06010096CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORM? N Z«:
BUILDING ADDRESS:
TAYLOR WOODROW HOMES
PERMIT 110.06010096
10281 TORRE AVE BLD A
NEWS NAME:
PERMIT ISSUEDATE
TAYLOR WOODROW HOMES
2300 CAMINO RAMON STE 10
02/03/2006
NE:
SANITARY NO. CONTROL NO.
(925)365-3100
ARCHITECITENGINEER:
-
BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTORS DECLARATION
lob Description
I hereby affirm Out 1 am licensed under provisions of Chapter 9 (commencing
P
wish Section T0I10) of Division 3 of use Businessand Profcssion Code, and my licemse is
in full 24�d
REVISION--ROOF TRUSS CALES
p:N `I ' coomL� .A�
> NO NEW PERMIT ISSUED/ORIG. #05100167
ARCHHECTS DECLARATION
1 understand my plans shall W tied as public meet&
Licensed Professional
OWNER-BUILDER DECLARATION
I hcrchy affirm that 1 am exempt from than Conlnctoes License law for the
following reason. (Section ]W faW
1.5, Business and Pronm Code: Any city or county
which want. a permit m construct. alter. impirm. dcmoinh. or repair any structure
prior m its issuance, also requires the applicant for such Permit to Elea signed statement
not he is liccmed pursuant to NC Provisions of the Contracwr's License Law (Chapter 9
Sq. Ft. Floor Area
Valuation 0
(commencing with Section 7") of Division 3 of the Business and Profeuim s Code) or
Nat he u exempt liberation and IM heads firs the alleged exemption. Any violation of
APN Number
Occupancy Type
P y yp
Section 7031.5 by any applicant for a permit subjects the applicant in a civil Penalty of
not mare Nen Eve hundred dollars (S500).
36940017.00
0 1. as owner of the property or my employes with wages as their solo compensation,
Required Inspections
will do the wads and Ne abuctarc u not in erend.,offered (Dolle (Sec. ]ON, Business
and Pmfessiam Code: The Conuactors Liccrm raw docs not apply in an owner of
Property who builds of improves dereon, and who does such work himacl f or through his
own employees. provided Out men improvements art nal intended or offered for sale. If.
however. the Wilding or improvement is sold within one year of completion, the ower
builder will have dte Widen of preving that he did not Wild or improve for purpose of
sale ).
/
❑ L ower of Ice property am exclusively cafessi ns withlicensed:ThCoonuanort i-
u
c me Lal the project (Sec. ] an Business and Profession Cadet pro Contractor's Li-
mesand
chose law dos not apply w an owner of preperty Wilds or improves Norton. and
(�
v
Lcontracts for such proteose with aeonlrutar(s)Iiunud pursuam to the Contractor's
La
\
0License.. ext
❑lam exempt under Sec. ,B&PCfar this recon
\,
at Data
WORKERS COMPENSATION DECLARATION
1 hereby affirm under Porosity of perjury arc of Ilse following declarsdom:
1 have and will maintain aCenifiale of Content to self-inum for Workm
etsCopen-
aWan, as provided for by Section 3700 of the Labor Code, for NC performance of the
wok for which this permit is issued.
❑ 1 have and will maintain Worker's Compensation Inmsems, as acquired by Section
3100 or On tabor Cade. for the performance of the work for which Nis permit is Issued.
My Work/c.e, Compensation I1nt`unnce cstria and Poli, number are:
C.rrie,:fOM,u' 4h I�k`sn„Q.. PDO, Na.: ia (3 5
_
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(71dU.6wri need not W completed If the permit It (prom hundred dollars ($100)
or less.)
1 aniry that In the performu¢e of the work for which Nis permit is issued. I Asti not
employ any person in any manner in as to become subject to the, Workers' Compensation
Laws of California. Dale
Applicant
NOTICE TO APPLICANT. If, after making this Cenifeare of Exemption, you should
become subject w Oc Workers C.mmmustion prevision of Ile tabor Code, you most
'
forthwith comply with such provisions or this Permit shall be deemed invoked.
CONSTRUCTION LENDING AGENCY
I Wreby affum that there isaromtru It. lendintagercy for the permar aeof
On .,it fur which this permit is issued (Sec. 3097, Civ. C.)
Lander's Name
Lender's Add.
1 certify that r have mad this application and sue that On, above information is
cabinet. I agree w comply with all city and county ordinances and sure laws relating w
Wilding construction, and hereby authorise mpresumadves or Nis city w enter upon the
above-mentioed pmperty, for inspection purposes.
keep hayinCan the
(Wc)agree to cash, indemnifyexpenses
Or Cupertinold
Ilablllti[a,lUdgmCnts. Cents and CxpCmn Whl[n may In any W.Y aLLNC Bgalrlilaald Glly
yac City
6i
nee of the granunt of this Pgrmit
T UNDERSTANDS N WILL COMPLY WITH ALL NON-POINT
Issued by: Z� 7
EGULAT}ONS.Re-roofs
Date
ApplicandCon t ateHAZARD
S MATERIALS DISCLOSURE
Type of Roof
dw.pplicant or future bui g occupant store or handle harsrdous material
V�'th.ldrtxa
y de Cupenina Muaw 1 Code. Coarser 9.13, and tie Ncalth and Safety
ea, 35533(x)?All
m athe
roofs shall be inspected prior to any roofing material being installed.
applicant of future Wilding occupant me equipment of devices which
If a roof is installed without first obtaining an inspection, I agree to remove
air contaminants as fined by the Bay Arca Air Quality Management
all new materials for inspection.
Oiavice 7.
❑ Ya
I have lead the ha inhial meed-Isrequiremcntsunder leaper 6,95.fthe Califor.
nix Health h Safety CDM, Sermon 25Ns5, 25533a it 25534. Imularand lhatifthc Wilding
J et uncntly hoc a raan W it' my responihility w etify the occupant of the
yairemLtswnicn syn t r anLeoracemraear cep Ly
Signature of Applicant Date
All roof coverings to be Class "B" or better
owner ,area .<aag(Lnl D,