02060198 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
TMINtSTSHORE CT DRAEGER CONSTRUCTION INC PERMIT n 060198
tl`Msl'i TLLIKKANI 605 COMMERCIAL ST APPLICA6181 `O8AW/ 2002
PHONE: (408) 536-0420 SANITARY NO.
CONTROL NO.
O zo ARCHITECVENGINEF.R: BUILDING PERMIT INFO
BLDG ELECT' PLUMB MF,CIT
LICENSED CONTRACTOR'S DECLARATION
i z in o I heresy afirm that 1 am liicenwI un�mvismns of Ch, ter 9(commencing S I DING RE PLACEM description
,yC with S,Nun]0<)0).f Diwsivn3onhv Burin fid"noz"itesCodc.and myllcnse
is in
off fare=sis6d a t. 7 f� fp��'pI1t111 tI��
:Oea.mU j_1`/ ARCHITECT;9UEC7mC 1ARATION �� It—al1�'' ALED
I y
vvata O; 1 untlersmnJ my plans shall be usul as pubbo meoNs
WY
6 aLicensed Prntessin.a' J U L 3 1 2002
c ute, O\VNER-BUILDER DECLARATION
'+ =' I hereby aRrm that 1 am exempt Irom the Contractor's License Law for the $12000
t-Z, following ream..IS,,l on 7031.5.Bminexa and Professions Cade:Any city or county
i F G which residue..a permit to consumer,aha,improve,demolish,so rtpair any strucmrt
UILDI !Gn C3we prior m in issuance.al,°requires the applicant for such permit flea.signed summon - -
ton heislicensed punuammth0provisions of the Coal racme,Licenxlnw(Chapter 9r s, i a Valuation
(commencing with Section 7000)of Division 3 of the Business and Professions Code) y, ,'t r, t•. 1 (', 's t ) ' ,
or that he Is exempt therefrom and the breis for the allegi d eiemaion.Any violation
of Section 7031.5 by any applicant for a permit .bWarhe...)learn in a civil penalty
of not amthan rise hundred dollars($5oo). iOiAPN Occupancy Type
01,arenvoi ofthe pmIance,or my employees with wages er their sole compemation, 102 — PIERS
will do,he work.and the someone is not intended or offered for sale(Sec.7041, -
"ill
and Professions Cwe:'The Contractors License Law does not apply to an Required Inspections
of pfope ry Who milds or improves thereon,and who does such work himealf 104 — RE
m thrrough his own employeesprovided that such impmvemems are not intended or 1-05 — ANCHOR BOLTS -
oRered for Salo-IL however.the Wili ing or improvement is evld within one year of -•�, „ - --
icompletion,lothe owmer.Wilderwill have the burden ofpm°ing that redid notbuild or 106 - SEWER & WATER
m.r. ..e f a,tapas of atne).
202- --UNDERFLOOR PLUMBING.. _ .. ...
°marcor her voicepmpcny.amBusinissandProfeinion,'ecensed Cmraroraro 203 — UNDERFLOOR MECHANICAL '
iceWa the project(Sec.
appl 7044.owner of
and eddy who
Codes improves
Contractor's
Licensehwd«a not for such
won owner a commons)
on)liceuilds ere paratesmt the 204 — UNDERFLOOR FRAME _
and.who contracts for such pr°jcas.with n cammcmr(s)liccnxd punuam to the -
Contractors License Law.
205 — UNDERFLOOR INSULATION
°1 am exempt under See. .B&P C for this reason
301 — ROUGH PLUMBING
Owner WORKER'SCOMPENSATION DECLARATION 302 — TUB & OR SHOWER
I hereby affirm under Penalty ofperjury,one othe following cimlaratiom: 303 — ROUGH MECHANICAL
1 D I have and will maintain a Certificate of Conten to.elf-come for worker a 3 04 — ROUGH ELECTRICAL
. \• ./ Compensation. as .mvmea for by Section 3700 of the Labor Crude, ova the 305 - FRAME
performance.of the work for which this.encit is issued.
