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05100025 CITY OF CUPERTINO BUILDING DIVISION PERT CQrN�awm'1 R. A+t G—TF0•;e Rr. !NmmQ��v ,A�,.©,N� —i> td. . K~� §wC . = A, BUILDING ADDRESS: ASSOCIATED ENGINEERING & 005100025 OWNERS NAME: PERMIT ISSUE DATE BANDLEY CENTER INC 1771 TIMOTHY 01/04/2006 E: SANITARY NO. CONTROL NO. (510) 357-5729 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH app LI7SED CONTRACTOR'S DECLARATION ]pbDeSCII Description I krthy affirm dsu 1 am IiannW uMc pa m�s of maga 9(oomttscncing P i0 Milh SttUm7IX1: Diwbn Saf Ux Buaircas and liafcdtva Code.aM myl4w¢a in fullfnrte eDtt {/ Ix.. 6T6 REVISION--IHR CORRIDOR tqz oars cl.,: k3y co B9� �yqqqqoW Dar t /04-/e(e Cmuaam Assee £N.�'nayYtnS NO NEW PERMIT ISSUED/ORIG. #05010057 3 Fa< ARCHITECTS DECLARATION WU Iutdwaatd my'Is.shall k usoi u'Nx rtwada Cipuf+' Po Luxoad Pmfcuional . ` 5 OWNER-BUILDER DECLARATION .� 1 hereby aRirm Thai 1 am e.emp from the Canuanars Liana law for Lis p o following won.(Secdm 7101.5,Bitur.and Prof=wdora Cade:by coy Or county $ which squires a Pmmlt to cm t,alo r.Improse,demol4h,or m*r any somctum Piix u iu inuuruc,also tcquimsik iWiu,a.,for such Permit to flit a sills d=mem < ibar he u littnad ptuaunt to lk pmatos of tk Cotdncttr''s 1J Lav(Chaprr9 Sq.Ft. Floor Area Valuatio 102 E€F (commencing wllh Soclion 70)()N Diviwion 3 of lk B urns and lhfemitau CO&)Or — Nat M 4 r.....p t umofrom and ds Eua for Ne allcLcd ewnPlion Any violation of Swim 7071.5 by any ippldant for a pesmlt abjccu Lis aPplialtl a a ll lPorodya APN Number Occu anc od rose than ewe huilm,1 dol4n(5500). 32633097 . 00 P yTyPe ❑L u motto of tk property,m my wnPloriTa wiaE wgn u tktr sok mmpemulma MB dotkwork.andtksat Com 4rotsIa Qua Lawddforak(See.lag,B of and Prey w1ouu code Tat Cmtlb a I wlbo VM doss oro aPPly m an mwar of Required Inspections Isroputy Mhob o,.d mpma Lir aeon,std Mho amrio,tnlc k hlmaeifil through hu ow wtpkyxa,provioNThu wishlmpmsemnuart oro rJ`Oml ,fm sale B. holm willehdldiogbu pOf t ,emit Mdid arc you of mmpiedon,themu,of / \ hoWo will N.e the Mrdut or proving uuw k did m WW or Imprmc for pvtpoa of ask.). S' ❑1.a awrc!a ds popeny.and achdvcly cavlfatiM1(MIN Iksraed Wm amors to eaosuuet Ik poky lyse 7t5W.Bumicam and PtofeaCCOs Cods:)T Caavanols U \�j\ ane law don oro apply to an mmw of impmy.wfin Itilds Or intposn tai and, V who canllKL for uxdb pmrm v,i b a Cm YYlmfs)Ilux.d(XPvanl in Rha eNWaa(a n I.M. ❑lam eamtp ttMO See .Bir PC for lbV Boson Owrc Dale WORKERS COMPENSATION DECLAkX ION I knotty affnm under pevlly of Per}my.of the folMittg di� - Mmad w111mrimalnaccmffi e cmoex to aslf-inwort far Wm scasnpm- u provided for by Sadm 7100 of Us Ichor Code,for ds prfarntana a the wont for which this permit u iu—i 1 have and will maintain Wurtr ,Cmnpenudm InaRarta,as rtq.i,cd by Sndm 5700 of dtc Labor Cade.fa 14 Pwfordi.of tk Mort fa MEW toutN.114 Lori My Work es Conopnudon I=.aa.M and Poi number art: C.w: STAT;: f7VIVDPmicyNo_ I—f6loso—� CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (TT4actim and rot c cmnplowd Iftk Itacth 4 fm Ons huodmd down(5100) m ka) 1 cerdfr that In We puformmt of tk Mork for which this Nmilt 4lutsd.I shall not cmPlvy any K.to any oanmr a u to bmaroc atbRtt to tk Wortin'Cmopouadan I of Cidifomia.Dao - Applix, NOTICE TO APPLICANT:If,afw making Nis Cerdrtcus of Ea.lition,ym ahouW ti a whjna b tk Worker'.Compmtim pmldma Of tk Inbar Code,you moa ,Jz funhoddh cnmlly wlW such pmrWtvo or 04 pwdid,"I to,t4amrd rtated. zO CONSTRUCTION LENDING AGENCY I ktcby amm Bial dere u,. dam,dion luting.gory for tk Puform.of !Y the wsat rar whish W4 lxrrO t 4lssucd(Sec.SU97,Civ.C.) QIadrYs Narnc , = z IndeYa Addrta U Q 1 Citify duet I hart rod Lida aPPlkuim ab Bute that Lis ak.e inf.mim 4 D. ^ caner.l agme w canPly with all illy and calmly ordi.,and some laws rt Win[to 0 build ea MnKtion,and kmby&Ud=M Mlm=oUdiM3 of Uta city n cosec upm tk �W shove miiued pmpcny for WPccdm"oatm (We). a Raw,mcRmnify,slut tap bamtka Use City ort Cupnino against F'y gra Iiatillitkl judgmwtu,elms and eapic.Mhieh may In any way a[9ae agaltw aid City UZ, in cooqui of tk graming or 0ap.iL APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date REG 710 S. —�"-off Re-roofs Slgnuurtof Applian MATERIALS DISCLOSURE Oak, Typc of Roof Will dcapp' toms 'luting oxrymt port orbWkhuardvos mauxW u d firi by Ik CupeNoo teal Code.CEalaw 9.12 and tk Hcalib and Safety Cade,Sad.25551(,)7 Yn All roofs shall be inspected prior to any roofing material being installed. ' Will use yrpliant or ralurt bulking ottvpant me Waimtrnl or hrvity whkh If a roof is installed without first obtaining an inspection,I agree to remove ba,. air wnt 1.0;as deBmd by the Bay Arca Ai.Quality Mutapunenl all new materials for inspection. iCL7 E)Y., 1 hma rtad die Wudous mas,rimis rtmwtu untkr Clupm 6.95 of Uc Cah[m. na HaltE h Safety Code.Smdao 75505,25533 and 25554.1 ortkrsnnd Ulu if tk holding d XS not cvmnUy haM•r-,,.M that It 4 my napoulNlity b mufy Us=upam of die n.whkhm=kmel Prior wl.W,,tce Of.Cm F.r Of aap2Xr. Signature of Applicant Date t--4—o"S. d.pnt mrt All roof coverings to be Class "B" or better