07070132 CITY OF CUPERTINO ' �
BUILDINC DIVISION PERMIT ���T����� ���������� �
BUILD � v �� D �� ess SCENIC CL TE HUNG HUANG P 07070132 .
. NER'S NAME: PERMIT ISSUE DATE
TE-HUNG HUANG � 10 29 2007
PHONE: SANITARY NO. COMROL NO.
ARCHITEC[YENGINEER: BUILDING PERMI'I' INFO
BLDG ELECT PLUMB MECH
� 0 0 0
i p p LICENSED CONTRACI'OR'S DECLARAT[ON
� v� I hcrcby affirm �ha� I am licct�ed undcr provisions of Chaptcr 9(commcncing Job Description
;z� withScction7IXw)ofDivision3o(iheBusinessandProfcssionsCodc.andmyliccnseis CONCRETF RETAINING WALL W� ROOF OVERHANG
� a a � full force and clfec�
j� Z Licensc Class Lic. #
; F � Datc Contractor
ARCHITECI'S DECLARATION
i� Q I undcrstanJ my plans shall Ix used as public recorcts
7yU
' u. y Liccnsed Pcufcssional
� y � OWNER-BUILDER DECLARATION
j >' 1 hcrcby aCGrm ihat I am excmpt trum thc Contractor's Liccnsc Law for the
p O following rcason. (Scction 7(Y31.5, Busincss and Profc.uions Cadc: Any city ar rnunty
�,°, � which rcquires a permit to conswct, altcr, impmvc, dcmalish, or repair any suucture
�� y prior to ia issuancc, also rcquires thc applican� for such permil to filc a signccl sulrmcnt
�= o that hc is liccnscd pursuant to mc pmvisions ot mc Contracwr's Liccnsc taw (Chapicr9 iq. Ft. Floor Area Valuation
u F- �(commencing with Section 7000) of Division 3 of lhe Businecs and Professians Cade) or $ 3 0 � �
��.. that he is ezempt iherefrom and the buu for the altegcd exemption. Any violation o(
Section 7031.5 by airy applicant tor a petmit su6jects �he applicant to a civil penalty of Number Oeeupancy Type
not more U�an fivc hundccd dollazs (SS00). 3 5 7 � 7 � 0 5��
❑ I, as owner o[ tt�e property, or my cmployces with wages az their solc compensauon,
will do ihc work, and ihc strrc:ure is not+:ntended or offered tor salc (Set. 7(YW, B�aness Re u ired ins eCt10IIS
and ProFessians Cadc: The Conuactor's License Law docs no[ appiy w an owner of Q P
property who builds or impraves thercon, and who does such work himsellor Uuoagh his
own employces, providcd tha� such improvemen�s are not intended oro[fered f�sala U.
however, the building or improvement is sold within one year oC completion. �he owner-
builder will have the burden of proving that hc did not build or improvc [or pmpose o(
sakJ.
�l, as owner of the property, am exclusively conlracting wilh licensed contracwrs m
LOnstruct the pcojea (Sec. 7044. Husiness and Profcssions Code:) The Coatnao�'s Li-
ccnse Law daes aot apply �o an owner of propeny who builds or improves Idereon, and .
who convac�s for such projec�s wiih a conuactor(s) Iicensed pursuant co We Convxto�s
' �cense Law.
` am exempt undet Sec. , B& P C for ihis �cas�n
vwner �/7 _ /7�� Date `� � _ .
- �W R ER5 C PENSAT[ON DECLARATION
I hereby �tm under penalty o[ perjury onc o( �he following declaruions
❑ I hsve and will mainiain a Ccrtificatc of Consent to sclf-insure for Worker's Comppi-
sation, as provided for 6y Section 3700 af the [abor Code, for the performarcc ot �hc
work for whieh Wis pertnit is issucd.
❑ I havc and will maintain Worker's Compensation Insunnce, u required by Scaian
3700 oC �hc Labar Codc, for Nc perfortnancc ot �he work for which this permit u iswel
My Worker's Compensation insucance camer and Policy numbcr arc:
Cartier: Paliry No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSAT[ON INSURANCE
(ihis sectian nccd no[ be completcJ i( the permic is Cor onc hundred dollus (5100)
or Icss.) •
[ ceni(v th�t in thc performancc of thc work for which �his permit is issucd, l shall na
employ any person in any manncr so as W bccome bject arkcrs' Campensauon
Laws of Califomia Da�c -�� n ��
Applicant
NOTICE TO APPLiC : If r �s CcrtiGca�e of Ezcmption, you sdouW
become subjcct w lhc Worker's Compensation provisions af Ihe Labor Codc, you must
� O forthwiih comply wi�h such provisions or this permit shall bc dccmcd Rwokcd.
z '"" CONSTRUC!'lON LENDING AGENCY
�� I hereby aCfirm that there is a conswctinn Iending agc�rcy lor the perCormance u(
C�i � �hc wock Cor which ihis permit is issucd (Scc. 3097, Civ. C.)
� Q Lcndcr's Namc ^
� z L,cnder's Address
U � 1 ccctify that 1 havc rcad this application and sutc ihat �hc abovc info�maaun is
w � corrcct. I agree lo comply with all city and counry ordinances and s�a�e laws relaung w
0 U building conswction, and heeeby authori�e representa�ives of �his city to emer upnn U�c
� W abovc-mcntioncd property (or inspccdon purposes.
(Wc) agrce to save, indcmnify and kecp harmless the City of Cupertino agaiast
�� liabilitiu, judgmcn�s, costs and expenscs which may in any way accruc against said Cty
U z in consequencc oC ihc granting aC this permit. �-- D�1LE
� APPLICAM UNDERS7ANDS AND WILL W1TH ALL NON-POINT Issued by: G �Z i
SOURCE GULATIONS.
d �a � '� Re-roofs /
Signazurc pplicanUConvactor Da1e
HAZARDOUS MATERIALS D[SCLOSURE Type of R�of
Will lhc applicant w Cuwrc building occupanlstoro or handlc harardoiu muaial
.icfincd by the Cupenino Municipal Codc. Chap�cr 9.12, and �he Hcalth and Safay
�o� Scction 25532(a)? All roofs : hall be inspected prior to any roofing material being installed.
� Ycs �No.
Will the applicant or futurc building occupant usc eq�ipmcnt or dcvi¢s �rhich If a roof i: installed without first obtaining an inspection, I agree to remove -
emit harardous air conuminan�t as dcfincd by thc Bay Arca Air Quality Managcment all new m. iterials for inspecxion.
�;s��c�?
� Y�s �QJ�
I havc rcad the ha�ardous materials rcquircmcn�s undcr Chaptcr 6.95 of Ihe Cali(or-
nia Hcal�h & Safcty Codc, Sccdons 25505, 25533 and 25534.1 undcrs�v�d that iCiAc buildina
docs no� curtcndy havc a tcnant, U�at it is my rcsponsiAility to noul'y Uu accupant a! the
rcyuiremcnts whi must be met priar W issuance of a Cenifica�c of Occupancy Signature �f Applicant Date
� �.� .. �� � d
Owncrora rizcda cn� o„� All roof coverings to be Class ��8�� or better