03030044 4OUCILTDI'ING
OF CUPERTINO
UILDING DIVISION PERMIT
COIV RA`kC. =UR INFO A;A9,,
ADDRESS: PERMrr N0.
T. M. SWEATT CO. INC
ENAME: 1518 PYRAMID CT PERMIT Lou
HUNTER P O
(408) 984-5699 SANITARYN . 113: LNG.
ARCHITECTIENOINBER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
o l�
1 g LICENSED CONTRACTOR'S DECLARATION Job Description
under pmvW=of Charter 9(commencing
Nd.'e dhereby
7yalo DMalon 3 ormer that I am laMeB sinus Profeubm Code.and mylunmb p .
seta t rc REMOVE ALL
j License N -
3 Dam Conlrecmr
ARCHITECTS D U ATION 1
I I understand my plum shall he used u IWR
e mcoms
Licensed Professional -
GAINER-BUILDER DECLARATION EXP
a I P hereby affirm an 1 am exempt from the Contractor's Co License law for my `-
p o fallowing mason.permit
a 7(013,Eutlner.and w.do oro Cade:Any clay or county
which requires a permit m ennsmuct,alcor.Impront,demnluh,a Repair my stroetum
�^
price it)its Issuance.also requires the applicant for each permit to file a signed statement
2 0
that he Is licensed pursuant In the Provision or the Contractor's taw(Chapter 9 $q.F[.Floor Area $1�'�llatiOn
$ (commencing with Section 7000)of Division 3 of the Business and Profession.Code)or UU
.. thal he Is exempt therefrom and the basis for the a legad easmpdan.Any violation of
Section 7031.5 by arty Applicant[for a permit subjects the eppliunt M•civil rurally of 3ARAIdwom 0 0 Occupancy Type
not moa dram five hundred dollars(MI
0 1,as owoor of the property,a myempinye,with wagtaco ftemle campcwtlon,
will do thework,and the net..h notlntendedmoQered fmsak(Sec.7011,Busimust NO ASSIGNED RF +' t TI75'
and Proludems Code:The Comm.ctoYa Liana Law data WE apply m an owner of
property who builds or Improves demon,end who dauuch wark himself m through his
own employees,provided that such improvements ss notimendW uralfead for sole.if,
how.wa.the building or improvement is sold within oro year of completion,the owner-
Wilder will have the burden of proving dist he did not build as improv for purpose of
coin.).
0 1,u owner of the property.am inclusively contacting with licensed canuanm to
construct the project(Sec.7014,Business and ProfeWoa Code:)The CammctaYs Li-
am Law data not apply to an owasr of property who WHO or improves thereon,and
who somas for such projects with a conuacmr(q licensed pursuant In site Conuacme,
License Law.
am exempt under sec. .B dk P C far this racoon
Dam
wORKER9 COMPENSATION DECLARATION
1 busby aElmt under penalty of perjury ale of the following daluahr :
1 Mw and will munaln a Certificate of Content to self-hav re fm Warker'sCompen-
utloe,u provided for by Section 3700 of de labor Code,for the performance of site
work for which this permit H Issued.
0 1 hew and will maintain Woftes Compensation hours e,as inquired by Swim
3700 athe labor Code,for the perform.me oto eypM fpr which this pennh Is issued.
My Warkafa CompuuW1;Incoaracolaand PoIRv' other am:
Caller Policy o.:
' CERTIPICAOE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
rrh)suctitm need not mcc mpleted If de permit Is Furse hundreddollut(SIM)
or las.)
I unify that In the pufnrmaam of the work for whidh this Permit Is issued.I shall not -
employ any person In any mmmrm as to becomo sobjecl In the Workers'Compenudm
Iowa of California,Dam
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should
became subject to the Workers Compensation provisions or the labor Code,you mum
.,O forthwith amply with such provisions or this permit shall W deemed rewked.
2CONSTRUCTION LENDING AGENCY
1 hereby tlfirm that Nem Is•eammuctlen lending agency for the perfomunce of
Y& the soh for which this permit Is issued(Sea.3D97,Civ.C.)
i1 Q LendeM1 Nurse
z Lendeh Addmco
J p 1 unify that I haw read this application and me that the show Infomratlom is
y T-I conal.l ague to comply with dl city and county ardiims of and cum laws rotating to
.7 moviegcational Mand herebyection arepmtenmlveaof thirdly to enter true de
0. shove-(We) I property for indemnify
and)Map .
(We)qts to cont,ind expanses;
end kap may
In an the City ruCupertino galas
E"ty Ilabllidta,judgmenu.eosu and expruu whichmgln anyway mems galnn said City
U7 APPLIq see or DERSTNuresis per mit.
Fry APFLw UNDERSTANDS AND WILL COMPLY WITH ALL NO Poll Issued by:9 Date s0 R AT 0 S. V
Re-roofs
Sig uaof Applica Ccctmcmr Da
AZARDOUS MATERIALS DISCLOSURE Type of Roof
WJldmappli a torfuwmbuildingoeeupamswmorbandlehsardoamaterW
Rud by the Cupertino Municipal Code,Chapter 9AZ and the Health and Safety
Section 35337(.)7 �� All roofs shall be inspected prior to any roofing material being installed.
0Yta
Will the applicant or future building occupant use equipment or dcvicu which If a roof is installed without first obtaining an inspection,I agree to remove
It hazardous air mnuminanIs u armed by the Bay Asea Air Quality Management all new materials for inspection.
urict7
❑Yes u
1 have mad the Itaardtws materials requirements under Chapter 6.95 of dmCalifor-
adsWAI @Stray Code.Sadao 75505.25533 and 25531.1 urdertWd thin If the,building
dos n bare ly hew a enrol,dist it k my responsibility in nadfy gaup I of de
mgabo sen tMmetpn wmaaneeancenliRcamara Signature of Applicant Date
All roof coverings to be Class"B"or better
Owner onuthoi r d e enl Dam