Loading...
0806011500 Lu ZU � N �z Liar imv d row H� It� ,zsQ CITY OF CUPERTINO _ BUILDING DIVISION PERMIT, , a . 4 W�©:�3 4.•n ,a%4.r ...,pS eulLgl�c�n�DF WOLFE RD # 2 0 7 4 PAR�KWA Y CONSTRUCTION & PERMIT NO. ;8060115 OWNER'S NAME: ERMIT ISSUE DATE BENIHANA INC 1000 CIVIC CIR 07/01/2008 PHONE (972)221-1979 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER eUILDING PERMIT INFO BLDG ELZCr PLUMB MECH LICENSED CONTRACTOR'S DECLARATION licensed Chapter 9 Job Description 1 hereby affirm that I sun under provisions of (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is REVISION INTERIOR AND WIND SCREEN OR I G # 0 7110 0 5 0 in full force and effort License Class Lic. 0 Date Contractor ARCHITF•CPS DECLARATION 1 understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason. (Section 7031.5. Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure - prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed to the of Lhe Contractor's license Law (Chapter 9 Sq. Ft. Floor Area Valuation pursuant provisions $ 2 2 5 0 0 0 0 (commencing with Section 7000) of Division 3 of the Business and Pro(essions; Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of 316 2 0 0 3 7 Number Occupancy arc P Y Type Section 70313 by any applicant for a permit subjects the applicant to a Civil penalty of not more than five hundred dollars (S500). . - ❑ L as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work, and the structure is not intended or offered for sale (See. 7044, Business and Professions Code: The Contractor's License law dots not apply to an owner of property who builds or improves drown, and who dots such work himself or through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of sale.). L as owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Conuactofs L.i- cease law does not apply to an owner of property who builds or improves thereon, and. who contracts such pro'cct 1, . s w tor(s) licensed pursuant to the Contractor's undo B& P C for this reasoonnnORKER'S Vn,.t.w. COMPENSA ON DECLARATION rcb affirm under of y penalty perjury one of the folowing decluations: nd wuTl mainuim a Certificate ofComm toself-insure for Worlte{s Compen-rovided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 370D of the Labor Code, for the performance of the work for which this permit ha issued My Worker's Compensation Insurance artier and Policy number are: Carrier: Policy No.: CERTIFICATE 7F5FZMPIION FROM WORKERS COMPENSATION INSURANCE (This section need not be completed if the permit Is for enc hundred dollars ($100) or less.) , 1 certify the' in the p nuance of wo or whic)i ht is permit is issued. I shall not employ any pc In any manor s o b c su c to the Workers' Compensation Laws of Califo a td Applicant A Tkj after making this Certificate of Exemption, you should m )teesto theWodceesCompenwtion provisions of the LaborCode, you must tNanCE hcomply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Cho. C.) Lender's Name Lcndcr's Address 1 certify that I have mad this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction. and hereby authorve representatives of this city to tens upon the above -mentioned property fen inspection purposes. (Wc) ague to save, indemnify and kmp harmless the City of Cupertino against liabiliLimjudgments, costs nsa whit ay ire arty way accrue against said City in c q of the tin of th' permi A CA UND S D COMPLY WITH ALL NON -POI Issued by:9 Date s CE UTAM / Re -roofs Type of Roof < insure of Appliant/Conuacmr D HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardo material as deemed by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety cone, Section 25532(a)? roofs shall be inspected prior to any roofing material being installed. ❑Yes )(N.All If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which cmiL hazardous air contaminants as def)ncd by the Bay Area Air Quality Management all new materials for inspection. DisuicL7 �,� [3 Yes D N. ve ms 1 haw the hazardous requi =is under Chapter6.95 of the Califor- nia Health & Safcty ode, 2550 255 25534.1 undersund that if the building does c d have a m nsibility to nodry the occupant or the requw chmusL .p' r i or aCertificatcofOc ry O K. Signature of Applicant Date t -e-c.— 7 / All roof coverings to be Class''` or better Ow94 or authorized agent Date