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05090159 CITY OF CUPERTINO • BUILDING DIVISION PERMIT kCONTRACTQR INk'ORMATI®N",-�, BUILDING ADDRESS: C & D FREITAS CONSTRUCTION PERMIT NO.05090159 i0 I 10 LOCKWOOD DR NER'S NAME: PERMIT ISSUE DATE VASUDEO HADAP 23610 MORREL CUT-OFF RI) 09/2 ; /2005 NE: SANITARY NO. CONTROL NO. (408) 353-1228 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 u0, LICENSED CONTRACTOR'S DECLARATION lob Description 4 F I thereby affirm bar 1 am licensed under pnovivans of Chapter 9(commencing p `uf withScniun'/0(111)of Division 3 of the Business and Professions Code.and my license is � N in full form and effect. i 95r(�517 TEMP POWER POLE jLlZ License Cpm%. As Ci ei o Dam' amimracmr ARCHRECT`S DECLARATION 9, 1 understand my Ptons shall he used as public men,& \ tc. O Licensed Professional \ I OWNER-BUILDER DECLARATION I Wrehy affirm that I am exempt from tM Connactols License Law for the E O o following mason.(Section 703 1.5,Business and Pofesviom Calc:Any city or county m which mquirm a permit to consumer,almr,improve.dcmolub.or.,air any swctom $1000 prior w its issuance,also requires the applicant for such permit o file a signed statement < that W is licensed pursuant to the provisions of Nc Comrectur's Licence Law(Chapter 9 Sq.Ft. Floor Area Valuation (commencing with Section 7")of Division 3 of the Business and Professions Codc)or i $ that be is exempt Ncmfmm and the b.is for the alleged eaeil Any violation of Section 7031.5 by any applicant fora permit subjects Ne applicant to a civil penalty of Occupancy Type not mom than firs hundred dollars(S500). 0 1,as owner cribs property,er my employees with wages as Ncir ale compe.ssdmn, willdo Nework and theswaum 4 notimendedorofrered for3alc(Sce.7000,Business Required Inspections and Prom fcssiaCaon de:The CmcwYs Lisme Law docs not apply to an owns,of _ q p popery who buildsorimprnws thereon,and who doessahwurk himself or though his awn employees,provided that such improwmena are not intended or offered for sale.If, however,the building or improvement is old within one you of completion.the owner- builder will have the burden of proving that M did not Wild or improve for purpose of site). ❑I,as owner of the property.am exclusively contracting with limmed contractors to coriander the project(Sec.7004,Business and professions Code)The Conracmr's Lt. cone Law does not apply to an owner of property who Wilds or improves Neuron,and, who contracts for such projects with a contraemr(s)licensed pursuanno Ne Contractor's License law. El 1 am exempt under Sec. .B&P C for this mason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby afRrn under family of perjury ane of the fallowing decluaions: I hare and will maintain.Certificam of Co..,to self-insureforWorkeel Compcm sa,ien,as provided for by Section 37M of One labor Code.for the poromas of she work for which Nis permit is issued. ❑1 have and will maintain Worker's Compcmetlon Insurance,as required by Section 3700 of Ne lather Code,for the perform...of the work for which this Permit is issued. My Worker's C\ompewtion Insurance ea,rier and Policy number am: Carer.5A,1C PolicyNo.: CERTIFI TE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This seetim need Out be completed it the Permit us for one hun0ed Mllars(S 100) o,less.) T C.m*but in Nc pruicrommo of the work for which this Permit is issued,1 shall nm employ any pecan in any manna az m Wmrn.objcn to the Workers'Compensation Laws or California.Dau Applies., NOTICE TO APPLICANT:Ir.after making this Cenifieate of Exemption,you should become abject to due Worcer's Court Notation provisions of the labor Code,you must .J O forthwith comply with such provisions.,,his Nouni shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY �-+ I hereby affirm that them is a cmruuctinn lending agcray for she Performance of LL' 7 he work for which Nis permit u issued(Sec.3M.Civ.C.) fg1 Q Lender's Name lLz Lendor'SAddrem U Q 1 comfy Nat 1 have mad Nis application and sate Nat the shove Wourro ter is , it, r correct 1 agree to comply with all city ad county ordinances and one laws rola ding to 0U Wilding construction,and