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03090209
CITY OF CUPERTINO �•'"` ' " s ' BUILDING DIVISION PI;I2MIT CONTRACTOR INF�+ORMATION BUILDING ADDRESS: PERMIT Nl0 3 0 9 02 0 9 R'S NAME: PERMITISSUEDATE DAVID -PIETROMONACO & RENA T KA 11/10/2003 ONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO LFEE AM1116 PLUMB MECH (� 0 +00 LICENSED CONTRACT'OR'S DECLARATION U 1 hereby affirm that 1 am licensed under provisions of Chapter Y(commencing Job De cri O MI—ALM 1111111 with Section TN41)of Division Sof OC Busindssand Prpfassions Code,and my license is y <„ Lfenmmaand effect. ADD 201 SQ. FT. /REMODEL NOV GOO Z License Class Llc.g „-,a Datc Contractor e ARCHITECTS DECLARATION C� I understand my plans shell he used as public mrnNs BUILDING■ ■I Y �fqa 0 o uDU LVw H Licensed Pmfcssional g OWNER-BUILDER DECLARATION 'yL a Y 1 hereby affirm that I am exempt from the Contractors License Law for the _ 0 0 following mason.(Section 71131.5,Business and Professions Code:Any city or county <m which myuires a permit to construct,alter,improve,demolish,or repair any structure B 0 0 0 pdono its issuance,also"does the applicant forsueh permitei life a signed statement E C thatheislicensedpursuanttotheprovisionsoftheContmcmr'sLicenseLaw(Chapter9 Sq. Ft. Floor Area Valuation 2 $ (commencing with Section 7")ofDivision3oflheBouremoulProfessionsCode)ur 36914007 . 00 Nat he is exempt therefrom and the basis for Ne alleged exemption.Any violation of Section 7031.3 by any applicant for a Permit subjects the applicant to a civil penalty of APN Number Occupancy Type not mom than five hundred dollars(SSW). p Y YP ❑ 1,as owner of the property,or my employees with wages no,their sole compensation, will Professions r fie work,and the he Cont is nor s Livens or a w does not apply anQan Business and property Wh oha Code;The improves do em,ndOlm Law such not apply tf an owner of Required Inspections propertywhobuild¢orimprovesch improvements so nsuchwask himselfedthrough his .we employees,ping or that suchimpm old wit so net intendedmneared far¢ale.Owner. however,Nc building a improvement ie sold within one year of mmplmio r Ne oseof builder will have the burden of proving Nat he did not build or improve for purpose of sale.). Q 1,as owner of the properly,am exclusively contracting wit licensed convectors to Construct the project(See.7044,Business and Professions Code:)no Contractors Li. _ cense Law does not apply to an owner of property who Wilds or improves themed,and who contracts for such projects with a contracmr(¢)licensed pursuant to the Contractor's License Law. ❑ l and toempt an�&,� ,,7 ,B&P C for this reason 1370Wr sea w Date lij0%?+ WORKER'S COMPENSATION DECL6RA'fjON 1 hereby and under penalty of perjury one of the folTTlowing declarations: ave and will maintain a Cenificac ofCmd WO In self-insum for Worker'sCompen- ,as provided for by Section 3'/00 of the labor Code,for the performance of the for which Nis Pempit is issued. ave and will maintain Worker's Compensation Insurance,as required by Section of Ne Labor Code,for the performance of the work for which tis Permit is issuedorker's Compensation Insurentt carrier and Policy number am: r: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thlssection need not tecompleted if the Fermil is Import hundred dollars($100) nr less.) 1 certify Nat in the performance of Ne work for which Nis Permit is issued.)shall not employ any personVym n�pOn; nMcome subjecna the Workeri Compensation Laws of Califfq Ddte / f1/ Applicant K"id. fRSA S NOTICE fO'APPLICANT:If,after making this Cenifeate of Exemption,you Am.5 become )ct to he Workeri Conapcnmtion previsions of the Labor Code,you must �Q forthwith comply with such Prnvinums or Ni¢Perm it shall Mtleemed mvoked. Z� CONSTRUCTION LENDING AGENCY I hereby affirm Nat there is a convection lending agency for the Performance of 'yr> NC work