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071101032 09 �0O _R Iq m` > F- �0` iGC 4.9 _ze FSC i 0 � � Z W? CIO �:)2 UC 441- 0 fj R U:2 CITY OF CUPERTINO DIVISION PERMITi�TR4�CT�}I* BUILDING BUILDING ADDRESS: 11830 UPLAND WAY ALLBRAD'D WINDOWS PERMIT NO. 07110103 _.✓NER'S NAME. PERMIT ISSUE DATE VENKATESH BHIMACHAR 23312 CABOT BLVD 11/16/2007 PHONE: SANITARY NO. CONTROL NO. (650) 62-0330 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is WINDOW RE PLCMNT ( SAME S I Z E r SAME LOC) 11 RETRO F I T r 1 in full form and effect. License Class Lle. BAY WNI IW r 1 PATIO DR S L I DR Date Contractor ARCHFMCISDECLARATION 1 understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following mason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the Professions Code) $10875 (commencing with Section 7000) of Division 3 of the Business and or that he is exempt therefrom and the basis for the alleged exemption. Any violation of 366030-E 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 (s500). ❑ 1, as owner of the property, or my employers with wages as their sole compensation, Required Inspections q p will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law dors 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.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cade:) The Contractor's Li. cerise Law does not apply to an owner of property who builds or improves themon, and. who contracts for such projects with a contractor(&) licensed pursuant to the Contractor's "cense Law. am exempt under Sec. B & P C for this mason Uwner Dale WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Certificate of Consent to self -insure for Worker's Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. g4have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My WorkZCompensation Insurance carrier and Policy number Cartier. Polity No: Lr1_ CERTIFICATE OF EXEMPTION FROM RKERS' 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. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender'sName Lender's Address j I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorise 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 j liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this permit I APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by Date �1 PPTPEE R TIONS. - -91�� p� - I I Z 1 6 O Re -roofs Type of Roof Signature of-Applicant/Contractor Date HAZARDOUS MATERIALS DISCLO URE Will the applicant or future building occupant store or handle hazardous material Aimed by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety ,ode, Section 25532(a)? ❑Yes All roofs ;hall be inspected prior to any roofing material being installed. If a roof i; installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? �� ❑ Yes M4. I have read the hazardrnu materials requirements under Chapter 6.95 of the Califor- nia Health & Safety Cade, Sections 25505, 25533 and 25534.1 understand that if the building the occupant that it ' y responsibility to notify die occupant M the n Itoni met trio mance of a Certificate of Signature Of Applicant Date t All roof coverings to be Class "B" or better Owner or authorzed agent Datc"' BUILDING DIVISION FEICM1 )ING ADDRESS: 11830 UPLAND WAY OWNER'S NAME: VENKATESH BHIMACHAR o p LICENSED CONTRACTOR'S DECLARATION m 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing Z with Section 7000) oCDivision 3 of the Business and Professions Code, and my license is dr in full force and effect �"- i Z License Class Lie, p p Date 1 Contractor � � RCHI CTS DF�L.AR T10N L) 1 understand my plans shall be Used as public records ' w y Licensed Professional y OWNER -BUILDER DECLARATION 1 hereby afnim that I am exempt from the Contractor's License Law for the `pet following mason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure Z �? prior to its issuance, also requires the applicant for such permit to file a signed statement a that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 r (commencing with Section 7000) of Division 3 of the Business and Professions Code) or y that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by airy applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($501). 0 I, 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. 7144, Business and Professions Code: The Contractor's License Law does 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.). 0 I, 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 b an owner of property who builds or improves thereon, and. who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. 0 1 am exempt under Seo, B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 1 have and will maintain a Certificate of Consent to self -insure for Workces Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 9-l"havc and will maintain Worker's Compensation Insurance, as required by Section 3700 or the Labor Code, for the performance of the work for which this permit is issued. My Wor s Compensation Insurance carrier and Policy number Cartier. h, e, Policy No. • 102 CERTIFICATE OF EXEMPTION FROM RKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) or Icss) 1 certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant N077CE TO APPLICANT. If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must Oforthwith comply with such provisions or this permit shall be deemed revoked. �b CONSTRUCTION LENDING AGENCY H rr I hereby affirm that there is a construction lending agency for the performance of (� ✓ the work for which this permit is issued (Sec. 3097, Civ. C.) a A Lender's Name Z Lender's Address V Q I certify that I have read this application and state that the above information is correct 1 agree to comply with all city and county ordinances and slate laws relating to building construction, and hereby authorize representatives of this city m enter upon the ®U H aabove-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against Fy t/2 liabilities, judgments, costs and expenses which may in any way accrue against said City L) T in consequence of the granting of this permit. r7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT KMWE RFTIONS. WgnatureofApplicam/Contractor f Date HAZARDOUS MATERIALS DISCLO URE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? 0 Yes V. Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District? OYes 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 cwt if the building dors my have a tenant, that it y responsibility to notify the occupant of the - mrem hi mel tvpan prio trance oC a Ccnificatc of Occup �1 b t Date ALLBRAND WINDOWS 23312 CABOT BLVD (650)622-0330 PERMIT NO. 07110103 PERMIT L55UE DATE 11/16/2007 SANrrARY NO. CONTROL NO. BUILDING PERMrr INFO Job Description WINDOW REPLCMNT(SAME SIZE,SAME LOC)11 RETROFIT,1 BAY WNDW,1 PATIO DR SLIDR Ft. 36603056;` Issued by: Re -roofs Type of Roof $10875 Required Inspections Date #.' (6-,e-. /t/ All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant Date All roof coverings to be Class "B" or better