06040112CITY OF CUPERTINO
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CLINTRACTnI2 TNQTtMr1.TION:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
WO NT REAL ESTATE SERV
uINO-06040112
20875 VALLEY GREEN DR
OWNER'S NAME:
PERMIT ISSUE DATE
WOODMONT REAL ESTATE SERVICES
06/16/2006
NE:
SANrTARY NO. CONTROL NO.
ARCHMSCrIENGINEER:
BUILDING PERMIT INFO
BLDG ELECr PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job De$CrIpI100
1 hereby affirm Net 1 am licensed under provisions of Chapter 9 (commencing
with Section 7") of Division 3 of Ne Business and Professions Cade, and my license is
in full forte and effect
REMODEL EXISTING LEASE OFFICE NON STRUCTURE
License Clair Lk.0
Data Contractor
ARCHriECTS DECLARATION
1 understand my plans shall k used as public facings
Licensed Professional
OWNER -BUILDER DECLARATION
1 nitrify MEMO that 1 am exempt from do Contractor's Lomas Law for tk
following mason. (Section 703 1.5, Business and Professions Code: Any city or county
which mquimos a Permit to construct. altar, improve. demolish, or repair any structure
$20000
$ 2 0 0 0 0
! prior in its issuance. also Acquires tk applicant for such permit to file assigned mtomcnt
is liccri to the of do Contractor's l3ceuc Law (Chapter 9
Sq. Ft. Floor Area
Valuation
that he pursuant Provisions
I (commencing with Sation 70M) of Division 3 o lk Business amd Professions Cade) or
Nat k is eumpt Nucfrshe and the buss for dm alleged eumption. Any violation of
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not mofa Nan five hundred dallan (5500).
L u awrcs of dx propmy, a my wployw with wages as Jmv sole eompcuaJon,
ns Required Inspections
9 P
wiildo Nework.eed Neswctum4nutimcndedoronemdforsale(Sa.7W4.Busitsss
Ad ner of
s License law dol apply n ow
And Professions CodThe e Ommuactorn ti
his
p
aworoffeed forugh
ownertywha,s. pmodimprovntot h improndwbo am not intended
earofdoroBered for ale.IL
LED
provemimprommenuamnm
or Old within Otte year of c f Ne owncry
Ne building a impro
ebuil building
��ph
gQUtl�®twV[[91,Y�p/''�'k`HID
Wilderhowever.
proving prove r
Wilder will blue Jss buMdm of proving Nal k did rot build ar improve for PORase of
akJ
. u owner of the property. am exclusively contracting with licensed contractions to
coosuuct the project (Sec. 7044. Business and Profusions Code:) ThContractor's Li.
`,C rpL rIOOC
Ve ' V, 6 L tl
cc= Taw docs not apply in Mn owner of property who builds Of improma Hereon. and,
who conescu for such projects with a an r(s) licensed pursuant on Ne Contractors
Licenseam Law. O
❑lam tie N d S ,B PCf nth twain
putt 3�)7[{ypW�1 �I tQ �"@@,t%���g`,'
u
GUIDIN
nu
WORKER'SCOMP TIONO CIARATI N
�4y{� �'�aw
1 kmby aEm under pemlty of perjury rte of the following declamJons:
-
❑ I hs n and will maintain a Cerdfmenn of Consent o self-iuurt for Workers Comped.
salion. As provided for by Section 3700 of Ne Labor Cade. for tk pedammus of be
work for which this permit is issued.
❑ I hast and will maintain Workch Compeuation Insu . As required by Section
370 ofam Labor Code, for Ne performance oftk work fa which this permit is issued.
'
My Workers Compensation btaoance ,artier and Policy number aa:
Cartier. Policy No.:
CERTIFICATE OF EKEMPnON FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be complend If the Permit Is foram, hundred dollam (SIM)
of leas.)
1 certify that in the perfomaoec of the wale for which Nis permit is iva0.1 shall not
,
e -Ploy any perm- in any mmncnm As n Wed. subject to be Werkcn' L'ompe uuaJan
Law'of California. Da n
Applicant
NOnCE TO APPLICANT. If, after making this Certificate of Exemption, you should
become subject in the Workers Cempcvation provisions of Ne labor Croda you most
' forthwith comply with south fusion. or this, pemilshall be darned revoked.
j CONSRIUCcION LENDING AGENCY
1 hereby that Nem is construction agency for Nc performmcc of
which s d(So,lending
work for which this pcmil is issued (Sec. 7097. Civ. Cd
Landers Nene
Li
!.coders Add.
'
I campy Nat 1 ham tend this applicants. And sun di the above information is
' correct. I agree to comply with all city and county ordinances and sure laws relating to
building construction. and hereby amhmrim representatives of his city to enter upon the
l Mbove-mentioned propc lands on purposes
(We) agree to am, indemnify And keep humleu tk City of Cupertino against
i costs expea may in Any way acrncagaiulsaid City
is.the
incritiu,je.Or
A consequence of the greeting of Nis permit.
.Lt., of Ilia crank.
' APPLICA UN ANDS WILL OMPLY WITH ALL NO POINT
SOUR
Issued by: Date
el O
6/�
Re -roofs
bognantre O ApplinnJCtsntractot Data
HAZARDOUS MATER! DI CLOSURE
Type of Roof
Will the applicant or future building scup tom or handle haamdous mannal
as behead by tk Cupedim Municipal Code. Chapter 9.12, and the Hnith And Safety
ata.y.8115'2ssJ2(,)7
tec Yn
DO
All roofs shall be inspected prior to any roofing material being installed.
Will Nc future
If a roof is installed without first obtaining an agree to remove inspection, I
P
applicant at building Occupant vac equipment or devices which
emit ha ammus air contaminants u defined by the Bay Area Air Quality Management
all new materials for inspection.
❑ Yu 5?45,;
1 have read Ne hate dsus matanals requirements under Chapter 6.95 of be, Califor.
nice Hca1M&Safety CAdc.Sc 0u255051255JJ 125534.1uMcrstand NOifNc building
does not cum. ham a nL.thaI it u my p.mibil ty n notify the occupant of Nc
mquiAcmc khan �' fnia of, rtiI....( c
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owner Of ethnnredagent D,