306 — HOEDOWNS
°1have and will maintain
ortheperfomance ftewokfasta9nitaabys«eon 307 — INSULATION
3741 of the Lahr Cotler for the performance of the work far which this permit is
. - iu.ea.My „prkeracnmpen.aconientrancecamaanePnhrynumxrcm 308 — SHEETROCK
lee:' bb a '1>nu� �� S�� �� •309 — , EXTERIOR LATH,,
CERTIFICATION F EXEMPiPIONFROM WORKERS" - -
COMPENSATION INSURANCE ,.._ . ' f :. ... ....._ .. .310_...-....INTERIOR .-LATH...—_......
section aired
(This ctaired not be completed Hire pamiu is for one hundred do)[. 311 '— SCRATCH COAT
81041 or1") 313 — ROOF NAIL
I certify that in the performance or the work for which this permit is issued,1 501 — FINAL ELECTRICAL, .ENERGY
shall not employ any person in any manner ser as to become subject to the Workers'
Compensation lox's of C.rfomla.Date 502 — FINAL PLUMBING ENERGY
Applicant
NOTICE TO APPLICANT.If.after making this Cemfcate of Exemption.you should 503 — FINAL MECHANICAL ENERGY
O 0 becomnm
become object the Wmler'.0° penzmma provisions Mme Labor Code.you muse 504 — FINAL BUILDING ENERGY
form,im comply with suds pnmisim,s or this .or shall be dimmed revuked,
z 505 — FINAL ELECTRICAL
f•' ^ .�' CONSTRUCTION LEN DI NO AGENCY
tY ] Ihereby afrom that[here isaconsw -
construct 506 GAS TEST
ohne work for which his pemm is namdlfscc.3097.civ.C.)Lenders
de
507 — FINAL PLUMBING
baidcr's Address - - -
508 — FINAL MECHANICAL
U'O 1 artily mar l have mail has applieadmn sad ,are mat he above and!orm.tien is 509 — FINAL GRADE
fa' E. contact.1 agree m comply with all city and county ordinances and state laws aideg
O U to building conetmerionand hereby authorize r' m
epmseativesofthiscitytoenterupne 510 — FINAL PLANNING
y
the alroe-ion, don.Apeopenyforinspectorpurposes. 514 — FINAL PUBLIC WORKS
Lo P. ( ee)agrto save,indemnify and keep hatmhepe
ss the City of Cupertino against
to liabilities,judgmcros,enols and expemes which m.y in any way accede against said
V'z City in ronseemence of'he'renting of0d nnit.
AP4LICANT UN AT TNTSAN ECO' YWITHALLNON IN Issued by: Date
Dric"' Re-roofs
UOUS MATERIALS DISCLOSURE
N'ill me applicant orfuwrt Wilding mapam store or hatM)c rSxW,us mmerial Type of Roof -
' as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Codc,Section 25532(a)7 •�, , ' '
°Ye °;r.,' - All roofs shall be inspected prior to any roofing material being installed. -
-
Will uhcapplicantorfuture buihding«em,em,use cquipmemordevice, bi,h If a roof is installed without first obtaining an inspection, I agree to remove
emir hazardous air contaminants as defined by the Bay Area Air Quality Management
District, all new materials for inspection. Applicant understands and will comply with
°Yr all non-point sou�regulatis.
Ihave mad the havrdous materials uequiue cots under Chapter 6.95 0(the
Glifomia Health&Safety Cade Sections 25505.25537 and 25574.1 understand that
if the building does not cumenJy have u mown,that it is my uesponsibiloy to notify the Q v
occupant of the re i menti which must be met prior to issuance of a Certificate
"' a Jcant Datil
n o as on
en a, All roof coverings to be Class "Bit or better
.• }>. OFFICE