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BUILDING ADDRESS:
TAYLOR WOODROW HOMES
PERMIT NO. 06070179
10281 TORRE AVE
D ER'SNAME:
PERMITISSUEDATE
TAYLOR WOODROW
230CICAMIN
PANE:
SANITARY NO. CONTROL NO.
(925)365-3100
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
I herby affrm that 1 am licensed under provisions of Chapter 9 (commencing
P
wish section 7") of 0ivition 3 of she Businessland Professions Cade.and my license is
'
in full forte and iffier. 3S-�0y-7_
REVISION -INSTALL NON ILLUMINATED BUILDING
mm.> �'YT—TTL cwadc2.r t.✓uZt
ADDRESS NUMBERS-ORIG PERMIT #05030080
ARCHITECTS DECL ,RAS
I undersunJ my plans shall be used as Public records
Licensed Professional
OWNER-BUTLDER DECLARATION
I hereby a10rm that I am Mm.,, from she Comfamar'a Liecnsc Law for the
following won. (Section 703 L5, Business and Prefcssians Code: Any city or county
which rtquims is permit la emospucl, alter improve dcmniksh, or mpain my ewctuw
! prior in its issuance. also requires Ote applicant for such Permit a file a signed stavmenr
that W ks licensed pursuant o the pmvidims of the ciumnawr113cmoc Low lChape, 9
Sq. Ft. Floor Area
V42108 5 3 9
(commencing wits Section 7(k00) of Division 3 of be Business and Prafessinns Cork) or
! Nat he u exmnpt Ihemfwm and the buis for the alleged exemption. Any violation of
APN Number
- Occupancy Type
Section 7031.5 by arty applicant for a permit subject the applicant w a civil penalty of
nut more than firs hundred dollar ($SW).
3 6940058.00
0 1, as owner of the property. Or my cmployces with wages as Thew sok compensation,
ns
Required Inspections
q P
will do once worLand the swnua is not intended or offered for sale(Seelou, Business
Corrosives License law does apply
and Profound u Cade: The oat w an owner or
property who builds¢ improws themon, and whodoessuch wort himselforthrough his
own emplay¢s, provided that each implovemenu a2 notinu.MN oroffered for sale If.
however, the building or improvement is sold within one year afcompleuon. the owner -
bull&, will hoe the burden of proving WI M did not build or improse for whose of
/
sale.).
1, as owner of the property. am exclusively contracting with licemed contractors v
c met the project (Sec 7064. Business and Professions Code:) The Conuamoh Li -
come law does not apply to an owner of property who builds or improvo Ihemon, and
who contrails for such projects with aconuvctm(s) Iiemsed pursuant in the Conuacves
License Law.
0 I am ocmpt under See B d: PP CC forthiis,r,.^n
Date . ii, o b
IVWORKER'S COMPENSATION DECLARATION
1 hemby of i m under Penalty of perjury one of the following declamations:
0 Ihamandwillmainuina Cu rinwofCoruentwwlf.insumfarWofkcesCompen-
.,I., as provielm for by Saeuan 37W of the labor Code, for the performance of the
week for whim this permit is issued.
D 1 have and will mainuin Worker, Compemaaon Insusinee, as myairod by Seeker
37W of the Mbar Code.f« the Performance of she waste ear whim this permit Is ismad.
'
My Worker's Compensation Insurance carrier and Policy number art: ��
tinier /Yw�1 f. Polity No.: �gZ_
C��/
O
CERT( ATE OF EKEMP ION FROM WORI(FRS '
COMPENSATION INSURANCE
.
(This section need nut W conflicted if tW permit is forone hunNedidich n (S1 W)
of less.)
.
I eenify Na in the performance of the work for which this Permit is issued, ) shall not
c,nploy my person in any mame,in as to became subject in lW Workers' Compensation
'
Laws of California. Dw P• „• D/n
Applicant
_ig"
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
became subject in the Wormes Compensation provisions of the labor Code, you must
'
forthwith comply with such provisions or this permit shall he deemed rewired.
1
j CONSTRUCTION LENDING AGENCY
' I hereby affirm thou there is a conswetion lending agent, for the performance of
the work for which this permit u ivued (Sec. 3097, Civ. C.)
Lenders Name
Lori Md.
1 I eenify dor I have read this applicoian and saw Nu the mew irdormatian is
comet. I agree in comply with all city and county ordinances and sate laws relating to
,
building construction. and hereby authrrim repremnutiva of this city to enter upon the
c for Purposes.
show-ms,judg
(We) acme to ave, indemnify and keep harri the City of Cupertino against
st
j liabilities, judgments,
ems. and expenses
expenses which may in any way attruc againstsud City
in consequence of the granting of this Ite
inaremd
' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
WILL
Issued by: Dale
SOURCE EGULATIOy19-�
(]S l�
Re -roofs
Sngnourt of ApplicnnVCanuacmr� Date
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant car future building occupantstore or hurdle havardaas material
as defined by the CuPenina Municipal Code, Chaple, 9.11, and the Health and Safety
cc. Schon 15532(a)?
Dy. �(No
All roofs shall be inspected prior to any roofing material being installed.
Will the mlilicarl of future building aecupant use equipment or devices which
If a roof is installed without first obtaining an inspection, I agree to remove
emit harudoua air commum nus as dcfmed by the Bay Arta Air Quality Management
all new materials for inspection.
District?
Dy. kNu
1 have mail the harafdusu mavriab rtquirtmenuundcr Chapter 6.95 of the Califor-
Me Hod" Safcuy Codc. Seem. M505,25533 and 25534.1 undersand thatifft Wilding
does not currently hart a term. dist it h my mmmuhility v notify the occupant of the
n
mvaimmenZL,.h mnslWm naar,cenratearaaprcy.
Signature of Applicant Date
_� 0 R_ ��"
All roof coverings to be Class "B" or better
Owner on t oncd age.. Dau'