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CITY OF CUPERTINO
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"CONTRACTORINFORMA
- •'
ION S:.
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
TAYLOR WOODROW HOMES
PERMITNO.06010163
10280 TORRE AVE
OWNER'S NAME:
PERMIT ISSUE DATE
_ TAYLOR WOODROW
2300 CAMINO RAMON STE 10C
03/01/2006
E:
SANITARY NO. CONTROL NO.
(925)365-3100
ARCHITECrIENGINEER:
BUILDING PERMIT INFO
BLDG ELECTPLUMB MECH
(� I� L! t�
LICENSED CONTRAC TOWS DECLARATION
Job Description
1 hereby affirm that 1 am licensed udef provisions of Chapter 9 (commencing
P
with Section 7W).f Division 3 O Oce Business ad Professiwu CoC..and my license is
iur.11f..andcrfea
REVISIONS -DRILLING FOR PLUMB/FIRE SPRINKLER
U.11
LiaLie
Damte Class Contractor-
ATS CLARIFICATION/PLANTER FOOTING CLARIFICATION
E
ARCHITECTS DECLARATION
NO NEW PERMIT ISSUED-ORIG #05030100
cnJ my plans shall used as public
1 undrsu
Licensed Professional
OWNER.BUILDER DECLARATION
I hereby affirm that I am exempt form dm Conuan.Ys License Law for the
following mason. (Section 7031.5, Business and Profeuio s Code: Any city or county
which myvims a permit m cmaoxs t. alter, improve, demolish, w repair any m ovum
prior 1. it, issuance. also requires tW applicant forsuch .it,. file. signed statement
Nat W is licensed C.nmettr's Limns UO,(Chapte, 9
Sq. Ft. Floor Area
Valuation
pursuant to the provisions ofthc
(commencing with Section 7000) of Division 3 of the Businessand Professions Cods) or
$ 0
that h u exempt therefrom and de but, for the allegd exemptim. Any violation of
APN Number
Occupancy Type
P Y YP
Section 7031.5 by any applicant for a permit subjects therapplicant to a civil penalty Of
not more than five hundred dollars
❑ 1, as owner of the property, or my employees with wages as their sole compensation,
will do the woh and the swctom is rot intended woffered farted. (Sec. ](tCA, Business
3694661t? . 90
Required Inspections
and Professions Code: The Conuacmr, Liceme Law does not apply to in motor of
pmpeny who Wilds or improves themon.and wh.d.eatuchworit himself., through his
own employees, provided that such improvements an nut intended.roRered formic. If,
�Y
hwever, the Wilding or improvement is sold within o e year of compledon. the ownu-
,will have Ne burden of proving that he did not Wild or improve nor purpose of
.a1
V`
eade.,
tiled.
I, as owner of the p exclusively with licenced c.nsacmrs
amowner
' coutwct the projem (Sec. ]BW, Bminess and Proreui.ns Calc:) The C.nuxmr's V-
/�
ny.whocontracting
Geese law cats to a,
d
man owner or propcny.wW W d or improves themm, and
apply of
who contracts for ouch projects with ac.nmemKs) limned pursuant to the Contractor's
for
\\)
en
orae sunder C. .B&PCfw th' won
ome Date
i
WORKERS ATION DECLARATION
1 reby effswruncer PnWs pedo,.ne of de following declinations:
❑ I bane and will maintain.Ceni(lam of Consent or self -wart for Worknes Compen-
sation, as provided for by Section 37W of the, Labor Cdc, for IW perform.nm of she
work for which this permit is issued
❑ 1 have and will maintain Worker i Compensation Insunnm, as required by Section
37W of NC labor Code, for the performantt of the work for which this permit is issued.
My Workers Compenution Insurance carrier and Policy number art:
Cartier: Policy No.:
CERTIFICATEOFEXEMFTION FROM WORKERS'
COMPENSATION INSURANCE
(ibis auction need not be complcmJ if the permit u form= hun meddollars ($I00)
or lace)
1 certify that insrmanexof the work for ich�his permit u issued, I shall not
cmployany nin mannerxuubec. It tt. the Wortrns'Compenssilon
Laws of Catlin.. Da
Applicant
NOTICETO PPLIC ;'ItTalumakingibiM i mateof Eacmption, you should
become subj t to Worker's Compensation p siou of the LaWr Code. you mut
foMwith en I W such provisions or this permit shall he deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby aRnan her then is a construction lending agency for the performance of
IW with fur which this permit Is issued (Sec. 309?. Ci, C.)
Lender's Name
benders Adder
1 certify that 1 have rad this appliesdon and mute that the Ida. information is
CorrecL 1 agree to comply with all city and county ordinances and state laws relating in
Wilding consuuction, and hereby authorize reprtscnutives of this city to curer upon do
above-mentiond property for inspection purposes
(W.) agree m save, indemnify and keep harmless she City of Cupertino against
Iiabili' cru, costs and c.,. which may in y way accmc against said City
in nxquenee. the granting.( this pcnniL
PLICANT U ERSTANDS AND WI CO P{.Y WITH ALL NO -POINT
Issued by:
SOU EREGU TIONS. / /
Date —O
Re -roofs
f/�-^V-
usof IS on0acmf ase
HAZARDOUS MATER L� DISCLOSURE
Type of Roof
de applicant W future Wilding ant a.m Or handle harudous material
u mad by the Cupertino Munici I Code. apmr 9.13, and the Health and Safety
Coon.Section 355320)?
prat N
All roofs shall be inspected prior to any roofing material being installed.
Wil the, lions., forum WiI '
pp ng.ccupan esu cyuipmem.r devices which
If a roof is installed without first obtainingan inspection, I agree to remove
P $
. nit havamnus air c.numinans as mJ by the Bay Arca An Quality Management
DisOin?
❑Yet N
all new materials for inspection.
I have mad the hazardous mamrodWpuim ensutol Chapmr6.95ofthcCaliror-
nia Sarcty C.dc.Smtiars 35503.25533 2553A.Iundntandthxtirde Wilding
not co ndy hmc • enen4 Nat it h y spmslbillty m notify the me OIL r the
ymrtmcnL wmm�mpa. cora mrtcam.ra<.p,w.y.
Signature of Applicant Date
Lur 3
All roof coverings to be Class "B" or better
Uumer9fluth.dradagent D