04040007 (4) CITY OF CUPERTINO ' '� "� " e`•t
BUILDING DIVISION PERMIT CONTRA CTORINFORMATION
.GILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT NO.04040007
HER NAME: PERMIT ISSUEDATE
IRVINE APARTMENT COMMUNITIES605 COMMERCIAL2004
E. SANITARY NO. CONTROL NO.
(408) 536-0420
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
u re00 LICENSED CONTsed and R'SDECLARATION Job Des
I ionhereby70 af0rm that l am ftho BO i under provisions of Chapter 9(commencing
� with Scnion]0(kOaf Division3 ofthc Business and Pmfcasinm Cndc,end my license is FINALED
in mu force and effect. STAIR REPAIR
License Class LIc.N
Dam GontacDEC �3 2004
ARCHITECTSC.Ot.t DECLARATION
W
u 1 understand my plans shall be used as public records
3oX Licensed c,.hy affix BUILDI■ Y
g OWNER-BUILDER DECLARATION
BG
E a Y I hereby affirm on 1 ore exempt from the Cnmmam's License Law for the
p O following uies a.(Semen]ensu,Business and improve,
de i demolish,
Code:Any city nr county
m'n which requires a permit re construct,eller,improve,demolish,m mpaigned statement_Mr that hnsl lensed proodant alsore to theres theapplicantthe Coforsuchpermiuoiensecit aw(Commem
E¢G thathewith
pSectio7WQ)of Division
of theContractor'sLimnselaw(C Code)uple,9
Sq.Ft. Floor Area Valuation -
>a-$ (enmmene xem it theeirom and
basis for
the
the Business and Professions Cole)or
y�.. Ihel he is exempt therefrom and Ne basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of more 3IkeN 5Z Faer00 QGGD
not than five hundred dollars(5500). Occupancy Type
I]L as owner of the propcny,or my employees with wages as their sole compensation,
will do the work,and the struame isnot intended or offered for sale(Sec.7044,Business
and Professions Cede:The Contractors License Law does not apply in an owner of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements arc not intended or offered for sale.IL
however.me building or improvement is sold within one year of completion,the owner.
builder will have Ne burden of proving that he did not Wild or improve for purpose of -
.1c.).
;In��,
s owner of the property,am caclusively contracting with licensed contractors to
ct the project(Sec.]044,Business and Professions Code:)The Contractor's Li.
aw docs net apply to an owner of properly who Wilds or improves thereon,and
ntracts for such projects with a ChaireCorfs)licensed pursuant the Contractor's
La 1
ea upit cc. ,B&PC rhisre o Date
VOR �R' OMPENSATIONDECLARATION
the ya tmt Oder Ity of perjury ane of the fallowing declarations:ntain a enificme ofConsent m selfinsum forWorker'sCompcmas provided for by Section 37M of the Labor Code,for the performance of the
work for which this permit is issued.
❑1 have and willmaintainWorker's Compensation Inammer,as required by Section
37W or the Labor Code,for Ne performance of the work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy number am:
Cannier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE .
oris action need not W completed if the Permit is fmone hundred dooms($10)
nr coal
1 certify that in the performance of the work Por which this permit is issued,1 shall not
employ any grown in any manner so as sea become subject to the Workers'Cnmpensmion
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should _
become subject tm the Worker's Compensation provisions of the Labor Cnde,you mull
O forthwith comply with such provisions or this permit shall he deemed revoked.
'z 5; CONSTRUCTION LENDING AGENCY
[-+��+ I hereby affirm that dome is a construction lending agency lot performance of
!Y'ti the work for which this permit is issued(Sec.3097,Civ.C.)
Q Lender's Name
D z Lender's Address
U Q 1 certify that I have read this application and lam that do above information is
l4F correct.l agree to comply with all city and county ordinances and state laws relatingm
U building construction,and hereby authmme representatives of Nis city m enter upon the
4 abnvetms,judg judgments,
crtyost for i expenses
purposes. ,�
(We)agree to save,indemnify and keep harmless the City of Cupertino againsl
Uroc liabilities,judgments,coatsindof this eainit. may to any way acerae againstsaid City
U,Z in cnnuyucn mf the gra nting of this permit.
" APPLICA U N S AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE 5:
Re-roofs
Signamrco Ap ¢no tr it el
HA R S MATERIALScuplexSCLOSURE Type of Roof
Will the Chcant rupia Code,
Chapter 9,12,
handle Health
us and Safety tl
az defined by the Cupeninn Municipal Cude.Chapter 9.17,and the Hcahh and Safety
c,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑YcsA.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it hazardous air contaminants snts'm dcfncd by the Bay Area Air Quality Management all new materials for inspection.
D1tricR /
❑Yes
1 have read the havandous materials requirements under Chapmr695 of the Califor-
niaHcalth Safety mlc Sector 25505,25533 and 25534.I undcmmnd Natithe building
does not em a Churl,that it is my responsibility m nosily the occupant of the
mquire w u r outssamceOrace"Heamofoccuy. Signature of Applicant Date
owner ora or .oda e I Date All roof coverings to be Class"B"or better