07100187 CITY OF CUPERTINO " � ' `
BUILDING DIVISION PERMIT ����� �T:�� Z������ '
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PERMIT NO.
BUILD � rr � n ��� ss STEVENS CREEK BLVD VKK SIG]�MAKERS INC 07100187 •
pERMTT iSSUE DATE
ER'S NAME:
JONATHAN LEE 10 26 2007
SANITARY NO. CONTROL NO.
PHONE:
(650)363-0931
BUII.DING PERMIT INEO
ARCHI'CECI7ENGINEER: BLDG ELEC7' PLUMB MECH
� 0 � �
i p Q UCENSED CON7RACfOR'S DECLARAl'ION JOb DeSCTlpt10❑
i V� I hcneby �rtn that I arn licenscd undcr provisions oC Chaptcr 9(commencin;
; 7� wiih Secdon 70oU) of Division 3 of thc Busincss and Protcssians Codc. and my Iicensc is I N S T L M� �NUMENT & BLDG L ETT ER S
; j y in full foree and ellec� G4� # � 3 !' Z �
� v� Z Licensc CI 1Lic
p Da�c Con�ra��� ti
: � � ARCHi"fEC['S DECLARATION
i a a I undcrstand my plans shall bc uud as puAlic records
)yU
' u. � Liccnsed Pcufcssional
: a a OWNER-BUILDER DECLARA'CION
j a� 1 hcrcby alTirm that 1 am excmpt from ihc Canvactors I.iccnsc Law for chc
. p o (ollowing icazon. (Scction 7(Y! I.S, Busincss and Profccsions Codc: Any city m munty
�,°, � which requims a permit to canswc6 altcr, improvc. dcmaliah, or repair any stn�cture
rior to i�s issuancc, alsu uircs thc a hcani for such rtnit io filc a si ncd s�cmcni Valuation
'.? r� �'+ PP � g ;;q. Ft. Floor Area
< that hc is IiccnscJ pursuant to �hc provisions oC thc Contrutor's Li��cnsc Law (Chaptcr 9 �
� t �(commencing wi�h Scction 7000) of Division 3 0( �hc Businccc �nd Profcssions Codc) ur 3 5 0 0
��... �hat he is eumpt thcrefrom and the basis Car U�e altcgcd exempdon. My violuion of
Section 703I.5 by arry applicant Cor a pecmit subjecu the applicant to a civil penalty of 3 7 5 0 2 0 21 �� Number Occupancy Type
not more �han five hundrcd dollars (5500).
Q[, u owncr of the property. a my employca with waga az che'v solc compensatioo,
wiU do the work, and ihe swaure is nocincended or of[aed far salc (Sa.7044. Busness Required Inspections
and Professions Cade: The Conuactor's L'uense Law doin not apply w an owner of
property who builds or improves thercon, and who does such work himsel[ar thmugh hia
own employccs, provided that such improvements are no[ imended or o(feced Ca sakak. iC,
hawever, the building or improvemrnt is sold within one year o[ complcdon, ihe owmer-
builder will have Uu burden o[ pmving t6at he did no� build or improvc for puryase af
saleJ.
❑ I, u ow�r af Uu property, am uclusively conuacting wiW licensed conuactnrs w
consenut Urc p�jea (Sec. 7044. Businas aad ProCessions CodeJ The Coalnao�'s W-
ccose [aw does not apply �o an m�mer o( propeny who builds or impmva t6e�eon, and ,
who convacts for suc6 projec�s wiU� a rnnvactor(s) licensed pursuant to t4e Convxwrs
License Law.
^[ am uampt undcr Sec. . B& P C far this �eason
.xr Date _ .
WORKERS COMPENSATION DECLARATION
I�reby aflicm under penalty of perjury one af the folbwing decluatianz
❑ 1 hsve and will maimain a CcrtiGcatc of Consem to self-iasure far Worloers Compen-
sation, as provided for by Secrion 3700 of �he Labor Cade. far �he performarce o[ the
worlc for which U�is permit is issucd.
❑ I have and will mtimain Workcfs Compensation Insuranu, as required 6y Scaion .
3700 0[ the Labor Code. Cor the performance of the wortc (or which this pem�it is issued.
My Worker's �o rion Insu carticr and Policy number are:�
Cartia: Sl������� �� PolicyNo.: �
CER7'IFICATE OF EXEMP170N FROM WORKEitS'
COMPENSATlON INSURANCE
(This scctian necd not be compleled if the pertnit is for anc hundred dollars (S IUO)
or IcuJ
I cenity thm in ihc performancc of ihc work for which Wis permit is issce0.l shall not
amploy any person in any man�rcr so u w bccomc subject to the Workces' CompcnsaGm
Laws of Califomia. Datc
Applicant
NOTICE TO APPCICAM: If, alYcr making �his CcrtiGca�c of Excmptian, you s6ouN1
become subject w the Worker's Campensation pmvisions of �e l.ahor Code, you must
�,� forthwith comply with such provisions or this permil shall bc dccmcd ccvolccd_
z O CONSTRUCfION LENDING AGENCY
H � I hcreby alTirm Uwt thcre is a consuuction knding agcrrcy (or the performanw uf -
�., � the v+ork Cor which this permit is iuucd (Sec. 3097. Civ. CJ ,
W Q L.cndet's Namc
� z Lender's Addrcss
U � � certifY �hat 1 have rcad this application and sta�c ihat �hc above informatiun is
w *� cortcct. 1 agree to comply wiU� all city and county ordinances and sute Iaws �ela�ing �n
� U building consuuct�on, and heroby au�hori�e reprcsentalives of ihis city to enter upon �tu
� W aM1ovc-mcntioned property for inspecuon pur�wses.
� (Wc) agree to sare, indcmnify and kcep harmlcss the Ciiy o( Cupcnmo against
H � tiabilitiu, judgmen�s, cosLS and expenses which may in my way accruc against said Ciry
�) ,'� in conteqixnce o[ Uic granu is permit. Date �.� L G G�
►-+ APPLICANT UNDE� A S AND WILL COMPLY W1TH ALL NON-POINI' Issued by �
SOURCE O . .
Z � d Re-roofs �'�.---��-
Signawre of lian✓Contcactor �� T of R oof
HAZARDOUS MATfRIALS DISCLOSURE y�
�11 �hc applicant a futwc building oaupant store o� handlc ha•rardoia mucrial
fefincd by �he Cupertino Municipal Codc. Chaptcr 9.12, and the Hca1W a� Salety
a� Sixtion 25532(a)? �.{ All roofs �hall be inspected prior to any roofing material being installed.
❑ Ycs W "o -
�II �hc applicant or fuwre building occupant use equipment a ekvioes whic6
If a roof i� installed without first obtaining an inspection, I agree to remove
cmit harardous air conwninanu as dcfincd by the Bay Area Air Quality Maoagancm all new rr aterials for inspec�ion.
Disuict?
❑ Ycs `1��
t havc reaci the ha�ardous maicrials rcquiicmcros undcr Chaptcr 6.95 of the Califor-
nia Hcal�h & Safcty Codc, Scctians 75505, 25533 am125 _ 1 undcrsund dut if Ure buildin8
docs not curtently havc a 4�< i� is my res bitity W naify ihe ottupant of �he
rcyuiremcn nich metpriorwissu [aCenifxa�ofoc SignatureofApplieant Date
�.�.. /o LG U'� All roof coverings to be Class "B" or better
Owncr or au rizcd agcnt �