06050252CITY OF CUPERTINO
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BUILDING DIVISION PERMIT r�,'Q1�TRd1QR'aIMAIaN
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NOVO CONSTRUCTION
PERMITNo.06050252
20400 TORRE AV
OWNER'S NAME:
PERMIT ISSUE DATE
CUPERTINO CITY CENTER ASSOC1042
HAMILTQN COURT
()6/19/2006
Et
SANrIARY NO. CONTROL NO.
(650)701-1500
ARCHrfECTIENGINEER:
BUILDING PERMIT INFO
BLO ELECT PLUMB MECH
O
LICENSED CONTRACTOR'S DECLARATION
lob Description
1 hemby affirm that I am licensed under provisions of Chapter 9 (commencing
with section 7000) of Division 3 ofthe Bnsinat and Profcasioos Code. and my license is
in full force and erreett7, 79 toss
•V
T.I. INTERIOR IST FLOOR 120/130
Uccnse au g
Dam �+�1 —Convacmr AJOU6 )pv �
ARCHITECTS DECLARATION r`...V
I understand my pins "I W cold an public records
Licensed Patients.(
OWNER -BUILDER DECLARATION
1 hereby wE m Thal 1 am exempt from the Commerce's License Law for the
fallowing moon. (Sudan 7031.5, Business and Pro(asions Code: My city or county
$60000
which acquires a permit in coosacL almr, improve. demaloh, or repair any swaum
pilar m its issuance. Alla mquiM the appliam farmch permit to Me ASigned aummem
Canbmmr'1 Lice= Law(Chslam 9
Sq. Ft. Floor Area
Valuation
Nat he Is licensed Putman in the provisions of me
(commencing with Section 700D) of Division 3 of the Business and Profeuians Code)a
that he u exempt thmefrom and me basis for me alleged csanpdaa. My Halation of
Section 7031.3 by any applicant for a Permit aubjecu Nc applicant m A civil Penalty Of
er
Occupancy Type
Out mom ton five hundred dollars ($500}
Q I,uownerordispmperty,amyemplOymwithaMaas kmaampenudon,
Required Inspections
q P
will der the work. and me atmnum is notimeMed aoffead forssm(Sm. 7044, Buainns
and Professions Code: The Cant olutes Lkeosa e Law does not apply m an owner or
property who bullds or impmws thereon, and who dos such work himself or 0uouah his
own employees, provided dtuauch improvements arc not Intended orOBetnd for de. If.
however, me building or Improwmant is mid within one yew of ampiction. the Owner.
builder will Nva the burden of proving that be did not build or Improve fa purpose of
tale.(.
Q 1. as owner of me propeny am ealumKiy contra 3ma wire licensed anamors in
contact the project (See. 7064. Business and Falesc am Cade) The Commerce, LI.
cave law docs not apply to an Owner of property who Wilds or Improves menton, and
who common for inch projects who A anawmr(s) licensed pursuant to me Cantamoes
Lianas law.
Q lamexcermunderSec ,B&PCformiamamn
Owner Data
WORKERS COMPENSATION DECLARATION
I hent affirm under pendty a( perjury ane of the following deelaatiurec
1 ham and will maintain a CertiOam of Cement m mlf-lasum fm WorlmesCompen-
ation, u prey tled for by Section 3790 of the labor Code, for the perfonnana of de
work for which this permit is issued.
Q 1 haw and will maintain Worsees Compensation Insurance, u required by Section
J700 of the Labor Code, fame performance of the work for which this permit is Imbed
My Workees Compensation losyurance carrier and Policy number am:
Carrier. Rap ml, I C J ML7-,h,='P Policy No.:O 2.6 q9 t e)S
CERTIFICATE OF EXEMPTION FROM RKEAS'
40 "r AYlas.,- - COMPENSATION INSURANCE
'
CThosemion tend rothocanPkmd If the permit o (sane hundad daBus (3100)
a lea)
'
I Unify that in the performance of me weal, fa which this permit Is hound, l shall not
employ any parson in my mannerso As n becomo subject m the Worlon' Comperwtion
.
Laws or California. Data
Applicants
NOTICE TO APPLICANn IL after making this Certificate Of Exemption. you should
become mbjem in me Worseh competent provisions of me labor Code, you must
forthwith comply with such provisions or this permit shall be decmW rewknd.
CONSTRUCTION LP,NOINGAGENCY
1 hr tau there u • rending agemy fame performance of
whalihm
ed (Sm. 0
me was for which lists permit ts issued (Sec. J097, Ch. C.)
Iandees Nice
landeh Address
v
I certify clm I have read mica application sed some that the show ofamatien Is
4 comet. ( agree or comply with all city and county ordinances and sate Ian mating m
Wilding construction, and hereby aumorise repmsenotiva of this city In enter upon me
U above-mentioned property for inspeeuon purposes
4 (We) agree to ave. indemnify and keep harmless the City of Cupertino against
7 liabilities, judgments, costs and expense, which may in any my acme against hod City
v In cunsequcmre of the granting or this permh.
APPLICAYT NDERSTANDS AND ILL COMPLY WITH ALL NON -POINT
Issued by; Date
SOUR LATI
Re-roofs �� ---
Type of Roof
9'0
Signal 1'AppliamIConuacmr Dam
or
HAUS MATERIALS DISCLOSURE
Will meapplicmtafutma Wildingaceup.LMMorhn h..,doamaterial
As ned by the Cupenins Municipal Code. Chapter 9.11 and the HmIm and Safety
Cade, Seems 25531(a)?
All roofs shall be inspected prior to any roofing material being installed.
Q<
If a roof is installed without first obtaining an inspection, I agree to remove
it h1QY.
Will me applicant or future Wilding occupant use equipment or dcvias Mich
m. air cooaminanu u defined by the Bay Area Air Quality Management
all new materials for inspection.
District? J
❑Yes LDNu
I have read the haardtma no m ialsm ptimm teas under Chapmr6.95 afthe Calier-
nis Hoallh& SefctyCode, Seldom 25505,25533 and25534.1 understand Ihalfmc Wilding
dao oat cu nt haw A mnan4 th h u tmpamlMllry m ratify Of the
st cc panty.
mqulmm w m et waayanmarAccruneamaraaPmry.
Signature of Applicant Date
,/i,o(a
All roof coverings to be Class "B" or better
Owns r wthariped engem Dam
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