06070123 CITY OF CUPERTINO
BUILDING DIVISION PERMIT r CONTRAS QR INT,ORMATIQN.
BUILDING ADDRESS: , DPR CONSTRUCTION INC PERMIT No.06070123
101
R'S NAME: PERMIT ISSUE DATE
LANDMARK PROP. 1450 VET
JE:
SANITARY NO. CONTROL NO.
(650) 474-1450
ARCHITEC1YENGIN1i BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
I� 0
trop LICENSED CONTRACTOR'S DECLARATION ' Job DOSCrIp000
I C 1 krcby affirm Nal I on li¢nxd under,provisions of Chapter 9(commencing
,2w with Section 7000)ofDwW.m 3 of the Brunei and Profession.C p.O my license is
« mmumreeandaffect- STRUCTURAL CLARIFICATION REVISION
`"`" Claim Li g ORIGINAL PERMIT #05110089
F Dam contractor
ARCHITECTS DECLARATION
l W� I undersand my plans shall
all he he uo sed as public records
?n
G Littrtmd Pmfrssional
OWNER-BUILDER DECLARATION
F I Wrchy alum 0.1
1a.1. .Bent from Ne C tsions rots Been C law for the
a 0 following reason.(S.I,t 7(131.3. t.siness and Pete i inn Calc:Any oily or county
;m(L which Rquims a permit a construct.+ler,improve,demul W,at repair any suumvu '
zy priore its issuance.aen requires the applicant for each Permit to file a signed Com ont
< that he is licensed pursuanuo Ne prevision of Me Contractor's License,law(Chapmr 9 Sq.Ft. Floor Area V¢j gig g g g
(commencing with Section 7000)of Division 3 of Ne Business and Profession Code)or
_ Nat he is exempt therefrom and Ne basis for Me alleged exemption.Any violation of
Section 7031.5 by ury+pplicant for a permit tubi Me appl;canu0 a civil penalty of APN Number Occupancy Type
not moto Nan five hundred dollars(35001 31620037 . 00
❑I.uowncr of Die pmpmy,or my wployces with wagesasthev salcwnpewdan,
will do Ne work,and the structure isnot mended or.need foram(Si 7044,Business
and Profession Cade:The(Donation's License Law does ret apply th an owner of Required Inspections
properly who builds or i mprnv Menomonie!who does s uch work himseR m through his
awn employers,povided Nal such improvements arc not intended araffered for Sale.If.
however.the Wilding or Improvement is said within am year of ompicuon-Ne ouni
builder will have Ne Widen of proving OR he did out Wild or improve for puryose of
sale.).
0 1,as.vier of he property,am uelnively contracting with licensed on.actme a
ontruct Ne prefect(Sec.7044.Business and Professions Code:)The CodM car's Li
cane law dors not apply m in owner of property who W;Ids or improv thereon,and.
who contracss for such projects with a Conuaeror(s)licensed pursuant to the Convacto's l/'/py�•�J,
License Law.
M, V
❑ laempr under Sec .B&PCfm this touon
er Dem
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one.(the following dedara0on:
0 IWmandwillmaimaina Cenificamof ...tmself insuufe WorkcYSCompir. D
ration,as provided for by Section 3700 of the labor Cade,for the performance of Ne
work for which this permit is issued
0 1 basic and will maintain Worker's Compensation Insurance,as required by Section
3700 of Ne labor Code,for Me performance of the work for which Nu permit is issued. '
My Wor h persauon anuance canter and Poli n a'm,/s�
Grricr. Paltry No ` —�
CE0. IFJCA F EMPnON FROMWORKERS'
ACG OP C Aj10N INSURANCE
(Thu section need notbo completed if the permit is far.hundred d.vaa($100)
car leu)
1 cenify Nat in be performance of the work for which this Permit u issued.1 Mall not
employ any person in any manner aro as to become sabjec7 to the WorkeW Componatim) ,
Laws of California.Data
Applicant
NOTICE TO APPLICANT:IL after making Our Campeau:of Exemption,you should
become subject an Ne Worker's Compensation provisions of Me labor Code,you most
,,- O fordwlN comply with such provision or this permit shall be deemed ranked.
Z CONSTRUCTION LENDING AGENCY
(-+ l hereby affirm Nat Mem is a Coaswetion lending agency for Ne,parfurmance of
C'> Ne,work for which Nis Permits issued(Sec 3097.Co.C.)
QLeaders Name
=z Lenders Add=
U0 I mnify Mai 1 ban mad this application and ram Nat Ne a"information u
Correct.I agree m comply with all city and county ordinances and sad totaling to
buildi
)•��U abonngc.nonedpr and hcmM1yaush.mempsescmativcs f � y cr upon Mc �(`/v`[/t,/ty(/, /
shove-mentioned property for insPcewon pugwxs.
f~a (We,)agree losave,indemnify and keep harm) a Cil Cupertino against
U z habiliues,judgmemv,cossandapcnev which yin yway. cagainsisaid City
in consequence of the granting of Mis permits
APPLICANT UNDERSTANDS AND WI9 LY ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. / �-p-6�
O Re-roofs
Signauto or Applican✓Contracor Dam
HAZARDOUS MA IALS DI LOSURE Type of Roof
Will the applicant.,forum Wilding occupant more tar handle haeud.us material
u defused by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Socha zss3za37 Yu All roofs shall be inspected prior to any roofing material being installed.
W11 Ne applicant or future Wilding occupant use equipment v;ec.wn;ch If a roof is installed without first obtaining an inspection,I agree to remove
emit ha'rardnus air conaminapu u defined by Ne,Bay Area A;r y Manegcmcnt all new materials for inspection.
Diri
0Y.
I have mal the harardsasmam-a R ndcr pmr6.95 of Nc Cal it
ria HcaIM&Sanely Code,Sccuon85fIS 5 .1 rsmnd NmifNc Wilding
does not euri ham a li that Ir v hility away,de occupant of Ne
R4UIRrtICIILI which mush act poor is . ace manor tafp7mer. b Signature of Applicant Date
Owner s ardamooeUagem Date All roof coverings to be Class "B"or better