07060080 CITY OF CUPERTINO � R �f� �ZQ �
BUILDING DIVISION PERMIT
PERMIT NO.
BUILDING,A{?{�RRNTER LN PARAMOUN^ SIGN CONTRACTORS 07 0 6 0 0 8 0
�1�V W 1V PERMIT LSSUE DATE
'".R's NAME: 06/12/2007
iUNTER PROPERTIES 2701 RD
SANITARY NO. CONTROL NO.
PHONE: (7 07) 485 -7555
BUILDING PERMIT INFO
ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH
ao 0 LICENSED CONTRACTOR'S DECLARATION Job Description
iv(= 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 my license is INSTALL 30 SIGNS ON TOWN CENTER LN BETWEEN TORRE,
o in full force and eff DEANZA-PER SITE PLAN. PARAMOUNT RENEWED BL
i n i License C ass LK•
o Date Contractor 6/12/07 . REPLACES EXPIRED PERMIT 05060186 .
;t".,w A CHITECPS DECLA
i ot< 1 understand my plans shall be used as public records
>aU
a H Licensed Professional
O a OWNER-BUILDER DECLARATION
3< 1 hereby affirm that I am exempt from the Contractor's License Law for the
00 following reason.(Section 7031.5,Business and Professions Code:Any city or county
which rcquireS a permit to conswct alter,improve,demolish,or repair any structure Valuation
"rn prior to ifs issuance,also inquires the applicant for such permit to file a signet statement S Ft.Floor Area $65000
Z< that he is IicenseJ pursuant to the provisions of the Contractor's License Law(Chapter 9 �'
as C (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
5 F that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant ro a civil penalty of 36940033
?($ Number
not more than five hundred dollars(5500).
0 I,as owner of the property,or my employees with wages as their soic compensation, Required Inspections
will do the work,and the structure is not intended or offered for sale(Sec.7044,Business
and Professions Code:The Contracmr'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.).
0 1,as owner of the property.am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractoes 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. g&P C for this reason
0 1 am exempt under Sea
er
Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
0 1 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.
0 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 Compensa[tiion'Insura carrier and Policy number e:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars(SI00)
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
Z forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
F,�r 1 hereby affirm that there is a construction lending agency for the performance of
the work for which this permit is issued(See.3097,Civ.C.)
W Q Lender's Name
91+ Lender's Address
(certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating to
0 U 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 /
rE"t liabilities,judgments,costs and expenses which may in any way accrue against said City Date
U Zin consequence of the granting of this permit.
►� APPLICANT UNDERSTAN S AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOU ER ULA NS.
- Re-roofs
Signature of Applicam/Comractor Dam T Of 1.00f
HAZARDOUS MATERIALS DISCLOSURE Type
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
I Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
C]Yes Wo If a roof .s 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 [*No
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
does not currently have a tenant.that it is my responsibility to notify the occupant of the Date
rcqui cots hi It Qry;t be m nor to issuance of a Certificate of eupancr. Signature:of Applicant
A -I�(lh All roof coverings to be Class"B"or better
Owner or authorized agent Date