fur which this permit is issued(Sec.3037,Civ.C.) WRQ Londcr's Name Z Lend,,'s Address U r) I certify Nat I have read this application and send that to above information is W F.r eondet.l agree no comply with all city and county pNinanees and aem laws relating to C)U building construction,and hereby autorin representatives of his city to puler upon the a above-memioned Property for inspection purposes. (We)agree to savd,indemnify and keep harmless Na City of Cupertino against r) to inconsequenc of,hecosuantl expenses granting Of thismit, may inany way accmc against mid City U z APPL CANTeUNDERSTANDStAND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULA NS. Re-roofs gra urc of AP ¢�no untractm Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will to applicant or fulum building occupant at..nr handle hanrduus material pleaded by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Section 25532(a)? C]Yes _6N. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove Inia havamnus air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. d'? OYesI have mad Ne haMous materials requirements under Chapter 6.95 of the Callum. ealth&Safety Code,Sections 25505,25533 and 25534.1 understand tat if de building notcurrently haveameant.Nat it is my responsibility m notify the cecupanl ofthe mmpnts whirl usthe met prior to issuance of a Ccuificam of Occupancy. Signature of Applicant Date u/�/ nermapthor'rzpd agent Data All roof coverings to be Class "B" or better `I NEWS NAME:OF COPERTINO _ CfSNTRAt^T01k IN�`t RMATTUN BUILDING DIVISION PERMIT ' auILDING ADDRESS: - SUN SUN ENTERPRISES INC PERMR NO.04O90090 L� OWPERMIT ISSUE DAM DU RIAAI\Tn — - ONE: SANITARY O OL NO. ARCHI7ECf/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH ilIZ LICENSED CONTRACTOR'S DECLARATION I O O UW pp 1 hereby affirm Nal 1 am licensed under president;of Chapter 9(commencing n¢�+ wire Section 70M).f Division Sof NC Business and Professions Code,and my license is <oin full fame andcffat. TEMP POWER Dy�� License Clens Lu.« SEP �6- 2004 � p Dow TSDECr ARCHITECTS DECLARATION 1 undcrsmnJ my plans shall W reed n public rccmNa BUILDING G� Licensed Pmfceaionel g OWNER.BUILDER DECLARATION I hereby affirm'he'I am exempt from Ne Contmetors License Law for the —no following mason.(Section 7IB 1.5,Business and Professions Cade:Any city or county r$ which enquires a permit m connotes,alter.improve,demolish.or repair any slroclure ruderu,its Wtomce.also mod.lhcapplicanl for such permit to Glcasign.d statement prhe,he is licensed It p ursuantI.therovisionsoftheContract&.Licenmlalu Law Sq.Ft.Floor Area Vaation y�a (commencing with Section 70(10)of Division 3 of the Business and Profession Cow)or that he Is exempt therefrom and the bask for Ne alleged exemption.Any violadon of wi�n��y Section 7031.5 by any effluent for a permit subjects the applicant a civil penalty of 3 W194 b erO 0 Occupancy Type not mom than five hundred dollars($500). ❑I,as owner ofthe property,or my employees with wages as their sole compensation. willdo mework.andmeawaure isnot intended.roffemd forashe(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License law does not apply m e an owner of q P property who buildwr ireprevm timrcon,and who dws such work himml f or through his own employees,Provided that such improvements are not intended oroRered foreale.If. however,Ne building or improvement is sold within one year of completion,Ne owner- ' builder wiB have the burden of proving Net he did not build or improve for purpose of sale.). I,as owner of the property,am exclusively contracting with licensed comments to • construct the project(Sec.7044,Business and Professions Cade:)The Convector's Li. cense Law does not apply to an owner of property who Wilds or improves Ihemoo,and who contracts for such projects with a Welasemr(a)licensed pursuant in me Conbaeme's Licenselaw. I]I am exempt under Sec. .B&P C for this...aai v, j'j 'SL.