06070151 CITY OF CUPERTINO cXj...'`%':^s„s tw`'.$.x- ,:� °:' "•: a,;:y >..„; :c.
BUILDING DIVISION .„CONTRtACTOR^Il ,OR1VI TION:.`s
BUILDING ADDRESS: — RI HARD & TRACEY MENG PERMITN0.06070151
,225 ALCALDE RD
NA
4'S NAME. PERMIT ISSUEDATE
RICHARD & TRACEY MENG 09 /20/2006
PHONE: SANITARY NO. CONTROL NO.
ARCHTTEC flENGINEER: BURRING PERMIT INFO
BLDG ELECT PLUMB MECH
!oo LICENSED CONTRACTOR'S DECLARATION Job Description
! I hereby affirm that 1 am licensed umkr provisions of Chapter 9(commencing ,
z1 wIth llram7dOfifDlvidan3aftheBUUnevandPra(caslunsCade,andmylkcnsela DING A MASTER SUITE AND REMODEL EXISTING
ti in full fmco and crfec.
;�o
License Class cutimam, BATHROOM HALLWAY AND OFFICE 510 '
TFE ARCHITECT'S DECLARATION
1 r<. 1 understand my plans shall he used as public records
lid Uy'Lummud PNTGUanal
N
OWNER-BUIIRER DECLARATION
0 0 1 nosh .(Sven Nat 11. exempt from the Contractor's bout Co e:My c Law for the
y O po( following reason.(Scout 703 1.5, t.alma and Professions Cade:My em or county
($LL whim asW e, .Idea oc ennslfdic altar.improve,h Permith,or Rash signed aWmYm
pd.,u heal iensedprsen,to the tloapplmmf(much Law Val atib®328
FF �
mum he tsliccnmd aursuantWthc pmvtslans of the Conuacmr's lacciim lAw(Chmmr9 Sq.Ft. Floor Area $''yAQ'''�
e€5 (commencng'mtn herctads,and of Divtsiof r I the Busineumd Profem vl Code)ear �1 -� •�
e�� lets he I.exemPt thmcfrom and the bssts fm the a11cgW exemption MY vioddr of -G' •v
Sedan 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty a. 3 4�1 O U`J' 6 . 00
Occupancy Type
trot mart than Rw hundred dollar,($5B5k
�❑I,u owner of ten property,ar my employes with wage u their Wletompens,ton,
will do thework.and the suacture is not Intended”offered formle(Sec.70th,Business Required Inspections
and Professions Cade:The Conuecier's License Law does cot apply W an owner of q P
property who build,or improves tlorton,and who does such work himself or 0uough his
own employom,provided then such improvements arc not Intends d oroQertd forsaln If.
however.the building or improvement is sold within am year of completion,the Owner.
budder will have tlo burden of proving that he did cot build or,improve far purpose of
;el'as owner of the Property,am exclusively entwining with licensed rnaanmss W
construct the project(Sec.Wad,Business and profesdam Cade)The Countesses LI-
tcae Law does not apply W an owner of property who Wilds or Improve thamm.and,
who contracts for such projects with a contractods)licensed purse mil W the committee
License Law.
I assn exempt under See ,Bic PCfor then
•�a Dam I O
WORkER'SCOIHPENSANON DECLARATION
1 hereby air=under actually of perjury arm of the following declarations:
❑1hawaMwImunuinaCe ricaMofConmmtWsel(-inaumfarWofte,COmpen-
sumn,as provided far by Scot..3700 of this Mbar Code.for the perfmmuux of the
work for which this permit is issued.
❑1love and will maintain Worker',Compensation Insannce,u required by Section
37M of ten Libor Code,for the performance of the work for which this pesmtt is issued.
My Worker's Compensation insummx caner and Policy number are:
cmm'.. filmy No'
CER11FICATE OF EXEMPDON FROM WORKERS'
COMPENSATION INSURANCE
('Obis section need not becomplemd!film permit Is fm ON hundreddollam(SIM)
ar lnss)
I certify that in the perfomhance of the work for which this permit is issued.I shell not
employ any person in any mmmWu e b C mraect to the Workers Compensatian
Laws of California.Dam
Q
Applicant
NOTICE TO APPLICANT:If.Wr making this Clinificam of Exemption,you should
become subject W the Worms Compensation provision,of the Labor Code.you main
Oforthwith comply with such provisions in this Permit shall he domed revoked.
z vo CONSTRUCTION LENDING AGENCY
[mot Ihereby affirm that them is a construction lending agency for the pertmonanco of
ai r�s the work far which this permit Is issued(Sec.W.Civ,C.)
W Q Lender's Near-
CL Z lenders Adder^
U C) I totally that I have read Nis application chid scale that the above information is
W P: canect.I agree W comply with all city and county ordinaan and sum laws relating to
0U budding consuuauon,and hereby authonre representatives ofths city to cover upon the
W move mentioned property for inspection purposes
0. (We)agraa to save,indemnify and Imp harmless the City of Cupertino against
U 7 habdia m,judgmcntacnsts and expenses which may in any way acme against mid City
in conmquence of the granting of this permit. 2/ ��
�1- APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
1 I a6 Re-roofs
SignuurtofAlsplianVCan r
H US MATERIALS DISCLOSURE Type of Roof
Will ON appliant m future building corpantumc"handle hnardom mamnai
SaOrd by the Caperton Municipal Cade.Chapter 9.12.and the Health and Safety
.man 25532(.)? All roofs shall be inspected prior to any roofing material being installed.
❑Y. IX/Na
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
cmlt h¢ardnns air contaminants as dented by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Ya '�41Nu
I hat mad the Weem mumamriab mquiremsuts under Chapierii.95 often Califor.
nh HalthkSafdyCodc.Seedw US05,25533md25534.IurhdcrmuOth ifthe building
deex rut currently hew•tram.that I'm my mtsp mmulay m miry the occupant tar dm
requlmmmss which mum Is met prior W hssuanco of a Ccmrteam of Occupancy. Signature Of Applicant Date
� 9ZIX6
owns armthomed.grt � r risen All roof coverings to be Class"B”or better