05030044 CITY OF CUPERTINO *'�:' •rx.•x.+p rr art '�- t �.a , ,
BUILDING DIVISION PERMIT 7.�C®NTRACTOR�INFfMATIOa
r � ,If E t r:u: tr ids.
BUILDING ADDRESS: TAYLOR WOODROW HOMES 05030044
OWNER'S NAME: PERMIT ISSUE DATE
TAYLOR
WOODROW HOMES 2300 CAMINQ RAMON RTF 10-C— Q7120/2005
E: SANITARY NO. CONTROL NO.
925) 365-3100
ARCHITCCTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
y�
upz LICENSED CONTRACTOR'S DECLARATION JobDescrition
�r u 1 hereby a flim last 1 Am Ihenscd under provisions of Chapter 9(commencing P
with section TOM)of Division 3 of las Redeem end Professions Code,And my remain is
n in full force and offset.
NEW CONDO. (19381 -LIV. SPACE)
j id 2r License Lle.P
g D Coto,mr --GARAGE 5 6 8 '
ARCHITECTS DECLA 10f A-5
on u m plana M used u public
yGIcnnsed Pot a A
OWNER-BUILDER DECLARATION
hereby affirm that I em exempt fmm the Contravoes License law for me
O Inwing reason.(Section 7 31.5,Business And Professions Cees:MY city or county
i
t$I which requires a permit in co mrua.Alto.Improve.demolish,m expert my tenure
_Zan prior to is issuance.Alan requires the applicant fnrsoch permitto(le a signed satemcm
F < 241650
that he I.licensedpursuantmNeprovlelonsofthtConmcuriSq.Ft. Floor Area Valuation
$ in oLianseiaw(Chapter9
e( ommentlng wlN Satire 7000)O(DlvtsionJ of Ne Businesemd Rofrssim Cadc)ur
than he is exempt therefrom and Ne but fm me alleged exemption.Any violation of
Section 7031.5 by Ary applicant for a permit mbjuts the applicant to•Civil penalty of APN Number Occupancy Type
not mom than flue hundred dollars(5500) '
❑I,uownv of lase property,mmY emPloycu with waguas Nov sole ampemllm,
will do the work and the sevum 4notintended Or Offered forule(Sm.7044,Besiass Required Inspections
and Profusions Cade:The Consumes Liana law don tut apply m e
An ower Of q P
property who Wildserimpmaws thereen.andwhodoessuchwark himselfor through his
awn employ=,provided tam such Improwmom Are no,Intended orartered for mle.IL
however,the Wilding or empowerment Is mid within one you of rompledo.thse owner.
Willer will have the burden of proving that he did rot Wild in improv fa purpose of
ale.).
C)1.as Owner of me property,am exclusively eantrulang with licensed antratara to
construct the project(Sec.70",Business and Professions Code:)The Contracar]LL
cense taw does not apply in an Owner of propeny.who Wilda or improws thereon,and,
who contracts for such projects with a comnmor(s)licensed purmanm in the Communities
License law,
❑I am exempt under Sea ,B d P C for this mason
Owner Dat
WORKERS COMPENSATION DECLARATION
1 hemby&(film under peoatty of perjury aro of the following declaralaons:
❑1 baa and will maintain a Certificate of Consent roself-insure fa Workees Compen.
satlen,as provided for by Section 3700 of Ne labor Code,for the perforrim,a of the
work for which this permit is tuned.
❑1 have and will maintain Workce5 Compensation Intimates.as tqulmd by Scanlon
3700 of the Labor Cade,for the performance of due work for which this permit is bound.
My Worker')Qmremation Insurance cam er and Policy n.urymM�r'm�:-y �$
Cartier. Policy No.:yrs ! d
CERTIFICATE OF XEMPOON FROM WORKERS'
COMPENSATION INSURANCE
CM13 action need not he complvW if the permit isforone hundred eallan({100)
or leu)
I ratify the,in Ne performance of las work for which this permit is Wad,I mail on
employ any person in my manner An as to become subject in du:Workers'Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject in the Worker's Compensation provisions of the Labor Cade,you mus,
O'7.. forthwith comply with such provisions or this Tamil hall be diamond revoked.
„z„O CONSTRUCTION LENDING AGENCY
(..r IMreby aMom that mere is aconstrectirn lending Agency I.the pcmformamu of
C> sit ash for which this permit s ivad(Sts.3097,Cih,C.)
0 Leadees Name
7 Iandee,Mdress
U O I au fy that I haw=d this Application and ant that the abow infoonmun is
jy r' cartem.I agme to comply with all city and county ordinance,and sass len rooting Or
O rV^ building construction,and hereby mthonm mpmanuthes of this city to Crum upon the
Gil above-mentioned property for Inspevlon purpaes.
(Wc me to saw,Indemnify and heap hstraime the City of Cupertino Against
r0.qib ,ted s,eons and experse which may In my way we=against add City
V ranee t
Iing of
this permit.
APPLICANT UN TANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
tab
UL NS,
Re-roofs
ensure 0 A t2aAm;ZOW Data
HATARDOUS MATERIALS DISCLOSURE Type of Roof
thc appliamorfuuuc Wlldi upam store or lunatic hazardous matrfai
ncd by Ole CupeninO Munid otic.Chapter 9.12,W the Hemh and Safety
%d—.i
n 25532(.)? All roofs shall be inspected prior to any roofing material being installed.
en the applicant or future W Ing occupant tea equipment or dc*cs which If a roof is installed without first obtaining an inspection,I agree to remove
nu.oir conaminenu u ted by Ne Bey Area Air Quality MAnegemenl all new materials for inspection.
es, tithe haou.mucnals mquimacnmunderChuptr6.95o(GtCalifor-
sefc Cadc,Sa7ions 25705,335]3 A,W735)M.I undcreuad thuifthe Wildin{
rroal h&w a tnmt met It u my nespon.ihility in rich coos ant of mes ' hmust 'orluiau ceofa CveOcafcofOn c, Signature of Applicant Date
orimd ascnl N/ late 105 All roof coverings to be Class "B"or better
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