00060072 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILD IG ADDRESS: PERSON NO.
y 11032 WESTLYNN WY ALLIED AIRE SERVICE INC 00060072
OWN 'SNAME: APPLICATION SUB[)At17.
HOFFMAN MABEL A AND MICHAEL A 661 SINCLAIR FRONTS E RD06/12/2000
)NE SANITARY NO, C(lKIROI,NO,
(408)934-8844
7WZ.
CHITECT'/ENGINEER: BUILDING PERMIT'INFO
BLDG ELECT PLUM11 MUCH
LL), LJ IJ L=1 I:�J
5 yi - LIC ENSE1)CONTRACTOR'S DISCLARA'I'RON Job Description
m5,=� L hereby alran mat I am rcenwd under pmvido't.of chapter 9(commencing .
�r with Seelinn 7rnlllof Di ,io 3 I he Hminemaad Profe,,ar,C:de.amlmy license
d -' is in full lune ci
a Lkcny�t CZQ _'1 FURNACE
3 i v Dme � G'6 S DECLARA
ARCHITECPSDECLARA I'ON
E°=O a I nndcmmnJ my plum shall he:tied as public mcaNs
y�In
Qi
it p O LicerncJ I'rnlcssionul
ce OWNEWHUILDI3R DECLARATION
a.
1 hereby aW..a that I l cxcmpl from the Coauwm's License Law for he
F C Iullowing rel.....(Stan 171131.5,Hrrsinc.0 and Pml'cesions Code,,Any city or county
o which qu a felt I 1 It,, tip d olish r p' y.t tum
m�
prior in isalso requite 'he applicant f uch Permit tfile a signed:l l trmnt
math licensed pursuat to the provoions ofn Contractile.,LLow(Chapter 9 Sq. Ft. Floor Area Valuation
(cmnmanci ng with Section 7000)of D vNion 3 of dm Itusinale and Profe,%am Code)
I,,that he is cac"tet lentiltoamidoehook rnrIn..11,nd cxi spoon,Any vauidon $9600
of Sectio 7031.5 by any applicant for a)mad ahi the applicant m a civil penalty
III not more than eve hundred dollars 6500). A PN NumberOccupancy Type
1,.1 ranee Prupertyo my umplayac with wngm as 1111.1 solcm'np:m:aion, 2
will do rthe work.and the structure is no' intended or offered list sale(Sec.7(M.
ifusinms and Pnacssion,Coble:The Commcho,License law does not apply 10 an Required Inspections
rorpmpeny Who hailds or impnwcs Inertia,and who does such work himself
owner or
lar own clnployoce.anvided on such ingnuvemmate tam on intended or 303 — ROUGH MECHANICAL
offered for sale if,however,the building or ilnprovelncat is sold within tine vent at 04 — ROUGH ELECTRICAL
completion,the nwncnhudder will nave the harden of proving that be did not build or X.�
lmpmvehnpu� cor.�lc.). 505 — FINAL ELECTRICAL
01,mnwnearda,motion,;all exclusively contracting with acir,idcnmtactor ,I 508 '— FINAL MECHANICAL
nswn the project IScc.VA4.[las and Pad. a G.lel The Comrucmr's
License Law does not applyto an owner of property who builds or impmm.thereon.
Eau]who contracts .in such projects with a co n alo asl licensed purvaam to the
Camrenors Licenw haw.
01 am lxempl under Sec. .It&P C for'his III
Owner Date
WORKER'S COMPENSATION DCCLARAIION
1 hereby affirm under penally of perjury one of the following dedolation,:
0 I have and will maintain u Cirtilica'c of Consent to silt/atsum for WorAer's
Cnmpensmi(in, as provided for by Section TURD of the Ltnor Code, for Thu
'iforrnanca of the work for which anis permit is issued.
khn o and will maintain Worker's Cmnpinalion Insurance,as required by Section
til the Luhn'Code.for the penonnance ofthe work for which this permit is ( /1
ix J. Wo ker�L con In trance carrier and Policy number are: LY
Car,d�l}�/ a.:�G NtJ7171
/O
CERfIIICA'1'ION OPF EMPfION PIi(IM WORKERS' aI9
COMI'ES SA'MON INSURANCE V
(This section need not M completed If the permit is for one hundred dollar
(51111)or lass.)
1 certify that in the performance of the nark for which this peril is issued,1
shall not employ any person in any manner so as ,,become subject re the Workers
Companamion Laws of Cnlilbmla line
Applicant
NOTICE APPLICANT.If.oiler making this Cenircam of plamptilm,you should
Meome subject to the Workers Compensation provisions of the Loiter Cole,you must
Q O loom,I it,comply with such ponislom ur this peri shall be deemed revoked. r
CONKRUCTIONRUCTION LENDING AGENCY
a 7 1 hereby alio that them is a construction lending agency for the perfoancc
of the work for which this pertan is issued(Sec.3097,Civ.C.)
Q I,cndcrs Name
7 z Lender's Address
U Q 1 Oil that I have read this application and clot, her the above informim is
fes P correct.I agree .I could,Iall till city and coolly ordinances and nmm haws relating
Q V rebuilding cnnswetion.and hereby authnrim mprocnta,,el"I do,eitym enter upon
fit the dawn mentioned property for iropeainn pwryrws,
[}.t 0.
(We)agree m save,indenmify and keep harmless the City of Cost to against
(A hilonilic.v,jldgn lla%.cost`anJ expenses which nay in any way accrue against said
Uz Car in conwwmme I the smming of ods lannnh.
APPLICANTU ER ANDS AND ILL COMPLY WITH ALLNO POI Issued by: Date
SOURCE:Rr LAS. �./�y V
Sismh'mt Applr mc6mmclm G u'-7—, Re-roofs
HAZARDOUS MAO aw q DISCLOSURE
Will theapplicuntor ancmbuilding occupantsmm or handle Imardswn macnal Type of Roof
ve defined by the Cupertino M.awmal Code.Charter 9.12 and the Health and Safety
Code.Smt....25532Uoq
0Ym -5_N�,, All roofs shall be inspected prior to any rooting material being installed.
Will theappliean'mmtureNOLing occupantuse equipment oits ii«s which If a roof is installed without first obtaining an inspection. I agree to remove
mit haeunlous air sonmnrinants as detined by the Huy Area Air Quality Management
uislder �� all new materials for inspection. Applicant understands and will comply with
Oyes " all non-poin source regulations.
hove read the hae:adans macrials requhe'nents tinder Chapter h95 of the
Culifnnda Health&Safety Cuda,Sections 25505,25533 and 25534..odars'and that /.y\.
ifthe building docs moa currently have atenant.That it is my no,onsibilltyre olify the V V
9ccupam of dre quitts x hich nm.a be met prior m issuance or a Cenificme of
OccnPtney ) /I Date
Signature of App 'cunt
o eroraumod�- All roof coverings t be Class "I3" c r better