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CITY OF CUPERTINO
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BUILDING DIVISION PERMIT.,CONTI2ACTORIAiFURMATIOI�
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ULL T/TRTANNA DR
FAISAL & FARAH MERCHANT
NO.
08040171
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SANITARY NO. CONTROL NO.
ABC HITECTPENGINEER:
BUILDING PERMIT INFO
BLDG EIECf PLUME MECH
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LICENSED CONTRACTOR'S DECLARATION
Chapter 9
Job Description
1 hereby M. that 1. licensed Order provisio tit of moo mencing
with Section 7000) of Di. n 3arme Business and Pmressionacada. and my Brenmu
ADD 457 SQ FT 2 BDR, 1 BATH, 1 LAUNDRY RM ADD TO
Lt...a nand effete. Lic.g
THE GARAGE. REMODL WALL, ROOF, CEILINGS,
Data cmunioso
ARCHmcrSDEC1ARATION
GARAGE—REROOF 19 SQUARES. SANITARY IS SUNNYVALE'S
1 undcrsund my plans shall be used as public mends
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Lice.ad Pmfessianal
OWNER -BUILDER DECLARATION
1 beach, M. that 1 am aempt from the Conuamors License Law far 1M
following mason. (Section 7031.5. Business and Professor. Code: Any city or annoy
which mquires, a permit m ctmsuucl alun. improve, damaltsh, m mpoh any structure
prior b its muence. also.quires the applicant for such Permit o file a signed submem
tNt he is licensed pros Ito the pariamnsrr the Cmurammre License Law (Chapter 9
Sq. Ft. Floor Area
Valuation
(cammcmung with Secure ]OD) Of Divisom 3 of be Business and Prrf.siens Code) or
$110 0 0 0
that he u esemp themfrom and the boat for the alleged exemption. my violation of
Section 7031.5 by any applicant fro a permit subjects thc applicant to a civil penalty of
37529010. Number
Occupancy
Pone Y Type
rot mom than fin hundred dollars ISM
❑ L, as owner of the property, or my employees with wages as their ark compe.auon,
will do the work... thcnronurt is .1 rounded or offered Tor$am(Sec. 7014, Business
Required Inspections
and Pro(esdans Cade: The Convaemrs License Law don set apply to an Owner of
q p
property who Wilds orimprovrsthemon.and whodoessuchwmk hinwlfmthmugh her
Owns mnplolnes, provided that cash improvements are notimmmadc l molfered for ale B.
however, the building or improvement at sold within am year of cmnpleuon. the owner -
Witter NB ha a don WNra of poring dal he did rot Wild or improae for purpose of
um.).
T1, so owner of tiro property ern excluively coasting with licensed rontrctms an
mtmst the pmjen (Sec. ]Use, Business and Professions Code) The Convaebh I.I.
.
«nse law does not apply to an Owner of property who Wime Or Ingram theman. and
who contracts for such projects with a eonlraetaHa) licensed pursuant an the Contractors
Licene
❑lare
. Z
WORKER'S COMPENSATION DECLARATION
1 hereby alrim Order penalty of perjury ore Dram folowing dalantians:
1have andwillmaintaineCerr,37M of Come.raCom.for fro Wer4YaCepshe
salon, provided fro by Sasso 3]00 of the labor Cede. (. be Performance of the
r
work for which this Rrtnit is atsued.
❑ 1 have and will maintain Workers Compewtim Insurance. as nquhed by Section
3700 of dam labor Cade. fro the pforramac of the works far which NU permit at issued
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My Workers Compensation Inaaoce center end Policy number art:
-
Cartier. Policy No.:
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CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thu section need trot W completed if the Penn![ is far me hundred dollars (S 100)
Or lost)
I ectoly that in the performance of the work for which this permit is issued. 1 shall net
employ
ption, you skoulJ
become subject or the Worker's Compensation provisions of the La We Cade, you mom
forthwith romplY with such pmvidrna orNu permit shall be rimmed mamked.
CONSTRUCTION LENDING AGENCY
1 Wmby ellirm that then is a construction lending agency for thc performance of
the wank fur which that Rrmh at issmA (Sec. 3097, Civ, e)
Landers Name
Leaders Address
I certify that 1 have road this application and sum that thc above inroemeuun I.
cones 1 agree 10 comply with all city and county collimates and sum IM misting to
Wilding construction. caul hereby authorise repmsemsdm of Nu city to enter upon thc
aWve-mcnuproperty far inspection
(Was) agree m ave, internally, and keep harmless tiro City of Caperuno against
judgments. cool and expiuea which rosy in my way accma agdrmseid City
which may
in consequence
in consequence of don gnnung of this prnnis
of
APPLlq,
HAZARDOUS MATERIALS DISCLOSURE
Re -roofs
Type of Roof
/
Will sib a m IMuni Wilding eceupat stem ter auntie
u deRned Cuporl
the GURIYIIo Municipal Code. Chapter 9.12. and the Health anJ Safety
Health and
codes«danzss3z(a)] K
io
❑Yes No
All roofs shall be inspected prior to any roofing material being installed.
Will the mplicat or future Wilding accuPaul use equipment or used. which
If a roof is installed without first obtaining an inspection, I agree to remove
L `arardous air contaminants u defined by don Bay Area Air Quality MmagermaL
all new materials for inspection.
Ci saty
❑Yes 0No
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dam rot cumndY have •tenant. Use Io u my ecryonsibililY b nail, thc oceupat or don
myvimmcn boon muuW me[prirrlaissunceofa
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