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06090104 CITY OF CUPERTINO BUILDING DIVISION PERMIT � ` �� ` PERMIT NO. BUILDJIj(iQQD�tESS BLANEY AVE A TO Z GENE:ZAL CONSTRUCTION 06090104 S /`�y-E: PERMIT ISSUE DATE ?R'S NAME: DUNCAN WONG 3063 KING ESTATES 05/24/2007 SANITARY NO. CONTROL NO. PHONE: (408) 223-1358 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p Z 'S CONTRACTOR'S DECLARATION Job Description vF I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z� withScction7000)ofDi 'ion3ofthe Business and Professions Code.and mylicense is ADDITION-MA 3TER SUITE 495 ' r REMODEL 40 ' <A. in full force and effect ? Licensfrc Lieu M6 SANITARY IS SUNNYVALE' S JURISDICTION E o Datc Contr�or = PERMIT � ARCHITECTS DECLARATION REMODEL 40 '.K100 .75 4 0 3 0 tau< 1 understand my plans shall be used as public records yU w tW- Licensed Professional y j OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the a0 following reason.(Section 7031.5,Business and Professions Code:Any city or county �Z which requires a permit to construct.alter,improve,demolish,or repair any structure Z y prior to its issuance,also requires the applicant for such permit to file a signed statement _< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation F✓$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $11 014 3 r3 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 Number Occupancy Type not more than five hundred dollars(5500). 3 6 9 2 3 0 5 2 � ❑1,as owner of the property,or my employees with wages as their sole compensation, will do thcwork,and the structure is notintended or offered forsalle(Sec.7044.Business Required Inspections and Professions Code:The Contractors 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 Contractors 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 License Law. ❑I am exemet under See B&P C for this reason r 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 Workers 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 Worke s ompensation Insuranc carrier and Policy nm be Cartier. Policy No.: CERTIFI ATE 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,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 D O forthwith comply with such provisions or this permit shall be deemed revoked. H CONSTRUCTION LENDING AGENCY �►+ I hereby affirm that there is a construction lending agency for the performance of 1,> the work for which this permit is issued(See.3097,Civ.C.) L1 A Lender's Name j2 Lender's Address 0 1 certify that I have read this application and state that the above information is m-. correct.I agree to comply with all city and county ordinances and state laws relating to DU building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. y Q. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City Z in consequence of the granting of this permit. Date ►- APPLICANT UNDERSTANDS AND WILL CO PLY WITH ALL NON-POINT Issued by: SOURCE REGULATIONS. �.— Re-roofs Signature of Applicant/Contractor D81e �' of Roof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant or future building occupant store or handle hazardous material n fined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Section 25532(a)? All roofs shall b-.inspected prior to any roofing material being installed. ❑Yes 1 No If a roof is insta led 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 defined by the Bay Area Air Quality Management all new material;for inspection. District? E]Yes u 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Codc,Sections 25505.25533 and 25534.1 understand that if Umc building docs not c iiielt have a tenant that i ' my responsibility to notify the occupant of the requirements must be met 11% iss ce nra certificate of Occupancy. Signature of Applicant Date -gr,c All roof coverings to be Class"B"or better Orvmcr or--­­;ped agent Date CITY IF CUPERTINO � � •PERMIBUILDING DIVISION PERMIT NO. BUILDNffb ESS: TONY BAIL 07040153 CALVERT DR pERNU ISSUE DATE '4R'SNAME: 05/25/2007 PONY BAIG SANITARY NO. CONTROL NO. -,)NE: BUILDING PERMIT INFO BLDG EO PLUMB M ARCHITECT/ENGINEER: i ZLICENSED CONTRACTOR'S DECLARATION Job Description FI hereby affirm that I am licensed under provisions of Chapter 9(commencing HOUSE DEMO with Section 7000)of Division 3 of the Business and Professions Code,and my license is N in full force and effect. Lic N z License Clea --Contractor W Date ARCHITECI"S DECLARATION aI understand my plans shall be used as public records �U i F Licensed Professional 7 a OWNER-BUILDER DECLARATION a 1 hereby affirm that 1 am cxcmpl from the Contractors License Law for the p o following reason.(Section 7(131.5,Business and Professions Cod Any city or county Valuation which requires a permit to constructalter,improve,demolish,or repair any structure S Ft.Floor Area rn prior to its issuance,also requires the applicant for such permit to file a signed statement $2500 Z a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q' I.- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or Occupancy Type a that he is exempt therefrom and the basis for the alleged exemption.Any violation of 3751902 2` $ Number Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ❑1,as owner of the property,or my employees with wages as their sole compensation, Inspections will do the work.and the structure is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds of improves thereon,and who does such work himself ar 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 Professionswho builds improves thereon,and. cerise Law does not apply to an owns :)The Contmtor's Li- of property who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. B&P C for this reason ❑1 it unocESAC. Ivy Date WORKFR5 COM SATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ure iii 11, ❑)hsve and wd for b maintain Section 3700 of the Laboficate of Consent rCode!(or therpctforntance of situs self cation,as Prov' Y work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,as required by Section 3700 My oorker Labor Codc�for the rfoance of the work n Insurance carrier and Policy number ar which res permit is issued. Carrier. Policy No.: CERTIFICCPEXEMPTION WORKERS' CERTIFICATE OF INSURANCE (This section need not be completed if the permit is for anc 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 u to bee subject to the Workers'CanPerxvden Laws of California.Date Applicant NOTICE TO APPLICANT:1.atter making Urs Cent(icatc tX Excmpuon,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J. 2 forthwith comply with such provisions or this permit shall be deemed revoked. Z Q CONSTRUCTION LENDING AGENCY H.�. 1 hereby affirm that there is a construction lending agency for the performance of p!> the work for which this permit is issued(See.3097,Civ.C.) W A Lender's Name G. Lender's Address U Q l certify that I have read this application and state that the above information is [T H correct.1 agree to comply with all city and county ordinances and state laws relating to 0U building construction.and hereby authorive representatives of this city to enter upon the above-mentioned property for inspection purposes. iagainst ��>1 a (We)agree to save,indemnify and keep harmless the City of Cupertino ag tFm CA liabilities,judgments,costs and expenses which may in any way accroc against said City ( Date in consequence of the granting of this permit. y: U Z APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued i REGU4LATIONS. Re-roofs Signa"tureeofApplican ` ntractor Dato Type of Roof HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future: utubuilding occupant store or handle hazzrdous material re u defined by the Cupertino Mu 'cipal Code,Chapter 9.12,and the Health and Safety Section he Cu a)? All roofs shall be inspected prior to any roofing material being installed. C]Yes No If a roof is in;talled without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which all new materials for inspection. emit havardous air contaminants defined by the Bay Area Air Quality Management District? ❑Yes 7a I have read the hazardous materials requirements under Chapter 6.95 of the Califor- ng nia Health&Safcty Codc,Sections 25505,25533 and 25534.1 understand that if the buof the Date docs not currently have a tenant,that it is my responsibility to notify the occupant of dere rcesnotcn ustbemetpriortoi�o rtcatcofOccupancy. Signatureof.Applieant All roof coverings to be Class"B"or better Owner or authorized agent —� Date