___._. ...._.,.,
with Section 7M)of 0ividon 3 of tiro Butineu.d Professions Codc.and my licenan is
; = itn Tnumoree and off Lis.
ljj�
f• Dare TSDE L
` CHTECse DECLARATION
1 undersunJ my Pkm shall bo used as Public rtcorN
3
T wp r^ 51mized Pm(cssiaml
OWNER-BUILDER DECLARATION
i�% T hereby aRnn Nat 1 em exempt from she COmractor'a License Law for the
y O O fallowing mason.(Section 7031.5.Business and PmfcWom Cade:My city or County
Z§9 which requires a permit m Construct,alren improve.dermllals or.Pair any swnure
prior to its imumet.alm requires she applicant for such permit m Gk a signed suument
pps< ,hat be is licensed puuuanLto tie Provisions of the comrami'l License law(ChapNr 9 Sq.Ft. Floor Area Valuation
yZF$ (commencing with Section 7")9Division Sof the Business and Professions Codc)or
Nat he is aemp,therefrom and the basis for Ne alleged exemption Any violation of
Secdon 7031.5 by arty applicant for a permit subjects the APPlkant m a Civil Penalty of APN Number Occupancy Type
sm Come tiun It.hundred dollars(SSW} P Y YP
❑Lis a wor of tW yoprrty,a mY maPloyw with wga ss drew mk cmnpewtim,
will do,trwork,andshe he CimB toes Lt doraRe t tarsale(ily in
H,Business
and Pmfwhimu Code:The COnhactah uttnz law dam,Cot apply lf an owner Required InspeCtlOns
propicutywho,builds orimprovesdermn,and whodmamtworkhimself arNmugh his
k
awn emplayces,pmWdM Na,anch impmvemenu arcoo,inrendM moRcrtd fmssk If.
however.Neave, imeimprovement Ice sold wishd oneyamorimprovefo•dueowmer-
builder wi0luve she burdan of proving Nat W aid Cot With m improve for purquu of
tile.).
. ❑1.as owner of tie property,am atluaivcly Co tracting with licensed cvmranme to
Comtmct the Project(See 7004,Business and Professions Code:)The Contranar'a Li.
comm law does no,apply se an owner of property who Wilds or impmvm Neroon,and
who contracts for such projects with a comirmuf(s)licensed pursuant in the Contractor's
Lk..Law.
awpt undo See .lid PCfm Nu reason
Dau
WORKER'S COMPENSATION DECUBATION
I hereby affirm under pemlry of perjury ane of the following deelwtiom: -
ThamaMwBlmainuinaCe flmmor ,Comentwwlf-Wumfm Workcra Compere - -
aadon.as provided for by Section 3700 or the tabor Code.for the Performance of the
art for which Nis permit is issued.
❑I have and will maintain Worker's Compaction Insurance,as resulted by Section
37W of the Labor Cade,for the performance orde work for which this permit Is issued.
My Warkee.Compensation Insuramx artier and Policy number am:
carim: Policy Nolle IL'?_�")gf1�4-V�y
CERfIFl TE OFPrION FROM WORKERS'
COMPENSATION INSURANCE
(chis shim need not W cmnPked ifthe Pmmil is fmmc hunNcddaBass(5100)
or less)
I certify Na,In the perfommce of to work for which this permit is issued.l shall not
employ any Person in any maoncran as to become subject to Ne Worlmot COmpensa0m
Laws of Califomis.Due
AppOant
NanCE TO APPLICAN..If,afkr mating Nu Certifiau of Eacmplm,you should
became subject b the Warton']GampenL4an pmvlYm,a of de Lmor CM,you miss
.J O forthwith Comply with such Provisions of Nu perm,shall W deemed rooked.
zt4 CONSTtUCf10N LENDING AGENCY
[•+r 1hemby arm Na,Vert isa commmuon lending agency for use,normmarce of
C'> she,work for which d,is permit Is issued(See.3097,Civ.C)
4 IM Lender's Nurse .
z Landers Address
V Q T cenify Nu I have read this application and sou Nu the she,informadm is
L,w !' correct.T agree th comply wish all city and county Ordinances and sum laws mlafing th
0 SV^ building construction.and hereby authoriss mpraenuuvu of this city N Corer upon the -
Fam-manuomd property for inspersion purpmes ybo (We)ague to save.i emnify and
fA Iiabilides,jMgmpmlanraCairWsmd Cinents,cnstt whech yi"ofCupeslin"gaw
V z i a" fNeg Un this Permit.
.-� SOUR DER A 1 rAND WILL COMPLY WI A NON-PoINT Issued by: Date ,y�(r6�
signamrc of App VCan Re-roofs
HAZARD US MA 5IS DISCLOSURE Type of Roof
Wits New bentmfuture MAngo upan,smro mho 11c bmrdons material
fined DY Ne npenim Municipal Cade.ChaPmr 9.1x.and Ne Heads aM Safety
'scram ns (.)? All roofs shall be inspected nor to an roofing material being❑res � P P � Y S g installed.
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
emit haaardom air conuminame as defined by she Bay Arta Air Quality Management all new materials for inspection.
District? — / P
C]Yea !10
Thaveroul Ane
vdmsma sialsmquimmenuunder Chapwr6.95ofNeCdifor-
meHalth&safely Scotia Z 05.25533end25534.1uMcrsund Nuifshcbuilding
dmaq�t unen ly um th 1,k my remonsiklity b Duty N occupant Of the
I Tren rhkh misaBocw crd'ftcy cera a Signature of Applicant Date
ownmma dims agent -dse. All roof coverings to be Class'%¢"or better