00100043 (2) CITY OF CUPERTINO
nuu.0NEG.InVtslo,-,, PERMIT CONTRACTOR INFORMATION:
BIALI)lN0 ADdRIiSS: PI:RM I'1•NO.
OW'AhNLR'S N'AMH. AI'I'I.ICAfION SGB DATE
6360 MYRTLEWOOD DR 00100043
of0N H: SANITARY NO, CONTROL NO.
LAWRENCE WILLIAM L AND RU—THD 10/05/2000
O % ARCHI'1'IiC'1'IENGINF.ER: 1111LDING PORMIT INFO
w00
w_ _ LU' ELECT' PIN4 MIEC11
y`-' LICENSE[)CUNIIVATfOR'S DIiCLARAfION Job Description
0 Z✓�O 1 humpy u8inn i,. I It 3IiccrneJ older provi,iol of Chapter 9(commencing ,
1..,�3CW with Section 9111 N»nf DivlsinuJ ml'mc Rosiness soul l'rulms'nns CoJ�cy"t Imyllecnsc
ell lura and cL
z d_ 2u,"I acs on ;ET
LCioD-
1 understand my plans shall be ueJmErCacLmArRATION
- V
'
as public nemNs TERMITE REPAIR
O Licensed Yndcxsionnl
I hereby 0111111thatI u;n excnlpt Irnm;he Cnn;nmtor'x License Law bounce
t%< fallowing reason.section 7W1.5.Business and It memos Code:Any eityar county
5 2 p which requires a permit to construct,alar,improve•demolish,or repair any amctme
as
wprior to its issuance,also requires the applicant formpc
ch stood to file a signed statement
c. that he is steered pursuant to the porn„ons ofthe Cm,lowsms License Ww(Chapter 9 Sq. Ft. Floor Area Valuation
(commencing with Section 7000)of Divieion 3 of the Business and Pmfc,sions Code)
or that he is cxampt Ihmctmm and the basis for the alleged escmpinn.Any violation
MSection 7031.1 by any nppli, II'ory peroul.,object,the applicant Iso a c ivil penalty
mf malnmre than me hundred']"hall(55(h), APN Number Occupancy Type
01,as owner of the properly-O,ary employm'if'ages as theirsNe cral'umtion. ??
will do the work,and the structure is not intended or offered for sale(Sec.7614.
Business and Profesimns Cede:'the Contractors License Law does not apply to an Required Inspections
, hr of property Who(wilds or improves thereon,and who docs such work himself
mmgh his own employee',pnwidcd thin such imp o,ens,ns arc not intended or 369113012. 1210
offend for sole.It,buss,,.the budding ter impmvcnlenl is sold within one ycur of
completion,the owner builder will hove the burden of proving That he JIJ nut hated or
imp r..vefurparpo,cofsale,). 516 — FINAL BUILDING
01.0 manne,nflhe proper,am exclusively romrening with licensed comracamm
construct he pmjwr(Sac.9614.Elastics.aad Pod ism Codc)The Convector's
License Law does not apply to an owncrof property who builds or improves thereon,
out who cnnwcls for such projects with a c nnacmmHl licenced pure urt tome
C000uc6, . ionwsc Luw. /
01 son exe.mpt under sec. .If&I'c Inv This reason
Owner U /
we /
WORKC:R'S COMPENSATION DECLARATION C/
I hereby alT nn under penalty of perjury une of the following declamdons: 7
❑ I have and will mainwin it Cemili.:ne of Call,eltl in xelt-insurc for Workers
Cnmpenwtien, as provided 1'ur by Section 37118 n1' the Labor Code, ler the
per(mmoue ol'mc work far whid,this permit is kood
01 have and'ill nmionam Worker's Compensmiun Insurance.as required Cy Section -
37M of the LuMv Code,far the perfur cc of the work for which this permit is
su J.M ,k/ear'•Cm uan Ins ante r rtier:m/A PQI�cy�numM:ra���reY�/q
`Curr rC_ nsa IsAwy MIT .14,
CERT dCAI'ION 01;IIXEMPI'ION FROM WORKERS'
CONIII17NSAi'ION INSURANCE
(alis section need nut be completed if the)crib is for one hundred dollars
(31 W)or Ices.)
I ccrli fy that in he felt ornnmer of the work or which this permit Is Issued.I
,hull nut employ any person In any manner so ns In becnnm suhjccl to the Workers'
Compo nhtiou Laws of Calilinnla.Dam
Applicant
NOTICE:TO APPLICANT:If,alter making this Cenilievm of Esempimn,ymu should
become subjecno the Waders Compensation puts isian of the Labor CWc,you must
O fordo,th comply with such provisions or this permit shall be deemed revoked.
Hrn CONS'I'RUC'FION LEN DI NO AGENCY
a I hcrehy all! than marc Ix a cor,tractino Iending a&'nay fur the perfnonarce _
of the work it,which This)connd l,issued(Sec 3097,Civ.CJ
S Q Lender's Name
Z Lender's Addmss -
U O cis 1 certify that 1 ham read this upplic limn and store thanhe obore information is
TSI
Gu E+ .1 agme to comply with all city and county ordinances and nate laws relining
O U mbulldingcornmucdna,and hereby aunmrire remesontwivex of this City to enter spm
�y ry) dieabovo-ncill oned pmpaoy to,inspection pupnws.
(Wd;tgmc mseve,lmlciaml'yuW keep conlesame City n1'Copeninmaga,nn
V) liabilities,judgmenn,costs and expenses which may In any way accrue against.said �\
U Z Cil i yucnce of the 6mntin•of this permit._ /G/ (/�J
L cis all' ' DERSTAND I W LY WITH ALL NONPOI
Issued by: Date
(� 7w
s gnuuvc nt ppllc:uNCon m Umc
Re-roofs
IIAZARDt❑S MATERIALS UISCI.O handl
' Wllh,the Capto .Mme htpal C «a,panl xwm 2.a handle e Health n mwcdal Type of Roof
as defined by me Cupertino Municip:e CWc Chapter 9.12 stud IM1e Health and Safely
Cede,Section 255321,)'!
0 O No
All roofs shall be inspected prior to any roofing material being installed.
W 1 the con,camorfuture budding occupant use equipment orrloiceswhich 11'a roof is installed without first obtaining an inspection. 1 agree to remove
m'a h:v:rrslon,stir c.manioam,an delined by the Bny Area Air Quality Management
El Yet
oN all new materials for inspection. Applicant understands and will comply with
all non-point source regulations.
I have mead the hmmNous nmmrial,requirenrems under Chapter 6.95 of the
California Heahh k Safety Calc,Semens 25585.23533 and 25534.1 understand that
i!the building does not curtently have a lenanh mw it is my re>pnnsihility m notify the
ant of the requiremena which must be met prior m,issuance of a Certificate of
ccnppOCy' Signature of Applicant Date
owncraraal......eaagem vale All roof coverings to be Class`•B” or better