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CITY OF CUPERTINO
BUILDING DIVISION PERMTr��1
Bu11II1cbRR :
PERMIT NO.
OAKDELL PL
ARGONAUT WINDOW & DOOR, INC
08060161
OWNER'S NAME:
PERMIT ISSUE DATE
1901 S BASCOM AVE STE 800
06/23/2008
PHONE:
SANITARY NO. CONTROL NO.
(408)378-4018
ARCHITECTIENGINmt:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACT'OR'S DECLARATION
Job Description
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Businm and Professions Code, and my license is
SCOPE OF WK W I NDW R PLC MNT LIKE 4 L I KE BDRM S TO MEET
in full force and effect
LicenscClass Lic.I
EGRESS REQUIRMNT
Date Contra=
ARCHrrECrS DECLARATION
I 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, Busiom 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 Gk a 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 7000) of Division 3 of the B usinm and Professions Code) or
$18996
that he is exempt therefrom and the basis for the alleged exemption. Any violation of
32618 044. Number
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty or
not more than five hunama). a dollars (sso
❑ I, as owner of die 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, Businm
and Professions Code: The Contractors 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 are year of completion, the owner -
build will have the burden of proving that he did not build or improve for purpose of
ns owner of the property, am exclusively contracting with licensed conotc'ton to
CnnsknCl cite projeet (Sec 7044. Business and Professions Code:) TTY Conuaetoes Li-
cense Law does not apply to an owner of property who builds or improves Ihemon, and.
who contracts for such projects with a contractors) licensed pursuant to the Contractor's
License Law.
❑ I am exempt
DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a Certificate of Comient 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
❑ I have and will maintain Workers Compensation insurance, as required by Section
3700 of the Labor Code, for the performance of the work for which this permit is issued
My Worker's Compensation Insurance curter and Policy number are:
Carrier. Policy No-
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(this season need not be completed if the permit is fa ono hundred dollars (5100)
or Icss)
I certify that in the performance of the work for which this permit is issued, I shag not
employ any person In any manner so q4 w bg5om$-u 5 tla the Workrn' Compmtudon
Laws of California. Date G L --P�
Applicant
NOTICE TO APPLICANT: If, after making this Ccrdfiate 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 M -Mired.
CONSTRUC-17ION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
the work for which Lids permit is issued (Sec. 3097, Crv. C.)
Lender's Name
,
Lender's Address
I certify that 1 have read this application and state that the above information Is
correcL I agree to comply with all city and county ordinances and state Iowa relating to
building construction, and hereby authorize 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
liabilidc&judgment&, costs and expenses which may in any way accrue against said City
In consequence of the granting of this permit
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALi. NON -POINT
Issued by: Date
DISCLOSURE
Will the applicant or future building occupant store or handle hazardous material
as damned by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety
Code. section 25532(&)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yes
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 hazardous air contuninanta as defined by the Bay Area Air Quality Management
all new materials for inspection.
District?
❑Yes Woo
I have read cite hvsrdous materials requirements under Chirpier 6.95 of the Califor-
nia Health & Safety Code Sections 25505, 25533 and 25534.1 understand that if the building
does not currently have a tenarrL that It is my responsibility to notify the occupant of the
requirements w ' must beme .orb . of a Ccrificam of Oc z
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Signature of Applicant Date
All roof coverings to be Class an' or better
Owner Date