050300700z
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CITY
BUILDING DIVISION
BUILDINGPEEMT
4� TRACTOR INFORMATION
BUILDING ADDRESS:
I Q2,R1 TORRR AVE # R5).n
TAYLOR WOODROW HOMES
PE"NO05030070
OWNER'S NAME:
PERMIT ISSUE DAM
TAYLOR WOODROW HOMES
2300 CAMINO PAMON. STE
07/20/2005
E:
SANITARY NO. CONTROL NO,
(925)365-3100
ARCHITECTIENGINEER:
BUILDING PERMIT INFO,
BLDGPLOMECH
LICENSED CONTRACTORS DECLARATION
Job Description
I hemby Orlon that I son licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of ft Business and Prollessions, Code, and my license I.
to fell to.. too rft, ra
NEW CONDO 1691 SQ FT LIVING
Lien C, _Uc, is
Comment ID1 L��Isca
SQ. FT. GARAGE
RCHIIECTS DFCLARXE9!N
BMR UNIT, NO CONSTRUCTION TAX
Lica d Taxi tl
OWNER -BUILDER DECLARATION
I PY AMM that I am exempt from the Contreactor's License Law for the
(a reas n (Section 7031.5, Business and Profession Code: My city at county
wh6 .. Permit to construct. Alto, mrs... cimmAlsill fire any suoulture
low in incensed slau requires ft applicant far such Permit to rile a signed stamencent
is licensed ft Comu,amca's Lumme Law (Chapter 9
Sq. Ft. Floor Area
Valuation
that Ine pursuant to previsions of the
(c.menchil with Section 7000) of Division 3 of on, Business and Profession Calc) W,
$211030
that las bremenpot obernfroun and the basis Our the alleged cumption. Any violation of
APN Number
Occupancy Type
Section 7031.5 by any applicant for a Permit subjects the applicant to . civil penalty of
not nocare than live hundred dollars ($500).
13 1, as owner of de, PmPWY, w MY employ= with analres as thole Win COMIscmultim-
3694E)8±7. 915
Required Inspections
will do Newark and the sommune is net Imuselcul .offered far are (see 7044. Bonham,
and Professions Code: The Corrommal Lienee Law does Out apply On an Owner or
property who builds orimprow demon, and who domairch work himself or through his
Own employees, provided that such Improvements are not Intended or offered for sale. If.
however. Me building or Improvement Is sold within one you of completion, the Owner.
builder will have the burden of proving that M did not build or improve for purpose of
ask.)
1—) 1. as Owner of the property, . exclusively Mmuracning with licensed cantracmn to
moment the project (Sec. 70", Business and Professimm, Cade:) The Commences Li.
moom Law does em apply to an Owner or property who Wilds or improves demon, and
Who OMMOCIS for such projects with a conuactor(3) licensed pursuant On the CDft"CWS
License Law,
0 14anexemplumunrSec. .B&PCforLh1jmumn
Owner Data
WORKERS COMPENSATION DEC"RATTON
I thmemy Afflan under penalty of perjury one of the following declarations:
". and will maintain a Cardificam ofConsunt in self-Insum for Worker's Cmnpm-
sati.n. as Provided for by Section 3700 of the Labor Code. for the performance of the
work for which this Permit is issued.
C] I have and will maintain Worker's Compensation Insuranm. as roquirml by Secdon
3700.1' th. Labor Cook. for the performance .fthe worls for which Nis permit Is issued.
My Worke a Com emado hummm motor and Policy number me -
Policy No.:I�JQ'90
CERTIFICATED ExEMPTIONPROM WORKERS'
COMPENSATION INSURANCE
(IMISSOC11011 Wed nOlICCOMPIClud if tie permit is formu,humirml
m loss.)
I certify Ittat in the p.,firrons. of the work for which this Permit I. issued. I shall out
employ any person in any manner m as ve become subject to the Workers' Compensation
Laws of California. Dow
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject in the Workees Compensation provisions of the Labor Cods, you most
forthwith comply with such Provisions x this permit 0,11 to decreed revoked.
CONSTRUCTION LENDING AGENCY
I hereby &AIrm that done Is. construction lending agency for the perfurtnmm of
the work for which this permit Is Issued (Sm. 3097, Ch, C.)
Undoes Narnc
Lender's Achlreas
I certify that I have need this applicardon and sum that Use move i.f.W. Ir
toren. I a&rm M comply with all city and county ordinances and mum Imus mtalinj In
Wilding construction, and hereby sunhorice representatives of this City M cMm upon the
above-mentioned property for Inspection purposes.
(We) Agree to save, indemnify and keep Intruders the City of Cupmum, against
list, 0 c and'.pone, which may I. any way a..e against said City
ts,
_�i.�.Jwjnnc
� c "' d' the I=IinZ of this permit.
01PMLIC; AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOURCE RYNDERSTANDS
R LATIONS.
Re -roofs
Type o I Roof
"El 'I'm
ARD05�DISCLOS21
rillid. pi
ft.pplicniorru�Nil%Z=upmtswmDrhondleha4oMousmaWdid
a -defined by the Cupertino Muniti Code. Chapter 9.12, and the Health and Safety
we. Section 15532(.)?
All roofs shall be inspected prior to any roofing material being installed.
Dyes
If a roof is installed without first obtaining an inspection, I agree to remove
Will the APPUCAM Of IVIUM but ing Occupant one equipment or dMims which
I m7indous air commoninams as 01 cd by the Bay Arm Air Quality Management
all new materials for inspection.
Di,uict?
C] ym ellml.,
I have MW the thundonta materials W,ulnummismuls, Chapter 6.95 of the Calilm.
me .Sanas 25505.25533 and 25534. 1 undemand " ifft Wilding
nota rely avo&umant,dualtiannyompmurbilkywo f theme, maorde,
" Pon �v5--
M Monte h must plmctpiiortuiuu=cor.ccnincawofr!
Signature of Applicant Date
1114 0/1
All roof coverings to be Class "B" or better
ZT. I I DOW
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