03070236 CITY OF CUPEWI'INO �:'tt'� +' «, x•r ` + ' y
BUILDING DIVISION PERMIT I CONTRACTOR INFORMATION
BUILDING ADDRFss: PINEWAVE CONSTRUCTION, INC .PERMITNO03070236
'ER'S NAME; 3515 RYDER ST. PERMIT ISSUE DATE
PHONE: (408) 245-3836 SANITARY NO, CONTROL NO.
ARCHITECf/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
300 LICENSED CONTRACTOR'S DECLARATION
f 1 hereby affirm that I am licenud under provisions of Chapter 9(commencing Job Des
cri [ion o
h lion]IXKl)of Div ion Sof tho nem and csinna Cndc.end myliccnse is
Li�cslaod.y,l.
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4ARCIi1TECT� S)sECLAR 1 N {
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Lu nsed Professional
33 OWNER-BUILDER DECLARATION
f I hereby affirm Net I am exempt from the Contractor's License Law for the
p O fallowing metol.(S,cfiun 703 1.5,Business and Prorcason Code:Any city or county
5$ which requires a pmmit to construct.aitea improve.demoalh,or repair any slmetam
y prior In its Issuance,also requires the applicant for such permit to rile a signed statement
t:Q that he is licensed pursuant to the pnrvisionsofthe Collector's LimnuLaw(Chapter 9 Sq. Ft. Floor Area Valuation
$ he mowith Section 7")orDivision3 of the Business and Prorcuinn Code)or
e
that he is eumpt therefrom and the bub for Ne alleged exemption.Any violation of 31620037 . 00
Section 703 LS by any Applicant for A permit subjects the applicant o a civil penalty of APN Number Occupancy Type
not mora than five handled doll.($500).
Q 1,as owner of the pmpcny,ar my employees with"go As Nair Asia compares n,
will do she work,and the avle is not Intended or offered for rale SAC.7W.Business iul — d Inspections
And PmfC.IoM Class;The CanVa[lafa License Lav,doe]cot apply b as..At of 10 2 - PIERS p
property who builds or improve Nemon,end who does such work himupf or through his
own employee,provided that such Improvements Are not incnded or offered forule.If. 103 — UFER
however,the building or improwment is sold within one you of completion,the owner.
builder will have the burden of proving that he did not Wild or Improve for purpose of 104 - REBAR
ata`)' 105 - ANCHOR BOLTS
1,As owner of the property,am exclusively contracting wish licensed contractors w
senatmcuhe project(sec.]ora.Business and Profession Cade:)]To Constructor',Lt.
106 — SEWER & WATER
rte law does not apply to on owner of property who Wila or improves themes,and 202 - UNDERFLOOR PLUMBING
who contracts for such pmlccu wish a combactor(s)licensed .
d puuatn Re the cWtraeora
LicenaeLaw. 203 UNDERFLOOR MECHANICAL
❑lam exempt under Sea .B h P C for this rtuon 204 - UNDERFLOOR FRAME
r Date 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
I hereby afimt under penalty of perjury one of the following declarations: 3O1 — ROUGH PLUMBING
❑I haw and will maintain aCenireuteof Conuntwulf-insumfor WarkeriCompon- 302 — TUB & OR SHOWER
action,As provided for by Section 7700 of the labor Code.for the performance of do 303 — ROUGH MECHANICAL
work for which this Permit is issued. 304 - ROUGH ELECTRICAL
❑1 ban and will maintain Warnes Compensation Iorsones,ai requied by Section
3700 of the labor Coals.for ft performance ofthe work for which this permit is issued. 3O5 — FRAME
My Wmkel,Compenudon Inaoraoce calls, liry num 306 - HOLDOWNS
cam`' ryO 307 - INSULATION
CERTIFICATE OF EXEMPTION FRO R
COMPENSATION INSURANCE 308 - SHEETROCK
(Thb section led not Mcmnplczd lfthe permit is for one hundred dollars(SIM) 309 - EXTERIOR LATH
arolor, 310 - INTERIOR LATH
ecertify that er thein anymance of As work for which Nis permit is handnsCo I shoal nm 311 SCRATCH COAT
Low,o any person in any manor As u w become mbjecua the Workers'Compcnatian
Laws of California.Dow
Applicant 313 - ROOF NAIL
NOTICE TO APPLICANT.If.after making this provisions
the
Lanor odyoushould 501 - FINAL ELECTRICAL ENERGY
bocomehcompy the Worker's Coons or his provision of Ne reed r Code,you must
�z ronnwnn,amptywunAsehprawinnt,rNiapermh=haEeed„m,drevoked. 502 - FINAL PLUMBING ENERGY
z CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
I hereby afroNn Narcits conlrucimn lending agency(or the porrmanance of 504 - FINAL BUILDING ENERGY
z>
the rwhich llispemitbland(Sec.yB9 ,Civ.C.)
Lendersder'sName
505 - FINAL ELECTRICAL
31�
5 Z Leader,Add., 506 - GAS TEST
JO 1 canal,Nat I haw reed this Application and sate that do above fid no niun is 507 - FINAL PLUMBING
y F
comes.I agree to comply with all city and county ordinances and sou laws relating to
V Wildingcanuuction,endlatelymNod.mpreunmivesafOtiositytocaw,.,.the FINkWNG
CAL
W 'how-mendonedPot for Inspection pmpoua Q9 FI
(We)agree to save,indemnify and keep harmless the City of Cupertino against
r W1 liabilities,judgments,costs end A”"
yI.any way accmoagainst'Aid City 5
in conuquono Ne grants of th Permit.APPLICANT U ERSTA DS ND WILL OMPLY WITH L N -POINT Issued by:- IWORKS Dat
SOU ECUL ONE
Re-roofs
S' arc of Appliasn"Co r Da¢
N DOUs ATEFU DIICLOSU E 'Type of Roof
Will du applicem fuwreW ding Ase panumrt or lundlc harWous malarial
As deaud by the Cupent Municip a Code.Charter 9.12,and the Health and Safely
Section 255d2(a)? All roofs shall be inspected prior to any roofing material being installed.
C]Yes RN.
Wi)I 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
cath ha.ol air conlnminants As dErmd by the Be,Area All QAAhIy MBNgcarnal all new materials for inspection.
District?
❑Yrs 0FNo
I have no she husrNus crialsreyvirt nuunder Chep¢ 95 ofsh Call for.
Safctyc Sccu 505.2555E 255N.1 9�9
ildao not v ntly haclan Nat it is my nibility ohe to m rats ire I W m tpd issu ora Signature of Applicant Date
o crunuthori'rc opens Gala roof coverings to be Class eB° Or better