06070037CITY OFCUPERTINO.-,re>+rs�''�"A,'�n�t"r`��`�"I��'♦"�'
INFURMA' I0.1�T ;.
BUILDING DIVISION PERT
:.COINTRACTOR
x 2 Yew..., a.-n;h .o-,. ,.'�0'su ,-•,--xi7^v':`
BUILDING ADDRESS:
SOLAR CONSTRUCTION
"'`MITN0b6070037
'2268 BELLEVUE AV
R'S NAME:
PERMIT ISSUEDATE
YESSNE-BATES
1560 BULB AVE
07/10/2006
PHONE:
SANrTARY NO. CONTROL NO.
(831)479-0107
ARCHITER/F1,GINEER:
BUILDING PERMIT INFO
BLDG ELECT PWMB MECli
LICENSED CONTRACTORS DECLARATION
Job Description
I lum by .mnn mu 1 An 11¢aad undo, P.,taoa a Cbapu 9 (commencng
vim Scrum "10011)ofDivldm3ordm Budrcv rod Pro, Cock and my liaama
in fWlfame and
SOLAR PV INSTALL
Lkcruc Gu.
Dat, 7/a/] Conuanar
� ARCHITECTS DECLARATION
I udcrsund my pli dullbeaidu pWIk omoN,
Lkcrtad Pmle nal
OWNER -BUILDER DECLARATION
I mcchy air. mu I am cumpt fmm mo Conl,.cmr, Licmx law Tar on,
-
i f.dv bg mum. (Sccd. 7o31.5. Buiw Aml Pmfenk" Codc: A" Coy «cdmtY
$49674
Which qW.. pumit m coouoocL a . hnpro e. dcmnliAl «-pair any
prior on a, i,vu«c abo mguaa lbc.ppiant roc u PC -it m nk. dgocd,um,rcm
'
Sq. FL Floor Area
Valuation
Iwx�liaa.Qapmw«mwePro.iyan,wurcanl,.emr,ua�l,.ra�.p�9
til Saamra00)of oi.bim3 nano Badrc Prafaloru Code) or
. aaa he i, aaop -coca-- .nd the but, m, YIRcd cmjd alalaum or
dbooM pj
Occupancy Type
-d
pumawb}eeumc.pptictmmaevilpm.nYM
Any it Applicant
hundoBURara(
n« ma,e m.n RK bmdrtd calors Lssm>.
nRxthamfiy
❑ I. At ovmf of on, poopwy, «my eoployea -bb WaLa u theh,ok eoenprnada,
Required Inspections
a name«oR �r«ndepply.rou.B
Antiaa.nameman�,a
Anti Pmreudom coat The Conuacmr, I3mue Vv dna —apply m d aunt, of
pmpeny vim puilN «Imprmc meman,.rd who daa,aeh vvt him,dror wooLe nu
awn emPoym, pmrdd mat,ueb impvsemeu, arta« mkand «oRad f«ale. V.
'
baWewl.Ib<huldinL«Impmrtm,mbRdavimin lererp,.m.tndawty-
buibc 1 Me me burden of pmWnL mu K did nae MUN « Imnmpro,e f« pu,pox of
C) L u was d ft property. am acLeively cmbx,inL ram Maud coou.nm, n
cmau 1n Budtraand Rafas«u Caac)TLcntthco" Ll
/
anx Vv dart, appymb, Of vEo ll mertoc.d.
LAdoca W, apply
/
mIRopety partnpmm,
d
r«,LIN pmjecU vim.eontrxtorp)bandpamaumme Geu.cmrs
rho mchc
La,,.
IseAa Lay.
lam amnp uiav See .Bh PCf«mu room
Dae -
WORMS COMPENSATION DECLARATION
SG+
I hemhy .from under pmdty of pujmy ane ar Ih fdlaWiot Aru—dowor
Ihart and wBlmainuina Cauaane of Cave«m,eU-inuue farWarkda Compem
utimt u po dial f« by Section 31f00 of me Labor Code, Tor me pmf«mrtm of me
,,cd r« Which mi, P ii uLvoem
I nab, aid Will maintain Worteh Canpnuaaian Inmruta, as n quirtd by Sad.
' )cf lK oJe, for do perforn. .r m, vai, r«vhkh mi, Perna 1, hmrd.
. MY Wohce• ^ �I^.°aIm¢ (am", a11
,
aE
R: S
Gmien N, No.:
'CRTFlCATEOEEXEMPTION RO WORrK
COMPEP4SATIONINSURANCE
'
mot, im rad rot 4 cadgd r Bme puma a fame bound dollars (Slai)
air ka)
I anifr do, In da, pa o mttnco of me vort f« Which mu puma IS l,med. l doll not
cmpoyanypc..Io any ma"«..nu V bttamewbjct to V Warless'CmWcmtmn
lav, of Calirorda ale
Appian
NOTICE TO APPUCANP. If, .ftcr making, ma CcniBoc of E —Pton, yw,bonm
beans .uhjm m the Worker, Compcmatioo pmvldoru of the Labor Code, you nota
formwith comply With,ucck pm irioro«mu perrdii"I d darcL r d.
Caitbc Ila LENDINGAGENCY
acamuucdnn dint arency f«tk porfarmaea of
I bco,by anionhchM
,
pCdueb
> do v«b for Which IM, puma b W uta (STs. 5041. CW. Cl
.
Lcna,ra
, Na
'
y L<w,e, Aare„
D I ceniry that 1 hate and Lha appioum aid vote mu ds .hon inrem.tiun a
7 mim-I.1 arra ILA comPly Wind ail city and coumy bc"L , and ,we lav, rtHunl to
JWilding consrocliun,.M hcmby audmrirc rtpemnutiv of mi, city to crocr upon
cjodg d cnY Tao in,pccum purpoms
(Wc) a,ra mea, mdrmmry and kap bumla, tk City of Cupcnim Law
linWa nla. au.d apaun rhi.hmryiv any wya,sx.plm, LAIN Gry
at con'". or
?in PLICAumeofthe RSTANof ANp M
APPLICANT NDER NDS AND WILL COMPLY WTIH ALL ON-POIM
Issued by: Date
(/
SOURCE ULA _
I" /� 1//D�
Re -roofs
Amoi,
MIc HAZARDOUS MATERIALS DISCLOSURE am
Type of Roof
MH me appliae, or ruuac WildieL a..Pamt pore or handle baamonot or—ri.l
Med by the Cupert oo Mumapal Cade. Duper 9. 12, and thc Icahn LAW Selmy
. seaum 255340'
All roofs shall be inspected prior to any roofing material being installed.
❑Ya 1, �No
If a roof is installed without first obtaining an inspection, I agree to remove
w mcappka«ormap. Wilding egulp.ent«ae.l� Weke
aatp,ntum
cook baiaAoos At coria nuunu a dcM by the Bay Arta Aa Q�uy M.n.Lc=ng,
allnew materials for inspection.
DWokt7
❑YaPu
Iham mad Ne ba>ydou�maviai,5533 mue,vndcr Chape,695orlh.Cal S
55 lydc hukt
niaHalm myI=Savoo,25,it
nand25hituy to nouaodmu
Jae hn. a taupe ma, it is my rtapmldMlitY m ooufy Nc or dr
is
he met Pai«m mupc are Gxti&acor
Signature of Applicant Date
r 7 i ZV/%
All roof coverings to be Class nBn or better
Or ror,mh«vsa.g.m ac`