07070102 CITY OF CUPERTINO `
BUiLDING DIVISION PERMIT '��l�k����� I�������N ;
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PERMIT NO.
BUfLD Urcbn�pq�ssMORETTI DR TBD — T�) BE DETERMINED 07070102 •
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PERMIT LSSUE DATE
OWNER'S NAME: .
JENNY LOUIE 10/02 2007
SANITARY NO. CONTRO(. NO.
VE:
BUILDWG PERMiT1NF0
ARCHITECT/ENGINEER: gLDG ELECT PLUMB MECH
� � 0 �
� p a LICENSED CONTRACTOR'S DECLARAT[ON JOb DeSCflpt10T1
� V� 1 hcrcby aCGrm that I am licensed undcr provisions oC Chap�cr 9(commencing
; Z� wiih Sccdon 70c�> o( Division 3 of thc Busincss and Profcssioas Codc. and my liccnsc is S FI�wL 2, 3 2 2, GARAGE 4 6 8 ' — SAN I TARY I S SUNNYVALE ' s
�< a in full [orce an d c f fect
�� z Licensc Clazs ��. � JURI SDI'�TI ON . GARAGE 5 6. 3 8 X 4 6 8
" p Dam Con�ractor
: t" � ARCH[TECI'S DECLARATION = 2 6 i 3 8 �
j a .a
a I undcrswnJ my plans shall bc uud as public rcconis
)aV
' a y Licensed Pmfcssional
; � < OWNER-BUILDER DECI.ARATION
� <� 1 hcrchy atTirm that 1 am excmpt Crum ihc Contraaar's Liccnsc Law for Nc
p o following rcason. (Scction 7Q31.5, Busincss and Profcssions CoJc: Any ciry or munty
�$�i which rcquires a pertnit to conswct, altcr, improvc, dcmalish, or repair any struccure
�^ N prior lo i�s issuancc. also mquires �hc applicant far such permit to Glc a signcd s�alrmcnt � � Valuation
: z a thai hc is licenscd pursuan� to thc provisions of thc Contrutur's Liccnac Law (Chaptcr 9 ,� Ft. Floor Area � 5 2 415 3
,� t �(commenciag with Scction 7000) of Division 3 oC Ihc Busincss and Profcssians Code) w
i�� ihat he is ezempt themttam and Uu bazis [or the ailegcd exempdon. Any violaUon o( Oceupancy Type
Section �031.5 by ury appiicant foc a permit subjects �he applicant to a civit penaity of 3 7 516 0 5 9`°.'�� Number
not morc chan five hundred dallazs (5500}
❑[, as owner o[ Uie properry, a my employces with wages u their saic compensauon,
will do the work, and ihe suucturc is noe intended or ofiucd for sale (Sec. 7044. Business Required Inspections
and Professions Codc: "fhe Contcacwr's L'uenu Law docs not apply w an ow�rcr of
prapeny who builds or improves thereon, and wha das such work himself or �Mough Ais
own employccs, providcd �Aa� such improvemenls are not intendeA or a[fered for sala If,
however, the building or improvement is sold within one year ot compiction, tlrc owner-
builder will have the burden oC pcoving that he did not build ar improvc far purpo.0 of
saleJ• '
� as owner of the property, am acclusively conuacting wi�h limnsed rnnvutors to
co�stma the project (Sec. 7044. Eusiness and Profcssions Code:) TMe Con�s Li-
ccase Law docs not apply �o an ownu of property who builds or improves Ihe�eon. and .
who conuacts Cor such projects with a contractor(s) licensed pursuam to the Contractor's
License Law.
❑ I am exem r Sec. . B dc P C for this rcason
0���`� � Date ��L��12_,[.sc1_ _ • _.
K ' ENSATfON � 1
1 hereby aCfitm under penalty o[ perjury one o[ �he follawing declaruions:
�] I hsve and will maintain a CertiGpte of Consent to sel!-insme for Workcfs Compen-
sation, as providcd for by Sectian 3700 0[ che Labor Code, for ihe performance of the
work for which Ihis permit is issucd.
❑ I havc and will maintain Workcr's Compensatian Insunnce, u rcquired by Scction .
3700 of thc Labor Codc, for �he performancc of t6e work for which �his pecmit is issued
My Worker's Campensaoon Insucance carricr and Polity number a�c:
Cartier. Poticy No.:
CERTIF[CATE OP EXEMPIION FROM WORKERS'
COMPENSATIONiNSURANCE
(Chis scction nccd not bc completcd if the permit is foranc hundred dattazs (S1U0)
or Icss.)
1 cenify thxt in �hc performancc of thc work for whic6 Wis permii is issucd. ! shall not
employ any person in any manncr u lo becomc wbject to Wo rs' Com 'on
Laws of Cali[o '
Applicant �
NOTICE �O LI : If, aftcr m mg �h�s Cc�iufiw�c of'Ezem�(uon, you shouW
bccome subject to the Worker's Compcnsation pmvisions of thc Labor Codc, you muu
� z forthwith comply with such prpvisions or this permit shall bc dccmcd cewkcd.
�
Z '—' CONSTRUCC(ON LENDING AGENCY
F r � 1 hcrehy a[tirtn ihat there is a constructinn lcnding agenry for thc perturmancc uf -
�, � thc work fur which this permit is issucd (Scc. 3097, Civ. C.) ,
W A Lcndcr's Namc
� � L.cnder's Addrcsc
() � 1 certi(y ihat I have read this application and sule tfu� the above informatiun is
w � cortect. ! agrce to comply with all city and counry ontinances and sute Iaws relating m
0 J building conswction, and hcreby authori�e represcnutivcs of Uiis city to cntcr u{�n thc
� W above-mentioned pmperly for inspecuon purposes.
a (We) agrce to save, indcmni(y and kccp hartnless ihe City o( Cupcnino agains�
�� liabilities,judgmcnts, costs and expenses which may in any way accruc agains� said City /J
U,'� io consequence oC �hc granting of ihis permi� Date /� C����
�+ APPLICAhi!' ER NDS AND COMPLY WITH ALL NON-POINT Issued by
SOUR�E'FtEG �
' P� Re-roofs ��
Sig urc of ApplicanUConuxtor �� T of R oof
HAZARDOUS MATERIALS DISCLOSUR YP
Wil( ihe applicant or futurc building accupantstorc or handle harardous matcrial
as dcfincd by the Cupenina Municipal Codc. Chap�er 9.12, and t6e HcalU� and SaCetr
c� Scction 25532(a)? �/ All roofs shall be inspected prior to any roofing material being installed.
❑ Ycs 1�1'�`+� .
Will thc applicant or futurc building occupant usc cyuipmcnl or dcrices which
If a roof is installed without first obtaining an inspection, I agree to remove
emit harardous air contaminan�s u dcfincd by the Bay Area Air Qualiry Managcment all new rr aterials for inspection.
District? �
❑ Ycs �''[,�
1 havc rcad the ha�arCous matcrials requircmcn�t undcr Chap�cr 6.95 of �hc CaliCor-
nia Hcalih & Safcty Codc, Scctions 25505, 25533 and 25534. I undcrstand �hat it Uu bui�din8
docs no� curtc y havc tcnan4 �at il is my responsihilily to noUl'y Uic occupan[ nf thc
requi nis bc tprioru�issuanceoCaCcrtil'icatco�oc � . Signature ofApplicant Date
� � All roof coverings to be Class "B" or better
ncr or authori•r.cd agcm ���