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06070191 CITY OF CUPERTINO e BUILDING DIVISION PERMIT TRACT CONORINFORMWTION; BUILDING ADDRESS: ELISABETH TU PERMR N0.06 O 70191 1024 TUSCANY PL OWNER'S NAME: PERMIT ISSUE DAIS ELISABETH TU 07/27/2006 E: SANITARY NO, CONTROL NO, ARCHnECDENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 o o LICENSED CONTRACTORS DECLARATION Job Description WF I hereby affirm that 1 am licensed anular provisions of Chapter 9(commencing P :Zara wiNS don7O(Mof Div n3oftMBusitte ftfcssiom Coda.and lice !�N in full force andeffcm 16 X 29 PATIO SUNROOM 464 ' K Licente Class Lia.p r o Da¢ Conuacmr kANITECT'S DECLARATION HAWAIIAN SUNROOMS PAID FOR BL 7/27/06 i < I undo /'M m plans 0.11 he used as public oni rds iyV Qy Liecrun'd Pmraasmtil 5 OWNER-BUILDER DECLARATION iI hcrchy alirce that I am exempt from the Conaumrs License law for the :p O following msson.(Section 7(131.5,Business and Professions Coda:Any city or county ex which requima a pemit to construct.alter,improve,demolish,or mpoir my structure prior m its issuance.also requires the applieml for such permit to file a signed statement : o that he is licensed punown10the provisions Oftoo Comaimesl emeLaw(Chapter 9 Sq.Ft. Floor Area Valuation 2 $ (commencing with Section 7000)of Division 3atthe Business and professions Code)or $26161 .- shat he is cumpt therefrom and the basis for the alleged caempdms My violation of Sectio 7031.5 by any applicant for a permit subjects Ne alglicant W a civil penally of APN Number Occupancy Type net more Nm five hundred dollars(5500). P Y YP I,ss owner ofllrc property,or my eroployces wish wagesssllcv ale compensation. will ti the work,and Ne structure is notimmnded or offered for�(Swc.704s,Bmilmu and Professions Code The Comrumrs License Law does.1 apply in an owner of Required Inspections pmpertY who builds erimpomms Nmmm,and wheldoessuchwark himselfm Waugh his own employees,provided that such improvements am not intended oroRered forage.If. however,the building or imprevemem is mid wishinone year of cempledoa,the owner. builder will have tic Wrden of proving Nat k did ret build or improve for purysre of ��rA ® S 1,as owner of the property ma exclusively conium,with licensed canwneu m construct due Mjca(Sec.70x4.Business and Profession Cotler)The Contractors Li ED cone Law does not apply to an owner of property who builds or imprevc,daemon.and who contracts for such pmjecm wish a conuacmr(s)licensed persiont to the Cantractues Lftmme Law. -4y r 2 4 2006 ❑Iamcxemp,mder Sec. ,B&PCfmihiamuon Owner Cam— WORKERS �8� �^ y hercWORKER'S COMPENSATION DECLARATION {� Hvk©1 1 bY aRm unmlt der pey of perjury ane of lh<followingdeclarauam: �J arc and will maintain a Cenificam of Consent o salt-insure for Workers Compen. as provided for by Sweden 37W of the Labor Code,for use,performance of W work for which Nis permit is issued. 1 have and will maintain Workers Compensation Insurance,as required by Section 37(X1 of da labor Cock,for use,peRormanee of Ne work for which his permit u issued ' My Workers Compensation In nee carder and Policy number am: Cartier.- Polity No.: CERTIFIOF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE flhu semlon need not 4 compiewl ifft permit is fare=hundred dollars(SIM) or less.) 1 certify that in Nc performance of the wart for which this perm'Is issued.I"I not employ any'cun in any mmmrm as to beta s pj o K Workers'Compensation Laws of Califami am Applicant NOTICE APPIJCANT.If.after makin Nu Certificate of Exemption,you should become su at m the Worker's Compensation previsions of the Labor Codc,you mug .J z foMwiN reply wish such provisions m Nu permit shall ed dcemcd tewkcd. Z0 CONSTRUCTION LENDING AGENCY F-' 1 hereby affirm dust Nem A.construction lending agemy for W pe,fomse ee of tLaNe work for which the permit u Luued(Sec.309'f,Civ.C.) CL Q Lenders Name :D z Lenders Address U0 1 comfy that 1 have read this application AM sum that she above information is D,t" comet.)agree to comply with all city and county mdnmces and state laws mlating to O U building construction,and hereby authodm mpmameatives of this city to anter upon the, abova-mcmidgm pmpcny for inspection purpowhich may a F y (Wo)agree to save,indemnify and keep hamlets led City of CuPutiou against Z inconscifu judgments. an and of thissesmit. mayNmy myacceue againstpaid City U z APPLIICCANTaor ft UN UNDERSTANDS A'ND WILL COMPLY WITH ALL NON-POINT Issued by:S4�� Date 7� SOURCE REGULATIONS. Com— 6z Re-roofs Si gam of pp iemUCOn Vdebr Dila HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will W applicant or future building occupant atom rehandle huallow material as&f1m l by the Cupertino Municipal Coda.Otapter 9.13,and the Health and Safety Coda.Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes ❑Na Will sha Applicant er future Wilding oxer, tat arc If a roof is installed without first obtainingan inspection,I agree to remove PP g pa c&Air erdar Management Pe ha'rardnus air contaminants u Jehned by the Bay Arca Air Quality Managcmant all new materials for inspection. ctn ❑Yes ON. I have read the husedous materials requinco mos emit,Chapter 6.95 of the Califor. nu Health&Safety Code.Sections 25505,25533 ami 25534.1 um3crund Nu it the White, does test cumndy have a tenni,wt it is my responsibility in mdry do oceapmt or Ne requlrcmenu which mug be mcIfmmu,iss...f.Q,tir.wc Occupancy. Signature of Applicant Date Zl g Dam All roof coverings to be Class"B"or better ow ter auNari'rnd agent �