07060241 CITY OF CUPERTINO � TI � TI�ITQN:
BUILDING DIVISION PERMIT
PERMIT NO.
BUILDING ADDRESS: TBD _ TO BE DETERMINED 0 7 0 6 0 2 41
7780 HUNTRIDGE LN
PERMIT ISSUE DATE
OWNER'S NAME: 06/27/2007
ED & AMY YU SANITARY NO. CONTROL NO.
JE:
BUILDING PERMIT INFO
ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH
p zz LICENSED CONTRACTOR'S DECLARATION Job Description
affirm
U 0 1 hereby arm that I am licensed under provisions of Chapter 9(commencing
z m with Section 7000)of Division 3 of the Business and Professions Code my license is REMODEL 2 BATHROOMS, NON STRUCTURAL, RELOCATE
>o y in full force and effec �I/-'!�J=�g!�T_ FURNACE & ADD NEW A/C.
v�Z License CI Lie•N
a Contractor
ip Dare ARCHITECTS DECLARATION
i a< I understand my plans shall be used as public records
:0.
U.I- Licensed Professional
O` OWNER-BUILDER DECLARATION
j in-4
1 hereby affirm that 1 am exempt from the Contractors License Law for c
:p O following reason.(Section 7031.5,Business and Professions Code:Any city or county
,�V which requires a permit to construct,alter,improve.demolLch,or repair any structure Valuation
)-w prior to its issuance,also requires the applicant for such permit to Glc a signed statement c Ft.Floor Area
?a that he is licertsed pursuant to the provisions of the Contractor's License Law(Chapter 9 (1' $28000
t H o (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
a that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type
Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of[3590604--A �Number P y yp
not more than five 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.7044,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 Contractors -9
License Law. B&P C for this mason
1 am exempt under Sec.
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations-
LJ
eclarationsL]I have and will maintain a Certificate of Consent to self-insute 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 La C Cor9�5!Policy
f the work for which this permit is issued.
My Worke ompe atianand Policy num
Cartier. No..
CERTIFICATE OF EXEMPTION FROM WORKER '
COMPENSATION INSURANCE
(This section need not be completed if the permit is formic hundred dollars($100)
or less.)
I certify that in the performance of the work for which this permit is issued.I 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. Z forthwith comply with such provisions or this permit shall be deemed revoked.
,Z� CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
CC .7 the work for which this permit is issued(Set:.3097,Civ.Q
w Q Lender's Name
fl+ Lenders Address
U Q 1 certify that I have read this application and state that the above information is
i- correct.I agree to comply with all city and county ordinances and state laws relating to
Ubuilding construction.and hereby authorise representatives of this city to enter upon the
above-mentioned property for inspection p poses.
>" a (We)agree to save,indemnify and cp harmless the City of Cupertino against
r�i liabilities,judgments,costs and expcnscs ch may in any way accrue against said City
U inconsequence of the granting of this per Date
r. pp DERSTANDS AND L COMPLY WITH ALL NON-POINT Issued b):Re-roofs
S E CATION &-2710 `
Signature of Applicant/Contractor ate T e of I�OOf
HAZARDOUS A LS DISCLOSURE yP
Will 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
Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
0 Yes /No
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new r laterials for inspection.
District?
Yes IN.
1 have read the hamidtws materials requ ents under Chapter 6.95 of the Califor-
nia safety Code,Sections 25505.25533 d 25534.fun rstand that if the building
d of c rrently ave a tenant it is my risibility Cy the occupant of the Date
req is wit must be mel r c of of Occupancy. Signatur.'of Applicant
• All roof coverings to be Class"B"or better
Owncr or authorized agent Datc