The URL can be used to link to this page

07010021 CITE'OF CUPERTINO BUI-LDING DT7ISION PERlY1IT Cd11' R[fiTQl �� ' BUILDING ADDRESS PERMIT NO. 2395 kANCHO DEEP CLI DR PLUMB I T PERhaTISSUE DATE OWNER'S NAME: ARTHUR, SCHWARZMAN 60 MEMORIAL DR STE 140 1/04/2007 )NE: SANITARY NO. CONTROL NO. BUILDING PERMIT INFO ARCHITEC7/ENGTNEER: REPLACE WATER HEATER BLDG ELECT PLUMB MECH a a LICENSED CONTRACTOR'S DECLARATION Job Description =U I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 7000)of Division 3 of the Business and Professions Code,and I'ensc is rn in full force and effect , ? Licenseas Lie,f/ — F p Date — Contractor �� RCHITEC"S DECLARATION m I understand my plans shall be used as public records a Zo H Licensed Professional n y.< OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the FCO following reason.(Section 7031.5,Business and Professions Code:Any city or county K BZ4 which requires a permit to construct.alter•improve,demolish,or repair any structure Z; prior to its issuance.also requires the applicant for such permit to rile a signed statement Sq Ft.Floor Area Valuation e that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 F=-G (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than rive hundred dollars(5500). ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sec.70",Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If. however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sec. B&P C for this mason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My W keres Compensation Insurance carier and Policy nupber are• Ca 'rY N 7 CERTIFICATE OF EXEMPTION FR6M WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date— Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. Z OZCONSTRUCTION LENDING AGENCY E.m CA 1 hereby affirm that there is a construction lending agency for the performance of p� 5 the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name aLender's Address V C) 1 certify that 1 have read this application and state that the above information is fl.m.r correct.I agree to comply with all city and county ordinances and state laws relating to 0 V building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against mE rt liabilities,judgments,costs and expenses which may in any way accrue against said City U Z Mncqucc of the granting of this gerntfL Date UNDERSTANDS D WILL COMPLY WITH ALL NON-POINT Issued ty: GU ATION . I / / JC! Re-roof; Signat f Applicant/Contractor Date HAZARDOUS MATERIALS D[ LOSURE Type of Roof ill the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Cede,Section 25532(a)? All roof s shall be inspected prior to any roofing material being installed. ❑Ycs /rU.N. o Will the applicant building occupant use equipment or devices which If a roof'is installed without first obtaining an inspection,I agree to remove .mit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? ❑Ycs No 1 have read the hazy eus materials requirements under Chapte .95 of the Califor- nia Health&Safety C. Sections 25505,25533 and 25534.l undo d that if the building currently have a tenant.that it is my responsibility to fy the occupant of the// rc c which mua tic m no to issuance o e oC cu17-!Z) y. / Date _G / Signature of Applicant owner authorized Date All roof coverings to be Class"B"or better Community Development h 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 4-UPEkTINO Buildilng Department JOB ADDRESS: �n �fAQ '�IQ� PERMIT# �� r�r� OWNER'S NAME: (•�, T- PHONE # V V tJ�- GENERAL CONTRACTOR Vle FAX # / /1 V I XI am not using any subcontractorsa �<-," 0 Signature Date Please check applicable subcontractors d corr_ lete the followin (rmafion: SUBCONTRACTOR BUSI"4ESS NAME BUSINESS LICENSE # Cabinets&Millwork Cement Finishing Electrical Excavation Fencing Flooring.Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Roc Tile /,bwner/Contractor Signature Date CITY ()F Cf' pR ' 010! 002 PERMIT ALJC1 _FORM A - N ' Buidi — mate:b Addr bG Owners-N acne_: — T� f G LLrIS� Soly ct Ph 1 Conrr4ctor: �M 4 one 1 Lie ense n: ' 1?uildii P Gupertino Business License — Bldg icense ;�: ' g. eranit Info: 1 i job -ZD Elecf Scriptldn: PILtr,b s ech Pesididntial Cdrnr,,ercia6 SO j Cost 0,_ Project: 601 R i i On Platform, ❑ Bond--i El i New I location _ Replacernenf i Arpli6ble Fee ID P WI1 EATER Fee Descriptio,_) 1 PPER-NUTFEE ��ter�eQter/°Jenf Fee Group l BENERGY PIt rnbi + `� Perrnif Issuance BC1Sl,IO ;rgy PL Ul"!1 I'NG a Eu.;;mess License BUILDING BUILDING 1 i p3lful M- b , �Lck a ��