01070131 (2) CITY OF CUPERTINO
nuu.DING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
7694 ORANGE BLOSSOM DR WINTER ROOFING INC 01070131
OWNER'S NAME: APPLICATION SUB DATE
TAI HSING H AND HUA K 151 WYANDOTTE DR 07/26/2001
• PHONE: SANITARY NO. CONTROL NO.
4083638052
o r o ARCHITEC rENGINEER: BUILDING PERMIT INFO
E00 BLDG ELECT PLUMB MECH
Nib CJ G_1 I-Li I.J
a
LICENSED CONTRACTOR'S DECLARATION
�5„? Job Description
O z_ 1 hereby offrm Division
1 am licensed under provisions of n,Chapter Code.teiand
any I ee og REROOF.
F,yFw wild Scctiun7W01 of Divisinn}tithe Business andProfe.vsiens Codc and myli<cnse
¢y orteande eI — Q REMOVE WOOD/SHAKES &
`c e z¢ Licen¢Clens Lic.q
x°a.w a. °a” IDUC"hr TILE 1/2 OSB & LIGHTWEIGHT
I r a 0 .I-i CHITECuse DECLARA u
I-- 1 understand my plans shall be used as public records
as
wa p Licensed Professional
>oLL OWNER-BUILDER DECLARATION
1 thereby of ost that 1 am exempt fwm he Cansmaor's Licence Law for rhe
F?Q following reawn.(Section 7031.5.Business and Professions Code:Any airy or county.
p which requires a permit to condoner,alter,improve,demnlisn,or repair any structure
d
3� ,pri.,wiu iaw.mac,alsorequnis rhe.,fica pursuer perrnitwBkaaigndsummcru - - -
'hat he is licensed ptavuuaro to the provisions of the Conoorcuor's License Law(Chapter 9 $ Ft. Floor Area . - }[sluation
(commencing with Sectiga 70(1)of Division 3 nfine Business and&of«cions Cods) -:) .- _9'1 L. (•. c.:'.�.'k a?i •�: $89H
or that he is cicmpt mkrefmm'rind the basis for the alleged esempdoa.Any violation
of Section 703 ES by arty applicant for a pemti, ,,bjeaa rhe upplic:wl m n civil penalty.
d of not wore than five hundred d°Bart a5oo). 3661"YIm�b -:• :<;dr ' Occupancy Type
❑1,us owner of the property,or my employees with wages as Meir sole psmpen.wdon.
will'do the work,-rand'the nmcwrc Iv nbfimended or'offered par'sale'(See.70D.- - --" - -- --
Busin,ss'andPridcs.si°ns Code:The Conrmctor's License Law does not apply to an 305 - FRAME Required Inspections,;•`t'-•k
wmcr of pmpeny Who Wilds or impwvcs thereon,and who does such wnfk hlnt.sell
or through his own employers,provided that such impmw
vearents e not intended or 307 - INSULATION
offered for'sale:'If,However.the buildinjcirlongRmvcmcw is sold w,01i7 one jcar of ---- --------ROOF-----'-'---�—'-—?---�'-"--- ----- -- --_----- -
ompIr rhe,owner-Wilder wenhasetheburdenof that he did not build or 601 - TEAR OFF
c lull, Proving
•improve for parhhae hr.mel 602 - ROOF PLYWOOD NAIL
ol:a.owner one<p(Sec.7ante.ewessadmraeemgwmres:)ThcC.olwrcrn 603 ------ROOF--.BATTENS.- 1 . . .
License the hes n Isco.]roan Busier. and eny who
Chdea The Chntmao n. Ii i„ v. .. .. ., ,
ur Lad . n°tapply man owner fp perry nnWilds
cemPwvesmenton. 604 - ROOF IN-PROGRESS
-and h c r crrc h-p 3c r .x m t mrd)Hcenscd Pursuant w the
0 empr nderStt .B&PCfnr mi:<rwson J'Ji3 `�isOl4 JIl
O
- - --WORKER 5 COMPENSATION DECLARATION
i.
