08030059 CITY OF CUPERTINOw�mz.=a"+ «."
BUILDING DIVISION PERNIIT �C,O1TRATQR{TN�`� tMATION'�'
B 1 PERMIT NO.
UI
"TMT1 WOLFE RD #2020 TBD - TO BE DETERMINED 08030059
1AIC11TECTENGINEER'
'S NAME: PERMIT ISSUE DATE
R. EUSON HUANG 05/02/2008
SANITARY NO. CONTROL NO.
INFO
COMM'L TI NEW COLSTONE BLDG BELECT PERMPLUME MECH
LICENSED CONTRACTOR'S DECLARATION
I Mseby slam Wt t am licensed ander pmviisiau of Chapter 9(commcnclog ^^^-- •• -- — ——————- _ Job Des6Fiption
n,t= w'Seedon7M)of Diviuon3ofte Businucsmd PmfeWom Code.mdmylicenseia
O H in full force and effect'
j i Liceohse Class lie.d
Conmeans
ARCHTELTS DECLAFFION
U I undenund my plans shall W used u public runts
Dip
gQ� Licensed Professional
OWNER-BUILDER DECLARATION
s� f 1 hereby alarm Nal 1 am exempt from the Convenor's License Law for f
i p O following action.(Section 7031.5.Business and Pmfeaiuns Cade:Any city or county
$( which sequisu a permit W calumet,afar.improve.demahivh,or repair my slranum
iiPriarthiu issuance.also mquimta to applicant for each permitth Ole aligned suthment
Nat he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation
y5g (commoneing with Section 7000)of Division 3 of the Businrss and protections Code)or
Nu he is exempt thuefrem and the buts for the alleged exemption.Any violation of
Secdom 7031.5 by M applicant for a .it subjects the applicant to a civil pemlty of APN Number Occupancy Type
.1.ore Dun fiw hundred dollasa(SM P Y YP
1,uowneroftedpmpmy,ormyemplo mwithmguaIWirmlemm =don,
and Pr IIs Wad[,rod the h.Comlane)NWdede Law dofnr Liepply,torus,core nett
and Prty,wh ons Code-mpr Common,Uccle Law does rot.Pour if rt owner of Required Inspections
Own cxn who Wilda ided that
thereon,and who doesouch work himself m through his
own employees provided upr Pell impmwmrnts am not intended maBued for saleer,
however.Ne Wilding a den of proving
is told within one yearw mpromf r IW owe of
Wilder will how the burtlen of pmvinf Nal he did not Wild a impmw for Purpose of
sale.).
1,u awur of the poepeny,am exclusively contracting with Ifcensed eormwn
ntW
continuer the project(Sec.7044.Business and Pmfestdons Code)The Conmclofs Li- .
sena Law does not apply to an ownu of prepeny,who Wilds or improv thesean.sed
who,contracts for such projects with a conlmtor(s)licensed pursuant an tbe Contractoh
License law.
❑l ameaonptunda See ,B&PCfuthumamn
in Dau
WORKER'S COMPENSATION DECLARATION
1 hereby alar under penatry of perjury one of the following declar o ns:
1 bare and will trainuun acnti0au of conxentto self4mum fu Wmtor's Compm,
titian,as provided for by Section 37M of the Leber Code.for On peAormmee of the
w—ar`t for which this permit u issued.
O{1 haw and will maintain Wmi er's Compelunion Insurance,u required by Section
3700 ort m Labor Code for the performance of the wort for which this permit is issued '
My Worker's Compeuatiw Wean¢carrierand Polley number tie:
Carrier. CPolicy
No.: � � l
C EPo
X MONFROMW
COMPENSATION INSURANCE
(mu section reed not Ito completed lithe permit isforone hundred dollam lSIWO
Or leu)
I certify Nat in the performanco of to wort for which this Permit is issued,i shall no
employ any oermn in my mavrGp�sio hacpmCphbjeet to the WOOL:&Compensation
Laws of Calif s Dau JJ!!)X•
Applicml ('��
NOTICE TO APPLICANT:H,afar maWng Nu C1,iftule of EaempMn,you should
become subject m the Worl eta Compensator provisions of the Lather Code,you most
.J O forthwith comply with such provisions or this Permit shall be dcened molted.
z7 CONSTRUCTION LENDING AGENCY
[-+� Ibemhy affirm Oat there is a construction lendin a for the
!Yi Rte work far whichlW gC.)
Performance of
t[7 !7 Lendn's Nene Permit u issued(Sec J097,Civ. )
z fender's Address
U O 1 mtify that I haw reed this application and sou tw the show oda mance is
ly.^ corntt 1 agree to comply with all city and county oNinauu al
and se laws misting th
.O SV^ Wilding cowmction,and hereby mNorim rtPreaenutiwa of Nu city to toter upon the
fad aWw-mmud and property for inspection pugosea
gL (We)agree to Lw,indemnify and tern hamtless the City of Cupcnioo against
fA in Croituonexce Of tnts.he
tratsand exanuirg Of thisplwhichtoryth my way accrm againslsaid City
U Z APPLLIC NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date S 2-0�.
SOURCE REGULATIONS.
�I�Z w 5 -fig Re-roofs
S rtofAppliaHAZA HAZARDOUS
Dam
HAZrfutum MATERIALS senomoSURE Type of Roof
Will to applicant a forum Wilding ompanlmrt o MMIC harudou material
A&Ldell by to Cupeniw Municipal Cade.CTapter 9.11.and the Healthand Safety
.Section z5mlpn. All roofs shall be inspected nor to an roofing material beim
❑Ya P1+>ao P P Y g g installed.
Will the appliant or futua Wilding occupant use equipment a device,which If a roof is installed without first obtaining an inspection,I agree to remove
t Wee dons it mnuminants as de0ncel by the Bay Area Air Quality Management all new materials for inspection.
District?
DYes Zt
I have ma!me hoomdous materials requirements umkr Chmacr6.95ofthe Ci ifo-
nuNext"SxfclYCodc,Su6ons 25505.25533 and]5534.I UMcsvaM theifthe Wilding
does not cwsem0y Mm a unml then II is my tupamihility in modify the occupmt of the
requirements which most the met priarlu issuance ofs Cmufxmc 0Ocm7, Signature Of Applicant Date
ow rnraamari>ed,gem Dam All roof coverings to be Class'n"or better