The URL can be used to link to this page

8040019I adz iUF, ,z =w n�z �yU .O� t . cc 'FO 15! CITY OF CUPERTINO BUILDING DIVISION PERIVIIT # .A t BUILDINGES �� bEPPER TREE LN EAGLE ELECTRIC PERMIT NO. 08040019 OWNER'S NAME: PERMIT ISSU DATE CHANDLER EDWIN G JR AND JEAN P 0 BOX 2482 04/03/2008 PHONU SANITARY NO. CONTROL NO. (408)241-9956 ARCHITECC/ENGiNEER , BUILDING PERMIT INFO BLDG PLUMB 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description Job 1 hereby affirm that 1 am liccnsed under provisions or Chapter 9 (commencing with Section 7000) of Division 3ofthe Business and Profcasiom dmylicenacis infullI�lrxandeffecfe NEW KTCHN CKTS TO OTLTS&DW/DISP SVC UPGRDINSTL 6 rl Lm �� FLUORSCNT LITES IN KTCHN&INSTL 10 INCDSCNT LITS Dam Ts �— Contrerycr L E EcEG� !� ARCHITECTS DECLARATION IN 1 understand my plans shall be used as public records DINE/FAM RM Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the following reason. (Se tion 70313, 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 rile s signed statement that he is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 701 of Division 3 of the Business and Professions Cade) or $14000 that he is exempt therefrom and the basis for the alleged exemption. My violation of 3 5 912 011 M Number Occupancy P Y Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, Required Inspections 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 property who builds orimptoves thereon, and who does such work himaeJf 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 Contractors Li- cense Law does not apply to an owner of property who builds or improves thereon, and , who contracts for such projects with a conuaemr(s) licensed pursuant to the Contractors License Law. ❑ 1 am exempt under Sec B & P C for this reason Owner Dam WORKERS COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations ❑ 1 have and will maintain a Certificate of Content to self -insure for Workers 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 00 of the Labor Code, for the performance of the work for which this permit is issued My Workers Compensation Insurance carrier and Policy number arc: f�.'V 4WPlP) r0'0 7 Carrier. _5� � Policy No.: / CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (5100) or less) 1 certify that in the performantx 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 Ccrdnccam or Exemption, you should become subject to the Workees 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.) - Lendces Name Lenders Address 1 certify that 1 have read this application and state that the above information is ' correct. l agree to comply with all city and county ordinances and state laws relating to building construction. and hereby authorize representatives of this city to encs upon the above-mentioned property for inspection purposes (Wc) agree to save, indemnify and keep,harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequenceo c granting of this permit. APPLICA NDERSTA S AND WILL COMPLY WITH ALL NON -POINT Issued by: Date LZI — 7 — SOUR Re -roofs Type of Roof 3 r Sig pplicant/Conu=lor Dam HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building o=upant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? , / ❑Yes All roofs shall be inspected prior to any roofing material being installed. future If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit husrdous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes No 1 havethe herardous materials requirements under Chapter 6.95 of the Califor- nia Sections 35505,25533 and 25534.1 understand d aifthe building doehave a tenant, that it is my responsibility m notify the occupant of the �HeWahh�etyCode, reywhit slhemet priormi eraCertificate o`Occa�ancy� Signature of Applicant Date All roof coverings to be Class "A" or better