08010142CITY OF CUPERTINO
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BUILDING DIVISION PERAUT
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Bu aGlWMESLEBANON DR
D & D CONSTRUCTION
PERMIT NO.
08010142
NER'S NAME:
PERMIT ISSUE DATE
.1447 HAMPTON DR
02/05/2008
PHONE:
SANITARY NO. CONTROL NO.
(408)666-5298
ARCHRECTIENGINEER:
BUILDING PERMIT INFO
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0 0 0
LICENSED CONTRACTORS DECLARATION
Chapter
Job Description
I homey affirm that l am licensed under provisions or 9 (commencing
with SO ..10110)afDivwon 3afdm Ban. and No(assiom Cade,prdmy0caacin
REV,RF FRMNG @LVNG RM LOC—ORIG #07040175
in full force m l.flect
License Clue U. g
Date Commutator
ARCHITECTS DECLARATION
1 und.wnJ my plan shall W used at pubit. o mrd,
-
Licensed Pnttcssi... I
OWNER -BUILDER DECLARATION
I bemby aRrm this I an eseoyl from Ne Canlreclar's License Law far the
following moon. (Section 711113, Business and PmleWen Code: Any city or coumy
which requires • permit W onnwuct atter. harrow. damolM4 m repair my sanctum
polar 1n jUb oWnR, alta oce,drial JC.pplleNt far such Patl111 m hot A SigMdaYmmall
he is licensed W the of the Committees License Law 9
Sq. Ft. Floor Area
Valuation.
Loss purananl provisions (Chapter
$ 0
(commencing with Section 70)B of Division 3 of the Business and Protection, Code) or
Nn ha , exempt therefrom aid the basis for ¢mption. Any vinladothe alleged en of
�,p WNumber
34214008 ftl
DCCU
Occupancy
section 7011.5 by any applicant for. permit subjects Ne applicant W a civil penalty or
nm mom lhsn OK hundred dollars ISM
❑ I, at waw of Ilio property, err my wages cmnpewtlm,
Required Inspections
will daIwwork. andintendedoro r nk, (ink
fa„akpplyt
e: The marenets Livens Lawdoffeamd
lf an owner
and pro Cade: The caterer. License 1.,w dao a wner of
ork hmas is
who Nermr endwM doessuchwork M1imeelfm Nm ugh M1r.
propertywho
s.iprowirepmwa
not intended mpRaed far
ownemployoWilding
or i provemimprawmutstae
comes. however, the willing or wpmwmant I.anld within one year of cpmpktion. the owncr-
builder.Wyw Ne Medea of p.,ing Na M did = build w impmw rue purport of
® u owner or Ne property me nelmovely contracting with licensed com.. to
contract than project (Sec. 1040. Business and protection Code:) The Cmwaora U.
came law dean not apply W an owner of property who Wilds or Improve+Ihaman, and,
who comment fanmh Prof. it.cantrantar(,) IionnxdpumtsntWN.Comutor's
,
Lice. Law.
❑Iamuemplund
DECLARATION
I wtcbY affirm under Penally or perjury an of the fallowing declmadon:
and W 'a
of the
mor by
SeCeNRute
ode. lire, ft Tiber
on, u Section 3100 of the labor Code, fm tite per(onnanm of IIW
cation, a provided for Lab
ide ce Of the
mi
wink for which Nis permit is issued
❑ I haw ,red will maintain Warkef, Compensation Uncommon, an required by Section
1700af dW Labor Cade, rue On performance err Ne work far which Nu perm, is issued
My Workce, Compensation Insurance carrier and Policy number me:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Ind. coal. need not be compowd if Ile permit 1. fmonc hundred de0pn (SIOn)
ar ten)
1 cattily Not in the performance of the work for which this permit is issued I shall Out
empiq my perann in try manllwf .I W become subjectW theWarYen' Cpmpenssdon
Law of Califomia. G In U f}^•
Applianl CJI
NOTICE TOA NT:IC agerresiting N, Cenons.1 of Exemption, you should
'
become subjectorit Wmh roCampcn ftLater Critic. you muss
thin emmLmepf
forthwith comply with such prorisiav m Nis pennil shail be domed rooted.
'
CONSTRUCTION LENDING AGENCY
1 botchy ai MThat Nem,, conlructian leading agency for the Performamx of
Ne work for which th, permit is issued (Sec. 31097, Civ. C)
'
Undoes Name
,
L.ndees Address
1 artily Nt I have mad this application and sued Na to .bow information is
cored. I agree to comply with all city and county ardinuntts and sine Iswe relating he
building mnuvction, and hereby anlhtom Mprnnenmtiwa err this any to enter upon Nc
.how-crendoned property for inspection purposes.
Iwo) agree la sone, indemnify and keep harmless the City or Cupenim again
liabilities. judgments, costs and sipones, which may In my way.erne qan said City
in contyuence of the gruling of this permit
APPLICANT UNDE ANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOURCE
MATE RIALS DISCLOSURE
Will the buildingeavpanttorewM1andk M1avrdOusmaterial
u defined DY Oe Cupiromfo�um
vo Municipal Cade. Chapter 9.13, and the Ha1N and safety
.k. Sa zsslx(.)?
32(.)?
All roofs shall be inspected nor to an roofing material beim Installed.
P P Y g g
❑vera �N.
y.
If a roof is installed without first obtaining an inspection, I agree to remove
Will Ne.pplicanl., for.. wilding aeavPa., ma.gtpmmt m &A. which
coil Isnommus air emllaminants at dcBned by the Bay Area Air Oudity MM.gement
all new materials for inspection.
District? — fu/
❑Yes Lyf
I have mal Ne havaWeus materials requirements under Chapter 6.95 of the Califor-
-is Hulls g: Safety Code, Suedmts 25505,75533 and x5514. Welcomed that lftha wilding
dm not currently ha a tenant Jin It is my mspamibility W notify cite =upmt of cite
requimmcnyrhkh bemetpriorwiuuwmot&Cmrxc orOc Ptrry/
Data -