-s... Da WORKER OMPENSATION DECLABATo 1 hereby aRml under Penally of perjury one of Ne following maturations: I have and will maintain a Certificate of Consent mwlf-insum for Worker'sCompen- cation,u provided for by Section 3700 of Ne Ube,Code.for the perf emaene of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,w required by Section 37wof the labor Cod.,for Ne performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number am: Carrier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thleramion wed mlhccomplemJ tribe permit is forest,hundred dollars(SIM) err let..) 1 cenify that in Ne performance of the work for which this permit is issued,I shall not employ any Person in any menwrao as to become subject m the Worker:Compensation Laws of California.Dare Applicata NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject m the Worker's Compensation prevision of Ne Labe Code,you no Q O foMwilh comply with such provisions or this Nomitshall W deemed revoked. Z CONSTRUCTION LENDING AGENCY (-i IherebyalBrm Nal mere is a construction lending agency fnrtheperfurmart Ne work for which this permit is issued(Sec.3097,Civ.C.) W QLender's Name 5 z (andets Address V Q I certify Net 1 have read this application mrd sum that the above information is - W F correct.I agree to comply with all city and county ordinances and sok Is.relating to 0U building construction,and hereby aumonea represenutim of this city to corer upon me r Gil above-mentioned property for inspection purposes. a (We)agree to save,indemnify and kap harmless the City of Cupertino against tiIA liabilities,Judgments.casts and expenses which may in any way seem against mid City C)4 in APPL conCANTof Me rmit. N; AND of IND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIOC�� T ) NS. 'a Qk Re-roofs SiSi res T onuacmr Damm s� HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or futum building occupant store or handle havarmous mammal m dented by the Cupertino Municipal Code,Chapter 9.12.and the Health and Safely Adwadk.Section 35532(a)7 "n All roofs shall be inspected prior to any roofing material being installed. ❑Ycs Will the applicant or future building acupanl use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove mit w,.m nus air contaminants as&ftwd by me Bay Arca At,Quality Management all new materials for inspection. Disuiet7 ❑Ycs �No I have mad me hmardow mamrialsrequimments under Chepler 6.95 of the Califor. .in Hnim&SalmyCode,Section 25505.25533 and25534.1 understand thatif ma Wilding docs not currently haw 0 tenant mat it is my rwpomMiiiiy to notify the occupant of the requirements which must W mel poor to sumew,of a Ccnifmam of Occupancy. Signature of Applicant Date \/ wncrmamhoriaxJagcnl DaIA All roof coverings to be Class"13'or better .. .. 1. µg.. .. i . ... .. .. y Community Development Cupertino 0CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 4$UPERTINO Building Department JOB ADDRESS: PERMI" q LDJ ' iGl tAr j-, G ��) l OWNER'S NAME: )< L PHO GENERAL CONTRACTOR: FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Fi ' g Electrical res e, �•. Excavatin Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile SA a Owner/ ct ature Date CITY OF CUPERTINO o Sam- TEMP POWER UPEkTINO PERMIT APPLICATION FORM APN # Date: c „O 361 — /4v — 0l6 ©� �- Building Address: i 0�o v,�cks BLARff br. 6,Aert�ilo . CA �-ry r Owner's Name: Phone#: X1 Qo Li11 DU a - Contractor: SUN StiN ki,vjerprr SeS, 7,g Phone: ��_3 q qp6 License#: Z Contact: hone: Cupertino Business License#: �5$�L Building Permit Info: IVI atybtc4p5in Adt(+(30 6sTsF Elect ❑ Lb. 0 g U O OOO Z Job Description: u , 4,p" ,o /-'ow Residential 0 Commercial ❑ Cost of Project: � sD GDD • Q , if A fab), Fee ID Fee Description Fee Group BTEMP Temporary Power ELECTRICAL EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING 2767 l