hereby authorim repmstrati s ofthu city to enter opium the y W above-mentioned Polarity for Inspection purposes. F+0. (We)agree to save,indemnify and keep harmless the City of Ch,com,sgaimr _ rn liabilities,judgmcom.e.a.d expuaes which may in any way antic againsrsaid City U in comeducnee of the granting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 2.3 J i— s EGULATIONS. �—� Re-roofs Signature of Applica uContraeo �aD.te r HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant of future Wilding Occupant store or handle havudaus material lZoesdefined by ter C.Nnino Municipal Code.Chapter 9,12.and the HeslN.d Safety We.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes u Wi II the applicant or future Wilding Occupant on equipment or devices which .If a roof is installed without first obtaining an inspection,I agree to remove it haordnes air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. orm? (]Yes VN. 1 have mad the hevaNtws materia0 reyuiremcna umkr Chapter 6.95 of the Caldor- Haslib k Safety Code.Senium 25505.25533 aa125530.1umlcrsand tat if he Wilding not currently haw a tenant Nat it is my responsibility to entry the occupant or the uirement,which must W met prior iniamuce of a Cerdfica¢or Occupancy. Signature of Applicant Date wns�1omnri�t 5 ��o te All roof coverings to be Class"B" or better Community Development 10300 Torre Avenue >' Cupertino CA 95014 Telephone(408) 777-3228 � CITY OF Fax(408)777-3333 UPEkTINO ByRding Department JOB ADDRESS: PERMIT # G Z1 ea Oro '? o is 4 OWNER'S NAME: PHONE # - GENERAL CONTRACTOR: FAX # z/a Zze-_ 3� _ I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO q TEMP POWERis 7211 -�CUPEkTINO PERMIT APPLICATION FORM APN # Date31: C _ Building Address: Owner's Name: Phone #: Contractor: Phone: License #: L - - Contact: Phone: Cupertino Business License#: C gf- Building Permit Info: Elect M Job Description: nn vJ Residential ly Commercial ❑ Cost of Project: Qty. if Applicable Fee ID Fee Description Fee Group BTEMP Temporary Power ELECTRICAL EP.ERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING � 3r33 ( CITY OF CUPERTINO • BUILDING DIVISION PERMIT kCONTRACTQR INk'ORMATI®N",-�, BUILDING ADDRESS: C & D FREITAS CONSTRUCTION PERMIT NO.05090159 i0 I 10 LOCKWOOD DR NER'S NAME: PERMIT ISSUE DATE VASUDEO HADAP 23610 MORREL CUT-OFF RI) 09/2 ; /2005 NE: SANITARY NO. CONTROL NO. (408) 353-1228 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 u0, LICENSED CONTRACTOR'S DECLARATION lob Description 4 F I thereby affirm bar 1 am licensed under pnovivans of Chapter 9(commencing p `uf withScniun'/0(111)of Division 3 of the Business and Professions Code.and my license is � N in full form and effect. i 95r(�517 TEMP POWER POLE jLlZ License Cpm%. As Ci ei o Dam' amimracmr ARCHRECT`S DECLARATION 9, 1 understand my Ptons shall he used as public men,& \ tc. O Licensed Professional \ I OWNER-BUILDER DECLARATION I Wrehy affirm that I am exempt from tM Connactols License Law for the E O o following mason.(Section 703 1.5,Business and Pofesviom Calc:Any city or county m which mquirm a permit to consumer,almr,improve.dcmolub.or.,air any swctom $1000 prior w its issuance,also requires the applicant for such permit o file a signed statement < that W is licensed pursuant to the provisions of Nc Comrectur's Licence Law(Chapter 9 Sq.Ft. Floor Area Valuation (commencing with Section 7")of Division 3 of the Business and Professions Codc)or i $ that be is exempt Ncmfmm and the b.is for the alleged eaeil Any violation of Section 7031.5 by any applicant fora permit subjects Ne applicant to a civil penalty of Occupancy Type not mom than firs hundred dollars(S500). 