07120219 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRAC' OR INFORMATI S
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BU11D1 A ORES ' n PERMrr NO.
li57'Kl STEGL:LNG RD LANDMARK DEVELOPMENT 07120219
/ NER'S NAME: PERMIT ISSUE DATE
AS :IAL,MAS STELLING LLC 1307 S MARY AVE STE 120 09/03/2008
PHONE: SANITARY NO. CONTROL NO.
11
ARCHRECf/FNGINEER: BUILDINGNEW TWO STORY TOWNHOUSE BLDG ELE PERMIT PLMB MECH
Y002 ;99 SF LICENSED CON1RACTOR9 DECLARATION ' O O O
u 1 hereby from that l aA licensed under provi men of Chapter 9(mmmemirg Job Description
with Smtion 70)(1)W Division]of the Busereas andPrressixted Code.and oty4ioneseu
n R1n mrull torte and crc 33�
��_ licariz Class Lk.
Dau L
ECConuaM
n F�F AR S DLARATION
W U I undemanJ my plans Nall be used as public records Cut"I
k Licensed Professional �-
5 OWNER-BUILDER DECLARATION
S 1 bemhy affirm that I em Cacmpt from Mc Conimermfs Liccnw Law for to
COO following mann.(Section 9031.5,Business and Professions Code:Any city or county
which requires It permit to construct.Cie,.impmm,dcmalLsh,or repair my abuetam
_z pow to its issuance,Can mquim the applicant for such permit to file a signed statement
hot he is licensed pursuant to the provisions of lie ConacmrS Boone Law(Chapter 9 Sq.Ft. Floor Area Valuation
Y€'O (commencing with Section Y000)Of Division]of the Busines and Profusions Cnde)ur -
y $ that he is e tempt themfrom and the buts for the alleged exemption Any violation of
Section 9031.5 by any applicant for a permit ubjects the appBcauo a civil pealty of APN Number Oeeu
ret mem thanane five hundred dollars(1500). p y Type
1,as maser of the property.or my employee with age u Nefrsole compenatlon,
will&the wont and t e suacWe ts rminended woQeed foral°(Sec.YON,Bumbess
and Professions Crdc:The Contaaures License Law docs net apply to an owner of Required Inspections
propenywho Wilds wimproves thetsan,andwW doessuchwork himselfor through his
mam employes,prodded that such improvements are not intended Cronemd fwsale If,
however,the Wilding or improvement Is sold within ow you of completion,the Mwrcr.
Wilder will have the better of proving that he did rot Wild w improve for purpose of .
a1°.).
❑1,a mora of tic pmpcny,am exclusively Counseling with licerand contratan On -
mutrm the project(See.7044.Business and Profwiou Cad°:)The Co°ortmes U.
come law does not apply to an Manor of propeny who Wilds or improves themon.and. .
who Conuscu for such projects with a mouncter(s)licensed porsuat to Ne C°ntraci res
License law.
❑Iarnmer"underSec ,BQPCfwthumasor
/ Dao
WORKERS COMPENSATION DECLARATION
1 hemby Cron under penslty of perjury Man Mf the following doeluatms
I leve and sill mainuln adorn Sem ofConsem r otic,for roe Wartda ceof Me .
aeon, r provider(pe by Sector]700 of the Labor Cade,for Ne Performance o!the
wort for which this permit is issuM
❑I have and will maintain Worke(s Compensation Warrants,as wired by Saturn
37W of t e Labor Codc,for the pcdormats of Ne work for which this permit is issued.
My WorkC pen ado" rmm carrier and Policy number me-
ardcrt wunj4Ae � acy r°^-Ty ZeYsYo
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Mussectlon need not be Completed lithe permit is Income hundred dollars(1100)
or ICs)
1 cwdfv amt in the performance of N°work for which this permit u issued,)Nall not
employ any pemen in any manner so as m become subject to the Wmken'Comp enation
Laws of Cnif.m n.Dam
Applicant
NOnCE TO APPLICANT:If,after making this Certificate of Facmpdon,you should
Wcome subject m the Worker's Compensation previsions of the Lahw Code.you most
,J z forthwith comply with such provisions or Nu remit MCI be darned revoked.
z CONmucnON LENDING AGENCY
[+ IWmhy afrirm that Nem is a connotation lending agency for the pef°manse°r
fY> to work for which this permit is issued(Sec.](19'0.Civ.C.)
W� Q Undoes Name
7 z LCndeh Address
V Q 1 comfy that 1 Noe and Nis application and sue that the above itdomation is ,
r. corct reI agree m Comply with all city and county ardinance and sue laws relating to
OW aY1Wve�monba' redtan,and botchy athodm«presennatives of Nu city m Crmrupmn the
pmpS for inspection purposes
tF-r r4/1 liabilitis,Judgments.mss indemnify whicch mney°nmy way the ti sue aof g vert said City .
V z inc nee �- 3
P DE
A°g 0f IL OMPLY WITH ALL NON-POINT Issued by: Date -C
R U 01
SignaumarA lisp ntraChn �3 Re-roofs
DOUS MATERIALS DISCLOSURE Date Type of Roof
WWII the appil art m fulum building wcupatstore w Abele haaNaw ounehil
.defined by the Cupenimo Munid Code.Chapter 9.12,and the Health and Safety
Ir.Suction Z1532(C9
❑ya NM All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applient rc future Wilding Occupant tax equipment or$vices which P g
D it haeumious air contam: Nu cfincd by Ne Bay Ars Air Quality Management all new materials for inspect'On.
0Ye
(have mal Nehasrdnus memdab rtyvirtmcnss un4yy Ch,tc,6.95ofthc Califw.
ria Health elycode ctiau25505.255]]anJ ,Iundenand Nuifte Wilding
does cu U •un Nat COU m notify Ne occupant n
m n ren mat en cent enifieae ar Ocmraq. Signature of Applicant Date
nor ar aatha D,m All roof coverings to be Class'%¢"or better