05030047 CITY OF CUPERTINO
BUILDING DIVISION PERMIT E.CONTRA.CTOR IN 'g12MATT0
BUILDING ADDRESS: TAYLOR WOODROW HOMES "ERMITND'05030047
20320 TOWN CENTER LN ft Rnq
OWNER'S NAME: PERMIT MM DATE
TAYLOR WOODROW HOMES 2300 CAMINO 07/20/200S
E: SANITARY NO. CONTROL NO.
(925) 365-3100
ARCHMICDENGINEER: BUILDING PERMIT INFO
BO EO PLUMB MOF.CH
3000 LICENSED CONDUCTOR'S DECLARATION lob Description
F 1 hereby affirm Nal l am m E a under previsions of Chapter 9(commercial
a� with Section 70110).(Division 3 of the Business and Pmfesduns C.ft..M my license is
mfulfmastUilcardeffect NEW CONDO 1691 SQ FT LIVING
�gI-i L' cunim a 02 SQ. FT. GARAGE
?p ARCHITECT'S DECLARI 10
�C 88 i der my plane shall he used As public remor
+1.c1 rented PrqpW.Al
J Oat I am exempt
form
DECLARATION
bo y affirm that 1 1 eaempl from the Gantamarl License taw for IW
D O (olio moon.(Sadao Wil 15,Balncat and Profes4uns Calc:Any oily or county
$ dr requires•peril m eatswct ally hr forsu de armil t or mash any mucwm
_zl= pdamits issuanc,alw,1.do.tieapplicanlfae Conneritreficustole netlstsmmenl
< (CatWucCenmd pumam 70th)of Division
iviom of thea Busier'Wcensclaws,Cout9 Sq.Ft. Floor Area Val$2ibd 030
y O
that
mel exempthherefrom and
basis nit theeged Business And Prafeuians Ca k)of
that he'll exempt therefrom and Ne bats for dm aiIeKO eamptian.Any violation of
Section 7031.5 by any applicant for a peril subjects the applicant m a civil penally of APN Number Occupancy Type
nal pram than five hundred dollars(s501]). 36940017 . 00
❑1,u owner of the properly,m my employees with mica As their sole compenadon,
will do the work,and thestruclum is notmmnded oro@teed rot sale(Sec.7044,Business Required Inspections
and Pmfessians Code:The Contmemrs Lialue Law dam not apply ed an owner of q p
property who buildaorlmproves thamon,andwho doeseah work himselfor through his
own employees,provided thmsuch Improvements Are not intended crafremE for We.IL
however,the building or Impmvemanl Is told within one year of completion,the owner.
builder will have the burden of proving that he did not build or improve for purpom of
sale.).
❑1,as owner of the property am eacludvely contracting with Ilansed conuactas m
construct the project(Sec.7044,Business and Prefessions Cotler)The Coruscates U.
came law dam not apply to an owner of property who Wilds or improv thereon.and
who contact,for such projects with a contractor(s)licensed pursuant an the Contactors
License law.
I am marpt under See .B&P C for this mason
Owner Date
WORKERS COMPENSATION DECLARATION
1 hereby affir under penalty of perjury ane of the following declan0ons:
❑I have and will maintain a Certificamof Consent mml6insute for Workers Campem
sedan,a provided for by Suction 3700 of the labor Cade,for the performance of the
work for which this permit is issued.
❑1 have and will maintain Workers Compensation Insurance,a required by Section
3700 of the Labor Code,for the performance of the work for which this peril Is Wised,
Co Workers C mpenation IasU a aria anal Policy nuen am:
Carder. Policy No.:~..�K,��-Tt `-f-Y➢1`/=1
E TIFICATE OF FX PILON FROM WORKERS'
COMPENSATION INSURANCE
CrhBsation need ret he completed if the permit is furone hundred dollars(51011)
or less)
I Certify that In the performances of tie work for which this peril is Issued,I shall not
employ any person in my manner an as a became subject to the Workers Campensadon
Laws of Ctlifomla.Data
Applicant
NOTICE TO APPLICANT:IL after making this Cerdficam of Exemption,you should
become subject An the Workers Compensation provisions of the labor Codc,you must
.,O forthwith comply with such provisions or this peril shall W domd revoked.
Z y - CONSTRUCTION LENDING AGENCY
E+ IWmby affir that there I..construction lending.l my,far the Perforame of
D:> the work for whim this perp is issued(Ser.3097,Co.C.)
W�Q Lender's Name
a z Lenders AM.
U O 1 certify that I have read thB application and sum that the above information h
IT.E cord.I agree to comply with all city and county ordinances and stem lawn relating In
Q SV' building convection,and hereby mthodm repmmnutives of this city to enter upon the
W aWve-mentioned property ra inspection purposes.
(We)agree to ave,indemnify and keep harmless the City of Cupertino against
rr radIlabllitie d menu,C,0umdexpowhich may In my way acme against said City
U
APPLICANT U STnaes ANDS AND WILL COMPLY WITH ALL NON-POINT
NT Issued by: Date
SOURCE TU ONS
2 f J0,57 Re-roofs
gwure afA Hd.CVoA^RD US MATERIALS DISCLOSURE Dille Type of Roof
tie'Pllcam a(atom WII ing acupanl gore or handle haatdoa material
fined by the Cupertino Muni Code.Chapmr 9.13,and IW Health and Safety
Ca do,Sation25533(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Y.
o
Will the applicam or future b ding oaupanl um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It he aNnw dr cantsminmts u Med by the Bay Am Air Quality Managcmcm all new materials for inspection.
"Am
❑ .
u
I have mW the haardnus materials requirements under Chapter 6.95 of too Califon
nh K'j'
.Sctiau 25305,25533 and 33534.1 understand that Ease Wilding
not cura tenant that It u my respoWhility be no the a<upmt of Ila
reyulrcprcnutWmetpdorWLuuanaofaCertificamof cupm Signa[ureofApplicant Date
atem ore
All roof coverings to be Class"B"or better
u