0 1,as owner cribs property,er my employees with wages as Ncir ale compe.ssdmn, willdo Nework and theswaum 4 notimendedorofrered for3alc(Sce.7000,Business Required Inspections and Prom fcssiaCaon de:The CmcwYs Lisme Law docs not apply to an owns,of _ q p popery who buildsorimprnws thereon,and who doessahwurk himself or though his awn employees,provided that such improwmena are not intended or offered for sale.If, however,the building or improvement is old within one you of completion.the owner- builder will have the burden of proving that M did not Wild or improve for purpose of site). ❑I,as owner of the property.am exclusively contracting with limmed contractors to coriander the project(Sec.7004,Business and professions Code)The Conracmr's Lt. cone Law does not apply to an owner of property who Wilds or improves Neuron,and, who contracts for such projects with a contraemr(s)licensed pursuanno Ne Contractor's License law. El 1 am exempt under Sec. .B&P C for this mason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby afRrn under family of perjury ane of the fallowing decluaions: I hare and will maintain.Certificam of Co..,to self-insureforWorkeel Compcm sa,ien,as provided for by Section 37M of One labor Code.for the poromas of she work for which Nis permit is issued. ❑1 have and will maintain Worker's Compcmetlon Insurance,as required by Section 3700 of Ne lather Code,for the perform...of the work for which this Permit is issued. My Worker's C\ompewtion Insurance ea,rier and Policy number am: Carer.5A,1C PolicyNo.: CERTIFI TE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This seetim need Out be completed it the Permit us for one hun0ed Mllars(S 100) o,less.) T C.m*but in Nc pruicrommo of the work for which this Permit is issued,1 shall nm employ any pecan in any manna az m Wmrn.objcn to the Workers'Compensation Laws or California.Dau Applies., NOTICE TO APPLICANT:Ir.after making this Cenifieate of Exemption,you should become abject to due Worcer's Court Notation provisions of the labor Code,you must .J O forthwith comply with such provisions.,,his Nouni shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY �-+ I hereby affirm that them is a cmruuctinn lending agcray for she Performance of LL' 7 he work for which Nis permit u issued(Sec.3M.Civ.C.) fg1 Q Lender's Name lLz Lendor'SAddrem U Q 1 comfy Nat 1 have mad Nis application and sate Nat the shove Wourro ter is , it, r correct 1 agree to comply with all city ad county ordinances and one laws rola ding to 0U Wilding construction,and hereby authorim repmstrati s ofthu city to enter opium the y W above-mentioned Polarity for Inspection purposes. F+0. (We)agree to save,indemnify and keep harmless the City of Ch,com,sgaimr _ rn liabilities,judgmcom.e.a.d expuaes which may in any way antic againsrsaid City U in comeducnee of the granting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 2.3 J i— s EGULATIONS. �—� Re-roofs Signature of Applica uContraeo �aD.te r HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant of future Wilding Occupant store or handle havudaus material lZoesdefined by ter C.Nnino Municipal Code.Chapter 9,12.and the HeslN.d Safety We.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes u Wi II the applicant or future Wilding Occupant on equipment or devices which .If a roof is installed without first obtaining an inspection,I agree to remove it haordnes air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. orm? (]Yes VN. 1 have mad the hevaNtws materia0 reyuiremcna umkr Chapter 6.95 of the Caldor- Haslib k Safety Code.Senium 25505.25533 aa125530.1umlcrsand tat if he Wilding not currently haw a tenant Nat it is my responsibility to entry the occupant or the uirement,which must W met prior iniamuce of a Cerdfica¢or Occupancy. Signature of Applicant Date wns�1omnri�t 5 ��o te All roof coverings to be Class"B" or better Community Development 10300 Torre Avenue >' Cupertino CA 95014 Telephone(408) 777-3228 � CITY OF Fax(408)777-3333 UPEkTINO ByRding Department JOB ADDRESS: PERMIT # G Z1 ea Oro '? o is 4 OWNER'S NAME: PHONE # - GENERAL CONTRACTOR: FAX # z/a Zze-_ 3� _ I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO q TEMP POWERis 7211 -�CUPEkTINO PERMIT APPLICATION FORM APN # Date31: C _ Building Address: Owner's Name: Phone #: Contractor: Phone: License #: L - - Contact: Phone: Cupertino Business License#: C gf- Building Permit Info: Elect M Job Description: nn vJ Residential ly Commercial ❑ Cost of Project: Qty. if Applicable Fee ID Fee Description Fee Group BTEMP Temporary Power ELECTRICAL EP.ERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING � 3r33 (