06100178 CITY OF CUPERTINO
BUILDING DIVISION PERMIT
vy
PERMIT No.06100178
BUILDING ADDRESS:
7949 B E L KNAP DR PERMIT ISSUE DATE
OWNER'S NAME: 10/3012006
CHI AND YUAN LIN Z HANGSANITARY NO. CONTROL NO.
NE:
BUILDING PERMIT INFO
ARCHITECTIENGINEER: BLDG EO PLUMB ME�CH
p o LICENSED CONTRACTOR'S DECLARATION Job Description
U 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 CONVERT 110 ' OF (E) COVERED COVERED PATIO INTO (E)
y in full force and effect.
z License Class Le•8
=_ MASTER BEDROOM
a Date Contractor
k LL), ARCHITECTS DECLARATION
i a< I understand my plans shall be used as public records
)4U
U. Licensed Professional
OWNER-BUILDER DECLARATION
3 e 1 hereby affirm that I am exempt from the Contractor's License Law for the
:m o following reason.(Section 7031.5,Business and Professions Code:Any city or county
m which requires a permit to construct,alter,improve,demolish,or repair any structure
y prior to its issuance,also requires the applicant for such permit to file a signed statement S Ft.Floor Area ValuO&3 5 8 0
?< that to is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q
F$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
.. that he is exempt therefrom and the basis for the alleged exemption.Any violation of APN Number Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars($500). 36208046 . 00
❑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 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.).
q1,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 contractors)licensed pursuant to the Contractor's
License Law. B&P C for this reason
❑1 am exempt undq Sec. i
Dau
Owner ->/'•`�^"�—'
`W KEffS COMIFENSAZIUN 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,is 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 Codc,for the performance of the work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy number am:
Carrier. Policy No.:
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,l shall not
employ any person in any manner so as to become subject to nW/rZ,C pc on
Laws of California Date — e d
Applicant —��—
NOTICEAPPLICA,%M.If,"after m mg this Certificate of Exemption.you should
become subjc to the Worker's Compensation provisions of the Labor Code,you mast
Z forthwith comply with such provisions or this permit shall be deemed revoked.
Z O CONSTRUCTION LENDING AGENCY
F-o.�• I hereby affirm that there is a construction lending agency for the performance of
a! .� the work for which this permit is issued(Sec.3097,Civ.C.)
w A L.endces Name
�in Lcndees Address
U 0 1 certify that I have read this application and state that the above information is
LL H correct.I agree to comply with all city and county ordinances and state laws relating to
CU building construction.and hereby authorizc representatives of this city to enter upon the
above-mentioned property for inspection purposes.
(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
U Z in consequence of the granting of this permit. Date
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: 1
SOURCE REGULATIONS.
Re-roofs
Signature orApplicant/Contractor Da1C T of Roof
HAZARDOUS MATERIALS DISCLOSURE Type
Will the applicant or future building occupant store or handle hazardous material
as de0ncd 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.
❑Yea VNo 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 all new materials for inspection.
nit hazardous air contaminants as defined by the Bay Area Air QualityManagement
District?
❑Yes 06.
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
mquircMC4 is which must be met prior to issuance of a Certificateof Occ panty. / Signature of Applicant
0 All roof coverings to be Class"B"or better
Owri r authorize apt! Date