07110011 CITY OF CUPERTINO � '
BUILDING DIVISION PERMIT �������� ���������
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BUI IN A ,p�2 RESS: PERMITNO.
�O�.iy FARALLONE DR ARGONAU'[' WINDOW & DOOR, INC 07110011 .
t�tt�r r�[rs Daz�
�NER'S NAME:
FOOT KENNETH 1901 S:3ASCOM AVE STE 800 11/02/2007
SANITARY NO. CONIROL NO.
PHONE:
(408) 37 3-4018
BUILDING PERMIT INFO
ARCHITECi/ENGINEER:
BLDG ELECT PLUMB MECH
� 0 0 0
u p p LICENSED CONlRACCOR oECURnnoN Job Description
;� � I hcrcby affirm �hat I am licensed undcr provisions of Chaptcr 9(commencing
z� wiih SccGon 7ocw) of Division 3 of thc Busincss and Protcssions Codc, and my licensc is RE P LC 3 WNDW S L I KE F OR L I KE � I�� S TRUC TURAL
�? y in full forcc and cffec�
� ? Licensc Clazs ��• x
' �, O Da�c ConUacwr
ARCHITECI'S DECLARATION
� a� l undcrstand my plans shall bc uscJ u public rccords
a
; u. y Licensed P�ufcssional
n y � OWNER-BUILDER DECLARATION
1 hcrcby alTirm that I am cxcmpt trum ihc CanUactar's Liccnsc Law far thc
� p O following rcazon. (SccGon 7Q31.5, Busincss and Profcccions Cak: Any city ar county
K,°, Pi which rcquires a pcm�it to cnnswc4 alter, imprcm, dcmolish, or repair any swctmc
� Z} priar w i1s issuance, also tequires the applicant Cor such pertnit to file a signcd sta�mcnl Ft. Floor Area Valuation
� _ � t h a t he is Iiccnsc J p u r s u a n t t o t l � c p ro v i s i o n s o f t h c C o n u a c t o r' s L i c c n s c C a w ( C h a p � c r 9 S 9• $ 1 1 0 0 0
� t- $ (commcncing wi�h Scction 7000) nf Division 3 of �hc Business and Profeuions Cade) or
y �., that he is exempt themfrom and the basis !or the allcgcd exempdon. Any violaUon of
Section 7031.5 by a�ry applicant for a pertnit subjecu �he applicant to a civil penalty of 3 6 9 3 9 0 3 3� Number Oeeupaney Type
not more �an five hundred dollars (5500�
❑ I. u owncr of tlie propertY. ar my emplaycm witA wages az �he'v sole compensaUon,
will do the work snd �he snucwce is notineended or ofte�ed forsalc (Sec.7044. Business Re uired Ins ections
and Peotessions Codc: 71u Conuactofs License Law docs no[ apply to an owner of 4 P
property who buitds or improves thercon, and who does such work himul[ or through hia
own employces, provided ihat such improvements ue not imm�ded or olLeced Cor sale. If.
however, �he building or imp�ovemem is sold within one yesr of compledon, ihe owner
builder will have the burdee o[ proving Wat he did no� build or improve for puryox of
sak.).
�u ow�rcr o[ the property, am uclusively conuacting wilh liansed rnnvactnrs W
consuuct the projea (Sec. 7044. Business and Pro[essions Code:) The Contncmr's Li-
ccnu [aw daes not apply io an owner o( propeny who builds or improves themon, and ,
who contrac�s tor such projects with a rnnuactor(s) Iicensed pursuant w ihe Convacror's
Litense L.aw.
I am aempt under Se . B& P C for is reasan
.,wner Date �� �
ORKER'S MPEN A170N DECLARATION
1 hemby �tTirm under penalty o[ pe�jury one of the tollawing declarations:
❑ 1 hsve and will mainuin a Cenificate of Conaent to self-insu�c [or Warkcrs Compen-
sation, as providcd for by Section 3700 af the Labor Code, for �he pedocmance oC thc
work for which this pertnit is issued.
❑! havc and wiU maintain Workcr's Compensatian Insunnce, u rcquired by Scction ,
3700 0[ �he Labot Code, Cor Ihe per[ormance of the worlc for which ihis pertni� is issued.
My Workers Compenaation Inwcance cartier and Policy num6er are:
Cartier. Poliry No.:
CER77FICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE '
(7Lis scctian need not bc completed it the permit is for onc hundred dollars (S 100)
or Icss.)
1 cenify that in thc performsncc of Wc work for whic this permit is iscucd.l shall not
employ any person in �ny manncr m u a me su t� m{x���
L;aws of Califomia. Da�e
AppGcanl
NOTICE 7'O APPLICANT: If, aficr making this Cenifica�c of Exemption, you shoulJ
become subject W the Worlcer's Compensstion provisions of ihe Labor Cada you muu
,� O fonhwith comply with such provisions or this pecmit shall bc dccmcd awokcd.
z ""' CONSTRUCTION LENDING AGENCY
F r �-�. I herchy affirm d�at thcre is a constnxtinn lending agcncy (or the perfortnancc of .
pC .� ihc work fur which ihis permit is iuued (Scc. 3097, Civ. C.)
W A Lendcr's Namc
� z Lender's Addness
V 0 I ceni[y U�at I have read this applicuion and su�c thu thc above infom�adun is
w� cortec� I agree to comply with all city and counry ordinances and sute laws reladng to
� U building conswction, and heroby authori�e rcprescnuuvcs of U�is city w cnter upon thc
� a atwve-mcntioncd propcny for inspection purposet
(Wc) agrce to save, indcmnify and kecp harmless Wc Ci�y o[ Cupertino against
�� liabilitiu,judgmcn�s, cosls and expenses which may in any way accruc against seid City
V z in consequence of the granting oC ihis permi6 Date - Z "� �
►� APPLICAN'f UNDERSTANDS ND WI L COMPLY WITH ALL NON-POINT Issued by:
SOURCE REGUL aNS.
��_ -' ; i�i�d,� Re-roofs ����
Signawro of ApplianUConuactor �e� T of F.00f
HAZARDOUS MATERIALS DISCI.OSURE }��
Will �hc spplicant or futurc building occupantscorc orhandlc harardous matcrial
kfined by Ihe Cupertino Municipal Codc. Chap�cr 9.12, and the Hcalth and Safcty
.,a�. Scction 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑ ves 6�0'
WiII thc applicant or [uwre building occupant ucc eyuipmcnt ar dcvices which
If a roof i s installed without first obtaining an inspection, I agree to remove
cmii ha•rardous air coniaminan�s u Jcfined by the Bay Ama Air Quslity Managcmen� all new r� iaterials for inspeckion.
District?
oYa �
! havc rcad �he hvacdau maicrials rcquircmcn�s undcr Chapmr 6.95 of ihc Califor-
nia Hcalih & Satcry Code. Scctions 25505.25533 aiu125534.1 undcrsund �hu if ihc building
ciacs rwl currcntly havc a tcnan4 � it is my onsibiliry to noul'y Ux occupant nf thc
requiromcn�s w ich s� be met r to iss � or a c�;r�a� or a��P�r. S ignature of Appl icant Date
pa � All roof coverings to be Class "B" or better
Owncr or authori��d agcn