05030083 CITY OF CUPERTINO77s �. '
BUILDING DIVISION PERMIT ; ��.NTAG'I.0M,ATIUN,:'
BUILDING ADDRESS: TAYLOR WOODROW HOMES PERMITNO05030083
20320 T
OWNER'S NAME: PERMIT ISSUE DATE
TAYLOR WOODROW HOMES 2300 CAMINO RAMON STE 10 07/20/2005
E: SANITARY NO. CONTROL NO.
(925) 365-3100
ARCH178CDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
r��tr0o LICENSED CONTRACTOR'S DECLARATION Job Description
`d wiNSretla7M).fDMSll a3 ofthe Busineulicensed rted PMfbW..Co&�Mmylcensaia
n; in full rogadaffect. NEW CONDO. (1742 '
SPACE)
DMZ Licause coo"Tsar a RAGE 515 '
ARCHITECTS DECLAR 10 A_
I un& n y Puns VI u p TROT
L' nsed Pml
m3
OWNEm ancran from
DECLARATION
E 0 I by.(Bert Net 1 em exempt from the Contractor's License law for the
p O oll g won.(Section consomme,
,Business and Pmfeaduns Cade:My city or county
112 Coll ,i its a•Waimea.Alto m a iM'be.slur, tforsu demolish,m mpoi'any nmatma
_iy pat W is
ensedpaluantin ma movisioso ft far Comusech mit to r's1-kesseaestal w(inatemenl
< thin .,.do& ad Soctintmum ofDlauion ofd.Buaamrwanssmins Case). Sq. F[. Floor Area Valuation
yFy s (rn he is exemit thenfrns,alf)ad the basis fur thesiBed ent ad cuumpton.M vi Codc)ar $217333
5�— But he ts exempt timm(rom and the buts fm the inlegM esemption.MY vialaUon of
Section 7071.5 by any applicants for a permit subjects the applicant On a civil penalty of APN Number Occupancy Type
nm mart conn five hundred dolWa(55001.
❑I.umvner oftlm property."my croplayas with wages"mckwletompensadon.
will do thework and deca mmm is at intended oraffomd for"m(See 70a,Buslrcas Required Inspections
end Profatsior,Cede:The Conuanoh U.Law dao not apply in an Avner e or q P
property who builds Or improves mean,and who doessuch work himselfor Waugh his
awn employ=,provided that such Improvements art notintendM m offered for We.If,
however.the building or improvement Is sold within arc year of completion.the owner
buil&'will have the burden of proving thin he did nm build or Improve for purpose of
axle.).
❑1."owner of the Property,am combatively contracting with licensed antracmrs to
comuuct the project(Sec.7014,Business ads Professions Code:)The ComuaemYa U-
a.taw does not apply an an awnm of property who Wilda Or Improv memon.and,
who contracts for such projects with acausemrt0 licensed panuam in den Caurse4us
License law.
0 1 am eampt un&s Sec. .B k P C for mb mown
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm un&r pcnsity of pmJury ort of eon following declaneons: '
❑I hsve4od will mdnuin a Ccrtifram of Conant io eel6lnaum for WmkeYaCompcn-
"tion.as provided far by Section 37M of W labor Code,far the pa rarramn of Ne
work for which this Permit Is Issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Sectlen
77011.1 Ne Labor Code,for the performance or the was for which this permit is based.
My Warka�r's C,o,m�pa0�000 Insurance ca der and Policy number am:
Cartier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERY'
COMPENSATION INSURANCE
Masuction need not be completed Hthe permit is forom hundred dnllam(51010
nr you.)
1 adify that In the performance of W work for which this permit is issued,I shell not
employ any Favor r in any mantra as to become subject in the Workers'Compensation
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If.after making this Ccnincate of Exemption,you should
become subject m the Warars Compensation provisions or the LAW Ca&,you must
0z forthwith comply with such provisions or mit permit shall M deemed revoked.
.Z.rO CONSTRUCTION LENDING AGENCY
I hereby affirm that mere is a construction tending agam:y for the performance of
fY r7 the work for which this permit is Issued(Sec.7097,Cih,C.)
6Wi Q Loonies Name
Z Lcoder's Addrms
U O 1 coolly that 1 have read this application and sate that W above 160MR00n is
U. comes.i agree in comply with all city and county ordinates and rete laws relating in
0 building construction,and hereby wtharim reponaudves of this city to enter upon the
W shove-mentioned property for Inspection purposes
(We)agree to save,indemnify and kap hsnmkss the City of Cupertino against
r W am eau and tape..which may in any my"com againat"idcity
U APPLICANT aU Egg��J'ANDS ANDdnir Of WILLWILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCEREG AT NS
2'1 Re-roofs
Si uumoIA icwVContncmr I Dm
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Ilteappliantmfutme Wild' oecupwtuareorh.Mlchrxdummatedal
a&fined by W Canardno Munfcf Cede.Chapter 9.13,and the Health and Safety
Ca&.Section 15572()? All roofs shall be inspected prior to any roofing material being installed.
0ya o
wtll ted applicant or future buil g aaupant saw cquipmant or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit haaNnm air coommicat red by the Bay Arra Air Quality Matugcment all new materials for inspection.
District?
❑Yes u
I have mad the h"aolwsmeterbb mqulmmenuun&r Chapurd.95ofthe Califon
nb at ,Sectiam 25505,25537 aM25534.[understand thu if&Wilding
d not Ito a mnant.that b b my respo alhility on notify tie tecupwt nr W
re mcntsw c uuWanatpdormissuwceofaCcolOcam. apac. Signature of Applicant Date
t
Oar ar A,sent Dam All roof coverings to be Class"B" or better
C,