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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
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C0NTRA.CTOR INF,ORMATIf'1N *s
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BUILDINpf.pDgESS'
. U!i` `J N STE'LL�ING RD
LANDMARK DEVELOPMENT
PERMIT NO.
07120223
NEWS NAME:
FERMrr ISSUE DATE
[,AS PALMAS STELL1NG LLC
1307 S MARY AVE STE 120
09/03/2008
PHONE
SANITARY NO. CONTROL NO.
ARCxnECnPNCLNEER:
NEW TWO STORY TOWNHOUSE
BUILDING INFO
BLDG ELECT PERMIT FL
TT UMB MECH
2,399
O O O O
LICENSED CONTRACTOR'S DECLARATION
SF
Job Description
Imany.Bn that l son liancrand mat provisions of Charms' 9(commencing
riN Scotia 70(IU)ofDi "'on 3afw Budar va Prafcsdan Code Wmylicncxu
N inns Tina as arcca <{
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uattm n . ua. 33�Ft%
Da¢ Comramar
S DECLARATION �}
I understand my plain Mall W used as Public wcora /
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Licensed Professional I
OWNER-BUILDER DECLARATION
1 hereby amt, that I em exempt from the Contractor's License Law for w
following rcuon. (Section 7131.5, Buriner and Professions Code: My city or county
which wti.l. • permit to ennstmcl altar, impmw, demulLN, nr wpair any soumum
prior to Its Wallace, elan sculls] the applicant for such remit to file a signed sYlemenl
can. as is licensed putauant mw provisions of w Cootracmr's Liaenra Law (Chap= 9
Sq. Ft. Floor Area Valuation
(commencing with Section 70D0) of Division 3 of she Business and Prorerions Cade) or
wt be is aarmpt thate(rom and Us buie for w alleged assumption. Any violation of
Secants 70313 by any applicant far a permit subjau the applicant N a civil pcoaity of
APN Number
Occupancy Type
Intl roam than five Wawa dollar. flim
❑ I.uoww ofw Propmty,ormy mnployaa with wagcau wv role camperuaaon,
win do wwark, and w structure is act intended oroffamd far sale (Sec. 7064, Bu it m
and Proraasiau Can: Thad Canaaawn Liana Law don not apply an an ownar of
Required Inspections
proprty who builds or iama as theman, as who does such work himrJf ar through hex
oats amployrrA, provided that nch impthmemanu art not intended oraRr+ed forsale a.
however. the building or improvemrs Umld within an year of completion. the amm,
Miller NB haw the buNan of proving that M did rot Mid or improve far pure. of
sale.),
0 I. u owner of the propcny w esctusiwly contracting with named anaac arm Or
construct the projen (Sec. 7044, Basin and Profession Codc:) The Contraemr'a U.
man Law don not apply m an owner of property who builds or improru thereon. and
who contract, for such pm)eem with a eantrncloon) limand promm, to the GnVactar's
Liaise Law.
❑ I am exempt, undo See , B d P C far Nis wuon
Data
Poor
WORKERS COMPENSATION DECLARATION
1 hereby .Dim under penalty of perjury on of w fallowing daclarmonc
❑ I haw and will maintain a CartifhnN of Commt to saINanm for Worker's Campo.
cation, to provided for by Section 3700 of the Labor Code, for the performmst of the
work for which this permit is island.
.
[ 1 have and will maintain Worker's Companutian Inunna, u wquiwd by Section
,
3700 of the Labor Cads, for the perrorm,nce ofw work for which NU postal, Is isslmd.
'
My Worker' Compensation Inmmna artier and Polity numbcrme:
Crier. Polity No.:
CERTIFlG O %EMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This emlon road not W completed if the psmb Is far ona hundta anan (S la)
or lea)
i anify, wt, in w paromarcc of w waft for which this permit abroad, I shall het
employ any Kama In my manner an a On bacmne subject in tie Workera'CompCM1raW
"
Laws of Caiifomis Dam
Applicant
NOTICE TO APPLICANT: If. after making Nu CcniOnm of Esampaon, yea Mould
bacame $not= Or w Wnhcr's L'ampcnakdan provisions of the Labor Can, you meth
'
forthwith comply with such praviaon or NU permit shall W doomed mated.
cONmucr10N LENDING AGENCY
-
I Wwby.Rim that Use la. canatmcdon loading agcmy fora peNmnrae of
w work for which cos Mora 4 Wood (Sec. 3097, Or. C.)
Lendar's None
Learner AM.
1 cooly Nat I haw mad Ihia application nand sent Net w,Ww iNOmatiun I.
carom- I agora m comply with all city and county ordinances and sum laws relating it
building concoction, and Newby instance mpmxnmfivea of this city in enmr upon w
show- mensand pmpeny for inspection purposes
m
(We) agave to caw, indemnify and kap hrmlw the C" of CupcMno against
cost, as cape whichm in Bane agant,said City
incoisex.Judgmcnm,
in conseq (Net of ',
APPL N AND N WITH ALL NON -POINT
S
Issued by: Date
ONS.
Re -roofs
Type of Roof
0
S ign o Applican on Dam
NAZAR USMATERIAMDISCLOSURE
Wlil yt Wilding ram or handle haruand
e Cupen m(alum
a. Chant
u alined by w Cupertino Munici 1 Code. Gaper 9.13, as w Hmth and Safety
Sassy
ae.Sactionu533(,)I
❑ Yu a
All roofs shall be inspected prior to any roofing material being installed.
Wiliwapplicmt row W)Iding onvpanl tie c9vipmentoravia which
If a roof is installed without first obtaining an inspection, I agree to remove
g pe g
la.! huudmm air cantaminnu defined by the nay Area Air Qlaily Management
all new materials for inspection.
❑Yn No
1 hew wad than haasNous meeriaiswquiromatsn umkr Chep=695ofse Glifor.
nb Naaldt &sa@lyCodeS Omm2550S. 533aa25 .lun �thall(lhe Wilding
does not curyya a ,vat t it' y I' o tie ocavpant, of Ue
".iwmprlG4phic a rot Pi air of f B �roM2—
D
Signature of Applicant Date
All roof coverings to be Class '%W` or better
owes aN .g n Dan,