07090143 CITY OF CUPERTINO10
BUILDING DIVISION
PERMIT
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"'DINT D R ,;;. PERMIT NO.
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� TLMSFORD DR ARGONAU'P WINDOW & DOOR, INC 07090143
iR'S NAME: PERMIT ISSUE DATE
HUANG KE-CHIEN AND JOAN-YU 1901 S 3ASCOM AVE STE 800 09/21/2007
SANITARY NO. CONTROL NO.
PHONE:
(408) 373-4018
BUILDING PERMIT INFO
ARCHITECT/ENGTNEER:
BLDG ELECT PLUMB MECH
0 0 0
p LICENSED CONTRACTOR'S DECLARATION lob Description
(: 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing
U
:zwith Section 7000)of Division 3 of the Business and Professions Code,and my license is WINDOW REP LAC EMENT, LIKE FOR LIKE.
t=y in full force and effect
License Class Lte•k
t p Date Contractor
ARCHITECT'S DECLARATION
i a a 1 understand my plans shall be used as public records
)yU
u y Licensed Professional
y OWNER-BUILDER DECLARATION
> I hereby affirm that I am exempt from the Contractors License Law for the
jp CO following reason.(Section 7031.5,Business and Professions Code:Any city or county
which requires a permit to construct,alter,improve,demolish,or repair any swcture
} prior to its issuance,also requires the applicant for such permit to rile a signed statement Valuation
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;xG that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 )q.FC.Floor Area 6 O O O
aF (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
4 that he is exempt therefrom and the 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 3 620902 3 �Number Occupancy Type
not more than five hundred dollars($500).
❑1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure isnot intended oroffered for sale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law docs 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 Contractoes
License Law.
❑lam er Sec. B&P C for this reason
etaDate
ORKE COMP NSA O ECL TION
I here y affirm under penalty of perjury one of following declarations:
❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compcn-
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 Worker's Compensation Insurance carrier and Policy number ate:
Carrier. Policy Na.:
CERTIFICATE OF EXEMPTION FROM 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,)shall not
employ any perso y manner so as to become subject o Workers Compensation
Laws of Cali ia.D
Applicant 1
NOTICE TO L1A :If,of making this Certificate of Ex NO , ou should
become subjeftiothe Worker's Compensation provisions of th Code,you must
Z forthwith comply with such provisions or this permit shall be dkfmcd revoked.
z O CONSTRUCTION LENDING AGENCY
E" I hereby affirm that there is a construction lending agency for the performance of
R�+ the work for which this permit is issued(Sec.3097.Civ.C.)
W Q Lender's Name
az
Lcndcr s Address
V 0 I certify that I have read this application and state that the above information is
LL correct.I agree to comply with all city and county ordinances and state laws relating to
0 U building construction,and hereby authorat reprcsentativcs of this city to enter upon the
W above-mentioned property for inspection purposes.
Q. (We)agree to save,indemnify and keep harmless the City of Cupertino against
fn liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit Date
APPLICANT UNDERSTANDS AND WILL OMPLY WITH ALL NON-POINT Issued by
CE GUL TIONS. /
7
Re-roofs C7
Si uu Appli t/contractor Date Type Of Roof
HAZARDOUS MATERIALS CLOSURE
Will the applicant or future building taco. store or handle hazardous material
defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
dc,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes 14:NN°
Will the applicant or future building occupant use equipment or devices which
If a roof i 3 installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection.
District?
❑Yes NNu
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building
docs noyturrenty have a tenant that it is my responsibilit to notify the occupant of the
re rcmcntswhic most metpriorwiss ancco c 'GcatearOccup Signature of Applicant Date
All roof coverings to be Class"B" or better
Owner or orizcd age Date