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07120225- PUB x CD U O O M .4 LO a) L] 06 0 N '�7 c4 H M O J M O P4 -4 J MO O + a N Z J J O F 06 -j LLJ J co F H p � pq coa a p(�q Z co Z U 0 7 k a i co LO 'D H w w H JQ O U w W W LLI O CM..! c a o apa O A co Z J ~ co Z ~ - � W vim, H W w M w o '� ❑ o � a w w ryy � = U Da w co � co ' 7 A k w .i. U - _ a ,7 N :0 L J a} vi N _0 — U 'Q O i-� O O Q U v U- ; M �, LP N a m n, t 3 co CL 2 V fu `-U - n s a a n O U idi' O �dI �� C 0 0 O Um LO co tz J O U ZIr C:) W LL V (1 CL > N U- M Z T N N, O O O W J Cb CD Cb O rt ' O O Qy (''] V U ° m co z N co — _ N 4 CT) cli 0 co CD M CD U OD r O C ) i x L C L . x xa) Cc v r o a� p t1 ° a} ~ j 'a' a a ax° w IL~ Z ar a T w v xo t in O c N +0 +0 D a) T] �D CD Il �+ U v ' O fu .a = U E ar a LU v -° 'O ° n a� a` ac v a`r CL a O Q m U O a_ o a_ a) ,L ILcn M Q a- U U U a_ E i m CL LL CITY OF CUPERTINO BUILDING DIVISION. PE'1 RMIT BUILDINp R ESS: PERMIT NO. !Jj N STELLING RD LANDMARK DEVELOPMENT 07120225 OWNER'S NAME: PII2NRP ISSUE DATE ;1S PALMAS STELLING LLC 1307 S MARY AVE STE 120 09/03/200$ PHONE: SANITARY NO. CONTROL NO. ARCHTTECTIENGINEER: BUILDING PERMIT INFO NEW TWO STORY TOWNHOUSE BLDG ELECT PLUMB MECH 0 0 a 0 o p 169 GF LICENSED CONTRACTOR'S DECLARATION Job Description P I hereby affirm that I am licensed under provisions of Chapter 9(commencing Y U with Section 7o00)of Divisi 3 of the Business and Professions Codepygd my license is s 7 y in full force and effect. (J 3 3 �( Y License C s Lie ti eau Date Conuaclor G �4�+�i✓t ,r ^AR IT'ECPS DECLARATION 2-U I understand my plans shall be used as public records )yU L 'U61 Licensed Professional rn OWNER-BUILDER DECLARATION , I hereby affirm that Iam exempt from the Contractor's License Law for the q`p O following reason.(Section 7031.5,Business and Professions Code:Any city or county <m which requires a permit to construct,alter,improve,demolish,or repair any structure u prior to its issuance,also requires the applicant for such permit to file a signed statement "? that he is licensed pursuant to the provisions of the Contractor's license Law(Chapter 9 Sq.Ft.Floor Area Valuation V tZ - (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(5500). ❑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.7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of Required Inspections . 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 Code:)The Contractor's Li- cease Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractors)licensed pursuant to the Contractor's , License Law. ❑I am exempt under Sec ,B&P C for this reason - Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: . ❑I have and will maintain a Certificate of Consent to self-insum 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. ❑I have 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 Workers Compensation Insurance carrier and Polity number am: Cartier. D_JLt�-n d Policy No.: L��-/.,f�i CERTIFICATE OF EXEMPTION FROM WORKLRS' COMPENSATION INSURANCE . (Thai section need not be completed if the permit is for one hundred dollars($100) or less) I eenif-v that in the performance of the work for which this permit is issued,1 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 ,Z forthwith comply with such provisions or this permit shall be deemed revoked. - z O CONSTRUCTION LENDING AGENCY E-s I heh:hy affirm that there is a construction lending agency for the performance of �i? the work fur which this permit is issued(Sec 3097,Civ.C) a Q Lender's Name . z Lenders Address V 0 1 certify that I have read this application and state that the above information is (y correct.I agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorize repmsentatives of this city to enter upon the Uabove-mentioned property for inspection purposes (Wc) to save,indemnify and keep harmless the City f Cupertino against liabRiti 'udgm ts,co d cxpe which ay,i way cmc against said City V z in co quenc - ting 00111s per�r ti. ►" A LI DERSTAN A W OMPL ITH ALL NON-POINT ISSlled by: Date SO GULATIO S ©© ,�,, L•--03—tt Re-roofs tgnature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof . Will the applicant or future building occupant store or handle harardous material as defined by the Cupertino Munic' Code,Chapter 9.12,and,the Health and Safety Code,Section 25532(a,- All roofs shall be inspected prior to any roofing material being installed. ❑Yes o Will the applicant r rtrtare building occapamt ase egtripmenl mr devices whim 'If a roof is installed without first obtaining an inspection;I agree to remove emit hazardous air contaminants defined by the Bay Area Air Quality Management all new materials for inspection. District? NU�la/_� ❑Yes /�I o - .1 have read the de Sccou—s mann rs u prer 6.95 if the Calding niaHcalth Codc.Scc' 25 2 u crstartdthazifthcbuilding docs n u y ha nt, m ilii o notify the occupant of the requirements w sl m riot of a C Ocatc of_Occupancy. Signature of Applicant Date Ow or onzcd agent Date' All roof coverings to be.Class'JQ``or better 4 v CITY OF CUPERTINO NEW SINGLE/MULTI FAMILY DWELLING CUPEkTINO PERMIT APPLICATION FORM D,7 d 2Z APN#�r 07 0 '57. 5 ,57. 5 Date:C 2- V3 , o-7 Building Address: Re Mailing Address (if different from building address): 1307 5 o - M12-0 5.;rt ,(t_I CA 4 V0 &-7 Owner's Name: Phone# D2V t�p )h q _r Co �n Z/0 (b `73-3 L►Cont&ctN D hn SSL �sz U ��am e�T �a 2 `nc� Phone#: L{u 15 '7'33— Fax #: 4/ '73 �— 9.2-99 Contractor License #: c8 3 3(f 9 Cupertino Business License#: Contact: Phone#: 41 o$ `733 �jt4o 2t �p5 �3�( - r X4'3 -- yeti �- 1�:�.2- Fax #: 410 9 735- 92- c Alternate Contact: Phone#: C1,v f5 ~73 �o A cfAVN .e— Fax #: -Ll o b 73S7, 9Z9J --- Single-Story ❑ Two-Story Three-Story ❑ Basement ❑ Hillside, ❑ Multi-family ! ,; Apartment ❑ Condo ❑ Townhouse Sq.Ft. Living Area (Including Basement &Attached Garage: Sq. Ft. Garage (Detached Only): U r/ 2-/(. 7 A 3,.,Js 5� Valuation: Job Description: /VeW -rte ,-? r Type of Construction (Usage Class): f Occupancy Type: 1 FR, 11FR ❑ 11, 111,V-lHR ❑ 11,Jl1, 1V V-N �.5 Project Size: Standard Large Major❑ Green Building: Must attach completed Green Building Checklist to the plans Green Building Points Achieved: For help, contact Build it Green at www.buildit2reep.or