Loading...
07050226 CITY OF CUPERTINO 7777�7 77777777- BUILDING DIVISION PERMITrC�R � ���` BUILQJt�'iQDJ8"bUBB RD MCLARNEY CONSTRUCTION P07050226 OWNER'S�JNL�ALM�E: PERMIT ISSUE DATE MISSION WEST PROP 05/22/2007 r: 4082468600 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH !0 z0 LICENSED CONTRACTOR'S DECLARATION Job Description I U p I hereby affirm that 1 am licensed under provisions or Chapter 9(commencing :z vii with Section 7000)of Division 3 of the Business and Processions Code,and my license is INTERIOR DEMOLITION OF OFFICE SPACE � 41- in full force and effect. ZZ Z Z? License r s Lie.N f Date Contractor ARCHITECTS DECLA A ION i a< I understand my plans shall be used as public records )qU u. Licensed Professional ya.I OWNER-BUILDER DECLARATION ja I hereby affirm that 1 am exempt from the Contractors License Law for the p O following reason.(Section 7031.5,Business and Professions Code:Any city or county `e$rE which requires a permit to construct,alter,improve,demolish,or repair any structure Zy prior to its issuance,also requires the applicant for such permit to file a signed statement a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation t=t] (commencing with Section 7000)of Division 3 or the Business and Professions Code)or $8360 i 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 ofNumber Occupancy Type not more than five hundred dollars($500). 3 5 7 2 0 0 3 6 A(I E ❑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 Contractors Licensee Law does not apply to an owner of 9 P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements arc 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.). ❑1,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 Milds 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 reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑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. ❑1 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 an: Cartier.Ad. ^ Poliq No.: 0 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section meed 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 Workcrs'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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z , CONSTRUCTION LENDING AGENCY ►rA— 1 hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) ALender's Name a Z Lender's Address U 0 1 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 rJ U building construction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against .q 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 COMPLY WITH ALL NON-POINT Issued by: SOURC�REG�TIONS. ,,,' / �I//'' ���_�Z �.��-�t�_ Re-roofs Signature o li t/ onuactor Dale HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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 Cole,Scction 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will the applicant or future building occupant use equipment or devices which If a roof is ins:ailed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ������////// ❑Ycs No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&SafctyCode,Sections 25505.25533 and 25534.1 understand that if the building does not currently tum a tenant.that it is my responsibility to notify the occupant of the re yuircmevn stxmetpriarwiastra�nracertiatc9toccuppicy. Signature of Applicant Date Z Owner or authorized agent Da _ All roof coverings to be Class"B"or better 77777777777777777777777 CITY OF CUPERTINO �1 'TRA �t?lt�� RMATIN* BUILDING DIVISION PERMIT PERMIT NO. B iLL[DNG�RDRES�yUBB RD MCLARNEY CONSTRUCTION 07050119 l lJ �j(J D PERMIT ISSUE DATE OWNER'S NAME: 05/15/?nn-7 MISSION WEST PROP 355 S DANIEL WAY SANITARY NO. CONTROL NO. AE: 4082468600 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB M�EH _C7 z LICENSED CONTRACTOR'S DECLARATION Job Description 0 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing P with Section 7000)of Division 3 of the Business and Professions Code,and my license is TEMPORARY PERMIT (GOOD FOR 30 DAYS) EXPIRE y in full force and effecti��Vl z License Class Lic.x o DateContractor ARCHLTECTS DECLARATION ' I understand my plans shall be used as public records i4 U ti Licensed Professional OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the 5o following reason.(Section 7031.5,Business and Professions Code:Any city or county �iimprove,demolish,or repair any structure which requires a permit to construct,alter, Valuation H prior to its issuance,also requires the applicant for such permit to file a signed statement S Ft, door Area $200 that he is licensed pursuant to the previsions of the Contractor's License Law(Chapter 9 q -$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or therefrom Occupancy Type that he is exempt t to a civil penalty of and the basis for the alleged exemption.Any violation of 35720037 . �Number Section 7031.5 by any applicant for a permit subjects the applican not more than five hundred dollars(5500). ❑1,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 forsale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of properly 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.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contiaetoes Li- cense Law not reon,and who contracts fapply or such po rojects with a nttrac or(s)licensed pursuant o the Contracor s License Law. B&P C for this reason ❑1 am exempt under Sec. 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. ❑1 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 Workees Compensa on Insurance carrier and Policy number are: Cartier. %ItE( Policy No.: ECTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is far one 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 04 > the work for which this permit is issued(Sec.3097,Civ.C.) L11 A Lender's Name a+ Lender's Address 1 certify that I have read this application and state that the above information is �O correct.1 agree to comply with all city and county ordinances and state laws relating to 0 J building conswction,and hereby authorize representatives of this city to enter upon the above-menti roperty for inspection urposes. ag a to save,Indere and k p harmless the City of Cupertino against liabi- es,jud ents,costs a xpenses whi h may in any way accrue against said City U Z i onsequc e o c g ng of this y: (� Date APPLIC D STANDS AND LL COMPLY WITH A L NO -POINT Issued b JC SOURC R ONS.... r FAII ofs Sig to A r Da of Roof DOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle harardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Scction 25532(a)? oofs shall be inspected prior to any roofing material being installed. ❑Yes ° 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 materia ils for inspection. Disuict? ❑Ycs No ave read the ardous rials require cnLs under Chapter6.95 of the Califor- ncalth&Safcty C ,Sc ' ns 25505,25533 25534.1 understand that if the building oes not currently h nant,that it is my ponsibility to notify the occupant of the ___�— Date rcquircmcn met priortoi ccoCaCcnifcaico pcfypan . Signature of Applicant All roof coverings to be Class"B"or better Owner authori d agent Datc