07120229 (2) CITY OF CUPERTINO
BUILDING DIVISION PENT �4e M6 a "*ON
BUILDINGA DRESS: PERMfr NO.
� J611 N STELLING RD LANDMARK DEVELOPMENT 07120229
7-H
NER'S NAME: PERMIT ISSUE DATE
AS PAI.MAS STEL,LING LLC 1307 S MARY AVE STE 120 09/03/2008
ONE: SANITARY NO. CONTROL NO.
CHITECT/ENGINEER: BUILDING PERMIT INFO
NEW TWO STORY TOWNHOUSE BLDG ELECT PLurdu MECH
O O D O
u00 69 SF
tion
' 1obDe):cri tion
ra F 1 bemby si ind door 1 sm luxnaed under pmvisiou of Chspler 9(commencing P
wiNSccuon7MIB.fDiv1i on 7 ofthc Business uN Profcssiun Code,andmyliccnmu
<s in full farm and effeel.
Liceem CI Ric.R
S F Dslo Conlmnur
R ITE( DECLARATION etAF.�aalNsJl
O I undersund my Plw shoo,bo used a public rteo,ds C.B
s LL Ls:edoze!Prof someld
yD5 OWNER-BUILDER DECLARATION
S I heroby.frim,the[1 am Mon,(from dm Canuactols Leon-Isw for the
Zoo following wen.(Section 7871.5,Business and Pmfesdom Code:Any city or county
Pi which inquires•permit he consumes.Who.improve,demulW,m mpalr my mumu e
_ prior toi"issusnce.sine requires the applinnl for well permit in file a signed sulemml
that W is licensed purmmt In the provisions of the Conamcuri license Law(Cheptcr9 Sq.Ft. Floor Area Valuation
F- (commencing wish Section 70M)of Division 7 of the Business mod Professions Code)or
d 3 dot he I,concept therefrom and doe basis for the alleged esempuats My vinh urs of
Section 70715 by s%applicant for a Purcell subjects the applieml to a doll penally of APN Number Occupancy e
not come thin five hundred dolles ISMP YZYP
❑l.uawnv of dm prperty,u my wPloym wish mgr uthe'v role compensauen,
will do the work.oro themumum b wtmm&d or oRerd faru,e(Sre.70ss,Business
and Pref,ssiom Cmc:The ComuscwA License Law does net spply In m owmr of Required Inspections
prpenywbo Wildaarimpeoves drawn,and whodoessuch work hireselfortlerough his
awn employees,provided dust such improvements tie net,nunded oroRued rorssln if.
however.the Wilding oriespmvemmt is sold within one year of completion,she..
Wilder will brow do burden of pmving that den did vel Wild or improve for purpose of
sakJ.
1,..owner of the property,sed esd.sivdy cowstim,with licensed com oner b
woutmet the proiees(Sec.7014.BusinnS am PrefeWons Cede:)The Conuao7urs U. .
cense Law dma vot apply In m owner of property went bellds m improves thereon.seed.
who contract/for such projects with acontrmtm(s)licensed pursuam us the Cowusor's
Lice's"
Law.
❑I.mesemptundef Sec .Bh PCfarthismason
k"
Due
WORKERS COMPENSATION DECORATION
I hereby alEw under ismsily,of perjury one of the following declumm,n -
❑I hsm and will maieufn a Cesufinu ofCommnt in mU-Inmm for worker's Compen-
section,u provided for by Section 1700 of the Labor Code.for the perfo,mmen of the
work for which this permit is issond.
❑1 have and will maintain Worker's Campenutian I...as myuired by Section
7700 of the Labor Code,for the pcor..of the work,for which this percents issmd.
My Worker's Cmnpenution Wumce carrier and Policy number are:
Cartier. 41C lsJnn.t�b� Polity Na.:
T� C COMPEN COMPENSATION
I MON MOM E ERS
COMPENSATION INSURANCE
(Thu medon nem Out he comp„ed if the permit is resow hundteddoRars(SIM)
or it.)
1 ecrify that be the pufmmence of the work for which this Permit u issued.I Nall am
employ my person in my connected as in become subject to the Workers'Compestsalim
Laws of Califoria.Da¢
Applicant
NOTICE TO APPLICANT:IL sAcr making this Cenifmese of Eumption,you should
llecome,mbj=us the Worker's Compensation p,wisms of the Labor Cade.you muss
.0 O forthwith comply with such Provisions or this permit shall be decmcel revoked. -- -
Z CONSTRUCTION LENDING AGENCY
[--,� I hucby alEthu this then u meed(S can 97,Cing sgenry fm the perfawanm of
C.>. uta wart red which this permit V meed(Sec.]OYf,Ci,c)
ao Undoes Name
O z Lender'.Add.
U O 1 certify dust I have read Ws applicuion W rise,out the above iNomatiw u
nr ^. cerrta 1 agree to deeply with all city and county enclosures sed mY Icer reining he
.O SV' Wilding construction,and hereby mtharix mprencesto s or this city m enter upon the
LU sllot'd enuowdpmpeny for Wpemion purposes
gy (We)agree to eve,indcmniry and kerGoly
y of Cupertino,grim,
U z liahiliuea ments.eom and ortie agsimtsald Ciey
in ca of u this wi
ER DS H ALL NON-POINT Issued by: Date 3��
UI.AT _�rl
S Re-roofs
Signswrt of App ianuCon pole
HAZAP,bous MATERIALS DISCLOSURE Type of Roof
Will the spplinnl Or future Wilding occupant nom ar lundle huespri maraca,
as dcEwd by de Cupertino Municipal .GMpeE
r 9. .coe Health
si dand Safety
ri Section 2557z(.)7 All roofs shall be inspected prior to any roofing material being installed.
Tes
If a roof is installed without first obtainingan inspection,I agree to remove
WIII the applincr or ets s Wilding oy t1ss B y A equipment or devices which P
emit hvardom alt cwuminmu u deli 0 by ted Bay Ara M Qulley Mmagcmcm all new materials for inspection.
Ditui,17
❑Yes o
I have rad dmehviNam ratios,.rcquiremcnor dcrCh.Ncr6.95oftheCalifm-
nu Hn1thh SafmyCMd Smiom 25505,25571 .I uodvn.m tharJde Wilding
does wt curer rove t m ' 7 ility to notify de occupmt of don
m n ch outs a Ccnif au:o apse
e% � Signature of Applicant Date
ld� r Or mth rise
All roof coverings to be Class'%W'or better
ager Dae'