I hemby ffitmJrpc Ity 1pel Y of maf;l owingd 1 uo
❑ 1 have d will actirrainfio Ceniticatic of Cntwnr to nell-insurc for Worker s
Croinperacau.n. as pm 'ded for by Sce,ioni of the Labor Codc, for me
'perfnrntunce of rhe work for which alis perstia is issued., -
_ `. 01 have and will nuinuin Wdrker's Chmperisaiiuri In umnce.0i requimd by Section
oftlic'Uhno bun
My WCnI f the perform n f the k f H this peon i s
s pc In upon can er�a d^P ky number rc: "
Cara of yNo '(ND00 J,��
CERpCa f,, i'I t•'I •itC.O . ws•2 U
IFIL 10 OPEKEMPr1ONFROM�LItWORK S s. i s u V X.3 0
s COMPENSATION INSURANCE•;,'•moo•-rte s-hr. — ---_ ___ _—_..--_ _____ ___. — — _ ---_—_. .
a (Thrs section need not be cmiapincd f me Permit is for ore hundred dollars irt. +'.I^i .r• 1)C'C 141 P)^`
131001rn1esx.) t
Icmfythrm rhe k,;W ccfah Wpa hchm pc t d I .�_,.z.,,«. ...•. _...„.,.- . .� -`'VI -{ I7 `'Yt.
sem II n t mploy any pe o dy my li wen by t t he W rksol - -
C pc i n La s of Cai f fn'a.Dae
:N(MCE TO APPLICANT B ftparkingrhk CertificatefL pmn you.should,
'i-s'' 1,• '
'become subject to the Worker v Coankr sa on provd dons of the Labor Coda,you mutt'
0 O forthwith comply with wich'provision.s or this pernat shall he record!revoked.
Zr .----_._.__.-._,._-__._---- ..----.----....,_..__-._.___..__ ..-..,..—.- _.__..._......._..._.__.. ___..___.__._._..-_.
'� s•l' ^ r-C6NSTRUC7nON LENDING AGENCY
7Manework
Ihcrehy ffimlh talo rte ib dens uF yf nhep rein 'n 'I •
e
� wsekf Fathm pe t .rtsu dlSec'1tl37 Cil Cl
D Z 'Lad :Addrcs
"I
certify that I,have mad this application and state that the above information is
fY acorrect;1 agree to comply,with all city and worry ordinances and swm laws o loin,
� w rhea ldngcon.wieuonady fori5whourar, true fah. tyt mvrupnn � . �''3 /
.'„ A. ;the aW a < i •dP ccryf inspection parry. .. _ ,
A. IW1greem ;!ad csfsand keeph astheC cy
ay fcpen no ago nit
VI ,li b i t j g cpp u c s J �cna h Y any y againw ver d
U Z Cry q nfc Int yrmn fall 'r 2—
APPLU! r UNDER D - W vE4MH.Y WITH ALL NONf�P01;5T• Issued by:UR
Date (O
y.1r"1U,Wzaod2c53
DamRe-rOOfs
ZARDOUS'MATERIALS DISCLOSURE . .il'mo applicant or(worse'buldinga npanf,ete hard) h:nnlooa k ..Type of Roof_bym Cupcnn M n ICod chaptr9,l drh Halrh and Salry'(01 r i F i - ;
°Ye __.All too shall be inspected.prior to.any-ioofing.material being.installed.
1 -
- Worm pplcamorlumrcb Ing p err equipment devices which Ifatoo is installed'withoutfirstobtainingan'inspec[Iori''I'agr8e'to'i'emove
train h d c num n nr a'deB d n5 theB y Arc A Q I'ty Sf nage t
tint all ne materials for inspecti Applicant understands and will-comply with
'qr
Ely.—lq 1 '"°: 1 1 ' ' �' all n hint source ie ulati
ni P B
h d the bosaudor,6.ncnhiv cars der Clu,n,i 695 or he
aC If mlhN Int&gafay Code S t m OS 255]7 and S53J landmund ban, - _
""il mel bulla dhcs'n 1< are nlyhm -t m malls mYtcp seer-t rifyJhe-
iaaepam rfie'rcqulrcmini tP;ted me f d CpmRm of o
re of Ap li
g Date
of n ,Date All roof coverings to be Class`B”or better` 'l .r a.
r
_ ..
OFFICE
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