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08100029CITY OF CUPERTINO �s7-a��,�-� �5 BUILDING DIVISION Pi`i1�LY11T BUILDING ADDRESS: PERMITNO. 20819 GARDEN GATE DR SOLVO BUILDING WORKSHOP, 08100029 OWNER'S NAME: INC. PERMIT ISSUE DATE 20587 MURANO CIR 10/08/2008 PHONE: SANITARY NO. CONTROL NO. (408) 982-3161 ARCHMC UENGiNEFR: . BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACT'OR'S DECLARATION affirm licensed 9 Job Description i hereby that I am ander provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is REV ROOF LINE LAYOUT) OR I G #08040146 in me force and effect. ,MINOR License Cl Lle, t♦ Date Comn! ARCHITECTS DECLARATION n 1 understand my plans shall be used a pubic records r r . Licensed Professional OWNER -BUILDER DECLARATION 1 hereby atfrn that 1 am exempt from the Conumors License Law for the following mason. (Section 7(/313, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any suuctum prior to its issuance, also requires the applicant for such permit to rink a signed statement that he is licensed pursuant to the provisions of the contractors License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commenting with Section 7000) of Division 3 of the Business and Professions Code) or $ 0 - that be is exempt therefrom and the basis for the alleged exemption. Any violation of 3263 0 0 4 6 p O Occupancy P y TYPe Section 70313 by any applicant for a permit subjects the applicant to a civil penalty ofNumber not more man ave hundred dollars (sane. .`° ❑ L as owner of the property, or my employers with wages as their sole compensation, Required Inspections will do the work, and the structure is not intended or offered forsale (Sec. 7044. Business and Professions Code: The Contractoeri June Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employe s, 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 ban the burden of proving that be did not build or improve for purpose of talc.). ❑ 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 contractors) licensed pursuant to the Contractors LJcense Law. ❑ 1 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: VI have and will maintain a Ceniacale of Consent to self-Insurefor 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. ❑ 1 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 Workers. Compensation insurance carrier and Policy number are: Carrier. Policy No.: CERTIFICATE OF EXEMP ION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred doll= ($100) or las) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so is tolbecofiYs��cll to the Workers' Compensation Laws of Califon{ are /]]�� (( Applicant NOTICE TO APP CANT: If, alter eking Ind Certificate of Exemption, you should become subject to the Workers Compensation provisions of the Labor Codc, 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 (Sex. 3097. Civ. C) Lenders Name Lenders Address I certify that I have read this application and state that the above information is correct I agree to comply with all city and county ordinances and state laws relating to building consuuction, 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 liabilities, judgments, 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 ALL NON -POINT Issued by: _ Date SOURCERE,qPAQfi C1 e Q Re -roofs Type of Roof Signature MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material is defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety Com, Section25532(a)? Yes ®'fro All roofs shall be inspected prior to any roofing material being installed. ❑ If a roof is installed without first obtaining an inspection, I agree to remove Will mea applicant or future building occupant pp g pail use equipment or t1CVIlx3 which emit hazardous air contaminants as mimed by the Bay Arca Air Quality Management all new materials for inspection. . District? ❑ Yes o 1 have mad the hazardous materials mgithernems under Chapter 6.95 of the Califor- nia Health & Safety Code, Sections 25505, 25533 and 73534.1 urvierstand that ifthe building does not currently of a Certificate — o p Signature of Applicant Date C� All roof coverings to be Class " '' or better g �' Dale � Owner or authorized agent �